Drug prices prompt biochemist's critique of big pharma

Gilbert Chu

For four years the Medical Scientist Training Program's "Unsolved Mysteries" lecture series has tackled a range of conundrums—from the rise of drug-resistant tumors to the cause of menopausal hot flashes. But Feb. 8's talk stepped beyond the usual bounds of biomedical research topics to confront a vexing political issue: Can big pharma's behavior change to benefit patients?

That was the title of the talk given by Gilbert Chu, professor of biochemistry and of medicine (oncology), who became engaged in the subject about six months ago when a physicist colleague complained about the cost of his Lipitor—and asked Chu for an explanation. Since then, Chu has been doggedly reading articles and books, and last week he took a crack at outlining the causes behind what is widely agreed to be a national crisis.

Before a packed house in Munzer Auditorium in the Beckman Building, Chu shifted roles from oncologist, physician and biochemist to political scientist, Wall Street analyst and advertising critic. He succinctly traced the origins and scope of the problem, starting with a change in the rules 25 years ago, when Congress passed legislation that let companies license government-funded work at universities.

"Basic research at pharmaceutical companies began to wither," Chu said and then quickly flashed two pictures on the overhead screen to illustrate the shift. The first was a picture of a bear, which he likened to big pharma, catching a salmon in a river. "Instead of finding their own food," he continued, "they have morphed into this." And the screen changed to a picture of a bear eating out of a trash bin.

These companies, he said, have moved away from hatching the ideas for new medicines, instead preferring to make their money by developing the ideas of others. "The pipeline for new drugs is drying up," he said.

The flip side of this decline in research, Chu said, is a greater emphasis on marketing to both consumers and physicians, which now accounts for about 35 percent of companies' budget as compared with 11 percent for research. Add to this equation patent law that essentially lets drug companies charge exorbitant prices and a government that lacks the resources to follow the drugs once they enter the market, and the basic ingredients are in place for a crisis, he explained.

Chu noted that many miracle drugs have been brought to market as a result of the companies' work and that the U.S. health-care system could not function without these firms. "The pharma companies are not monolithic bad guys," he cautioned.

Still, he warned that the solution to the dilemma is unlikely to come from big pharma itself. "Industries like these have to be regulated," he said. "The question is how do we adjust the balance."

To view Gilbert Chu's lecture in its entirety, visit the Web site, http://mstp.stanford.edu/events.html, and click on the link at the bottom of the page to download streaming video of his talk.