TCS Daily


Good Drugs

By Glenn Harlan Reynolds - March 31, 2004 12:00 AM

Though the subject has receded from the forefront of public debate for the moment, prescription drug prices remain a likely political issue in the 2004 campaign. I'm not entirely sure what to do about it, although I strongly suspect that the usual redistributionist, "soak the evil corporations" nostrums would -- as always -- prove utterly disastrous if enacted. I also think that it will be difficult for the Kerry Campaign to resist those pressures, given that senior citizens are among the Democratic Party's remaining core constituencies, and given that senior citizens have little incentive to support policies that will produce better drugs in the future at the cost of higher drug prices now. They're around now to reap the benefit of lower drug prices, and if they cared about their grandkids, well, they wouldn't be so resistant to Social Security reform, would they?

At any rate, for more on that intractable question, you might want to read this post by pharmaceutical research chemist Derek Lowe, who notes that coming up with good drugs is a lot harder and takes a lot longer than most Americans realize. (Most Americans also drastically underestimate how hard it is to get FDA approval, and how much money for drug development comes from drug companies, according to this poll by Research America and Parade Magazine, linked by Lowe). You might also want to read this rather pessimistic assessment of the pharmaceutical industry's future.

But I want to respond to something different. I hear a lot of complaint from people who object to the pharmaceutical industry's work on what are often described as frivolous products, like Viagra or drugs for treating acid reflux disease. I'm not sure that these drugs account for a major part of prescription drug costs -- among the best selling drugs most are for treating heart disease or mental illness -- but I do wonder just how frivolous such matters are. The term "dyspeptic," after all, describes an irritable disposition arising from stomach pain. As somebody who suffers from reflux myself, I can attest that acid-lowering drugs like aciphex and prilosec are lifesavers.

In terms of quality of life, they're certainly that. (In terms of reduced risk of stomach and esophageal cancer, they may be lifesavers down the line as well, with concomitant savings in medical costs). What's the dollar value of a life spent without stabbing pains in one's midsection? I don't know, but most people who take acid-lowering drugs consider the relief cheap at the price.

Viagra seems more frivolous, though I'm not sure why. My grandfather, suffering from impotence because of heart problems, submitted to coronary bypass surgery when it was still very new and risky. The surgery was expensive, and he wound up dying from complications. He knew the risk, but preferred to take the chance rather than live with impotence. My father has remarked that if Viagra had been invented then, his father might have lived considerably longer.

Was he silly to feel that way? Some people might say so, of course. But whether you think that his choice was one you might make, it's a clear indicator of just how important the benefits that drugs like Viagra bring are to some people. Not frivolous.

Likewise, although drugs that relieve depression are viewed by some as being frivolous -- standing in the path of the "authentic" existence that intellectuals always seem to define in terms of sadness rather than joy -- they are quite literally lifesavers for some people who might otherwise commit suicide. And even for those who wouldn't, they're an alternative to a life of misery. If you're pro-misery, I guess that's bad, but I'm not.

So as the debate goes on regarding pharmaceutical prices, I hope that the debaters will keep their eye on the ball -- how to promote progress in producing new drugs that solve long-standing problems -- and not engage in elitist talk about which problems are worthy of solution, and which are not. A cure for cancer may take longer than a cure for heartburn, but both are cures - which is more than the drug-price critics have managed to come up with.

Glenn Reynolds last wrote for TCS about "The Greatest Picture Show on Earth."


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What a minute, Viagra is a waste of resources? You mean looking for drug to treat high blood pressure is a waste because it affects blacks more than whites (racist)? Or are high blood pressure medications a waste because it is disproportionately a problem for men (sexist)? It was not that anyone set out to create a drug to cure ED, Viagra was a high blood pressure medication which had a side effect, almost missed during trials, which was beneficial. Heck, even when the side effect was discovered it was merely chance that some marketing type was willing to spend a small amount of money do market research to see if there was any market for a product for ED.

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