In a week when President Trump is upsetting diplomatic convention in Europe, it’s easy to miss the significance of another of his brash interventions.
On Tuesday, the pharmaceutical giant Pfizer announced that it would be delaying raising prices on dozens of drugs. This was in response to a tweet from the President on Monday, berating the company for raising drug prices in the USA, while “giving bargain basement prices to other countries in Europe & elsewhere”.
You might wonder what this has got to do with science policy in the UK. But, as we argue in a report published by NESTA today, the influence of the pharmaceutical industry is one of the factors that has led to the development of a biomedical bubble, with substantial real increases in research funding for the biomedical life sciences. This has been at the expense, not only of other vital areas of research (into sustainable energy, for example) but of other approaches to improving the nation’s health outcomes.
Will the bubble burst?
The sustainability of this bubble is now in doubt, and President Trump’s tweet highlights why. R&D productivity in the pharmaceutical industry has been falling exponentially for decades, with a single drug now costing well over a billion dollars to develop. So it’s only the power of the industry to charge high prices in the USA that has kept it afloat. The pharmaceutical industry is the UK’s leading high-tech industry, and the Life Sciences sector has always been the flagship for our industrial strategy. But an industrial strategy based on the pharmaceutical industry is in effect a bet that the US’s healthcare system will remain unreformed.
We argue in our report that we need to be smarter in thinking about the “Life Sciences Sector”. Fundamental research in cell biology remains vital, and the UK has a great record to live up to. The pharmaceutical and biotech industries are important to the UK, and we need to recognise the problems they face and focus research to try and overcome them. But we need to recognise that the overall commercial record of the UK’s biotechnology industry remains disappointing. This model for commercialising university research – venture capital based spin-out companies based on protectable intellectual property – should not be overemphasised.
Healthcare research beyond biomedicine
Crucially, beyond support for the pharmaceutical industry, we need to take a much wider view of the research that’s needed to ensure a humane and sustainable health and social care system, and to grow a successful medical technology industry. This view will need to go well beyond a purely biomedical perspective. New digital technologies offer great potential, but these will certainly need to take account of systemic, social and organisational factors. The large variations in life expectancy and morbidity across the nation make clear how important the social and economic determinants of health are, and how public health measures may be just as important as new drugs and therapies. All this will require genuinely interdisciplinary approaches to research.
We argue that there needs to be a much greater diversity of people, disciplines and perspectives involved in setting research and innovation priorities – we need to draw on more collective, distributed and democratically- accountable forms of intelligence and expertise. Geographical diversity is important, too. At the moment, 55% of publicly funded health related research is carried out in just three cities – Oxford, Cambridge and London. The parts of the country with some of the biggest health problems, and the most intractable economic problems are remote from our centres of health related research, and their priorities are unrepresented. This is bad for the economy, bad for our healthcare system, and dangerous politically.
A question of balance
These are difficult issues, and our questions will be uncomfortable to some. But the advent of UKRI and the new prominence of Industrial Strategy in our thinking about science policy makes it essential to have this debate now. The choices we make, about how we steer the nation’s research system, will have effects on the nation’s economy and health system that last for decades. We argue that too much focus on biomedical sciences has left our research and innovation system unbalanced and vulnerable. We shouldn’t leave it at risk of being disrupted by President Trump’s twitter feed.