What’s Wrong with this Picture?

Who caught this bit in Newsweek earlier this month:

“During the time Andrew S. Grove spent at Intel, the computer chip company he co-founded, the number of transistors on a chip went from about 1,000 to almost 10 billion. Over that same period, the standard treatment for Parkinson’s disease went from L-dopa to . . . L-dopa.”Andygroveintel_bw_2

“Grove (who beat prostate cancer 12 years ago and now suffers from Parkinson’s) thinks there is something deeply wrong with this picture, and he is letting the pharmaceutical industry, the National Institutes of Health and academic biomedicine have it. Like an increasing number of critics who are fed up with biomedical research that lets paralyzed rats (but not people) walk again, that cures mouse (but not human) cancer and that lifts the fog of the rodent version of Alzheimer’s but not people’s, he is taking aim at what more and more critics see as a broken system…”

Bravo, Andy! I’ve often wondered why progress in the Pharma industry seems so plodding, compared to other R&D-heavy industries. Obviously, patient safety is a huge issue. But industry observers are calling Pharma a “dry, dry desert” in terms of innovation.

A number of bloggers ask: Is the FDA standing in the way, by raising the safety bar and approving fewer drugs to avoid a repeat of the Vioxx (rofecoxib) and Avandia (rosiglitazone) safety scares? Or does the relative lack of approvals this year reflect the Pharma sector’s failure to devise innovative new products?

On the what’s-wrong-with-this-picture front, I also read recently in the Economist that “big drugs firms spend less than a fifth of their revenues in America on R&D, but over a third peddling pills.” They spend more than $12 Billion a year on marketing, to be exact. Wow!

As a person living with a chronic illness, I can’t help feeling that the large sums of money flowing in and around pharma innovation are justified. The problem is, most of that promotional dough goes to direct-to-consumer (DTC) advertising that “glamorizes and normalizes the use of prescription medication.” In other words, selling a bunch of expensive pills to people who don’t really need them. When they could be spending money on more effective treatments (and possibly cures?) for our diabetes and Mr. Grove’s prostate cancer and Parkinson’s disease, for example. Aaaarrrgh!

One more item on the what’s-wrong-with-this-picture agenda, btw. What is wrong with THIS picture?


You tell me. (Or click the image for a link.) Geezus.


13 Responses

  1. Anonymous
    Anonymous November 23, 2007 at 7:41 am | | Reply

    I agree that the dietary advice from DUK and the ADA is lacking, but I don’t see anything wrong with the Diabetes Forecast Cover. The key is the word celebrate plastered all over the front. Even those of us with diabetes are allowed to indulge once in a while. It’s about balance, and indulging occasionally is one of the keys to staying positive and actually doing well.

  2. Felix Kasza
    Felix Kasza November 23, 2007 at 7:52 pm | | Reply

    Regarding the front page of the D Forecast mag, I am sure that the cake is carb- and gluten-free — probably tofu-goop on a base of algae. :-)

    Regarding Mr. Grove, one point that he glossed over (and shouldn’t, given whence he comes) is that after the initial breakthrough of the transistor, nearly all the ongoing miniaturisation was just engineering — applied science, but not new science.

    Finding a cure for D (or discovering penicillin, etc) is more on the scale of the invention of the transistor: A confluence of someone very bright, the right time, the right conditions, and most of all, serendipity.

    It will come — but whether it comes next year or a hundred years from now is as difficult to foresee as the trnaistor was.


  3. JasonJayhawk
    JasonJayhawk November 23, 2007 at 10:29 pm | | Reply

    I’d love to see a successful business person like Mr. Grove work on the executive board of an organization like the FDA. Things would get done if the culture could be changed. While I was at Intel, I learned a lot about culture. He wrote, “Only the Paranoid Survive” — he’s a survivor. It’s time we get paranoid about finding cures.

  4. AmyT
    AmyT November 24, 2007 at 11:07 am | | Reply

    Hey Anon,
    I really don’t believe that people need any additional encouragement to indulge — certainly not from the ADA, which is supposed to be our partner in reducing temptations.

  5. Jim
    Jim November 24, 2007 at 2:50 pm | | Reply

    Folks, the important issue here is the pharma companies’ refusal to research genuine cures for diabetes and other chronic diseases, not a picture of a cake on a magazine.

    Grove has just discovered what any diabetic should already know: what incentive is there for a pharma company to research a genuine cure and kill this incredible cash cow? The billions that they rake in now come from drugs that treat symptoms or allow diabetics to “cope” – no way does pharma industry want to put an end to chronic disease.

    The FDA merely reflects the interest of the pharma companies who have incumbent drugs – the less competitors enter the market, the more money there is to be had for current drug producers.

    Follow the money, Mr. Grove.

  6. Jim
    Jim November 24, 2007 at 2:55 pm | | Reply

    Regarding the cake: is there any doubt that the ADA is comprised mainly of bureaucrats who are offering milk toast blather to diabetics rather than actively, agressively, advocating for a genuine cure?

  7. whimsy2
    whimsy2 November 24, 2007 at 4:34 pm | | Reply

    I wnated to add my comment before clicking on the image. That’s a wrong, wrong, WRONG image! Cake = carbs. Carbs = high BGs. What in the WORLD are they trying to tell diabetics???

  8. mcityrk
    mcityrk November 24, 2007 at 8:06 pm | | Reply


    It really should come as no surprise that a lot of the better R&D being performed in the diabetes area starts with either independent researchers in University labs or small privately owned companies outside big pharma. These are driven people trying to bring their one focused idea to the forefront who will initially work for substantially lower financial compensation [relative to big pharma] for the chance to make a difference in the treatment of the disease.

    While a extremely high percentage of this work never pans out to reach the market, those few entities with a “survivor” mentality who are able to financially stick it out long enough and work just smart enough to make key discoveries before going broke end up adding substantially to new technology.

    Obvious examples in diabetes treatment include the development of the insulin pump [primarily through Minimed], the implantable glucose sensor [primarily through Therasense and Dexcom by way of UT-Austin and UW-Madison], and Byetta [through Amylin by way of UW-Madison]. The nonlinear developement paths for these examples would never have been permitted in companies where every decison is microscopically monitored internally and then reported on and voted on by the stock owning public. While big pharma is still exceptional at marketing and sales, few companies now have the financial reserves to risk backing too many examples of risky new technology which management will be held responsible for on a quarterly basis if it fails to flow profits to the bottom line.


  9. Angela
    Angela November 25, 2007 at 10:44 am | | Reply

    Hm. Regarding the cake, we had a similarly astounding gaff in my neck of the woods last Hanukkah. A local grocery store featured Happy Hanukkah wishes all over the front of their weekly ad… surrounded by pictures of the pork products on sale that week. The picture of the nice juicy ham particularly stands out in my head. Big oops! I don’t think such a mistake is deliberately insensitive or malicious, I think that somebody REALLY wasn’t paying enough attention.

    At least in the case of the cake, a lot of people already know on the most basic level that diabetes + sugar = bad. My local pharmacy ran an ad last week telling customers that pharmacists can help if “you would like to know more about preventing diabetes”. No distinction made between Type I and Type II. I think that kind of error is far more harmful.

  10. John
    John November 25, 2007 at 1:23 pm | | Reply

    It won’t be the Pharma companies that find the cure, it’ll be the person who wants to!! http://www.abcnews.go.com/GMA/story?id=3810892&page=1

  11. Manny Hernandez
    Manny Hernandez November 25, 2007 at 6:48 pm | | Reply

    Bravo, Amy! I am happy with this post as I have not been in a long time.

    I hope more voice like Mr. Grove’s start coming up to lobby for more dollars in the US to go to R&D and not as much pushing drugs.

    As for the cover, whether it is a low-carb cake or not, it really sends the wrong message. I agree that ADA shouldn’t be presenting things this way.

  12. Bernard Farrell
    Bernard Farrell November 27, 2007 at 6:16 am | | Reply

    Good for Andy and I agree with you. Chronic diseases are chronically underserved by both big pharma and health insurance companies. Paying for treatment of outcomes rather than for prevention seems to the be the order of the day. It’s really sickening.

    As for Diabetes Forecast, I canceled my subscription recently and I can’t tell you how happy I am. I realized that this magazine had very little of use to me. Then with the recent speech by Richard Kahn I decided that there is NO WAY I’ll be supporting the ADA in the future. They seem to have completely lost touch with the real needs of those of us with Type 1 diabetes. I’m really not sure how well they serve folks with Type 2, especially with covers like the one you show.

  13. Sunil S Chiplunkar
    Sunil S Chiplunkar November 29, 2007 at 10:55 pm | | Reply

    Fantastic blogpost. Yes there is something wrong about healthcare research, it is in the hands of monopolies, patents…There is just not enough buzz in healthcare R & D and marketing, the kind of empowering buzz that you find in electronics, computers, and software is absent. What is required is more of open source healthcare working and this will create interdisciplinary and wider net of people working for healthcare; monopolizing by healthcare professionals and companies will end. For instance, Amy has done so much for diabetes management that even few doctors have done. Bravo Amy – the right way to go. A suggestion: if you can, please make a list of top non doctor people working for the cause of diabetes management. Also please focus a bit on India too as India is the diabetes capital of the world!

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