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What’s up with Le Carre and drug companies?

I have devoured pretty much most of John Le Carre’s spy stories, such as The Spy Who Came in From the Cold, Tinker, Tailor, Soldier, Spy, A Small Town in Germany and Smiley’s People. His novels have a chilly, grittily believable quality that stands in contrast to the sophisticated romps of Ian Fleming (Who is actually a pretty good read, as Anthony Burgess once said). More recently, Le Carre, bereft of a Cold War to provide his theme, has turned his attention in a different direction. He has turned it towards the supposed evil of global capitalism and big drug firms.

The Constant Gardener, a film which hammers the allegedly rapacious activities of drug companies, has now been turned into a film starring the British actor Ralph Fiennes (whom I once saw live giving a somewhat histrionic performance in London in the Ibsen play, Brand). The Social Affairs Blog, has a fine demolition job of the book and film here by UK academic Kenneth Minogue. Minogue’s treatment of the film is brutal.

Now I can see why, as pointed out on this blog concerning the firm Pfizer, some drug companies get a deserved hammering. But what I don’t quite understand is the sheer venom directed at drug firms in general by people who presumably must realise that developing and researching drugs can be highly expensive. If drug firms cannot be sure that their products won’t be instantly copied by other manufacturers, who can be sure that drugs to combat AIDSand other killers would make it to the marketplace? The issue of intellectual property rights does of course remain a very tricky issue among libertarians, but do the opponents of any such property rights imagine that we can or should leave drug development to the State, given the experience of our own Soviet model of national health care? It seems as if the attacks on drug firms stems from a desire to seize the hard work and graft of others because one has a “right” to curative drugs.

But if, as Le Carre and others contend, we should give drugs to the poor of the Third World for nothing, the bill for this could be enormous. I don’t really like the idea that the wealth creating capabilities of people should be held in partial ransom by the open-ended needs of billions of other people.

On the subject of AIDS, it is always worth reading Andrew Sullivan, who has HIV, on why he loves drug companies.

36 comments to What’s up with Le Carre and drug companies?

  • Patrick

    I so heartily agree! The worst part is people actually believing this kind of ‘big-pharma’ crap. Whilst there is clearly nothing angelic about big pharma businesses (did anyone catch that last word, businesses?) I shudder to imagine a world without them.

    That Sully post had particularly struck me, too, what a refreshing reminder it was! I quoted it to an anti-IP twit who felt sure that the ‘capitalistic system’ merely meant that such drugs were produced less efficiently since a) scientists produced uneccesary duplication of effort and b) not all research was devoted to important ends.

    Oh well.

  • Nick

    The point about the film lacking in political reality is perfectly true, but the review you link to is ridiculous. I’ve seen this film and I thought it was excellent. I can’t remember the details of the plot about the drug company because it wasn’t really important. What made the film excellent were the performances and the tragedy of a man discovering too late that his wife really did love him. The drug company was incidental, a Hitchcockian McGuffin. Criticising this film on the basis of its shaky grasp of political realities is like criticising The Economist for its lack of romance. If I want to watch a film about politics, I’ll stick to Starship Troopers.

  • Johnathan Pearce

    Nick, tell you what, I’ll see the movie and then we can compare notes. I’m serious.

  • Bernie

    This question applies to me to some extent. There are many issues and they are probably too complex to cover in a short comment but here is a stab in ascending order of oddness.

    1. I see no need for their stop state granted monopolies.

    2. Drug companies are powerful lobbyists for all kinds of nasties. The recent EU crap about vitamin and dietary supplement regulations was largely sponsored by drug companies and the post a few days ago about drug company sponsored anti tobacco lobbyists are two recent examples.

    3. Drug companies love the NHS and think they have a vested interest in keeping it and expanding it.

    4. Drug companies promote drugs. (????) Every real or PR created problem can be solved by taking a drug. Or the converse; Every problem is a result of a chemical imbalance or defficiency put right by our new drug. See the justification for Eli Lilly’s Prozac on their own web page by their own “doctor”. Depression is the result of a chemical imbalance. Losing your wife or job are only superficial causes!

  • Jake

    Bernie.

    Depression is a serious illness that affects many people. The invention of SSRI’s (like Prozac) in the 1990s was one of the great medical achievements of the 20th Century.

    In America, these drugs have emptied our medical health hospitals and created a surplus of psychiatrists. These drugs have saved society hundreds of billions of dollars in lost productivity and health care costs.

    There still is a large social stigma connected with depression and many people will not seek treatment because of that stigma. So I like to see drug companies advertise their anti-depression drugs the way they do to get mentally ill people to seek a cure.

  • Noel Cooper

    A thought experiment if I may. Bird flu is ravaging the nation and tamiflu is unavailable or at an exorbitant price. Happily it is discovered you can make your own tamiflu in the kitchen by combining dettol, baking soda and mr sheen. Would you make it or say “no, breaking a patent is wrong and pain and suffering is a worthy price for that principle”? Secondly, if you do make it, what would your reaction be when Roche and/or agents of the state attempt to seize your property or freedom because of your heinous crime?

    Apologies if this appears trite, but I want to suggest what is and what is not reasonable enforcement of a patent. In the west, with wealthy consumers, patent protection encourages investment and is reasonable. Where people cannot in any way afford your product and it is life saving, patent protection is unreasonable. Drug companies do not make this distinction (TRIPS for example) and make themselves targets as a consequence. Yes it may happen that cheap african drugs trickle back into the west (although I am not alone in thinking that may be a red herring) but that is not an intractable problem.

    In summary, it is not unreasonable to ask that the mercantilist behaviour of drug companies is examined and where necessary contested, making out that their critics are all pinko-socialists is unhelpful.

  • Jake

    Noel:

    The Trial Lawyers Association is having countless seminars all over America on how and who to sue over the bird flue vaccine

    Topics covered are who and how to sue if:

    There is no bird bird flue vaccine.
    There is a shortage of vaccine.
    There is an imbalance in the supply
    The vaccine doesn’t work for all types of bird flu
    The vaccine saves a person’s life but the person still gets sick.

    What company is fool enough produce vaccine and then get sued into bankruptcy no matter what happens. At the minimum, just as the drug companies do now, they will add a large premium on the price to pay for the lawsuits that are sure to be filed.

    The fastest way to end drug shortages and reduce drug prices is to reign in the The Trial Lawyers Association.

  • I am largely with Nick. I liked the way the love story was presented, and I liked the performances. I also liked the photography. (Africa can be rather intoxicating at times, and the film captured it).

    The whole big pharma angle was deeply stupid and paranoid, however. Yes, big pharmaceutical companies exist to make money. Yes, they are a bit cozy with states at times, and (like most businesses) they like it when they are granted monopolies and legal protection from competition. That’s the downside. The upside is that they make products that cure the sick, and most of the people who work for them are decent people who care about this aspect of it as well as making money. And the idea that a pharmaceutical company would deliberately rush a product that they know kills people to market (as happens in the film) is absurd, because (a) they would get their arse sued off lately and (b) the people who run corporations generally would generally prefer not to kill people

  • Patrick

    Noel, the precise problem with Tamiflu is that it is expensive and long to make. Otherwise, they’d make more of it.

    I am the only one who has real trouble believing that with governments queing up to buy it, Roche is just not making it out of laziness or spite?

    Also, strictly speaking, if you could make it with those ingredients, it probably wouldn’t involve breaking any of the patents.

  • Patrick

    If you want a better review, can I recommend everyone’s favourite film reviewer?

  • Noel Cooper

    the precise problem with Tamiflu is that it is expensive and long to make

    I am well aware of that. My point is a general one about patents and the production of drugs which are otherwise unobtainable to an individual for financial reasons. I could have used any emergency / drug combination as an example, flu just seems to be rather current. Sorry for the confusion.

    Also, strictly speaking, if you could make it with those ingredients, it probably wouldn’t involve breaking any of the patents.

    Drug patents apply to the active compound rather than the means of production, it is a manufactured article type of patent, not a process one. This is the point that is being made, enforced patents can stop individuals gaining access to something when all other barriers are minimal.

  • The Wobbly Guy

    And given the state of organic retrosynthesis, identifying the structure of an already patented drug and then devising ways to manufacture it is extremely easy.

    BTW, does anybody know how many new drugs the oh-so-excellent non-corporate Soviet system came up with? That should be all the evidence anybody needs to argue for the merits of capitalist, patent protecting, drug research system.

  • Sandy P

    Oh, Wobbly, Castro and his wonderful medical program will save us all.

  • Julian Morrison

    I disagree with patents in principle. That is, even if the result was a utilitarian good, there is no excuse for abridging the right to physical property. That would be such an unmitigated bad that it would overshadow any upside whatsoever.

    However, I also disagree with the idea that drug companies need patent protection. Compare the food industry, who don’t get patents. They also spend money on research, even though their product will end up commoditized. There is still an advantage in innovation.

  • ATM

    OK, Julian, show me a nonpatented food product that costs a billion dollars in R&D to get to market. Then I might believe you.

  • J

    I work with the enemies of big pharma all the time. All of them agree, that it is because of big pharma that we have the drugs we do today, and that without them we’d be worse off.

    But, mercifully, the enemies of big pharma are not utilitarian, and so do not confuse cost/benefit with ethics.

    The main problem with big pharma, basically, is that we don’t really mind Apple making dubious claims about iPod’s making us happier, but we do mind GSK making dubious claims about drug-x making us better.

    People simply don’t like normal capitalist marketing and advertising being applied to healthcare – people see it as the domain of science, of objective truth, impartiality, and so on.

    It’s this clash that gets people in a tizzy. We don’t, quite reasonably, expect corporate brochure, or TV adverts, to be founts of truth an unbiased wisdom. We do (quite reasonably) expect scientific research papers to be. And yet, the papers published by drug companies aren’t.

    It’s hard to imagine, just how low quality and duplicitious some drug company ‘research’ is. It is, quite simply, sophistry. No, some people may say “fair enough, free speech is great, let them publish junk, and let real scientists debunk it.” I tend to favour that approach.

    The problem is that competing pharma companies DON’T criticise each others researcg. It’s left to the limited (rightly limited, some would say) resources of the state to provide impartial analysis.

    The engineer and philosopher in me says we should continue to rain scorn and derision on people who publish junk science and peddle sophistry, from Greenpeace to Glaxo, regardless of how much good for society either of those great instituations provide.

  • The Wobbly Guy

    If you wish to be particularly obnoxious about it, you can argue against drug patents on the grounds that chemicals are simply a conglomerate of subatomic particles interacting in a particular fashion described by a series of mathematical functions. And since somebody had described maths as belonging to the human race as a whole, then we can extrapolate it to mean that there’s no such thing as a patent.

    That’s one heck of a slippery slope.

  • Julian Morrison

    ATM: show me a drug that would still have cost a billion dollars to dev, in an anarchy in which there is no mandated testing (only market incentives to get good independent certification) and where it’s perfectly legal to introduce new drugs as “live beta test, dosage is approximate, may kill you, caveat emptor”.

  • Johnathan Pearce

    J, a lot of what you say is true although I would not be quite so trusting in the ability of state agencies to offer impartial judgements on the efficacy or otherwise of a particular drug. The history of the state in this regard is at best, mixed. Ultimately, competition in ideas and viewpoints is the best defence against shysters. Let’s also not forget that companies in a truly free market are under pressure to acquire a reputation for having safe, workable products. It is usually lousy for business to kill your clients.

    Julian, like ATM, I ask is there a patented food product that costs billions to develop? I cannot think of one off the top of my head.

  • Andrew Duffin

    “we should give drugs to the poor of the Third World for nothing”

    Actually, we (the Pharma industry) do exactly that.

    The issue in the Third World is not the drugs, but the chaotic distribution systems, the absence of any supporting cultural ethos (e.g. no habit of taking the right dose and continuing the course) the complete lack of hygienic facilities, and – of course – the kleptocratic governments, who quite often just filch the free drugs and sell them back to the First World at a huge profit.

    It ain’t as simple as just providing free stuff.

  • ATM

    Well, Julian, while your Wild West pharmacological environment would be certainly interesting, it isn’t the situation that we are in and with our litigious society that demands someone be accountable, it isn’t likely we will ever see such a system. And going back to your food industry R&D statement, I would go further and say that you would be hard pressed to find a nonpatented food product that costs more than a million to develop (ignoring marketing and manufacturing capital investments). On the otherhand, you will find many drug candidates cost tens of millions to identify just to get to the clinical testing phase.

  • ATM

    Well, Julian, while your Wild West pharmacological environment would be certainly interesting, it isn’t the situation that we are in and with our litigious society that demands someone be accountable, it isn’t likely we will ever see such a system. And going back to your food industry R&D statement, I would go further and say that you would be hard pressed to find a nonpatented food product that costs more than a million to develop (ignoring marketing and manufacturing capital investments). On the otherhand, you will find many drug candidates cost tens of millions to identify just to get to the clinical testing phase.

  • Graham Smith

    J is reasonably accurate with regards to the notorious unreliablity of pharmacuetical companies’ published clinical trials. However measures have been put in place to correct that situation.

    The estimate of a billion dollars to develop a drug is probably a substantial underestimate. Big pharma will often spend a billion dollars developing a lead compound which then doesn’t make it through phase II, let alone phase III trials. So the research effort in most cases is massive and if anyone can think of a better system than the current patent system then lets hear it.

    And to build on the comment by Andrew Duffin, GSK for example has a research facility in Spain (Tres des Cantos) which is dedicated to developing cheap (effective) drugs for the third world.

  • The sad fact is pharmaceutical businesses are the finest example of socialist corporatism in the world today. Without first good health, there is then no labor to be economically exploited!

    Under this system at present, patents are “necessary” to: a) recoup the enormous costs of complying with terrorcrat regulations that serve to keep pharmaceutical competitors to a minimum; b) appropriate, via simplistic synthetic analogs, the natural interdependent chemical relationships present in nature. The end-result is drugs with high prices and harmful side effects, of which neither would be predominant in a true free market.

    Fortunately, the USA has an burgeoning unregulated supplement market where the limitations of patents on drug analogs do not apply and complex and largely unpatentable chemical cocktails presenting minimal side effects are sold at relatively inexpensive prices. Unfortunately, as long as there remains no OTC “caveat emptor” channel allowed for in the drug market, the socialist corporatist coercion will continue to be for censorship and regulating the unregulated, rather than encouraging productive competition.

    Machine Ghost

  • Luniversal

    Like the neocon war maniacs, Le Carre in the early 1990s had a problem. The Cold War, such as it had become, was over. He was stuck for an encore.

    Can’t make non-white terrorists the global villain– that would be (horror of horrors) ‘racist’, the sin against the liberal Holy Ghost. How about big ‘faceless’ corporations? Everyone hates them. Hmmm…

    And now that everyone hates the American government too, the problem’s solved! Henceforth the villains will be drug barons, in league with the CIA to hold the Third World down and exploit it. That should keep the ball rolling till the septuagenarian scribe hands in his licence to write pretentious thrillers.

  • Chris Goodman

    I have a DVD of Tinker, Tailor, Solider, Spy, and it is a fine piece of work (I have no idea if the book is up to the same standard) if you want a penetrating [albeit depressing] insight into the mindset of a Pre-Thatcherite but Post-Suez Britain. You therefore inevitably ask yourself how such an intelligent writer could go on to write such Leftist trash (if the reviews are accurate) as his more recent novels. The answer I suppose is that in his earlier books he was writing about a world that he knew quite well.

  • 1skeptic

    one wonders how things like flip-flops ever got made, without the inventor having any ipr. or how newton discovered the laws of gravity. or einstein formulated the theory of relativity, without an all-encompassing commercial patent. and how a libertarian can assent to the government telling him or her what chemical compounds are verboten to produce.

  • Patrick

    The great problem with IP scepticism is conceptual – as indeed previously noted on this blog, one runs around in circles saying ‘look at this drug’ and look at this ‘flip-flop’ (they aren’t patented? Id have said they were certainly patentable!) but since we’ve never really tried without them, we don’t know.

    Maybe the incredible development of the last couple of centuries owes a lot to IP, maybe not? It is hard to ignore the rough correlation between capitalism, patents and innovation, whether or not it is causal.

    Maybe drug companies would still innovate and rely, to the extent possible, on confidentiality agreements, etc. But the big advantage of them is that you have equitable remedies, which only exist in the common law world – even our relatively sophisticated European cousins don’t really have tracing or fiduciary duties.

    And, they often wouldn’t work because as mentioned above, many of the the pharmaceutical industry patents are (relatively) easily reverse-engineered.

    I think it is more productive for now, at least, to focus on easily ‘framed’ issues like patent durations.

  • Johnathan Pearce

    “Like the neocon war maniacs, Le Carre in the early 1990s had a problem,” writes Luniversal. Really? From what I could tell, “maniacs” like M. Thatcher, Ronald Reagan and, for that matter, Helmut Kohl of Germany had no problem at all at having successfully faced the Russkies down, Loonyboy.

  • The drug companies are in cahoots with the government to limit competition. The FDA is an arm of the drug companies just as the ICC became an arm of the rail companies.

    The War On Unpatented Drugs. Gives some insight into what is going on.

    And what do doctors know about all this? More than they let on.
    A well known secret

  • Drugs do help. They are very helpful in anxiety problems (sometimes refered to as PTSD).

    Now why would the drug companies be in the forefront of the anti-pot efforts? Well pot is a pretty good anti-anxiety drug and the last time I looked (around 2002) anti-anxiety medicines were a $42 bn a year business.

    A url to the appropriate article woul go here except that you have your filters wound so tight that it doesn’t get through. Look up my “Addiction or Self Medication?” on Google

    So there you have another significant support for the war on drugs. The “ethical” drug companies.

    And they are against street drugs because they are looking out for the public interest. Just ask their accountants.

  • Jake,

    Anti-depressants like pot have filled our jails.

    BTW tobacco is an anti-depressant.

  • Luniversal

    “”Like the neocon war maniacs, Le Carre in the early 1990s had a problem,” writes Luniversal. Really? From what I could tell, “maniacs” like M. Thatcher, Ronald Reagan and, for that matter, Helmut Kohl of Germany had no problem at all at having successfully faced the Russkies down, Loonyboy.”

    None of these three were neocons. They believed in masterly inactivity– letting the Soviet system collapse under the weight of its own contradictions– whereas Bush sought to cover his embarrassment at the most lamentable failure to defend America in its history by launching an unprovoked, irrelevant and illegal attack on an apparently weak state (and getting bogged down in it). With a view to propping up Israel and the oil business, he has achieved just the opposite.

    Reagan’s most decisive move in the ME was to cut and run from Lebanon in 1982, leaving Israel to fight its own battles for once. Imagine the PNAC-addled Emperor George daring to put America’s national interest first! Four years after 9/11 its borders are porous as ever, jobs are being exported wholesale and potential Asiatic enemies own the US Treasury and currency.

    Likewise, Mrs T’s most notable war was defensive and restitutory– nothing to do with the messianic fantasy about spreading democratic sweetness and light among the clans and bandits of Araby which besets the Head Prefect.

  • Edward

    My beef with the big drug companies is that they use the power of the State to squash the little drug companies. In any industry, startups are a key source of innovation.

    The medical industry is dangerously over-regulated. The bureaucracy increases the cost of drug development by several hundred percent. This completely destroys the market for any medicine that isn’t patentable — because you “need” a monopoly to pay back all those development costs.

    And the alleged safety provided by the regulators is illusory. Properly prescribed prescription drugs are the 3rd leading cause of death in the US.

  • I am against using state power to enforce Intel Prop Rights — even if they DO support innovation.

    Yes, they do. They act, effectively, as an innovation subsidy (to the producer) / tax (on the consumer). Very market efficient. Except that enforcement is not free.

    The more Info Tech empowers users, the HIGHER the cost of enforcing IPR — the Info Revolution is the one where the costs are greater than the benefits.

    One alternative is ending subsidies for innovation. I’d favor that, but not as much as another alternative.
    Honest gov’t subsidies/ taxes for those that innovate, using patent registration and rewards for performance seem a reasonable alternative.

  • David

    This is supposed to be a serious question and I would appreciate any thoughts on this. I agree with Johnathan Pearce that “developing and researching drugs can be highly expensive”. And I feel that recognition for that investment is essential if we want new treatments in future.

    I suppose also that developing and researching new music is highly expensive. But as far as I’m concerned BMI and Sony can hang when they can try to prosecute me if both me and my wife put the same CD onto our separate ipods. Am I being selective?