Advances in medical science have generally been matched, even sometimes prompted, by advances in new drugs. The world would be a very different place had it not been, for instance, for the work done on developing new antibiotics after the original discovery of penicillin. On balance it must be admitted that a great debt is owed to the pharmaceutical companies who invested in the development of new medicines and treatments. But great though that debt may be, it is now frequently argued that it is not as huge as Big Pharma would have us believe. Put bluntly, the pharmaceutical industry has been charging health systems way too much and exploiting the differences between markets. Thus, for instance, it emerged this week that a US drug maker which in the UK charges less than $4.50 for a pinworm treatment is selling precisely the same medicine in the United States for $800. The companies argue that they have to invest up to $1.5 billion to develop a single drug. Big Pharma says that while this cost has risen in the last five years from $1.2 billion the returns it is earning from its investments are falling from a high of 10.1 percent in 2012 to 3.7 percent this year. The drugs companies have only a limited period in which they have exclusive rights to sell a treatment. Patent protection varies from country to country and drug to drug. In the US this period is 20 years but the companies argue that since they patent a drug before exhaustive clinical trials are completed, the effective protection against "Me-too" generic copies from other producers is only a maximum of 12 years and sometimes as little as seven. They also claim that for every successful drug they come up with, scores of others are developed and then abandoned because they do not work as expected. Big Pharma's figures are at best opaque and in some cases have been proven to be extremely dubious. It can be certain that every possible cost is loaded into the final development figure. This can include the huge amounts that companies spend on marketing, which will typically include multi-day scientific conferences for doctors and surgeons that generally seem to be conveniently close to ski resorts and golf courses. Drug manufacturers are in business and so like any other enterprise they have to make a profit for their shareholders. The problem is that their products matter hugely to their end users, often meaning the difference between life and death or a decent or miserable quality of life. There is, therefore, a moral quality to their business. The tension between the profit imperative and the needs of patients is all too real. Even if some of their figures are phony, there can be no doubting the need of Big Pharma to make a reasonable living. The answer would seem to lie in greater transparency. Even allowing for the need to protect commercial secrets, the drugs makers must be able to set out their costings far more clearly and should be allowed to earn a return that is commensurate with the demand for a particular medicine. The problem is that "price gouging", such as charging 200 times more in one market than in another for a pinworm treatment, has rightly earned the industry suspicion and contempt.
