A Tangled Web of Self-Interest
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at the moment when the Merck or the Guidant (or the Goldman Sachs) tragedies were brewing inside each of these companies, what were the protagonists thinking? Scandals don’t materialize overnight; they begin with tiptoeing around the boundaries of the norm, until it feels comfortable to push a little further and the lines between proper and improper blur. And no industry is immune from this.
In life sciences, the same web of self-interests that holds the enterprise together constantly threatens to tarnish it. Academic researchers want tenure and funding; the medical journals want to keep their citation indexes high and their names in the press. The media wants to ramp up circulation; the journalists want a Pulitzer. The biotechnology companies want to survive to the next funding round; the pharmaceutical companies need to sell their drugs. The FDA wants the media, the public, and Congress off its back.
To satisfy these interests, patients’ lives are sometimes jeopardized. It happens when a promising research study is smeared by a scientist so a competitor does not get published. Or when the result of a conflicted study is hyped and the journal, plus the academic institution or company responsible for the research, get prime time visibility. Or when a biotech company shelves a drug candidate because it isn’t sexy enough for its venture backers or might hinder a possible IPO. Or when a pharma company kills a program because it’s just not worth it to deal with the FDA’s stringent requirements for that indication. Or when the FDA bows to pressure, on either end of the spectrum, to clamp down on drug approvals or make drugs more readily available, making decisions that are not always guided by patients’ best interests.
These are all examples of selfishness, some at a small scale, and they are the seeds from which the scandals of the future grow. They happen because in the day-to-day it’s easy to lose sight of the overarching goal of life sciences: to improve patients’ lives.
I will leave you with one last thought: Imagine these collateralized debt obligations had been treated as drugs—or more to the point, if they were treated as drugs are supposed to be treated. Imagine if, as potential new products to be unleashed on the market, the companies that created them first had to submit a voluminous packet to the SEC describing what the CDOs’ “ingredients” were, exactly how they were created, and what population they were geared towards. Imagine if the SEC had then asked these investment firms to spend hundreds of millions of dollars testing them out in market models, and in volunteers, for two or three years. And after that, imagine if the results of all that testing were presented to an independent panel of financial experts and upon any concern that these products might hurt people the SEC denied them from entering the market. I know, I know—what an utterly unrealistic scenario. Yet what a different ending this story might have had.