Prescription medication is a ubiquitous part of contemporary life in Canada. In a given month, more than half of Canadians aged 18-79 report using at least one prescribed medication, while nearly one-quarter (24 per cent) report using three or more. Certain medications – like those for mood disorders and high blood pressure and cholesterol – are common across gender and age. These are the medications that are more likely to be covered, at least in part, by provincial or private drug plans. They are also medications that tend to receive more funding for research and development – and rightfully so, their availability improves quality of life and makes it possible for people to live longer, healthier lives. But people with less common illnesses tend to have to fight for their medications – which also allow them to live longer, healthier lives – to be covered, or even made available to them, and the amount of funding that goes towards research and development for new or more effective treatments is often negligible because it is more difficult for drug companies to turn a profit off them.
One of the most underserved groups is pediatric cancer patients. Pediatric cancers – those that affect children 14 and under – are exceedingly rare (around 1000 Canadian children are diagnosed with cancer every year) and utterly catastrophic (while pediatric cancer patients have a five-year survival rate of 82 per cent, cancer remains the number one disease killer of children, and the second-leading cause of death of Canadian children overall).
Although the five-year survival rate for children with cancer continues to trend upward, the brutal effects of existing treatments on children’s bodies mean that many pediatric cancer survivors face a variety of devastating, long term, and often permanent side effects, from stunted growth, to neurological impairments, to heart, lung, and thyroid diseases, tooth loss, vision loss, hearing loss, infertility, and even secondary cancers caused by the toxicity of the treatments themselves. The financial costs of treatment for pediatric cancers also tend to be higher than the cost of treatment for adult cancers. And for some children, like those with rare brain cancers like Diffuse Intrinsic Pontine Glioma, the dearth of research into treatments means that a child diagnosed today has the same fatal prognosis as a child diagnosed 50 years ago.
Potential treatments for rare diseases are unprofitable – and therefore out of reach
It is at this juncture, and those like it – a place where the number of those requiring pharmaceutical treatment is so low, but the stakes when we get it wrong are so very high – that Big Pharma’s crushing grip on the world of medicine becomes abundantly clear.
Because in the for-profit pharmaceutical industry, what drives research and development is not the preciousness of human life, but the amount of revenue that Big Pharma companies think they can extract from new medicines based on perceived demand. Investing financial and human resources in developing treatments for the hundreds of thousands of children worldwide who are diagnosed with cancer each year is, simply put, unprofitable. There are other complicating factors when it comes to developing new pediatric cancer treatments, including the relatively small numbers of children diagnosed every year, but there’s no question that economic incentives and disincentives are a major factor.
Despite the fact that the existing for-profit pharmaceutical industry profoundly fails the most vulnerable in our society, sick kids, Big Pharma and their lobbyists and front groups threaten Canadians with the dire warning that if we win pharmacare – and if that plan isn’t suitably deferential to industry – research and development will falter. These companies offer so little, and what little they do offer, they wield like a weapon – do as we want, or we’ll hold your health hostage. This despite the fact that pharmaceutical companies are already among the most profitable in the world and the bulk of R&D is heavily subsidized from public sources.
When it comes to R&D, these companies aren’t just failing children – they’re failing all of us. According to the Patented Medicines Price Review Board, only five per cent of Big Pharma’s sales are invested back into researching and developing new medicines. That is to say that although financial circumstances could not possibly be better for Big Pharma than they are in this moment, these companies still invest more in advertising, share buybacks, and salaries for their top executives than they do in ensuring that illnesses are treated.
Medicine is a public good – it doesn’t need to be profitable
Medicine belongs to the people. The research and development of new medicines should not be wielded as a cudgel by pharmaceutical companies hoping to ensure their extraordinary profits, it should be conducted with the goal of improving quality of life and ensuring that no one suffers and dies needlessly. September is Pediatric Cancer Awareness Month, and when it comes to the incentives for researching and developing new treatments for these devastating diseases, this month – and every month – we should be focused on working towards a future where financial incentives aren’t a barrier to a cure.
Alex Birrell
Alex Birrell is one of the Council of Canadians Communications Officers, specializing in Research and Analysis.
