Physicians across the country are speaking out in favor of the patient-physician-industry-government partnership, one important article is a recent editorial written by William H. Frishman, MD in The American Journal of Medicine. Dr. Frishman uses the example of a recent conversation he had with his medical school classmates at a reunion, in which they discussed the area of pharmacotherapeutics.
Dr. Frishman noted that today, in comparison with when he was a student in the 1960s, what is now available for practicing physicians are “newer therapies that have favorably affected both the prevention and treatment of cardiovascular disease.” One of the leading reasons why such new therapies are and continue to be possible according to his article is because of “the advances in basic research supported by the National Institutes of Health (NIH) and the development of new drugs by the pharmaceutical industry.”
In his area of internal medicine, with a subspecialty of cardiovascular disease, Dr. Frishman noted that since 1969 he has seen the impact of such drugs in the lives of patients. Breakthroughs include the clinical use the beta-adrenergic blockers and calcium-entry blockers for the treatment of angina pectoris; angiotensin-converting enzyme inhibitors and angiotensin receptor blockers for heart failure; new drugs for systemic and pulmonary hypertension; thrombolytics for myocardial infarction; statins for hypercholesterolemia; and new antiplatelet drugs.
Another area of new drugs developed by the pharmaceutical industry he notes is “innovative drug therapies for cholesterol elevations, hypertension, and smoking addiction.” According to Dr. Frishman, such innovations have led to “major reductions in the numbers of acute myocardial infarctions” over the past 40 years.
If an acute myocardial infarction does occur, there is now a highly significant chance a patient will survive the event with the use of thrombolytics, antiplatelet drugs, beta-blockers, and drug-eluting stents. Other changes Dr. Frishman has seen include the reduction of the mortality rate while improving the functional capacity of patients for those individuals with class IV heart failure.
Dr. Frishman also discussed his experience as Chief of Medicine at a Bronx teaching hospital in 1982, where he worked with patients who suffered from the human acquired immunodeficiency disease syndrome (AIDS). Since this experience, Dr. Frishman acknowledges that the “intense drug development efforts by the pharmaceutical industry, in tandem with the discoveries by investigators at the NIH and elsewhere, has made AIDS an outpatient condition with a significantly reduced mortality risk.”
Additional breakthroughs of the same magnitude have also “occurred in the therapy of cancer, rheumatologic diseases, infectious diseases, and almost every other area of medicine.” Seemingly, Dr. Frishman precisely sums up the kind of relationship and rapid response industry has had over the past 100 years in helping solve such problems:
“There has been an unwritten understanding in the United States that the pharmaceutical industry, in a market economy, would develop the treatments that patients and their physicians require, and that the government would supervise the approval process and regulate the marketing and manufacturing of drugs.”
Industry does not just stop at funding research for medicine either. In fact, “industry also has helped to support an unfunded educational mandate from professional accrediting organizations by providing the missing financial support for graduate and continuing medical education, while helping to support our scientific societies, scientific meetings, and our erudite and not-so-erudite medical publications.”
While there have been cases of physician–researcher conflicts of interest “overall, however, the patient–physician–industry–government partnership has been a great success, and a union that has benefited many.” What is important to consider is that with such significant breakthroughs in the past and present, who or what would replace the pharmaceutical industry had no incentive to make drugs, and stopped developing them?
In response to such a question, Dr. Frishman noted that the government could not possibly develop drugs in place of industry because it is too busy and overspread dealing with a world economic crisis. Specifically, the NIH “could not even step in without a major overhaul of its mission,” and politicians are not likely to “nationalize the pharmaceutical industry as they did General Motors and Chrysler.”
Dr. Frishman’s conclusion, as well as that of the study identifies an extremely valid point from the discoveries and breakthroughs we have today: “clearly, America has benefited from the drug discovery process sponsored by industry over the past century.” While undoubtedly, continuing such discoveries will require regulations by the government, patients will still benefit from an ongoing partnership between physicians, industry and government, according to Dr. Frishman.
With such a tremendously successful past behind them, the pharmaceutical and device industry’s need to be protected if not for the sake of patients, then because each industry “has been looked at by the entire world for years as a source of strength in medical research and in the advancement of clinical therapeutics.”
While Congress is busy trying to get every American health care coverage, patients should ask themselves where America would be without such industries, and what sort of drugs and treatments will be available to us if there is no longer any reward in developing new treatments.