Bush, Kerry Make a Deadly Duo for Health Research

Posted February 20, 2004 at 1:56pm

If you or a loved one suffers from cancer, heart disease, diabetes or another dread disease — or you fear you might contract one — you have a hard choice when you vote for president this year.

President Bush is cutting the budget for medical research that might find a cure for your disease. At the same time, the Democratic frontrunner, Sen. John Kerry (Mass.), wants to strangle the revenues of the pharmaceutical companies who’d develop a medicine to treat you. [IMGCAP(1)]

Between the two of them, they’re a deadly duo. And Democratic Sen. John Edwards (N.C.) would be little better. He’s joining in his party’s jihad against drug companies.

Actually, it is possible to identify the most dangerous of the candidates. It’s Bush, who has a Republican Congress likely to do his budget bidding and give the National Institutes of Health a mere 2.7 percent funding increase this year — a cut after biomedical inflation is taken into account.

In future years, the Bush administration plans to increase medical research funding by 2 percent or less — with almost all of the increase going for obviously necessary programs to combat bioterrorism. The budget allocations mean cuts in research for all other diseases.

Bush administration officials assert that because the NIH budget was doubled over the five fiscal years from 1999 to 2003, the agency can’t absorb any further increases.

But that’s like arguing that because members of a malnourished family got more than 2,000 calories a day for a week, they can’t take an adequate diet any more and have to be starved in the future.

In fact, the true situation is worse than in that analogy. With the budget increasing at 15 percent per year for five years, universities and other research institutions opened labs, started projects and hired scientists that now will be closed, stopped and let go.

“It’s going to cause an ice age for medical research,” according to William Langston, director of the Parkinson’s Institute in Sunnyvale, Calif., and scientific director of the Michael J. Fox Foundation for Parkinson’s Research. (Disclosure: I’m on Fox’s board.)

According to Langston, “Young scientists who were attracted to medical research are just going to have to go into some other line of work if these cuts go through.”

The combination of NIH funding increases to $27 billion this year and annual research outlays of $100 billion by drug and biotechnology companies have produced some amazing results over the past several years — progress that will be slowed or halted if either Bush or Kerry has his way.

HIV/AIDS is no longer necessarily fatal, saving an estimated 62,000 lives in 2000, according to NIH’s director, Elias Zerhouni. New treatments for stroke prevented 241,000 deaths and for coronary heart disease, 815,000. [IMGCAP(2)]

Major new strides also have been made in treating adult and childhood leukemia, Alzheimer’s disease, Parkinson’s and schizophrenia. And the mapping of the human genome opens the way for discovering the causes — and, potentially, the cures — for numerous diseases.

There is a problem on the cures front, however. According to outgoing Food and Drug Administrator Mark McClellan, the number of new patent applications from drug companies has dropped precipitously — presumably because research discoveries are not being efficiently converted into medicines.

McClellan, newly named to head the federal Medicare program, says he has ideas on how to free up the process of drug development. One of them should be — but probably won’t be — adoption of Sen. Joe Lieberman’s (D-Conn.) proposal to create an Agency for Cures to translate bench-science discoveries into treatments.

The slowdown of new-drug development is not an excuse either for the Bush administration to stifle discovery or for Democrats to inhibit drug companies’ ability to conduct research.

Kerry and Edwards regularly attack drug companies for “price gouging,” neglecting to observe that it costs an average of $700 million to bring a new drug to market.

Kerry wants to, in effect, impose price controls on drugs by allowing the government to “negotiate” with drug companies on behalf of the Medicare and Medicaid program and by legalizing mass importation of drugs from Canada.

However, Medicare does not “negotiate” with providers such as doctors and hospitals on reimbursement levels. It imposes them, and Congress often gets into the act of changing formulas.

And, the reason that drugs are cheaper in Canada and Europe is that governments there fix prices based on the production cost of new drugs, escaping participation in the astronomical cost of drug development.

McClellan, probably the most imaginative health expert in the Bush administration, has tried to lower drug prices in the United States by speeding the availability of generic drugs and to convince foreign countries to make greater use of generics and stop underpaying for new brand-name drugs.

Steps do need to be taken to lower the cost of drugs to consumers. One is for the consumers and physicians to have up-to-date information on the efficacy and cost of one drug versus another, so that their decisions are not swayed simply by advertising or drug company promotions.

However, under Bush’s budget, the Agency for Health Research and Quality, the office responsible for improving information systems, has received no increase in funding at all.

In fact, as part of Bush’s effort to continue cutting taxes and satisfy his conservative, anti-deficit, anti-“spending” base by controlling domestic discretionary spending — just 17 percent of the federal budget — Bush has put a down hold on almost all civilian scientific research. That’s a failure to invest in the future. And, it’s dangerous to your health.