From Sam Edge, Ringwood, Hampshire, UK
Most of the cost of drug development comes from the public purse, not from the large pharmaceutical companies (3 June, p 22). Independent research has repeatedly shown that these companies spend only around 15 per cent of their revenue on research and development. Tellingly, most spend at least twice as much on marketing. The remuneration of the bosses has risen inexorably for no other reason than it has been able to.
From Bryn Glover, Kirkby Malzeard, North Yorkshire, UK
It is commonplace these days to encounter companies set up with notional dual objectives: to meet social needs at the same time as making profits for shareholders. I can think of no example where the two motivations haven’t sooner or later come into conflict as, for example, when economic forces place pressures on profits and the social need is pushed into second place and suffers.
A company may be supplying multimillion dollar drug regimes, as Clare Wilson describes, or social carers for pennies, storing up the crisis that James Bloodworth predicts (3 June, p 24). Whatever their initial ambitions, the profit maximisation imperative eventually takes over.
The obvious long-term solution in both cases is clear. All aspects of health and social care must be brought under social ownership and control. That way, the efforts of the universities – alluded to by Wilson – will be recognised; investment can be directed purely towards need, rather than towards areas of maximum potential profit; and any profits can be fed back into the system itself rather than into the pockets of remote and uninterested investors. (The above letters appeared in June 2017 editions of New Scientist, and have been edited for the sake of brevity).
My comment: the horse is long out of the stable. There is no public appetite for nationalization, and in any case government is rarely any good at managing companies. However, if company wants to do business with the NHS, there should be communitarian rules: limits on what companies should pay their CEOs (say no more than ten times the average salary?); no television advertising of ethical pharmaceutical drugs; the banning of gifts (inducements) to prescribing doctors. Or, if companies groan under this regime, they should be able to repay the government and universities for all research costs, and thus have more control Let pharmceutical companies make profits by all means, but, in the spirit of Epicurus, moderate profits. It is not acceptable for the public to be paying for most of the research only to be ripped off in the pharmacy.