Chronic Disease Drugs are Big Business, Antibiotics are Not

(A New Year’s Reflection from 2019 in a short series wrapping up 2023)

I have noticed several articles describing how antibiotic development has bankrupted some pharmaceutical companies because there isn’t enough potential profit in selling a ten day course to treat multi-resistant superbug infections.

Chronic disease treatments, on the other hand, appear to be extremely profitable. A single month’s treatment with the newer diabetes drugs, COPD inhalers or blood thinners costs over $500, which means well over $50,000 over an effective ten year patent for each one of an ever increasing number of chronically ill patients.

Imagine if the same bureaucratic processes insurance companies have created for chronic disease drug coverage existed (I don’t know if they do) for acute prescriptions of superbug antibiotics: It’s Friday afternoon and a septic patient’s culture comes back indicating that the only drug that would work is an expensive one that requires a Prior Authorization. Patients would die and the insurance companies would be better off if time ran out in such bureaucratic battles for survival.

Suddenly it’s perfectly clear: There is endless profit potential for countless corporations in America’s chronic disease epidemic and it is in their interest that people with chronic disease stay as sick as possible without dying from their disease. Why risk research money on acute disease when there is no continuing revenue stream to look forward to?

If people did all the things we know could improve their health, pharmaceutical companies, insurance companies, pharmacy benefit managers and many others would go out of business, just like shopping malls and print media companies.

Where are the disrupters in healthcare? Will the perverse motives of the sick care industry create a public uproar? Will the old system someday finally crumble?

Now, I’m just a country doctor but I’m starting to wonder if a system like the one we have can really continue to function much longer.

Happy New Year, American Healthcare.