| Summary: | Significant advances in drug research and development are herein reviewed first to set the background for a critical consideration of the economic sustainability of biologics and small molecules, why biologic drugs are more expensive, and how drug cost often influences patient access to one drug class over the other. Also strongly emphasized is the need for the drug-making, especially the biopharmaceutical, industry to consider a reassignment of priorities so that more patients can enjoy the great benefits that come with blockbuster drugs, many of which are of biological origin but extremely expensive. A balance between the efficacy of wonder-performing drugs and the patient's financial ability to access them must be established to obliterate the crippling effect of the high costs of drugs on the poor majority of patients – those who cannot afford them. The overarching point broadly emphasized is that the actual success in drug discovery and development and in healthcare delivery should be measured not only by the magnitude of scientific breakthroughs but also by the level to which they are affordable to patients as determined by their costs. To enhance patients' access to drugs and new and/or improved healthcare technologies, more research attention must be paid to such cheaper alternatives as small molecules generics, biosimilars, and antibody-drug conjugates; government policies must be established to encourage the commercialization of biosimilars; and pharmaceutical companies must be charitable enough to run assistance programs for eligible financially handicap patients while seeking to make profits from the drug-making business.
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