Is biotech evil?
Last night, my friend Lexi and her boyfriend Matt were packing for a camping trip in Texas. They invited my buddy Khiem and I over for drinks and dessert at her house in the San Fernando Valley. Later in the evening, Lexi’s father Ken, stopped by as well. Ken, like his daughter, works in psychiatry and has some fairly strong opinions on the pharmaceutical industry. Lexi had mentioned each of us to the other previously, but the two of us had never met face-to-face.
Ken’s main complaints were:
- Clinical trials sponsored by drug companies are not valid. Ken recited a statistic that 90% of corporate-sponsored clinical trials “succeed,” and implied that the number was lower for public-run trials.
- Drug companies and the medical community are too reluctant to espouse alternative treatments such as vitamin supplements
- Psychotropic drugs, such as antipsychotics, are unethical because they (clumsily) treat symptoms rather than cures. (Antipsychotics in this conversation included both atypicals, such as Seroquel, Zyprexa, and Risperdal, as well as typicals, such as Haldol and Thorazine.)
The theses of my responses were:
- Waiting for the scientific community to do our trials for us, if it happened at all, would slow down the approval process dramatically. Keeping valuable therapies off the market longer than necessary does a disservice both to patients and to shareholders. If corporate-sponsored trials tend to succeed more often than others, it could be because our trials are designed more effectively, with input from the therapy’s original researchers. I admit that “bad science” can happen, and if it puts patients at risk, then it’s dangerous. But blanket claims of industry-wide corruption are unfair and disrespectful to many accomplished and thoughtful industry scientists.
- If trials data exists to support such hypotheses, then in an ideal world, treatment patterns would follow best known practices. But marketing and medical affairs departments exist for very good reasons — to promote what their respective companies believe are the best practices. I don’t think that a marketing department should apologize for doing a great job of convincing the medical community of its product’s ability to help patients. (I can only imagine the reaction to a brand director proposing to highlight competing therapies in promotional materials.)
- Ken’s specialty area of interest is in psychiatric treatments, a base of experience I do not share. I have never worked much on any drugs that affect the central nervous system. Amgen does not currently manufacture any CNS drugs, nor does it have any in its pipeline. Although I consulted with AstraZeneca, I did not work closely with Seroquel. As a result, I did not have a lot of perspective on the topic.
As Ken and I mostly talked past each other on the little common ground we shared, I was concerned about how much intent Ken ascribed to each organization. It is probably easy for outsiders to imagine those who market pharmaceuticals and biologics as mustache-twirling ne’er-do-wells, cackling with glee as stacks of cash pile up at the expense of patient health and pocketbooks. There might be temporary places in the industry for people who don’t care about patients, but those individuals aren’t likely to last long.
The drug industry doesn’t have a perfect record, to be sure, but I do believe that for most of us, our intentions are in the right place. Unfortunately, employees in every organization, as brilliant as they are, occasionally succumb to being people, too. That means they sometimes become stressed, selfish, or lazy, leading to imperfect decisionmaking. That’s an unfortunate defect in any large organization.
Do you think biotechnology (or the pharma industry) is evil? Do they have different ethical biases? And what does evil mean anyway?
