A new Alzheimer’s drug costs at least £20,000 per patient per year.

But the mainstream media fails to question the power of pills and patents

By Alan Story    

The main role of the mainstream media is to ignore fundamental questions, let the main perpetrators of injustice off the hook, distract readers with side issues, and, more generally, “manufacture consent”, as Herman and Chomsky explained three decades ago when they talked about the propaganda model of communications.

What other conclusion can we draw when we look at how various media have covered the 22 August news story that “the first drug to slow the progression of early stage Alzheimer’s will not be available on the NHS in England”? (The cover photo shows brains afflicted by the disease.)   

The cost of Lecanemab, as well as the cost of administering and monitoring its use, could not justify the use of NHS funds as the treatment did not represent “good value to the taxpayer,” an agency concluded.

But private patients in the UK will henceforth be allowed to take Lecanemab if their private medical insurer agrees. In the US, Lecanemab costs about £20,000 per patient per year.

WHY IS LECANEMAB SO PRICEY? 

Not a single media outlet I read asked: why does the drug cost much?

The Telegraph blamed the NHS for not splashing the cash.

Other media focused on a range of side issues, such as whether the true costs had been calculated and the medical efficacy of Lecanemab.

I am not a medical doctor and so will ignore therapeutic matters connected with this drug or suggest how to best treat this vile condition called Alzheimer’s disease. 

But I did teach intellectual property law --- which includes patents, the legal and financial foundation of the pharmaceutical industry ---- for 17 years at two UK universities and have written various academic articles on the law and the drug industry aka Big Pharma.  (And to add: my mother died in 1991 in Canada of complications resulting from Alzheimer’s).

With that background, let me make a few basic points about the Lecanemab story:

“COULD YOU PATENT THE SUN?”

Dr Jonas Salk, inventor of the Salk vaccine for polio.

1) Don’t assume the creation and production of new pharmaceutical requires the patent system.

Big Pharma constantly tells us new pharmaceuticals simply would not come into being unless we had a patent system. (The patent system awards a government-backed exclusive property right in new inventions. That, in turn, gives the owner a monopoly in the production and sale of the patented product or idea.)

In fact, patents are NOT a precondition to develop new drugs and we would not go back to the dark ages if they were abolished. For example, back in the 1950s, the world faced an almost unchecked pandemic from the viral infection called polio. At its peak almost 500,000 people a year, including many children, died or were paralysed by polio. There was no known cure.

But by the mid-1950s, a US researcher named Dr. Jonas Salk developed a vaccine --- later called the Salk vaccine --- which had proven to be “safe, effective and potent” in preventing polio. Questioned on television as to who owned the patent on the vaccine, Salk replied “Well, the people, I would say” because millions of dollars had been raised by a US charity to fund his research. He continued: “There is no patent. Could you patent the sun?”

Instead of becoming a global commodity, the Salk vaccine was soon afterwards  freely distributed across the world and many, many lives were saved. (For more on Salk, read here and here.)  In this decade, many parts of the world have never received patented anti-Covid vaccines.    

Why can’t millions of older people be saved from the ravages of Alzheimer’s when a good non-patented cure is developed in the future …and why should only those with private medical insurance be able to access such a medicine? 

In recent decades, millions have been raised by charities to fund research into Alzheimer’s. Millions have also been donated by governments to pay university research labs and the salaries of its researchers. How about following in Dr. Salk’s footsteps 70 years later?  

And remember: by 2050, it is projected that 150 million will be afflicted by this killer world-wide.    

2) The huge profits of the pharmaceutical industry (and the high prices for its products) are directly attributable to the existence of the patent system.

It is impossible to discuss the Lecanemab story without also talking about the patent system. Not mentioning the patent system is like talking about the government of the UK without mentioning elections or political parties.  Yet none of the news or analysis articles I have read even use the word “patent”

As already mentioned, a patent holder/ owner is given monopoly power by the state. It receives this unrivalled power for a period of 20 years… and that period can even be extended by a legal fiddle through a process known as “evegreening.” 

As a result, the owner of the patent – usually a multinational such as Pfizer, Novartis, or GlaxoSmithKline PLC – is given the power to charge whatever it decides it needs and wants. And with the pharmaceutical sector regularly gaining a higher rate of return on capital than any other sector of the economy, what the sector deems it ‘needs’ often comes at a very high cost. (More on this in a moment.)

HUGE FEAR OF GENERIC COMPETITION

A huge fear of Big Pharma companies is that generic drugs will be developed that will compete --- at far lower prices --- with their patented pharmaceutical medicines. (A generic is a prescription drug that has the same active-ingredient formula as a brand-name drug.)

Look at the case of Biogen, a US drug company that has jointly developed Lecanemab with the Japanese firm Eisai (Most news stories did not even include the names of the drug companies behind Lecanemab. Google “Biogen” or “Eisai Annual Report” and learn about their corporate profile and profits. Quite enlightening! ) 

Biogen used to control the Multiple Sclerosis (MS) drug market in the US ---- again thanks to its patent ---- with its drug used to treat MS. But as soon as a generic competitor was developed Biogen suffered a serious economic “downturn” and prices plummeted. 

Just this week, the business press is reporting on a law suit where it is alleged that Biogen “ spooked by the prospect of earlier-than-expected US generic competition to its powerhouse MS brand Tecfidera, … entered into illicit agreements … to stifle generic competition while it “scrambled” to switch the market to its follow-on brand.”

A suggestion to those calling for more research into Alzheimer’s: advocate that a generic drug be developed. It will result in far cheaper medicines than anything a company such as Biogen will ever provide.   

3) The pharmaceutical industry makes billions every year

In a brief article such as this it is difficult to give a full picture of the profits gained by the pharmaceutical industry worldwide. Here, however, are a few bullet points:

+ the most profitable single company in the world in terms of profits per second is Pfizer, which hauled in profits of US$31.37 billion in 2022. That’s US$994.80 per second.

+ “ the prices the (drug) industry charges for its prescription drugs (in United States) have escalated at 4 to 5 times the cost of living increases during the past two decades,” concluded one academic study. It added: “the world’s 20 largest pharma companies realised 80% of the growth as a result of exorbitant price hikes.”  

+ The global pharmaceutical market has experienced significant growth in recent years. For 2023, the total global pharmaceutical market was estimated at around 1.6 trillion U.S. dollars. This is an increase of over 100 billion dollars compared to 2022 and more than a six-fold increase in the past 20 years.    

GROSS PROFIT MARGINS OF 71%

 + An academic study by the University of Southern California's Leonard D. Schaeffer Center for Health Policy & Economics has found that the gross profit margin of pharma companies in the U.S. was 71%, so the excuse of high research and development costs is questionable.

I think the point is clear: Big Pharma is rolling in $$$.  

4) What about the high cost of developing new drugs?

The last part of two sentences above hints that the large profits of drug companies might be justified by some because it costs a lot to develop new medicines. This is an argument often advanced by Big Pharma and its supporters.

Few would deny that developing new drugs is expensive and time-consuming process. I made that point in my own previous academic writing.

But call such spending an “investment” and the picture becomes much clearer. Fossil fuel companies spend a lot of money finding new supplies in the Arctic or the open ocean. Big tech companies may spend years developing new software. Indeed, few companies can earn mega profits without such investments. Pharmaceutical companies are no different.

The question to be asked about pharmaceutical companies is NOT how much did it cost them to develop a new drug. Rather the question is: what is your rate of return on the investments that you made? For decades, the pharmaceutical industry had a highest rate of return of ANY other sector of the economy. In 2024, it is no longer in first place, but it is not too far behind other sectors.

There is much more to say about how the pharmaceutical industry operates. That’s for another column.

To conclude: our news media has really missed the boat in how it has covered the Lecanemab story and has done a disservice to the many in this country, especially older people, who badly crave an escape from the possible clutches of Alzheimer’s disease in years ahead. And for all of us no matter our income level.

Lots of us who are older than 65 do NOT consent as to how this process is proceeding.

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 Edited by Alan Story, THE LEFT LANE is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber:  http://theleftlane2024.substack.com/subscribe

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