Image by Mykenzie Johnson.
The U.S. consumes an incredible amount of healthcare resources, spending more on healthcare than any other high-income country. Much of this spending occurs within the biotechnology sector towards the development of new healthcare technologies. As a result, the U.S. serves as the engine of innovation for the rest of world with many of our most powerful drugs and medical devices emerging from the U.S biotechnology pipeline. However, over the past two decades, the biotechnology industry, driven by profit motives, has innovated extensively without significantly improving our public health. The commodification of healthcare, while accelerating the production of medical technologies, has created a system that produces lucrative innovations over those that are socially beneficial and equitable. In turn, the medical-industrial complex borne from this process is rapidly destabilizing the healthcare ecosystem.
Most healthcare economists have recognized the dangers of over-commodifying the industry. Nonetheless, the biotechnology sector is poorly regulated compared to most major industries. Why is this the case? Unlike nearly every other commodity, healthcare is directly connected to our death and mortality. The inability to regulate the industry flows directly from arguments that feed off this death-anxiety. Specifically, the industry claims that increasing regulation would obstruct innovation and directly harm human life. Some have even said that Medicare caps are the “moral equivalent of genocide.” This ideological victory has made the industry attractive to investors due to its relative immunity from regulatory policies. These corporations further boost their argument by associating profit with innovation, when in fact it has been shown that innovation doesn’t increase linearly with revenue. In turn, the over-investment in healthcare innovation diverts precious resources from attempts at equity. Instead of dispersing new innovations equitably, the most advanced of our technologies cater only to those who can pay for the treatment.
The new “miracle” GLP1 agonists (Ozempic, Mounjaro, Wegovy) used to treat diabetes/obesity are a prime example. These drugs, while innovative, don’t do much to move the needle on improving public health; their benefits cease once the treatment is stopped, thereby requiring continuous use, and ensuring perpetual profit for the manufacturers. This “magic pill” mindset fosters an over-reliance on quick-fix solutions, neglecting the root causes of health issues and exacerbating health inequities. Meanwhile, traditional and less expensive diabetes medications, which have proven long-term efficacy and are much cheaper, are often overshadowed and underutilized. This misalignment prioritizes profit and innovation over the equitable dissemination of essential and affordable treatments.
No wonder then that the pharmaceutical lobby spends a majority of its effort combating measures that attempt to distribute drugs equitably and expand access to care. They understand that there is no possible way to equitably provide their expensive emerging technologies without limiting earnings. Recognizing this, the industry leverages our collective death-anxiety to push back on regulatory measures.
What would an appropriate response to the coming influx of medical technologies in the United States look like? Ideally, a central regulatory agency, operating downstream of the FDA, would evaluate newly approved drugs to determine the appropriate production levels for pharmaceutical manufacturers. This agency would then allocate these products to patients, prioritizing both need and equity (similar to the organ-transplant network). Such a system would function optimally within a robust public healthcare framework (e.g. single-payer) which could regulate the use of these medical technologies to balance individual autonomy with social justice.
The domination of the health sector by commercial interests ensures that the primary goal is profit, not health. The goal, then, is to innovate sustainably and in those areas that are socially necessary rather than lucrative. So yes, there may be less innovation, but those innovations that do arise would be essential and disseminated through platforms that exist to distribute the technology equitably. We must not be swayed by the pharmaceutical industry’s disingenuous appeal to death-anxiety. We must not allow these corporations to continue hiding behind a thin veneer of holiness. And, as with any advanced technology, just because we can innovate in healthcare, doesn’t mean we should.
A reckoning of the biotechnology industry is coming and only through an honest appraisal of both our great technological power and vulnerabilities will we be able to maintain a sustainable healthcare infrastructure.
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