Most Wednesdays I try to watch a program on the ABC called “Meet the Press”. People with something of interest to say to the nation speak about their topic to members of the press, who try, and often succeed in asking probing questions of the speaker.
Early in November Dr Brendan Shaw, Chief Executive of Medicines Australia spoke on the topic of Where do your medicines come from and why should you care?
Well, I learned a lot about the industry surrounding the economics of producing and getting medicines out to the public, and some of the marketing issues. The talk I heard today stressed the industry. Industry, in my experience, works to create a demand for its products. That, I suspect, can lead to all sorts of unfortunate issues for the public.
I learned some surprising things listening to Dr Shaw. The Australian Medicines Industry invests more than $1 billion a year in R&D and has annual exports $4 billion – more than the wine and car industries. It employs 14,000 Australians and spends 10 times more than the Federal Government on clinical trials. Australia manufactures and develops a large proportion of the world’s medicines.
Clearly the medicines industry is no cottage industry!
In his talk, Dr Shaw stressed the value of the medicines industry to Australia’s economy, arguing that what was good for the medicines industry was not only good for the economy, but for the health of the population.
He spoke about some of the challenges facing the industry: It takes longer to bring a new medicine to market than almost any other product; there’s about a one in ten thousand chance of success for new medicines to get to the market.
Dr Shaw then spoke of the economic difficulties the industry was facing. Exports fell by 7% last year. That led to a few questions: Was that because we are becoming less competitive? Is the government not providing the needed conditions for the industry to flourish? Should there be subsidy for the industry?
Other problems facing the medicines industry included the difficulty in finding people to participate in clinical trials of new products, and the fact that statistics are showing that only about 50% of patients follow through with the prescriptions given to them by their doctors.
I wonder whether these last two issues have something to do with a lack of trust on the part of the public, and maybe even lack of satisfaction with the medical products. We know that there is a huge trend away from what has been regarded as “mainstream” medicine in recent years. There are billions of dollars being spent annually on alternative forms of health care.
Dr Shaw suggested, none too subtly, that the public should consider investing in the medicines industry even through providing subsidies if necessary, as the industry could be the thing to replace the income from our country’s present mineral boom when it runs out. It was even suggested that with enough investment, the medicines industry would be well placed to manufacture medicines for diseases we don’t even know about yet.
Hearing that made me very uneasy.
Mostly, members of the press listened very attentively. It all sounded very logical and sensible, and questions built on the premises laid out by Dr Shaw were asked and addressed.
Some journalists were not happy with the premises Dr Shaw was working from, and asked some thought provoking questions.
Sue Dunlevy of The Australian raised issues of transparency; should doctors be getting kickbacks from pharmaceutical companies? Dunlevy asked Shaw how this issue was being addressed. It was pointed out that the Medicines Code of Conduct is only reviewed every three years. What is the role of doctors and the pharmacy industry in these reviews? What sort of relationship should they have? Dunlevy felt doctors should be talking about these issues more openly rather than leaving it to the medicines industry.
Mark Metherall, also of The Australian did not appear entirely happy with Shaw’s assertion that we would not be concerned about these issues. Dr Shaw used a rather shaky analogy to explain: we would be relieved to know that an aircraft manufacturer is allowed to speak freely with the pilots who flew their planes. In the same way we should not be concerned when manufacturers of medicines speak freely with the doctors who prescribed them to patients. I found myself agreeing with Mr Metherall. It was not a great analogy.
I find it heartening that some members of the press are asking good questions about what is driving the current medical model of health care, and are pressing for more transparency in and from the industry.
Christian Science Committee on Publication for Victoria, Australia
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