Can pharmaceutical drugs benefit society?

Here in the US, we’re apt to hear about the British health authority NICE (National Institute for Health and Clinical Excellence) when a stage-four cancer patient makes a desperate appeal for access to an expensive drug not in the approved formulary. The British system has been characterized as rationing, and conservative US politicians like to use such incidents to argue against “socialized” medicine, which will surely do away with Granny before her time is up.

There are big changes currently underway in the British health care system, and NICE will actually be replaced by a different decision-making process in 2014. Although health care reform in the US (the Affordable Care Act) rejects the British model, a recent article in the New England Journal of Medicine suggests there’s much we can learn from the British experience.

Why not design drugs to have wider societal benefits?

Of particular interest is the concept of the social value of drugs. The idea is that if a drug demonstrates “wider societal benefits,” the British government would be willing to pay more for the drug. Presumably this financial incentive would lead the pharmaceutical industry to invest more heavily in products with a high value to society.

What might these values be? In discussions of how the new system would work, the only example provided is drugs that benefit the care-takers of patients. The article’s authors, however, suggest a few more: “narrowing health inequalities, advancing children’s life prospects, reducing burdens on social services, increasing tax revenues, and decreasing workforce absenteeism.”

There’s more to the value of health care than clinical effectiveness for patients and cost-effectiveness for individuals and governments. As we plan for the future of health care, a welcome addition would be to consider the wider benefits to society.

In the US these days, it’s hard to imagine overcoming the political differences that prevent us from agreeing on what it means to benefit society. But it’s worth invoking the genius, power, and magic in bold thinking. This would be a great opportunity for those Harvard Business School types who advocate “shared value” in corporate thinking to make some concrete suggestions — an opportunity for a major contribution both to health care and to a better future for ourselves and our children.

Resources:

Image: The school for heroes

Ruth R. Faden and Kalipso Chalkidou, Determining the Value of Drugs — The Evolving British Experience, The New England Journal of Medicine, April 7, 2011, 364: 1289-1291

Michael E. Porter and Mark R. Kramer, The Big Idea: Creating Shared Value, Harvard Business Review, January-February 2011 (article is behind a paywall, but the extensive comments are not and are worth reading)