By EMILY SAADI (NHS ‘19)
Without the development of life-changing drugs such as penicillin and antiretrovirals, increased longevity would have been an unattainable prospect. The creation of new medicines and drugs have made significant differences in people’s lives, contributing to global health and individual survival. Nevertheless, the issue of medical innovation requires more awareness and concern than ever, since its sustainability and beneficial impact on human health is threatened. Pharmaceutical companies have created financial burdens within the research and development (R&D) sector by solely focusing on drugs that will reap lucrative profits. Innovative therapies for cancer diseases are skyrocketing, and new drugs have converted many cancers into chronic diseases. However, drugs for “lifestyle diseases” such as obesity have been faltering, and patients diagnosed with diseases other than cancer suffer from the lack of agents targeted toward their illnesses.
Continued medical innovation is key to ensuring that patients have access to new and effective therapies. Innovative therapies are expensive due to the costs associated with drug discovery and development. The entire R&D and approval process can take approximately ten to fifteen years. Including the cost of failure, the average cost of developing a new drug from discovery to regulatory approval is approximately $1.2 billion. However, the improved health outcomes that these medications offer outweigh the increased drug cost. For patients, the reward of innovation comes in the form of affordable medical therapies or drugs with improved efficacy. A majority of patients cannot afford these therapies without payer reimbursement. Whether it is a private insurer or the government, a patient payer must be willing to cover innovative medications in order to make these drugs accessible. Payers play an essential role in helping to promote innovation by helping to make breakthrough drugs widely available. Ensuring patient access is essential in driving the demand and sales for a given drug, and maintaining these sales is necessary to stimulate R&D innovation and to sustain the market.
Unfortunately, the number of innovative therapies being created by pharmaceutical companies has been declining over the past five years. In 2007, the FDA only approved nineteen drugs, the lowest total of drugs approved since 1983; in 2008, the number rose slightly to 21. The most important factor in the decline of medical innovation is the lack of incentives and reimbursement needed to fund new drug discoveries. Obesity, for example, remains an health area of limited innovation. This finding is curious, considering the epidemic nature of obesity in the U.S: in 2008, 10% of men and 14% of women were classified as obese. Such rates that were double those in 1980. Obese individuals also experience significant health problems due to their condition and have an increased risk for chronic conditions such as diabetes, heart disease, high blood pressure, and cancer. Patients suffering from obesity also have an 18% higher risk of death compared with the rest of the population. In addition, dealing with the health consequences that result from obesity places a huge financial burden on patients. In 2012, annual obesity-related medical costs were estimated at $190 billion in the U.S.
Despite this considerable health and economic burden, innovation in the treatment of obesity has been rare. In contrast, there has been a huge boom in the development of oncology drugs. There are more innovative products in oncology than in any other therapeutic area, with cancer-targeted medications representing approximately 30% of all drugs currently in development within the US. Pharmaceutical companies tend to invest in oncology drugs due to the high reward associated with these products.
In sum, innovation leads to the increased availability of cutting-edge medicines or products for patients. Making these drugs readily available also yields additional social benefits, such as improved health, reduced hospitalizations and more jobs. Although innovative drugs are more expensive, the improved health outcomes they provide often create economic benefits that trump the increased drug cost. If this cycle of innovation were to stop, then people would be deprived of new therapies that could increase their quality of life. It is essential that medical innovation be sustained so that patients can receive the health benefits they require and need.