From Alaska, USA:
I want to bring up an issue, just to get it off my chest. I'm sure that you hear/read of this all the time. What incentive does a company have to cure diabetes when there are 12 million individuals such as myself spending $8.00 to $10.00 a day on care products (a low estimate I'm sure)? At $10.00 dollars a day, we are spending $120 million a day! Multiply that by 365 and you have $43,800,000,000 per year (in the United States). How do I bring myself to believe that a cure will be brought forward if it is found with so much money, so many jobs involved in this industry? We are feeding the world with new industries and keeping people in jobs, if a cure came to pass what would happen to all those that are involved in the maintenance of we diabetics?
This question was referred to several members of the Diabetes Team, who have each given an answer:
Answer from Dr. Quick:As an endocrinologist who deals with people with diabetes every day, and knows the costs associated with this disorder (and the profits being made by the manufacturers of strips and drugs), I feel that your comments deserve a reply.
First, there's no denying that diabetes is expensive. And that some businesses are making a profit (the newest diabetes pill, Rezulin, will cost the consumer about US$3-4.00 a day!). I'm not going to comment on your math; there have been many estimates of what diabetes costs society.
But the search for a cure is based on different motivating factor besides the profit motive: a concept I'll call altruism. It's a consensus among patients and diabetes doctors and diabetes organizations (such as the ADA and the JDF) that we'd like to get this monster under control, and someday removed. Then we'll go on to other pursuits. Sort of like curing and controlling some infectious diseases (smallpox is gone; malaria is no longer present in the USA).
I think that we'll continue to live with different motivations in the world. There will always be people whose goal in life is making money, and they'll price their products as high as they can, and drive expensive cars, and own summer homes in nice places. Or go bust when new technology makes their product obsolete, or someone else brings out a better product. And there will be others who truly don't care about making lots of money, and would rather do a good job at whatever they do, and help make the world a better place for everyone.
I think that whether we can control and cure diabetes is not based on whether there are more moneygrubbers or more "nice" people. Research, and patient activism, and other nonfinancial factors, will eventually lead to a cure and has already led to much better control than was available twenty years ago.
It's our job, you and me both, to do the best we can with what we've got, and to keep others informed of what we're coping with, and get their support for what we want: better care for people with diabetes, and a way to prevent it, and perhaps someday cure it.
Answer from Dr. Lebinger:Although I can't give you an exact answer to your question about what incentive do the pharmaceutical companies have in finding a cure, I would like to offer my thoughts.
I don't think it is the responsibility of the pharmaceutical companies to find a cure for diabetes. Their responsibility is to help provide the means to obtaining the best possible control so people with diabetes will be healthy when the cure is found.
I think it is important to remember that research and develpment of new or improved products costs a lot of money and does not always lead to a successful profit. In a capitalist society, it is reasonable to assume that most companies will be driven to spend money to develop new products by the hope of making profits. I think it is also reasonable to hope and assume that competition between companies will help to keep the cost of products down and lead to new, improved products for people with diabetes. For instance, in 1978 the cost of the first commercially available meter, the Eyetone, was US$400. Now, 19 years later much smaller, more convenient, more accurate meters are available for less than US$100 (and even less than US$50). Also, there is increasing pressure from insurance companies to keep the cost of diabetes supplies down. I think a larger problem is passing regulations in all states mandating coverage of diabetes supplies by insurance companies.
I suggest you contact your congressman and senator to encourage the government to appropriate more money towards diabetes research. Increased public awareness of the complications of diabetes will also help convince private foundations of the need to support diabetes research. We all should individually support the American Diabetes Foundation, the Juvenile Diabetes Foundation, and other institutions in their fundraising campaigns to support diabetes research.
We all look forward to the cure.
Additional Comment from a Reader:I would sooner say that the profit motive is and always will be the only reason why diabetes will be cured. Without profit, there is no motive to do anything. Maybe the existing pharmaceutical companies won't find it first, but I guarantee you there's an entrepreneur out their right now dreaming of the money he's going to make when he finds the cure for this terrible disease. And you know what, he's probably got a competitor who thinks the same thing, only he'll do it better or cheaper. Shortly, the price is where we all can afford it. It's plain old capitalism, a flawed system, but unequalled on this planet. Remember, a couple of guys working in a garage shook IBM to it's foundations with their cute little computer with the little apple sticker on it. And the best acts of charity and altruism that I can do, I can do better with more money.
A Reader (MGTD74A@prodigy.com)
Original posting 29 Mar 97
Updated 4 Apr 97
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