Are Wars on Cancer and Alzheimers a Good Substitute for a National Health Plan?

Posted on | September 20, 2018 | Comments Off on Are Wars on Cancer and Alzheimers a Good Substitute for a National Health Plan?

Lipitor Revenue

Mike Magee

Arguably, the pharmaceutical “age of the blockbusters” ended nearly 20 years ago with Pfizer’s hostile takeover of Warner-Lambert which rewarded them richly with the nation’s 5^th statin, Lipitor. In 2006, it delivered almost $13 billion in revenue, and yet the company was in a full blown panic, as reflected in the firing of their CEO that year, because the 2012 patent cliff was fast approaching, and large biologics for small audiences were overtaking small chemical drugs for the multitudes.

Despite the promises of genetic optimists like NIH’s Francis Collins, and “personalized medicine” entrepreneurs at Stanford, and Columbia, and U Penn and hundreds of other academic medical palaces, the reality was this:

Pharmaceutical discoveries had collapsed.
Genetic and stem cell cures were over selling their promise and under selling the risk. (see Jesse Gelsinger case)
Funding for cures for diseases – especially those affecting older white male senators and congressman – were exploding, but public health funding was nowhere to be found.

The War on Disease has always appealed to Americans. “Defeat disease like we defeated the Nazi’s”, was the battle cry, “and health will be left in the wake.” Why do the hard work of preventing disease by investing time and energy in nutrition, education, housing, a clean environment, gun-control, and human empathy when you can just rest content in the belief, promoted by medical scientists, that cures for dreaded diseases are just around the corner.

Case in point, Nixon’s “War on Cancer”, promised to deliver in the 70’s – except it’s more likely to be in 2070 than 1970. We’re now repeating the folly with Alzheimer’s Disease, promising a fix by 2025. The year Lipitor went off patent, the HHS push for expanded Alzheimer’s funding began in earnest. By 2016, NIH funds to study the disease approached $1 billion, a 56% increase over the prior year. By 2018, the National Institute of Aging (NIA), a middle of the pack agency solidly in the center of the NIH’s 27 institutes and centers, became the 5^th largest institute with an appropriation of $2.6 billion.

NIH’s Francis Collins says, “Our continued investment will pay dividends for the millions of families affected by Alzheimer’s.” Others aren’t so sure. Long time University of Washington aging researcher Matt Kaeberlein notices a pattern of “following the money.” He says, “Nearly everyone I know is putting the words ‘Alzheimer’s disease’ in their grants in an effort to tap into the money.” Alzheimer researcher Samuel Gandy at the Icahn School of Medicine is even more pessimistic. He says, “I am convinced that we are destined to fail to make the 2025 goal and therefore look like we have failed at our promise.”

Former NIH director Harold Varmus, also feels the shadow of Nixon’s “War on Cancer” in setting a date for a breakthrough at 2025. He says, “No one denies the enormous need to make progress against Alzheimer’s. (But) I wish a date were not attached.”

What has been left unsaid is that the American belief, launched in the wake of WW II with the support of the AMA and America’s pharmaceutical industry, that a free-enterprise assault on disease was a reliable substitute for national health planning, universal coverage, and investment in the social determinants of health, has been proven naïve and false. What we have needed all along is a comprehensive national health plan for this country.