The pharma pessimist

IN SUMMARY: Peccisism; a tendency to see the worst aspect of things or believe that the worst will happen; a lack of hope or confidence in the future. When it comes to pharma that pretty much describes me. In my 20+ years in healthcare marketing, I have seen a transformation from an industry focused on patients to an industry focused on profits.

When I first started my career in ethical pharma marketing it was an exciting time. DTC was beginning to take root and the talk of high drug prices was non-existent. With the success of billion-dollar blockbusters, Wall Street began to take notice and pharma companies became more addicted to developing the next mega sales drug. CEO pay packages were being tied, more and more, to stock prices and Wall Street only cared about the sucess of new drugs in trials.

As a consultant within the industry, I have seen a lot of good, hard-working, patient-focused people leave. They were either laid off or just had enough of the pharma bureaucracy that focuses strictly on ROI instead of patients. Almost all have moved onto lucrative careers within other industries.

Then there is the “business of pharma marketing.” The endless conferences and pseudo pharma magazine awards that tend to give people a false sense of accomplishment. The information shared at these conferences is blatantly apparent but they are promoted on social media like a huge revelation.

Yesterday in Endpoint News was a great article entitled “Patients are not a company resource”. Richard Pazdur is a blunt speaker and tends to deliver on what he says when it comes to the development of oncology drugs. According to the article “And now heʼs clearly unhappy with the way the oncology R&D world has unleashed thousands of studies involving a rapidly proliferating set of PD-1/L1 checkpoint therapies that have created a whole new megablockbuster franchise for industry players to tackle”.

By last count, the Cancer Research Institute was tracking 2,250 clinical trialsunderway for PD-1/L1 agents, an increase of 748 from a year ago. And there are 1,176 combination studies underway, with a total of 240 different targets.

Pazdur moderated a discussion with a group of the industryʼs top I/O investigators. He hit hard on the need for more collaboration among the players, a better approach to testing these drugs collectively that would be less harmful to patients.

And then how much, if itʼs not too crowded, how much is enough? Because we had a session on China recently at this symposium and obviously the Chinese market is developing more and more PD1 drugs and they plan on bringing them here to the United States. When does the market cry, uncle?

One of the things that we were somewhat disappointed on, as far as lack of collaboration, was the renal cell cancer. Obviously a very wasteful approach to developing a drug without any collaboration here between the companies. And here again, our point of view from a regulatory agency is that patients, whether they be worldwide patients or the U.S. patients, are not a companyʼs resource. Theyʼre a global resource to answering important questions.

And when we have a sub-optimal way of developing drugs, with a lot of duplication, that can result in a lack of confidence in the system of clinical trials, for example. Or just unnecessary duplication and expense.

In other words…why does every pharma company want a slice of sales and when is enough of the same enough?

Another reason my pessimism is the money that pharma received as a result of the tax cuts. Top drugmakers channeled most of their savings to investors, not R&D or price cuts. Four pharma companies—Johnson & Johnson, Merck, Pfizer and Abbott Laboratories—reaped a combined $7 billion in savings from two provisions in the tax bill, according to a recent Oxfam report (PDF), and they plowed that money into stock buybacks and dividends.

Pharma companies benefited from the tax bill’s cut to statutory tax rates—to 21% from 35%—and rebates on previously untaxed foreign earnings. Among the companies Oxfam examined, the single biggest beneficiary was J&J, which received a reported $2.48 billion in combined tax breaks in 2018, equivalent to about 13.8% of the company’s profits.

We all need pharma’s life-saving drugs to help us through healthcare issues but when the industry has become a slave to Wall Street instead of patients we have lost our way. Yesterday healthcare stocks took a huge hit because they are afraid that Medicare for all could become a reality. Most vocal was an insurance executive, who makes over $80 million a year, who said that Medicare for all could disrupt our healthcare system. Let’s hope so because today it’s not working for patients.