Pricing principles
Your article “The pricing puzzle” (March 2001, p 36) was, for the most part, an excellent review of the process and risks involved in getting a drug to market. The truth is that altruism never has delivered the goods. If the drug industry or any industry operated on the altruistic premise instead of the selfish premise, where would the money come from to do all the painstaking research, development, testing, manufacturing, and marketing needed for such an enterprise?

Justice demands that the innovators, creators, inventors, investors— in sum, the producers—who keep the United States moving forward (and not stagnant) be rewarded for their awe-inspiring energy, effort, and brains. By rewarding these people, the rest of us get products that enhance our lives. Instead of suffering from envy and complaining about drug prices, we should be ever vigilant that government does not impede the efforts of U.S. industry to find new products that make our lives better. The drug industry in particular is one to be championed, not destroyed.

“The pricing puzzle” was essentially on-target. However, author Milton Zall states that most of the 12–15 years needed to bring a drug to market is “spent testing the drug to make sure it’s safe.” Not true. Drug safety is determined relatively early on. Test animals or humans taking drug candidate X die or stay alive, get sick or don’t. That criterion is measured not only qualitatively and quantitatively, but also fairly rapidly. The cost of doing it is low; and controversy is negligible.

In contrast, assessment of drug effectiveness has a huge subjective component. Experts (in government and the private sector) often argue over long periods of time about a drug’s efficacy. In that long legal struggle, opinions and beliefs (on both sides) sometimes trump science. As the years drag on, the dollars invested by both sides mount, and patients remain denied access to an effective medication.

Some heretical pharmaceutical scientists have recently suggested that the U.S. FDA regulate only safety testing of new drugs. Drug effectiveness, however, would be determined “in the marketplace” of academic medical centers, physicians’ offices, pharmaceutical companies, and learned clinical journals. Would that radical approach reduce the price of, and the patient’s wait for, new drugs?

Unsung nano heroes
In “Nanotechnology gains momentum” (April 2001, p 32), Richard Smith mentions many companies that participate in nanotechnology research, but the one company whose researchers won the Feynman Prize in Nanotechnology was not mentioned. To quote Hewlett-Packard’s press release: “The Experimental Prize went to the multidisciplinary team of chemist R. Stanley Williams and computer scientist Philip Kuekes, both of HP Labs in Palo Alto, along with chemist James Heath of UCLA” (www.hp.com/hpinfo/newsroom/press/13nov00c.htm).

Author’s reply:

HP’s work, especially the projects the company shares with Dr. Heath at UCLA, are fine examples of recent progress. Their recognition by the Foresight Institute was well deserved.

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