Week 6 Journal: The Global Pharmaceutical Industry

May 23

The anthropological violence of abstraction describes behavior where we begin to replace qualitative suffering with quantitative outcomes. Or as Dr. Henryk Krol more accurately argues, “I don’t see patients, I see data” (Krol in Petryna, 2013). The narrow lens of cost determines where the burden of accountability falls, and who is required to pay. The recent case of Turing Pharmaceuticals’ price increase for antiparasitic drug Daraprim, used in the treatment of HIV infection, spotlights issues of greed, but also the ethics of the cost of research itself (Tirrell, 2015). After widespread public outcry and appearing before a House committee (CNBC, 2016), then Turing CEO Martin Shkreli, made the case that the sudden price increases were justified in supporting deeper investment in research, and that his pharmaceutical company was obligated to operate at a profit.

But in the economics of his argument, patients become expendable in the pursuit of a positive financial outcome predicated upon conducting more research. The spreadsheet becomes blind to suffering. Vincenne Adams describes this cycle as the creation of evidence to justify and secure future resources, which in turn generate more evidence, which has become the actual goal of global health (Adams, 2016). That it's not about treating people anymore, but seeking out funding to continue trials. The more research Turing conducts, the more opportunities it has to be published, and the cycle of profit grows. Price increases fund future research at the expense of patient suffering, which is only augmented by Shkreli’s refusal to yield to the moral argument to help. In its development of antiparasitic drugs, Turing has itself become a parasite. It’s a deeply cynical position in direct opposition with clinical principles of nonmaleficience (Petryna, 2013), and where the patient themselves are reduced to little more than an atomic unit of greed.

References:
Adams, V. (2016). Metrics: What Counts in Global Health. Duke University Press.
CNBC (2016). Martin Shkreli Testifies Before Congress: Full Testimony | CNBC. YouTube.com. [Digital File]. Retrieved from: https://www.youtube.com/watch?v=LPIQ_gyiHag.
Petryna. A. (2011). Pharmaceuticals and the Right to Health: Reclaiming Patients and the Evidence Base of New Drugs. Anthropological Quarterly, Vol. 84, No. 2 (Spring 2011), pp. 305-329. [Digital File]. Retrieved from: : https://www.jstor.org/stable/41237497.
Petryna, A. (2013). The Right of Recovery. Current Anthropology. Volume 54, Supplement 7, October 2013. [Digital File]. Retrieved from: https://www.journals.uchicago.edu/pb-assets/docs/journals/CA_S7_v54nS7_potentiality_supplement-1593017836633.pdf.
Tirrell, M. (2015). Turing CEO Martin Shkreli Talks 5,000% Drug Price Hike (Full Interview) | CNBC. Youtube.com. [Digital File]. Retrieved from: https://www.youtube.com/watch?v=L-U1MMa0SHw.