EconTalk Vinay Prasad on Pharmaceuticals, the FDA, and the Death of Duty
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Jan 30, 2023 Vinay Prasad, an oncologist and epidemiologist known for his critical take on pharmaceutical regulation, talks about the troubling approval of expensive drugs with minimal benefits. He dives into how profit motives skew oncology drug development and critiques the FDA's shift towards less public health protection. Prasad highlights the ethical dilemmas in healthcare, particularly regarding elderly care, and laments the decline of personal duty in society. His insights urge a reevaluation of what truly matters in healthcare and patient outcomes.
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The Incentive Problem in Oncology
- The pharmaceutical industry thrives on profit, which incentivizes drug development.
- However, the system struggles to distinguish truly transformative drugs from those with marginal benefits.
Marginal Benefits of Blockbuster Drugs
- Many blockbuster cancer drugs offer only marginal survival improvements (median 2.1 months).
- Transformative drugs like Gleevec, which normalizes life expectancy for CML patients, are the exception.
Patient Preferences and Supportive Care
- Prasad suggests patients often prefer supportive care over marginally beneficial, expensive drugs.
- He gives an example of offering a patient cash for home help instead of a $40,000 drug.
