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Tuesday, February 14, 2012

Drug Shortages Highlight Failures of For-Profit Health Care

Rick Ungar (via @Captain Clarion and @AggressiveProgresive) has a great catch and analysis at Forbes, "Proof of the Failure of Free Markets in Medicine." He discusses the shortage of the cancer drug methotrexate, which has an 80-90% success rate in treating the most common (and once always fatal) form of leukemia, acute lymphoblastic leukemia (ALL). The medication, now off patent, is apparently no longer profitable enough for the five U.S. makers of this drug, and methotrexate is one of a number of life-saving medicines in short supply. There are approximately 3000 new cases of ALL each year diagnosed in young children.

As Ungar argues, it is implausible that all five current manufacturers of methotrexate are simultaneously having production delays:
What are the odds that 100 percent of these companies are, somehow, each experiencing manufacturing delays?  Does anyone imagine that these manufacturing delays were occurring back when these companies were making big bucks on the product, achieved by the huge mark-ups that accompany receipt of the patent protection that bars others from competing?
The Huffington Post's Linda A. Johnson reports that the five companies are Ben Venue Laboratories Inc., APP Pharmaceuticals LLC, Hospira Inc., Sandoz Inc., and Mylan Inc. She also notes that Ben Venue was the sole U.S. producer of the breast cancer drug doxil, which with methotrexate was affected by a November shutdown of a company plant in Ohio after regulators found recurrent drug safety problems.

When production of these drugs falters, people die. As Ungar puts it, "This means that kids are dying —and will continue dying— because the money just isn’t what it used to be for the five manufacturers who have long supplied the critical medicine."

If we think that's wrong, it's necessary to address the problems of the patent system, which leads to high profits (and medicines unaffordable in developing countries, according to Susan Sell) during the patent's life but abandonment of vital medications after the end of the patent. Instead, we are at present having to fight off attempts to expand protection of patents and other intellectual property: the for-now neutralized SOPA and PIPA, as well as the Anti Counterfeiting Trade Agreement and the Trans-Pacific Partnership. Ungar suggests that the patent system be modified to take into account whether companies stopped making needed drugs after previous patents expired. This could be helpful, but the deeper question is whether patent protections are too strong already and need to reduced.

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