J. David Schaffer’s comment

Barry Blackwell: Corporate Corruption in the Psychopharmaceutical Industry
Revised

 

             Barry Blackwell quotes Melody Peterson, an investigative reporter for The New York Times: "Selling prescription drugs - rather than discovering them - has become the pharmaceutical industry’s obsession.”

             This dynamic has also been observed in the consumer electronics industry. When a company, once innovative, becomes large, its management tends to become filled with people who are very risk-averse. Innovation is risky, by its very nature. Hence, these big companies generally decline and often cease to innovate at all. They become marketers of others’ innovations. Then who are the innovators? These became the start-ups. So, the big companies accomplished the out-sourcing of risk. Why would anyone deliberately take on another’s risks? The reason is simple: they have little to lose. A startup has minimal capitalization, so if it’s lost, it’s not that big. When a company gets big, it has much to lose. This dynamic seems endemic in capitalism itself.

             I witnessed this dynamic in the 25 years I spent in the consumer electronics industry. Once in the 1990s, when talking with a management consultant for the pharma industry, she described the same dynamics unfolding there.

             When Barry goes on to say that "...the multi-axial system invited the integration of biological, psychological and social dimensions...," I ask: "What else would one expect when the fundamentals of mental dysfunctions are nearly completely unknown? Humans strive for some kind of guide in the face of profound ignorance, but any attempt that actually precedes the real knowledge is doomed to be wrong, at least to some and, usually, to a great extent. With a wrongly-based guide, we are open to all manner of abuses.

             While Barry states that the reduction of NIH grant support fell by two-thirds in 1990s, the stat I have often heard is that in the mid 1990s the expectation for an NIH grant application to be funded was about 1 in 4. Today it is considerably less than 1 in 10. At least part of this is the result of the frozen NIH budget (since the mid 1990s) and the exponential growth of the research community. Congress has been penny wise and pound foolish. I hear that Trump’s budget proposal actually calls for a 20% DECREASE in NIH funding.  This while many including Nobel laureates have called for a DOUBLING of the budget (Gingrich, 2015; AARP, 2017).

             Although Barry offers suggestions for US legislators, at this point I would love to see an international comparison of the laws governing the approval, researching and marketing of drugs. Is the USA the dumbest country on the planet?

             Regarding Barry's concluding synopsis, I like it a lot. Thanks for writing it, Barry. I do fear that this is just one facet of a much larger failure of America. It’s happening all over in almost the exact same way.

             The computer game theorist Hans Berliner once said, “The number one rule in evolution is don’t make big mistakes.”  One big mistake can mean extinction, and then it’s game over. I claim the main reason for the triumphs of democracies over tyrannies in the last few centuries, is that “efficient” states have too few decision makers with too much authority. Sooner or later they make a big mistake. That’s why they have all failed. The growth of the super-rich and their dominance of our decision making is clearly moving in this direction. Instability and collapse are the inevitable result.

References

Newt Gingrich, Newt Gingrich: Double the N.I.H. Budget, New York Times APRIL 22, 2015, www.nytimes.com/2015/04/22/opinion/double-the-nih-budget.html, [last visited 2017-04-10].

American Association of Retired Persons, Senate appropriations subcommittee convenes hearing on nih budget. june 2013, www.aacr.org/advocacypolicy/governmentaffairs/pages/senate-appropriations-subcommittee-convenes-hearing-on-nih-budget46ba74.aspx#.woo-8owchiu [last visited 2017-04-10].

August 3, 2017