September 2, 2009
Regarding ‘Europe leads global drug discovery: Study‘:
PhRMA, the American pharmaceutical trade association, issued a strong rebuttal to an article in the August 25th issue of Health Affairs-web exclusive that documented the superior research productivity of Europeans to Americans in developing global drugs since 1982.
‘Global Drug Discovery: Europe in Ahead’ apparently touched a raw nerve at PhRMA because the article took a prominent study used to show American superiority and demonstrated it was due to companies investing much more money in the United States than Europe, especially in recent years.
By correcting for this bias and comparing innovativeness on a level playing field, however, Europe came out ahead. Written by Donald Light, the Lokey visiting professor at Stanford University and a professor at the University of Medicine and Dentistry of New Jersey, the article otherwise used the same data and methods as the original.
Light also cited evidence over the past 25 years that most new drugs offer few or no benefits over existing drugs.
The PhRMA statement also charges that the article “ignores the chilling effect of government price controls on such innovation”. In fact, Light notes that European research productivity has increased despite countries negotiating prices that reflect added value. He cites evidence that UK prices on patented drugs are high enough to pay for all research and related costs and make a reasonable profit. Several other countries and Canada have comparable prices. But companies can make more profit faster in the United States, where they can charge more; so they usually launch new drugs first in the US.
PhRMA charges that Light “paints a distorted picture that gives short shrift to the medical advances made possible by America’s pharmaceutical research and biotechnology companies…” In fact, all the new chemical entities credited to the United States in the original study claiming American superiority were included.
The industry trade association claims that cancer patients are living on average three years longer due to new treatments, and heart attacks fell by nearly half from 1999 to 2005. Evidence for such claims needs careful assessment, especially studies supported by industry. For example, earlier diagnosis of cancer results in higher 5-year survival rates regardless of treatment effects, just because the cancers have not advanced as far. Heart attacks have declined for a number of reasons, including the benefit of drugs.
PhRMA claims that Light used “misguided” ways of attributing new drugs to Europe and the US. Those methods, however, were developed in order to demonstrate how completely the US has dominated Europe in drug research productivity by Henry Grabowski, a distinguished economist whose studies the industry widely cites to claim its research costs are staggering and its profits are modest.
By correcting for investment size, Light found that dollar-for-dollar, European research productivity has increased to surpass the US in global and first-in-class new drugs. In biotech and orphan drug innovation, the US still leads. For all four kinds of drugs, the data from IMS and Grabowski show that US research productivity has been declining. Other methods for attributing new drugs might come to different conclusions.
Contact: Donald W. Light [firstname.lastname@example.org or email@example.com]
See PhRMA Statement Regarding Benefits of U.S. Innovation: