By Marvin Druger
Pills are part of almost everyone’s life. Who doesn’t take a multi-vitamin pill or a baby aspirin or a vitamin D pill or Lipitor or something else?
The cost of many drugs seems exorbitant, even though part of this cost is often covered by insurance. I once had lunch with a major executive at Merck pharmaceutical company. He explained why the cost of drugs is so high. He told me that, for the thousands of drugs that they initially start developing in the lab, only one may eventually come to market and it may take 12 years of research and development to get it there. If a drug seems promising, it has to be tested thoroughly and undergo clinical trials before it can be approved.
Major steps have to be taken for a drug to gain approval. Then producing the drug in large quantities, assuring quality control in production, giving the drug a unique name, marketing the drug — all of this costs a lot of money and the manufacturer needs to make a profit on eventual sales of the drug.
Naming a new drug is an art unto itself. The company that developed and tested the drug gives it a generic and a brand name and has a patent that lasts about 20 years from the date of filing. When a patent expires, generics can be marketed by other companies, with the approval of the Federal Drug Administration.
For example, ibuprofen is the generic name for a non-steroidal, anti-inflammatory drug used to relieve pain and fever. That generic name has the brand names of Motrin, Advil, Genpril and Nuprin and is made by almost 100 companies. To avoid accidental misuse, companies also have to consider name similarities of drugs. The names of drugs can be intimidating. Would you want to take any of these drugs: Tobramisona, Spersacarpine, Aprazolam, Lamividine, Zylagren, Ramidex, Cyclobenzaprine, Venlafaxine or Tetrazepam? I think I’d rather be sick.
Every drug has some potential side effects. Even aspirin has a potential for causing stomach bleeding in some people. Oftentimes, a particular drug has weird, seemingly unrelated side effects. A drug that is taken for enlargement of the prostate gland in men can cause a runny or stuffy nose, sore throat, cough, dizziness, back pain, blurred vision and tooth problems. This should not be too surprising, since every part of the body is connected. Mess up one body part and you are likely to mess up some other part.
The FDA requires that manufacturers state possible side effects in drug advertisements. When you watch TV commercials, you may notice that the possible side effects of a drug are often stated very rapidly, like a long laundry list, along with some peaceful, distracting scenes. You may easily miss that one possible side effect of the drug is “death.” Indeed, the FDA is considering much shorter statements of side effects and sticking to the major ones.
But can we live without medicinal drugs? Can we survive a cold without taking some sort of antihistamine to relieve symptoms? Can we survive the chronic backache without taking some sort of pain reliever? Can we live happy lives without drugs? Probably not.
The human body is an amazing structure that has remarkable properties of self-healing. But self-healing is often not enough. We often need drug interventions to stay healthy and keep body parts functioning well for as long as possible.
Manufacturers have to consider naming a new drug, so that it is unique and can’t be easily mistaken for another drug. The size, shape, color and form of the drug also has to be considered. Does it matter if we take the drug in the morning or at night, or with or without food? I am often amazed that tiny pills may have a profound effect on the body. Each morning, I gulp down a large, coffin-shaped multivitamin pill, along with an attractive, gelatinous vitamin D3 pill, and a tiny safety-coated, baby aspirin. As small as it is, the baby aspirin has an “81” printed on each safety-coated aspirin pill, indicating the dosage.
I can’t imagine a drug-free world, but I can imagine the development of pills that perform miracles. Cancer is the second leading cause of death in the U.S. There are more than 200 different types of cancer, but they all trace back to a defect in a single cell that can no longer control its division process. The cell multiplies wildly and spreads the malignancy throughout the body, leading to death. Suppose we had an anti-cancer drug that would get at the core of the cell division process and stop all cancers.
I think that a very promising approach to dealing with cancer is to find a drug that will boost the natural immune system of the body. I can’t believe that the billions of dividing cells in our body divide flawlessly every time. The cell division process must go wrong many times in many cells, but the immune system recognizes these abnormalities and destroys the deviant cells. It’s only when an abnormally dividing cell somehow evades the immune system that it can grow incessantly and lead to cancer. After all, the immune system enables bacteria that normally inhabit our body to live, but the immune system will recognize and destroy foreign bacteria that invade the body. Why can’t we somehow boost the immune system so that it more readily recognizes potential cancer cells and wipes them out before they take hold? Scientists are working on this approach to cancer.
The No. 1 killer in the U.S. is heart disease. Suppose we had a drug that would cure heart disease. Suppose we had a brain pill that would cure Alzheimer’s disease. I’m not suggesting drugs that would alleviate symptoms, but drugs that would actually cure the conditions.
Pharmaceutical companies are always trying to find these blockbuster drugs that offer cures, but also make profits. There are many economic and social consequences of drug manufacturing. If we find more miracle drugs, how does that effect the growing population of elderly people, and does the earth have enough resources to support such growth?
We already have an example of such a phenomenon. In 1900, the life expectancy at birth of men was about 46 years and the life expectancy of women was about 48. Because of modern medicine, improved hygiene and other factors, the life expectancy of men in the U.S. is now about 76 years and the life expectancy of women in the U.S. is about 81 years. How much more increase in the human lifespan can we tolerate?
Yet, we have to go on making more and better nursing homes, programs for the elderly and sick people, and developing new drugs to keep people healthy and happy and enable them to live longer lives. You may ask, why bother? Why not let people live their naturally allotted time on earth and not be propped up and kept alive by drugs? That’s because we are all involved in this amazing process called life and a mission of human beings should be to care for each other and make our brief time here as healthy and happy as possible.