Teaching Old Drugs New Tricks
Pharmaceutical companies won't study whether cheap old drugs work better than expensive new ones. But NIH should.

Suppose a researcher discovered that some cheap, long-available drug could treat a devastating disease. Patients wouldn't need exorbitantly priced new drugs, and they might be able to avoid surgery. Insurers and hospitals would save millions by adopting the economical new treatment.

It would be great news for everyone—except pharmaceutical companies. They don't care if old, off-patent drugs have novel uses. Their profits depend on new, expensive, patented drugs. They're not about to undertake costly testing to prove that a discount drug whose patent has expired works as well a pricey new one.

Since the pharmaceutical companies are the economic engine behind drug development, and since there is no incentive for them to find new uses for old drugs, such research is no one's mission. A Wall Street Journal story last month nicely illustrated the problem, describing the inability of Dr. G. Umberto Meduri to get sufficient backing for a major study to prove what his small, promising studies have indicated: Low doses of common steroids can help prevent death by sepsis, an often deadly bloodstream infection. The steroids, no longer under patent, cost about $50 per course of treatment. Eli Lilly & Co., the Journal points out, has just released a new sepsis drug that costs $7,000 per course. And Lilly is spending millions to promote its drug.
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Isn't the free market just wonderful?