Friday, 13 November 2015

Another One Bites the Dust: The Demise of the Off-Patent Drugs Bill

Today's article is from our chairman Robin Daly highlighting some important issues and his views surrounding the Off-Patents Drugs Bill.

 Last Friday, Tory Health Minister Alistair Burt used a blatantly unethical tactic - filibustering -  to deliberately block a bill with massive potential to help a wide range of chronic disease and to slash NHS costs. The human cost alone of the suffering that is the direct consequence of this action is sufficient to brand it as callous, inhumane and inexcusable. The description levelled at Alistair Burt was disgraceful. His assurancethat there is another pathwaysurely is a way of saying that there is another pathway that wont have any negative impact on the bottom line of the partys influential friends - the pharmaceutical giants? For what other plausible explanation can be imagined for blocking such a common-sense, practical and direct path to relieving human suffering.

Lets consider the present picture
The pharmaceutical industry regularly delivers the latest blockbuster treatment for cancer, or any other chronic condition. The media trumpets the joyous news (penned by the pharma-marketing department and based on their own trials) far and wide for how safe and effective it is. The cost is astronomic and completely unsustainable in the face of rising diagnoses, but demand from desperate patients can always be garnered to help pressurise the health service to deliver. A little way down the line, the cracks start appearing in the wonder drugstory, the often devastating side effects that have somehow been missedstart to emerge, its effectiveness is, well, mediocre, and maybe doesnt even justify enduring the side effects. But by then, the next blockbuster is lined up ready for the media.

Then there are a range of workhorsedrugs that have been around for years, and for a good reason - they are useful. Doctors are fully aware of their safety profile and their side effects, and furthermore, they are very cheap. They are cheap because the manufacturers no longer hold the patents that enable them to charge whatever they can get. Many of these drugs have been noted to have effects on conditions other than the ones for which they are licensed. The malaria drug artesunate, for instance, is being trialled for cancer with the support of crowdfunding1 at the moment, but has also shown potential in asthma, schizophrenia, organ trauma and probably many other conditions. In cancer alone, the potential for off-patent drugs to bring cheap solutions to sufferers quickly is significant, possibly far greater than with new blockbusters.

Two innovative bills - in the dust
Currently doctors can prescribe any of these off-patent medications as they see fit, but in practice, they simply dont. And the reason for this is the reason that Maurice Saatchi's Medical Innovation Bill was introduced. The Health Service is such a hostile environment to work in. It requires such conformity of its employees, that without some sort of protection, doctors are just not prepared to step out of line and prescribe for anything other than the conditions for which a drug has a license. Saatchis Bill sought to provide a coherent and safe pathway through which doctors would be able to safely stretch the limits of treatment without fear, and to thereby avoid endlessly repeating a failed experimentas Saatchi so accurately described his wifes cancer protocol. Saatchis Bill has, so far, fared no better that the Off-Patent Drugs Bill.

The Off-Patent Drugs Bill sought to provide another safe pathway towards better and cheaper medicine, by enabling the government to license drugs for other uses in cases where there is no financial incentive for businesses to do so. The only group of people who could conceivably have any interest in stopping such an altruistic initiative would be those with something to lose - pharmaceuticals and those in their grip financially or in a myriad of other ways. The sheer scale of this arena of business and its staggering profits means that this group is, sadly, large, and includes substantial numbers from medical and government circles.

Reclaiming our healthcare
A primary function of government is to represent and care for the public. This is never more true than in healthcare. We should be able to depend on our government to do the best for us. Tragically, the government long ago handed over the development of medicines to businesses that have no such mandate. Their prime motive is one of self-interest, which only occasionally is a perfect fit with public interest. If the chief motive driving the development of medicines is profit, then its no surprise that we get expensive medicines requiring long term use. 

It is imperative that we start to find a way out of the crisis of health and healthcare spending and take ownership of healthcare for the public. This is beginning to happen through initiatives such as the enthusiastically crowdfunded artesunate trial - of no interest whatsoever to pharmaceuticals or even to the many established charities that are in their circle of influence2 - and the Off-Patent Drugs Bill could provide a very important step in the right direction. If we leave it to government, it will always listen to the ever-present and insistent profit-driven imperatives of business. If we want wholesome change for the public good, we are going to have to raise our voices.

  2. Bowel Disease UK, a small new charity is supporting the trial of artesunate -

Read more blogs from Robin here

Follow Robin on Twitter at @RMK_Daly

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