Throughout history there have been several instances in pharmaceutical development where an unexpected benefit of a drug was found. Aspirin is a good example. Initially discovered to treat arthritis pain, Aspirin was later found to be a blood thinner and a heart drug. Those effects were found by serendipity, or a “pleasant accidental finding”. But today, what if a drug is found by accident to help Alzheimer’s patients? And what if the company that produced that drug did not follow through with the necessary research to know if the drug was truly beneficial? On the surface it smacks of deceit or fraud. How can that happen? This dilemma occurred with the drug Enbrel, made by Pfizer Pharmaceuticals.
The Washington Post reported last week that Pfizer decided to not pursue research that may benefit Alzheimer’s patients. In 2015, Pfizer discovered that Enbrel, sold to treat rheumatoid arthritis and psoriasis, may reduce the risk of Alzheimer’s or help with cognitive function. The data was published as a study by researchers at Dartmouth and Harvard in 2016. It was not a secret. But neither was there an effort to do more. In medicine, news such as this is big, especially when dealing with an incurable disease that affects millions of people. Not only that, but there are no drugs available that alter the course of the disease. The world is hungry for a breakthrough. Knowing this makes one wonder: Why would Pfizer not pursue research into a drug that had the potential to change millions of lives? Would they not stand to gain? Well, as it turns out, maybe not.
No Clear Answers
Pfizer claimed that because Enbrel does not cross the blood-brain barrier, they didn’t believe it would help Alzheimer’s. They didn’t act on the findings stating “It might lead scientists down an invalid pathway”. In reality, the truth probably lies in the finances.
Enbrel is nearing the end of its patent, which means other companies will be able to make and sell the drug under a generic formulation. That means profits to Pfizer will drop significantly since most insurers do not want to purchase branded drugs if a cheaper generic is available. Pfizer therefore has no incentive to spend millions on new research on a drug that will be sold by other companies.
Drug companies oftentimes will take a drug and reformulate it just enough to market it as a new drug. That has occurred with antidepressants, allergy meds, and others. It is a common practice. Pfizer could do that with Enbrel but chose not to. They said they did not believe the data was strong enough to follow through with more testing. Realistically, they would be looking at years of research and millions of dollars spent. Furthermore, they plan to disband their neurology testing division and let go 300 employees. They are serious about not seeing if Enbrel is the next Alzheimer’s drug.
Image from BBC.com
Many questions still remain as to why Pfizer did not pursue further research on a drug with Enbrel’s potential. Stating they didn’t want to “lead scientists down the wrong pathway” is a bit highbrow. Let the scientists decide if they think it is worthwhile to study the drug. The drug not passing the blood-brain barrier is not a valid reason to stop research. Lots of drugs do not pass that barrier and still do wondrous things. It is a lame excuse. And what about their reputation? Drug companies are notoriously unpopular with the public for many reasons. Not testing a drug that may help an incurable disease is not going to garner them any points. It simply reinforces the belief that drug companies are only in it for the money. Never mind that there are lives to save.
Find a Way to Make it Work for Us and Them
Granted, Enbrel belongs to Pfizer and they can do what they want with the drug. But the final question remains. How much responsibility does a drug company have to the public when it discovers a new use for a drug? The greatest loss in this scenario has been time, and the clock is ticking on finding an Alzheimer’s cure. The biggest disservice by Pfizer was to let the information lay idle, as if it was another piece of paper left in a stack with hundreds more. Where does responsibility for the health of the public play into decision making? Would Pfizer had done more if Enbrel was not coming off patent?
This type of situation with a drug will happen again. We need policies that address the problem of drug companies making decisions based solely on financial reasons. But, instead of being punitive, make the solution one that the drug companies respond to. Give them a financial incentive. One answer would be to allow Pfizer to reap some monetary benefits while allowing another organization to do the research. In other words, both parties would benefit from the sale of the drug when marketed as a new treatment. A win-win situation. It would be a form of partnership. It may sound like a deal with the devil but if it leads to producing a drug that helps millions, all the better. The goal is not to conquer greed, a lofty aim in its own right. It is to fight for the greater good.
Image from canstockphoto.com
“Pfizer had clues its blockbuster drug could prevent Alzheimer’s. Why didn’t it tell the world”? Business section, The Washington Post, June 4, 2019.