Allow me to rant for a moment.
We typically regard the various diseases that afflict modern humans as problems, sometimes as tragedies. Modern diseases cause pain, impair day-to-day functioning, prompt prescription pharmaceuticals, hospitalization, diagnostic procedures, sometimes premature death.
But I learned long ago that there is a flip side to human disease: profit.
Conduct a search for something like “trends in rosacea,” a common skin condition that afflicts between 5-10% of the U.S. population. You might (with some effort) uncover the epidemiological surveys that track the growing incidence of this condition. But you will also readily come across numerous market analyses gushing over the revenue opportunities of this condition, the expanding potential for revenue, and the push to switch from inexpensive generic antibiotics for treatment towards more costly agents. Take a look at this market report that took me all of 30 seconds to find: “The global rosacea treatment market size is expected to reach USD 2.6 billion by 2025 . . . It is anticipated to register a CAGR [compound annual growth rate] of 6.8% over the forecast period. Several factors such as an advanced formulations and high prevalence of the disease are forecasted to fuel the market growth.” Another market report states ” . . .the presence of generic drugs to curb related symptoms hinders the growth of the rosacea market.” In other words, the push by industry is not based on efficacy nor an understanding of the disease, but on revenue opportunities and profit. You will certainly hear no mention of the growing appreciation that rosacea is the result of a disrupted intestinal and skin microbiome, explaining why this condition can respond, at least transiently, to topical and oral antibiotics.
All you need do is to read annual reports filed by pharmaceutical companies with the SEC every year to recognize that, in their view of the world, disease is not tragedy; it’s opportunity.
Don’t get me wrong: I am in full support of a healthy business climate and robust capitalism. What I am NOT in favor of is exploitation, manipulation, and deception for profit. In the world of rosacea, for instance, let’s accept that the profit-seekers in the pharmaceutical industry choose to be willfully ignorant of the growing evidence that this skin rash is a product of a disrupted intestinal microbiome. Because the skin rash recedes temporarily in most people who are prescribed inexpensive generic antibiotics such as tetracycline and doxycycline, they are working to better capitalize on this market by developing biologic agents costing thousands of dollars per month and typically accompanied by potentially dangerous, sometimes lethal, side-effects—because it is more profitable. That’s not capitalism; that’s exploitation.
It means that the drugs that most doctors prescribe are not based on efficacy and safety, but on marketing. Pharmaceutical companies fund the science that is likely to yield the most costly agents, not the agents that actually address underlying causes. And, because doctors willingly and enthusiastically drink the Kool-Aid of Big Pharma, they tend to prescribe the agents that are most heavily marketed to them, largely unaware of the science that suggests that basic nutritional and microbiome efforts could yield results superior to what pharmaceuticals would achieve without the cost or risk of serious side-effects.