ChemCases.Com
Cisplatin - the Invention of an Anticancer Drug

Dr. Andri Smith

21. Case Discussion

In the past decade there has been a great deal of talk in Congress about the cost of prescription drugs. In the early 1990s, many people wanted to put a price cap on prescription drugs so that all members of American society would be able to afford them. Recently, a bill has been introduced in Congress that would allow U.S. citizens to buy drugs from other countries, where prices are often lower, without having to see a doctor there.

Case #1

How can the cost of drugs most reasonably be established or regulated? In answering this question, you will want to consider how reliable, unbiased data can be obtained.

Points to consider:

1. In 1990 the Tufts University Center for the Study of Drug Development reported the results of an unpublished study, stating that on average it took twelve years and $231 million to bring a single new drug to market. The results of a similar study conducted at the University of Rochester ten years earlier found that the average time for developing a new drug was ten years, and the average cost was $54 million, meaning that the cost to develop a new drug had doubled in ten years when adjustments for inflation were made.1,2

2. In 1991 a representative of the Pharmaceutical Manufacturers Association (PMA), a trade group representing more than 100 U.S. firms, stated that the money drug makers spend on research has doubled every five years since 1970 and that spending would reach $9.2 billion that year.3

3. In 1991 the Office of Technology Assessment (OTA), a congressional advisory bureau, released a study reporting the following: (1) It found no evidence of "dramatic increases in the time required for clinical research" to explain the reports of sharply rising research costs. (2) The financial risks for large drug companies were "very low" because they "have so little debt." (3) Pharmaceutical research does involve a "business risk" because of the many years sometimes required to produce a drug. (4) Drug revenues are immense: Average sales for new drugs introduced in the years 1984-1988 were at least $40 million in the first year, and average sales for new drugs introduced in the years 1981-1983 were at least $110 million by the ninth year they were on the market. (5) Drug companies benefited from tax credits in 1987 totaling $2.4 billion, cutting their taxes in half.3

Case #2

Should U.S. citizens be allowed to buy prescription drugs abroad without consulting a physician in that country? In answering this question, you may want to consider the issues raised in Case #1 as well as the ones outlined below.

Points to consider:

1. The price of tamoxifen, which is used to treat breast cancer, is eight times more expensive in the U.S. than in Canada, where drug prices are regulated as a result of socialized medicine. In a recent news report on National Public Radio, a Vermont woman who is being treated for breast cancer stated that tamoxifen cost her $1,000 more per year in the U.S. than in Canada. As it stands now, she must see a Canadian doctor before she is able to buy this drug in Canada.

2. It has been suggested that the high cost of prescription drugs in this country is the price that U.S. citizens pay for being on the cutting edge of technology.

3. It has also been suggested that other countries are getting a "free ride" by taking advantage of discoveries made by pharmaceutical companies in the U.S.

4. Without regulation by the FDA, it is possible that U.S. citizens might obtain dangerous counterfeit drugs from other countries rather than the same prescription drugs they would have access to in this country.

(1) Jackson, J. In The Scientist; 1990; p. 5.

(2) In The Philadelphia Inquirer; Philadelphia, 1990; p. 15-C.

(3) Freudenheim, M. In The New York Times; New York, 1991; p. D5.

Gain knowledge about cancer and the drugs used to treat it.	Comprehend how the original experiment was conducted and how the compound cisplatin was discovered.	See how this knowledge was applied to produce a highly effective cancer drug.	Evaluate the FDA drug approval process OR Evaluate what can be done to evaluate toxicity and drug resistance OR Evaluate the need for funding pharmaceutical research.

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Dr. Andri Smith
Amhert College
Amherst, MA
alsmith@amherst.edu

copyright 1999, Dr. Matthew E. Hermes