Apparently, I Am What’s Wrong With America

The oil companies, the drug companies, the health insurance companies, the predatory student loan companies have had seven years of a President who stands up for them…”  — Hillary Clinton’s acceptance speech after winning the New Hampshire Primary

I’ve spent the last 15 years working for drug companies.  I’ve worked on programs for anti-infectives, women’s health, oncology and diabetes.  Do you know how many marketed drugs I’ve worked on?

Zero.

Is that because I suck?  No.  By all accounts, I’m pretty good at what I do. The number is zero because bringing a pharmaceutical product from discovery to market is an incredibly difficult task.  Most things fail in the clinic and do not get approved by the FDA (the going rate is about 1-in-20 get approved), and that doesn’t even include the early stage projects that never make it TO the clinic.  My own estimate is that 1-in-10 to 1-in-20 research projects produce something that you might want to try in the clinic.  Lump them together, and you have about a 1-in-300 chance of getting to the finish line once you start.

So why do it?

For the money, right?  Wrong.  By this time in my career, I have a fairly rare set of skills and that means I get compensated pretty well.  But I know many people my age and younger than me that make more in different professions.

Oh – so obviously the companies aren’t sharing their wealth with their employees as they rake it in hand over fist?  Well, that’s not true either.  Here’s a 5-year chart of the pharma industry versus something I picked randomly – the clothing sector.  The pharma industry is the flat one.  Clearly, no one’s making a bundle off of drug companies.  (Seems to me Hillary should be railing against the prices at the mall, not the pharmacy…)

But they’re still charging too much, right?  Well, that depends on how you look at it.  Current estimates are that it costs $800,000,000 to bring a drug to market.  Before you ever get a chance to fill one prescription – and that almost-a-billion-dollars doesn’t guarantee that anyone will buy it.  Couple to that the likelihood that you usually have  7-10 years patent protection left by the time you start selling (before anyone can produce and sell a generic version) – and you don’t have a lot of time to recoup your investment (and the costs of the other 19 clinical programs that failed…) and turn a profit (and that chart tells you how flat pharma profits have been).

So, again.  Why do it?

My dad died of prostate cancer.  My grandmother died of cancer.  My mom was diabetic and died of colon cancer.  Friends of mine have high blood pressure.  I do this because maybe – just maybe – I can beat the odds and help make something that alleviates a disease as easily as drinking a glass of water or gives someone that otherwise might die a few more years with their family.  And I’m not alone – all the colleagues I know are motivated by the same thing.

So, if certain candidates want to paint the industry I work in and what I have chosen as a vocation as wrong, or greedy, or selfish – go ahead.

I’ll see you at the polls.

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46 thoughts on “Apparently, I Am What’s Wrong With America

  1. If it makes you feel better, certain right wing preachers have said that the Sept. 11 attacks are partly my fault.
    I don't think it's possible to blame an industry for the problems that the country's facing. (Unless you can consider politics an industry, and sadly, I don't think you can.)

  2. you, my dear, have the job at the good end of the spectrum. the work
    you do directly affects people. (whether the drug makes it to clinic
    or not, it's still helping.) i think she was talking about the
    higher-ups, the ones directing the money and programs and such, not
    necessarily the research end. but even still, i'd say the drug
    companies are one of the lesser evils on that list . . . without them,
    we wouldn't have half the life-saving drugs available.i think
    the biggest problem lies in the relationship between the drug companies
    and the insurance companies. insurance costs so much, people can't
    afford to have it. and then they can't afford to pay for the drugs
    they need. and the drugs are costly because it costs so much to
    produce them. it's a nasty circle that i've been in before.by the way, i think the topical anti-infective my doctor gave me isn't working. can you fix that, please? :)

  3. Great post, Steve. Where would be without people like yourself who help treat and sometimes cure us? Seriously, that's a scary thought! I am so thankful for those that do what you do! :-)
    That said, I would piggyback onto what erin said about the biggest problem being the drug companies and the insurance companies. My Grandma suffered from Chron's disease and could not afford all her medications. Luckily, she had a doctor who would slip her free samples whenever he could to ease her discomfort.

  4. Now you've done it Steve. You see, what you've just done is taken what people perceive to be the truth – that drug companies prey upon the little people for profit – and offered useful insight into the industry. Information that will make us more knowledgable about the industry, and better able to make an educated decision during this election process.
    Clearly Hillary would prefer to be able to just throw out a blanket statement that plays into peoples precieved fears about the drug industry, in order to garner the most votes possible.
    Don't you know that the truth is secondary to votes Steve? Way to go.

  5. Now you've done it Steve. You see, what you've just done is taken what people perceive to be the truth – that drug companies prey upon the little people for profit – and offered useful insight into the industry. Information that will make us more knowledgable about the industry, and better able to make an educated decision during this election process.
    Clearly Hillary would prefer to be able to just throw out a blanket statement that plays into peoples precieved fears about the drug industry, in order to garner the most votes possible.
    Don't you know that the truth is secondary to votes Steve? Way to go.

  6. I wouldn't say it was your Job that makes you what is wrong with America, the problem is deeper than that, hence you defending your evil job. J/k.
    Hellary Clinton is what is wrong with America.

  7. You'd think Hillary Clinton would say something about the government, which earns more money off oil taxes than the oil companies do. Budd's right — she's what's wrong with America. I respect and admire you for what you do, and think of it this way — if Hillary Clinton is unhappy with you, you must be doing something right.

  8. I hear what you are saying Steve and think much of it is right. I agree with Tamzen that Hillary is NOT what is wrong with America however. This problem is just way too complex for any one thing to be the solution. It includes patient abuse of the health care system, physician ignorance, false advertising, crappy health care providers, and IMHO gouging by the drug companies to name only a few of the problems. There are many examples of all of the above being major stumbling blocks to the heath care crisis. I don't think Hillary was bad mouthing R&D chemists…:) I think she's trying to address the fact that the current medicare part D program instituted by the current administration is a total joke; and that instead of actually helping patients like the ones I see every day that can't afford the $800.00 (out of pocket cost) just for their phosphorus binders alone; it put federal money into private companies that are already profitable. Also IMHO the thing that is keeping the entire thing from collapsing right now is dedicated health care professionals that work long hours for shitty pay, often in dangerous situations and do it over and over again just because they care about the people that they take care of.

  9. Tamzen, e*c, kelly et al. — thanks so much for your comments on this. I think we all struggle with a system that we know is broken at certain levels but can't seem to come up with any real steps to make things better.

  10. Actually, Hillary's bearing the brunt of this because she won last night and in her speech she lumped me in with the Corporate Axis of Evil. Of all the candidates, I think that Edwards has beaten the "fight-the-man populism" the worst. Sorry, Hill… that's what you get for winning…

  11. My brother is a Dr in Pharmacy, so I think drug companies are fabulous ;)All kidding aside, just wanted to say that you have – as usual – a thought-provoking and well-presented post. I hate oversimplification, and that quote definitely reduces the issues to a neat, albeit incorrect, soundbite.

  12. sdede2 and mello — I think you guys, of all the people that are in this neighborhood — see the bad outcomes of a broken healthcare system. And I know Hillary doesn't think she meant me, personally — she's taking a shot at big corporations and easy target for "average joe" I suppose. But as you might have been able to tell — I take it personally. Is there corruption in the pharma industry? Of course there is — its run by people — powerful people — and we know the effect that can have. Is it worse than any other industry? I sincerely doubt it. But broadbrush statements like that show a disinterest in addressing the issue, but merely pointing a finger at someone that can't point back.

  13. sdede2 and mello — I think you guys, of all the people that are in this neighborhood — see the bad outcomes of a broken healthcare system. And I know Hillary doesn't think she meant me, personally — she's taking a shot at big corporations and easy target for "average joe" I suppose. But as you might have been able to tell — I take it personally. Is there corruption in the pharma industry? Of course there is — its run by people — powerful people — and we know the effect that can have. Is it worse than any other industry? I sincerely doubt it. But broadbrush statements like that show a disinterest in addressing the issue, but merely pointing a finger at someone that can't point back.

  14. I totally understand. I get really annoyed when people bash the media, even though I know they don't mean me personally. But it's what I do and I love it and it's a fantastic job and I kind of want to punch people who mock it.
    Except Hillary has Secret Service people, so I'd advise against punching her. ;)

  15. Steve – fantastic post. Janette is right – Hillary's quote boiled it down to a 'neat' but incorrect conclusion that sounds good on a 15 or 30 second sound bite. I'm so sick and tired of 30-second sound bite politics. All it does is remind me that our politicians are mostly disinterested in real solutions and mainly interested in maintaining (or getting into) power.

  16. Again I hear what your saying Steve and like I said I agree with it for the most part. The complexity of the issue is also what I was trying to convey and the sound bite politics IS very disturbing as ashbylane said, but this is just politics in America right now and Hillary is only a player in that whole scene, not the cause. I think the difference between drug companies and things like the clothing industry though is people feel "trapped" into using the drugs that the pharm companies make. With clothing for instance you have many choices, this is only occasionally true with drugs. So in essence it presents this feel of "they can charge whatever they want" kind of thing where the clothing industry has prices that are controlled simply by the open market and competition, so if they charge more than you are willing to spend you don't buy it. If this allows prices to increase exponentially even, it's based on more of a free market, so people don't complain about it. This is seldom the case with drugs, patients are presented with the option of total financial depletion (even one's that have prepared fairly well for retirement) or an earlier death. It is because of these bad and worse options that people get angry and throw stones at the drug companies.Also, I truly think Hillary was attacking the current administration by that comment not the industries themselves. If anything I would support increasing government funded research into the medical industry especially for things like stem cell research and even pure research into just good ideas. OK i'm done spouting…:) Who is going to win the playoff games this weekend…:)

  17. Tam — I did a bad thing!!! I hit "delete" to your comment instead of "reply" == I really don't think that was Freudian, I swear!
    Anyway — its a really good question to ask — why is Hillary so polarizing? I wrote a post a month or two ago about why I thought the Dems were a little crazy if they think Hillary is really electable. It wasn't really about Hillary per se', but more about polling and the differences between the way people say they will vote and how they actually do vote. (Interestingly, the very same thing may have happened to Obama in NH — though its probably too early to tell to know if that's a chronic issue…) In the end, much of the commentary turned into a referendum on HRC, which might make for interesting reading.
    For my part, my difficulty with HRC is simply that I don't believe what she says. Any of it. She seems shrewd, calculating and manipulative. And I think she'd throw whoever was necessary under the bus to get and/or retain power. Also, riding her notoriety to a Senate seat in a state that she manufactured residency in is against the very nature of representative government.
    Now, the cynical (and likely correct) answer is that many if not most politicians would do the same. But at least sometimes there's a shadow of doubt that they might actually believe in what they're doing (most people are dissasisfied with President Bush, but I think most people would agree that he's doing exactly what he thinks is right.). For HRC — even the win in NH was colored to me — that phrase where she said "I listened to you and found my voice" — I interpreted to be "I was failing, so I listened and successfully repackaged myself into someone you would vote for…"
    So in short, while I am skeptical and don't trust most politicians much, I don't trust Hillary at all.

  18. sdede2 — yes, there's a very real difference between optional purchases and the deeply personal feelings about NEEDING medicine. My point was there, that as a whole, the industry really isn't doing all that well for all the price-gouging they're accused of.
    The problem comes in the ethical dilemma of: I have made something that can save your life if I give it to you, but I can not afford to give it to you. Drug companies are businesses and as such need to turn profits to remain viable. The more each failure costs (rising FDA requirements), the more I need to charge for the rare success. Many would say that more profit than is necessary to keep the company going is ethically troubling — but no one's going to buy shares in a company like that.
    You could say the government then will subsidize drug discovery and development, so that prices remain low. Maybe. You would gut an entire industry that thrives on competition — two things are big drivers — being First-in-Class and being Best-in-Class — if you turn discovery into a governmentally- process you remove the incentive and further politicize the whole endeavor.
    I know that's not much of an answer…

  19. It's okay…about the deleting. It' also kind of funny. :-)
    I'll look forward to checking out that post link…should be interesting!!
    I do agree, if Dems are to have a shot at the Presidency, perhaps Hillary is not the best choice because of the distrust issues. People seem to either really love her or really distrust/dislike her. And as much as I would love to have a female President, I wonder if she would be able to heal our country from the deep polarization that currently exists. And I understand what you are concerned about…I really do. It's part of why she is not my #1 choice.
    I am loving Barack Obama for many reasons, one of the most important being that he was the only candidate who did not support the war and stood up for his own belief which was that there wasn't sufficient information to warrant such a call. So far I see a great uniter in him and I think our country really needs that right now. He is articulate, intelligent and I think he could make progress.
    About President Bush (sigh), I am one of the ones who has never been happy with him. And I get what you're saying about how he seems to really believe that what he is doing is the right thing. But didn't Hitler have such conviction too? I am not saying that Bush is a Hitler, but I am saying that believing in what you're doing, doesn't make it okay. And I honestly believe that President Bush has done way more harm to our country (and other countries) than good. I'm not one to usually get too passionate about politics, but Bush has really fired me up in the past 7 years…sometimes even to tears.

  20. It's okay…about the deleting. It' also kind of funny. :-)
    I'll look forward to checking out that post link…should be interesting!!
    I do agree, if Dems are to have a shot at the Presidency, perhaps Hillary is not the best choice because of the distrust issues. People seem to either really love her or really distrust/dislike her. And as much as I would love to have a female President, I wonder if she would be able to heal our country from the deep polarization that currently exists. And I understand what you are concerned about…I really do. It's part of why she is not my #1 choice.
    I am loving Barack Obama for many reasons, one of the most important being that he was the only candidate who did not support the war and stood up for his own belief which was that there wasn't sufficient information to warrant such a call. So far I see a great uniter in him and I think our country really needs that right now. He is articulate, intelligent and I think he could make progress.
    About President Bush (sigh), I am one of the ones who has never been happy with him. And I get what you're saying about how he seems to really believe that what he is doing is the right thing. But didn't Hitler have such conviction too? I am not saying that Bush is a Hitler, but I am saying that believing in what you're doing, doesn't make it okay. And I honestly believe that President Bush has done way more harm to our country (and other countries) than good. I'm not one to usually get too passionate about politics, but Bush has really fired me up in the past 7 years…sometimes even to tears.

  21. I totally agree with all this. I by no means think the government should "run" the discovery process, it should just let pure research be and stay out of the way and not inhibit firstly and maybe even encourage it when able.I agree with Tamzen too, believing what you are doing is right is fine but it doesn't make you better suited for anything. Remember this is a president that says he "talks to god". To me this is scary as hell because who knows what god is going to tell him to do next? This is something that can and has been used to suggest mental illness in people. So for me to take comfort in someone believing in what they are doing when they don't question their beliefs or challenge their own ideas because they believe they are divinely inspired is just impossible. I take much greater comfort in a politician that challenges their beliefs, realizes that they don't know everything, and that they are a representative of the people, not god, and form their policy around that.BTW, I'm no great HIlliary fan. I think she's O.K. but like Obama better…:)

  22. I totally agree with all this. I by no means think the government should "run" the discovery process, it should just let pure research be and stay out of the way and not inhibit firstly and maybe even encourage it when able.I agree with Tamzen too, believing what you are doing is right is fine but it doesn't make you better suited for anything. Remember this is a president that says he "talks to god". To me this is scary as hell because who knows what god is going to tell him to do next? This is something that can and has been used to suggest mental illness in people. So for me to take comfort in someone believing in what they are doing when they don't question their beliefs or challenge their own ideas because they believe they are divinely inspired is just impossible. I take much greater comfort in a politician that challenges their beliefs, realizes that they don't know everything, and that they are a representative of the people, not god, and form their policy around that.BTW, I'm no great HIlliary fan. I think she's O.K. but like Obama better…:)

  23. "I take much greater comfort in a politician that challenges their beliefs, realizes that they don't know everything, and that they are a representative of the people, not god, and form their policy around that." ….I have strong spiritual beliefs and I couldn't agree with you more! Well said, sdede2!

  24. i was so mad, as a surrogate new yorker, when i found out that Hillary was going to be representing New York, a state that she never lived in before, in the Senate. but along with all the hooplah, i hear she's actually done some great things for the state. i'd rather have a productive Senator that is trying to better the state (and has now become a long-ish time resident) than a born-and-bred resident Senator who doesn't do squat.as for being a fan, i'm not sure yet. there's part of me that likes her a lot. and there's part of me that really likes Obama a lot. from what i've read and heard, he wants change. and no matter what color, sex, party, religion or whatnot our next president will be, we need change.now, who mentioned Bush and mental illness in the same paragraph? i've heard that it actually plagues the family greatly, and i wouldn't be surprised. i'm also LIVID at the fact that this Israel trip is his first in his presidency . . . in SEVEN YEARS. you'd think he'd visit the hotspot first in office to try and continue peace with our friends, instead of waiting until the last minute when his 'work' won't have time to take any sort of effect.

  25. Dear Steve, thank you for this post, I thought it was well-presented and informative.
    I am nearly ready to break out in hives every time I hear anyone (Hillary or otherwise) blame "The Drug Companies" for what is wrong with America today.
    A couple years ago I attended a talk about Big Pharma. A doctor (professor of Medicine at U-M) stood up and said, quote, "Someday I'd like to practice medicine in a civilized society." Also present were some people of Pfizer (before our state's hostile business climate motivated them to pull up stakes and abandon My Fair City — but that's a topic for another time) who showed a video featuring patients benefiting from, in my opinion, literally miracle cures. They had a Parkinson's medication that allowed a man who literally could not get out of bed or speak intelligibly, to reduce his tremors, get up and walk, and speak eloquently and at length about what a difference this medication had made to his life.
    Then Mr. Socialist Dr. Professor got up and showed a slide with the previous year's profit margins, of about 20 leading Fortune 500 companies — several of them drug companies — and bewail and bemoan the fact that Pfizer, for one, had a pretty healthy profit margin (at least at that time).
    What I took away from that chart — and I actually raised my hand and said so — was that Coca-Cola had an equivalent profit margin to Pfizer — and all THEY sell is flavored sugar-water!!!!!! This other company is selling miracle cures — literally allowing the lame to get up and walk — and all Coke is selling is sugar-water!!! Frankly in my personal opinion, the miracle-cure company has a MUCH greater right to their profit margin than the sugar-water company — judged purely in terms of the benefits to society of their respective products.
    Plenty of intelligent people will disagree with me — Mr. Socialist Dr. Professor included — and I'll hop down off my soapbox now — but, I just had to applaud you for this post.

  26. Dear Steve, thank you for this post, I thought it was well-presented and informative.
    I am nearly ready to break out in hives every time I hear anyone (Hillary or otherwise) blame "The Drug Companies" for what is wrong with America today.
    A couple years ago I attended a talk about Big Pharma. A doctor (professor of Medicine at U-M) stood up and said, quote, "Someday I'd like to practice medicine in a civilized society." Also present were some people of Pfizer (before our state's hostile business climate motivated them to pull up stakes and abandon My Fair City — but that's a topic for another time) who showed a video featuring patients benefiting from, in my opinion, literally miracle cures. They had a Parkinson's medication that allowed a man who literally could not get out of bed or speak intelligibly, to reduce his tremors, get up and walk, and speak eloquently and at length about what a difference this medication had made to his life.
    Then Mr. Socialist Dr. Professor got up and showed a slide with the previous year's profit margins, of about 20 leading Fortune 500 companies — several of them drug companies — and bewail and bemoan the fact that Pfizer, for one, had a pretty healthy profit margin (at least at that time).
    What I took away from that chart — and I actually raised my hand and said so — was that Coca-Cola had an equivalent profit margin to Pfizer — and all THEY sell is flavored sugar-water!!!!!! This other company is selling miracle cures — literally allowing the lame to get up and walk — and all Coke is selling is sugar-water!!! Frankly in my personal opinion, the miracle-cure company has a MUCH greater right to their profit margin than the sugar-water company — judged purely in terms of the benefits to society of their respective products.
    Plenty of intelligent people will disagree with me — Mr. Socialist Dr. Professor included — and I'll hop down off my soapbox now — but, I just had to applaud you for this post.

  27. just have to stick my head in and say, very interesting perspective, Steve. thought provoking as always. as someone on the other end of the whole drug thing–being diabetic and insulin dependant– i can say i don't think that the drug companies are what's wrong with america, and i can say i'm thankful for folks like you, cuz otherwise i'd be on non-synthetic insulin–much harder on the body than what i'm on. i am more of the opinion that our healthcare system as a whole (insurance, medicare, etc), is a bigger problem. but then, i'm currently on COBRA i can't afford, and cannot ever ever EVER let my health insurance lapse, as then i will NEVER be able to get insurance again, because of my "pre-existing condition." so i might be slightly biased in that regard…
    as far as Hilary and all the rest everyone's been discussing… i don't know enough about politics to be able to offer even a slightly informed opinion!

  28. just have to stick my head in and say, very interesting perspective, Steve. thought provoking as always. as someone on the other end of the whole drug thing–being diabetic and insulin dependant– i can say i don't think that the drug companies are what's wrong with america, and i can say i'm thankful for folks like you, cuz otherwise i'd be on non-synthetic insulin–much harder on the body than what i'm on. i am more of the opinion that our healthcare system as a whole (insurance, medicare, etc), is a bigger problem. but then, i'm currently on COBRA i can't afford, and cannot ever ever EVER let my health insurance lapse, as then i will NEVER be able to get insurance again, because of my "pre-existing condition." so i might be slightly biased in that regard…
    as far as Hilary and all the rest everyone's been discussing… i don't know enough about politics to be able to offer even a slightly informed opinion!

  29. My daughter Alexis had a Germinoma tumor on her pituitary gland as a teenager. It went misdiagnosed for several years- she lost weight so she was labeled as “anorexic”. She will be dependent on hormone replacements: cortef, desmopressin, and estrogen for the rest of her life. She has also taken testosterone and human growth hormone as well.

  30. My daughter Alexis had a Germinoma tumor on her pituitary gland as a teenager. It went misdiagnosed for several years- she lost weight so she was labeled as “anorexic”. She will be dependent on hormone replacements: cortef, desmopressin, and estrogen for the rest of her life. She has also taken testosterone and human growth hormone as well.

  31. Now you are going to hear the whining that Exxon-Mobil's profits are excessive.
    Give me a break, businesses exist to provide goods and services that people need or want. The owners of Exxon- namely its shareholders- people like you and me, retirement funds, etc. only invested in the company because they expect it to make a profit. This is more honorable then government using its police power to tax you so as to give your money to another whom had not earned it.

  32. Now you are going to hear the whining that Exxon-Mobil's profits are excessive.
    Give me a break, businesses exist to provide goods and services that people need or want. The owners of Exxon- namely its shareholders- people like you and me, retirement funds, etc. only invested in the company because they expect it to make a profit. This is more honorable then government using its police power to tax you so as to give your money to another whom had not earned it.

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