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Health & Medicine

Curing Patients and Other Bad Moves

— April 25, 2018

We live in a perverse world when curing patients is bad for the medical business and killing suspects is better for police than merely wounding them.

You’d think that the point of the entire medical industry is to cure patients of what ails them. In a perfect world, it would be. Here in the real world, though, or at least in the for-profit medical industry, curing patients is seen as a way to run yourself out of business.

On the surface it seems perverse, but think about it for a minute. If your pharmaceutical company were to brew up a miracle one-shot cure for any disease, that would end a revenue stream from a satisfied customer (or, more likely, from their insurance company). On the other hand, if you can produce a drug therapy that treats a condition – the deadlier and more expensive, the better – that keeps people coming back (and paying through the nose) for more, well, that’s an income stream to be desired.

That’s why we might not be seeing much in the way of permanent remedies coming out of Big Pharma. Earlier this month, Goldman Sachs analyst Salveen Richter and her colleagues produced a report for biotech firms interested in gene therapy, which could potentially offer single-treatment cures. Suggesting that curing patients is a fiscally unsustainable business model, the Goldman Sachs report pointed out the disaster of Gilead Science’s life-changingly successful hepatitis C cure. The drug, which cost $94,500 for the 12-week course of treatment in the U.S. (and $900 for the same treatment in India) reaped $12.5 billion a year for Gilead at its peak. “Unfortunately,” curing patients reduced the pool of Hepatitis C sufferers and now the company estimates they’ll only make $4 billion in U.S. sales of the drug. Doesn’t your heart just bleed for them?

In a similarly warped way, comments made in 2006 by a California sheriff in a re-election battle prove the same point in reverse. While Donny Youngblood, of the Kern County Sheriff’s office, says that his officers are supposed to use force only to stop threats, the department’s union posted a video of Youngblood making a chillingly different statement. There, Youngblood explains that if a suspect is merely wounded, the department faces a financial liability for the rest of the suspect’s life. However, if officers shoot to kill, the department and the family can negotiate a one-time settlement and then they go away – clearly a better choice, according to Youngblood.

Just as curing patients dries up the revenue stream for drug companies, killing suspects dries up the claims against police departments. A merely wounded yet living sufferer means that police departments have to keep paying, but drug companies rake in the profits.

Soybean plants showing damage from dicamba drift next to a field of resistant plants.
Significant cupping of leaves from dicamba drift on non-Xtend soybeans planted next to Xtend beans in research plots at the Ashland Bottoms farm near Manhattan. Photo by Dallas Peterson, K-State Research and Extension, via Flickr. CC BY 2.0

In a world full of examples, here’s one more. Agribusiness giants like Monsanto sell an herbicide called dicamba, which farmers spray on fields of resistant soybeans in order to kill weeds. However, dicamba doesn’t always stay where it’s put, and when it drifts to other fields where farmers have chosen to plant conventional soy, it can ruin their crops. After watching dicamba wither 25 acres of his non-GMO soy, Darvin Bentlage, a fourth-generation Missouri farmer, said that the solution offered to him was to buy the resistant seed instead, at twice the price. Seems like Monsanto and their dicamba-dealing peers would profit more from producing drifty dicamba and driving sales of their patented seed than they would by doing the right thing. Scott Partridge, a Monsanto VP, blamed drift on incompetent application and denies that farmers could feel coerced into buying seed. Legal action is pending.

The right thing to do isn’t always the profitable thing to do. The more that big, powerful forces in our culture and economy choose lucrative yet harmful actions, the longer we’ll continue to have some of the persistent problems we’re experiencing. How long can we afford to put up with situations like these? At the same time, how can we effectively combat the system when the powerful prefer the status quo?

Related: Dicamba Soy: The Problem is the Solution


It’s Official! Curing Patients Is Bad for Business
“Is curing patients a sustainable business model?” Goldman Sachs analysts ask
Goldman Sachs asks in biotech research report: ‘Is curing patients a sustainable business model?’
Sheriff: It’s ‘financially better’ for cops to kill suspects than injure them
US sheriff once said it was ‘financially better’ to kill than badly injure suspects
High-Stakes Pesticide Battle Pits Farmer Against Farmer

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