If drugs companies are scaling a cliff, AstraZeneca [AZN] looks stuck at the bottom. Sales at the U.K. pharmaceutical company fell 2% in the second quarter, while those at rivals Sanofi and Novartis rose 7% and 19%, respectively. AstraZeneca’s shares are the lowest-rated of all large-cap pharmaceuticals, and it’s hard to see them making up that ground. As a swath of blockbuster drugs developed in the 1980s and 1990s now face generic competition, some companies are faring better than others at making up lost sales…
There are some people who read the Wall Street Journal, watch CNBC, and check on the market throughout the day. There are others who looked at it the day after it plummeted in 2008 to see what the fuss was about on last night’s news. I’m in group B. It’s like the weather channel – something to watch when a hurricane is coming, but otherwise an intervening number on the way to something else. But the Internet is saturated with articles like the one above, generated in an endless flow that I’m sure would circumnavigate the earth if placed end to end many times in a given day. This morning, I checked in on AZN after Dr. Stahl mentioned AstraZeneca closing various labs. I Googled them and clicked News. 0.11 seconds later Google provided 1,250 sites to choose from. I didn’t get them all finished, but in a quick run-through, I didn’t find any mention of the Pharma-scolds, or Carlat’s blog, or Scientology. I did find out about some ups and downs:
This month, its best pipeline hope, blood-thinner Brilinta, gained U.S. approval, adding a potential $1.5 billion to $3.5 billion onto 2014 sales. But overall, AstraZeneca’s recent track record is poor. A panel that advises on U.S. drug approvals voted this month not to recommend its new diabetes drug. Lung disease and high cholesterol treatments were discontinued last year.
I read about some cost-cutting maneuvers:
AstraZeneca already has sold noncore assets, agreeing to sell its dental and surgical product business, AstraTech, for $1.8 billion in June. In the coming year there looks little by way of drug-development news that could materially boost earnings expectations…
I’d be guessing that rather that the complex psychodrama described in Dr. Stahl’s now famous rant, the closing of AZN’s CNS Division’s R&D labs was no more deeply motivated than as a cell on a spread-sheet under the column Non-core Assets [somewhere below Dentistry]. This is what runs such enterprises, "In the coming year there looks little by way of drug-development news that could materially boost earnings expectations," not something so lofty as, "Pharma have heard these protests loud and clear and are now pulling out of psychiatric research" [Stahl 2011]. On Carlat’s blog, Dr. Debbi Ann Morrissette, Dr. Stahl’s spokesperson comments:
"As our understanding of the brain and the influence of genetic and environmental factors increases we’ll have a better ‘big picture’ view of what goes wrong in the individual patient and how to fix it. In searching for that "big picture" there will inevitably be failures and successes. The bottom line is: we need to keep trying and like it or not, Pharma is our ally in this effort."
There are several Mythologies in the formulations of Drs. Stahl and Morrissette that bear correcting. First, the Myth of the Centrality of Psychopharmacology in the mind of Pharma. It’s not there now, nor has it ever been. Psychopharmacology just happened to provide the soil for the planting of some blockbusters [drugs exceeding $1 B sales]. Now it’s time to rotate the crops. CNS Medicine was a seasonal crop. Then there’s the Myth of the Alliance between Psychiatry and Pharma. Dr. Morrissette says, "The bottom line is: we need to keep trying and like it or not, Pharma is our ally in this effort." Pharma is not now nor has it ever been our ally. She’s been reading way too many ads. Pharma is a business venture operating on this formula:
Profits = Sales – Development – Production – Marketing – Settlements – Legal Fees
There’s no alliance that transcends that formula. She’s misunderstood the way we critics have used the term – "alliance." What we’ve said is "unholy alliance." Now that Psychopharmacology has become a Non-core Asset, this mythical alliance with Pharma is dissolving as quickly as it appeared twenty-five years ago.
My guess is that our problems with things like Conflicts of Interest, Pharma contaminated CME programs, the corruption of our literature, the Speakers Bureaus, etc. will lighten considerably in the coming years, even if we do dawdle in officially plugging the holes. I’m, of course, hardly advocating dawdling – there’s much to be done to restore scientific integrity and the medical ethic to it’s proper place. But the tea leaves say that Pharma’s empty CNS pipeline isn’t going to be funding those endeavors much longer.
I live in a beautiful and somewhat undeveloped area north of Atlanta that was crawling with developers hoping to score big time when I retired and we moved up here. A few years later, the "housing bubble" burst. As house prices began to fall, the developers, the mortgage brokers, and the real estate speculators were slow to hear the music – redoubling their efforts to keep their dreams alive. They lost their shirts trying to defeat what was, in retrospect, as inevitable as the earth’s journey around the sun. I still live in a beautiful and somewhat undeveloped area north of Atlanta. We haven’t heard the sounds of hammers or processed any new building permits around here for some time. Other than the clearing of some land along the highway for the obligatory Wallmart, the main source of deforestation has been the odd tornado. I wonder why I thought of that story?
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