Last week, the Indian Supreme Court ruled against allowing Novartis to patent Glivec, a cancer drug often used in treatment of leukemia. This allows other companies to continue to sell generic versions of the drug at a fraction of the cost Novartis charges. Organizations like Médecins sans frontiers and the Cancer Patients Aid Foundation (who led the court case) applaud the ruling as a 'landmark' for inexpensive access to cancer medication. For me, the media coverage highlights an already well-known fact: the role privately-owned-and-operated, for-profit corporations play in the development and dissemination of life-saving medication. It highlights the unsettling overlap of the free market and healthcare.
The overlap is of course unsettling to me, a Canadian who entrusts access to healthcare and coverage of costs to the provincial government. But perhaps the Novartis ruling is such a landmark because it also highlights the very influential and powerful role third-body institutions like the court system can play in mediating between free enterprise and those in need of healthcare. Perhaps this story should actually settle me because it demonstrates that there are checks and balances in place to ensure that the purveyors of cancer medicine are constrained by the rule of law. I am ecstatic and excited that more people will have access to a cheaper version of a drug needed for them to survive a terrible disease. But the $4.7 billion (US) that Novartis made on Gleevec last year just doesn't sit right.
I heard myself say once that pharmaceuticals saved my life. I was startled to hear myself attribute my survival to an industry, especially because the medication worked in combination with a team of expert doctors, nurses, pharmacists, radiologists, radiation technicians as well as years and years of research on how exactly medications can be most effective and used together. But without powerful, targeted medication, my treatment and survival (if at all) would have looked a lot different. It's true, I owe my life in a large part to an industry that is motivated by their bottom line. An industry that inevitably, profits from my disease.
I have no answers to these musings. I am an expert in nothing but my own experience. And I know that much of cancer research is funded by government, non-profit organizations and hospitals. My very basic research on this topic has led me to a book called "Big Pharma: how the world's biggest drug companies control illness", and that will be a starting point for me to understand more on this issue (or at least one side of it).
The Novartis ruling is an opportunity for all of us, survivors and supporters, to reflect on the balance of power in the development and dissemination of cancer medications. Who makes decisions about the availability of medication? The courts? Patients? Doctors? Pharmaceutical companies? If a cure is still so far from our grasp, its time to reflect on this dynamic and put our focus on where power belongs. To the only player who is completely indispensible in cancer experience. The patient.
So who's looking out for the patient?