Ethics and the Economics of Drug Discovery
Drug discovery is simple compared to drug development, which requires testing the efficacy and the safety of new drugs through clinical trials. The time (twelve to fifteen years) and cost (approximately 800 million dollars) of drug development are significant economic factors that limit the number of new drugs that come to market; many approved drugs never recover the cost of their development. How do companies decide which promising new drugs to develop? Clearly, there must be very good evidence that the new drug will be effective. But that is not enough; companies also carefully consider the economics of each potential new drug. What is the size of the market for that new drug? How strong is the demand? How effective are current drugs and what are their costs?
The harsh reality of these economics is that new drugs that may benefit only a few are unlikely to make it to clinical trials. Drugs that may benefit millions of people in developing countries too poor to pay for the new drug will also have a low priority for development. While AIDS, malaria, and tuberculosis affect countries that together contain ninety percent of the world's population, only about ten percent of the world's medical research funding is targeted at these diseases. Partnerships among government agencies, charitable organizations, and the pharmaceutical industry may allow companies to allocate some of their resources to developing drugs that will never recover their cost. In 2001 GlaxoSmithKline Biologicals, in partnership with the World Health Organization and the non-profit organization Program for Appropriate Technology in Health, began a program to develop a vaccine for childhood malaria.
Many currently patented drugs could be manufactured in third world countries as generic versions. However, pharmaceutical companies have strongly opposed this practice, fearing that these generic drugs will be inferior to the name brands and would enter the U.S. and European markets at low prices. Brazil has registered generic versions of several AIDS drugs, and manufactures them for itself and other developing countries. In response to worldwide pressure, drug companies have agreed to sell some AIDS drugs at deep discounts to developing countries. However, even with the discounts, the price is much higher than the generic version, limiting the number of AIDS victims who can be treated in poorer nations.
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