Pharmageddon by David Healy Read Free Book Online

discovery of therapeutically useful drug treatments ever. If product patents are retained, at the very least we should insist on a return to the spirit of the law—namely that we, the community, will offer your company certain privileges in return for a genuine benefit.
    Companies argue that the high cost of developing drugs, put at up to a billion dollars per drug, means they need the returns they get from the current system. But the greater part of these costs come from clinical trials that are in fact part of marketing and these costs escalate the weaker and less needed a drug is. The current patent system is central to both drug development costs and drug prices, and if we want to reduce drug prices the patent system has to change.
    We have in fact engineered a lose-lose scenario. The current arrangements underpin the development of blockbusters that have become so important to the health of companies that they are prepared to conceal trials or adverse events that might pose problems for their marketing, ghostwrite such trials as are published, and aggressively counter attempts by doctors to describe problems that arise in the course of therapy. This is a situation that is as toxic to good medical care as it is possible to have.
    THE FACTORIES OF POSTMODERNISM
    In the 1990s a dispute blew up that has since been called the Science Wars. 18 At its most extreme, scientists who viewed the products of science as real were faced with radical skeptics, postmodernists from the humanities, who appeared to deny the reality of anything. Everything, including scientific articles, the postmodernists claimed, were just texts whose truth value was uncertain.
    Postmodernism is linked to modern science. Once we in the West had seen God's revelation as coming in two books, the Bible and the Book of Nature. The rise of science led on to a radical or modernist doubt about the events portrayed in the text of the Bible. For a period, science remained immune to the crisis of belief in the biblical text, or indeed became a substitute for the lost certainties produced by viewing the Bible as simply a text. But as scientific advances began to show that older scientific “truths” were far from true, science itself faced a new radical doubt, postmodernism, that contested its claims to possess any revelation.
    The response of science has been that any attempt to restructure science along postmodernist lines would produce a cargo cult. In the course of World War II, US Air Force planes flew into islands in the Pacific, disgorging all sorts of goods. Some of the islanders were so impressed by the appearance of these flying cornucopias that long after the US military left they maintained the runways and control huts, beside which they continued to fly the American flag, in the apparent belief that the right appearances would lead to the right results. These were the cargo cults. For scientists reality is not a text that can be read one way today and another tomorrow. The ultimate defense of science has been that its planes fly, whereas having postmodernists in a laboratory would reproduce the airstrips and the US flag—and leave us waiting forever for results.
    The new drugs developed from the 1940s to the 1970s, based on breakthroughs in biology, pharmacology, and other medical sciences, meant the pharmaceutical industry of the time was about as far removed from a cargo cult as it was possible to be. In the face of such advances there was very little place for radical doubt. The first darkening of the medical horizon came in the 1960s with concerns about the emergence of a technological society, concerns that were applied to medicine by Ivan Illich in the 1970s. Illich's critique of medicalization came at a time when many had sensed the first intimations that not all was well with medicine. 19 The criticism at the time was directed at medicine itself, an apparently all-powerful institution, increasingly arrogating to itself the right to