Brilliant article, if you haven’t yet read it, you should. Who’d want to live in a world where we were medicated into having the same feelings or desires as everyone else? It would be a bit like allowing Simon Cowell to be in charge of UK arts funding.
Our conception of the power and respectability of medicine stem from an out of date idea about what medicine is. Interventions focussing on curing or treating disease or physical injury no longer represents the main focus of medicine. Most new public health interventions (in the developed world at least) are no longer about saving millions of lives but small improvements to existing practises. As a result the creative and entrepreneurial pharmaceutical industry looks for other ways to sell patented compounds.
It is worth dwelling for a moment on the achievements of medicine in the last 100 years. In the UK the life expectancy of new born children in 1999 was 75 years for boys and 80 years for girls. In 1901 baby boys were expected to live for 45 years and girls 49 years. [http://www.parliament.uk/commons/lib/research/rp99/rp99-111.pdf]. A good chunk of this improvement is down to the continued in advances in preventative and curative medicine, and the investment by made by private firms in order to reap rewards when they demonstrated positive health outcomes.
The problem is that once the industry was established it needed to continue to introduce drugs and get paid for them. To the companies it makes no difference if the drug ends widespread childhood measles or if it has no positive impact at all. All that matters is that someone will pay for it.
As with all markets there are constant calculations going on in the background to work out what is the best way to make money. For much of the last 100 years the most cost effective thing to do was to pick a medical problem that didn’t seem to have effective or side effect free treatment and to pay for R&D to develop a better one. More recently, straightforward research had been taken and the cost of a health breakthrough began to rise. The balance began to tip so that the best use of investment became to create a market for products rather than create products for the market. This is borne out in the deployment of resource of the companies:
“Lauzon and Hasbani showed that between 1996 and 2005, these firms [pharmaceuticals] globally spent a total of US$739 billion on “marketing and administration.” In comparison, these same firms spent US$699 billion in manufacturing costs, US$288 billion in R&D, and had a net investment in property and equipment of US$43 billion, while receiving US$558 billion in profits”- http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050001
Once pharma’s engine of innovation became focussed on creating a market for their products rather than creating products the market wants, the whole market idea starts to look rather sorry.
This leads pharma to define a Platonic human experience and sell this ideal in pill form. The more people can be made to feel inadequate, the more effective this approach will be. It seems to me that the model that gave humanity so many improved health outcomes has run its course and should now be disbanded and replaced with something better.