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      Why are our medicines so expensive? Spoiler: Not for the reasons you are being told…

      article-commentary
      The European Journal of General Practice
      Taylor & Francis

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          Abstract

          Often described as a natural economic trend, the prices that pharmaceutical companies charge for new medicines have skyrocketed in recent years. Companies claim these prices are justified because of the ‘value’ new treatments represent or that they reflect the high costs and risks associated with the research and development process. They also claim that the revenues generated through these high prices are required to pay for continued innovation.

          This paper argues that high prices are not inevitable but the result of a societal and political choice to rely on a for-profit business model for medical innovation, selling medicines at the highest price possible. Instead of focusing on therapeutic advances, it prioritises profit maximisation to benefit shareholders and investors over improving people’s health outcomes or equitable access.

          As a result, people and health systems worldwide struggle to pay for the increasingly expensive health products, with growing inequities in access to even life-saving medicines while the biopharmaceutical industry and its financiers are the most lucrative business sectors.

          As the extreme COVID-19 vaccine inequities once again highlighted, we urgently need to reform the social contract between governments, the biopharmaceutical industry, and the public and restore its original health purpose. Policymakers must redesign policies and financing of the pharmaceutical research and development ecosystem such that public and private sectors work together towards the shared objective of responding to public health and patients’ needs, rather than maximising financial return because medicines should not be a luxury.

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          Most cited references40

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          Unintended consequences of expensive cancer therapeutics—the pursuit of marginal indications and a me-too mentality that stifles innovation and creativity: the John Conley Lecture.

          Cancer is expected to continue as a major health and economic problem worldwide. Several factors are contributing to the increasing economic burden imposed by cancer, with the cost of cancer drugs an undeniably important variable. The use of expensive therapies with marginal benefits for their approved indications and for unproven indications is contributing to the rising cost of cancer care. We believe that expensive therapies are stifling progress by (1) encouraging enormous expenditures of time, money, and resources on marginal therapeutic indications and (2) promoting a me-too mentality that is stifling innovation and creativity. The modest gains of Food and Drug Administration-approved therapies and the limited progress against major cancers is evidence of a lowering of the efficacy bar that, together with high drug prices, has inadvertently incentivized the pursuit of marginal outcomes and a me-too mentality evidenced by the duplication of effort and redundant pharmaceutical pipelines. We discuss the economic realities that are driving this process and provide suggestions for radical changes to reengineer our collective cancer ecosystem to achieve better outcomes for society.
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            Selling sickness: the pharmaceutical industry and disease mongering.

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              The drug and vaccine landscape for neglected diseases (2000-11): a systematic assessment.

              In 1975-99, only 1·1% of new therapeutic products had been developed for neglected diseases. Since then, several public and private initiatives have attempted to mitigate this imbalance. We analysed the research and development pipeline of drugs and vaccines for neglected diseases from 2000 to 2011.
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                Author and article information

                Journal
                Eur J Gen Pract
                Eur J Gen Pract
                The European Journal of General Practice
                Taylor & Francis
                1381-4788
                1751-1402
                1 February 2024
                2024
                1 February 2024
                : 30
                : 1
                : 2308006
                Affiliations
                Institute for Innovation and Public Purpose, University College London , London, UK
                Author notes
                CONTACT Els Torreele e.torreele@ 123456ucl.ac.uk Institute for Innovation and Public Purpose , London, UK
                Author information
                https://orcid.org/0000-0002-2566-3770
                Article
                2308006
                10.1080/13814788.2024.2308006
                10836477
                38299574
                4fb1e6df-7f40-4d9e-9a57-5b45ae3afe3a
                © 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.

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                Page count
                Figures: 1, Tables: 0, Pages: 9, Words: 5965
                Categories
                Comment
                Opinion Paper

                Medicine
                Medicine

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