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The Advancement of Science and the Cost to Society / 科学の発展と社会のコスト

posted May 12, 2016, 9:20 PM by PARC Osaka University   [ updated May 12, 2016, 9:33 PM ]
The other day, I was astonished to read the top news headline on Yahoo! Japan: “A Drug that Will Destroy the Country”. This headline was linked to an article run by the S Newspaper. Thinking that the possibility of just one drug alone causing the downfall of an entire country was extraordinary, I read the article with curiosity. The drug discussed in the article was not a narcotic or stimulant, but rather an anti-cancer drug called O that in recent years has been newly introduced to the Japanese pharmaceutical market by Company O. O is a revolutionary drug with the unprecedented anti-cancer action mechanism of killing cancer by enhancing immune system functioning. Previously existing anti-cancer drugs have targeted cancer cells directly, but they can also attack healthy cells and have many side-effects. In contrast, O acts on immune functioning and has few side-effects and could potentially be effective against a range of cancers; thus, it is generating tremendous expectations as a cancer therapy. A point that we researchers in academia should focus on in particular is that the development of O is based on the research of Prof. Dr. Tasuku Honjo of Kyoto University and is a university-developed pharmaceutical. How can such a wonderful drug “destroy” a country? The answer is that the dug is incredibly expensive. Although the cost apparently depends on the number of times it is administered, O costs 35 million yen per patient per year. The article described how this fact became an issue in a Ministry of Finance meeting. If one half of the more than 100,000 non-small cell lung cancer patients who are eligible for treatment with O (50,000) were treated with O, the annual cost would be 1.75 trillion yen, and even with the government partially covering that amount, the cost could run into several hundreds of billions of yen. At this Ministry of Finance meeting, there was a debate over whether or not this cost burden had the potential to bankrupt national finances, and it was apparently proposed at the time that restrictions be placed on use of the drug for patients aged 75 years or older in order to avoid national bankruptcy. While it is impossible to ignore the financial reality, surely emotionally this is a truly pitiful story. Although it is not my intention to criticize debates such as this, what especially shocked me when I read the article was the problem of the cost involved when something new is developed through academic research. Unlike ordinary industrial goods, it is possible to commercialize and reap profits for pharmaceuticals—even when the cost is enormously high—because drug development not only received government assistance but is also an issue that involves human lives. Consequently, the tendency towards ignoring the extent of costs is likely to strengthen. This situation is not limited to O, and with the advancement of research, the number of diseases that will be able to be cured will increase more and more, while at the same time, the financial burden on society will also continue to steadily increase. This poses an unspeakable dilemma in which the lives of many people are saved but society as a whole comes under financial constraints. As scientists, it is only natural that we should think about how to create things that are effective yet inexpensive. However, when speaking specifically about pharmaceuticals, this could be an especially high hurdle to overcome. Thinking carefully about these issues, I remembered something—I personally have had the experience of developing a product jointly with a company up to a point just before commercialization only to have the project ultimately rejected because the production costs were too high. Unlike companies, in academia it is often the case that research and development is undertaken without taking into account the eventual costs from the very beginning. This is because in academia, what come first are establishing the principles of the developed drug (invention) and publishing academic papers. In particular, research that focuses only on lowering production costs does not produce academic papers with great impact in many cases. However, it goes without saying that carrying out research that can be practically applied to society should truly be recognized and praised. Reading this article reminded me, partly as self-admonition, to keep this point in mind as I carry out my research activities.

May 13th, 2016
Yuichiro Hori, Associate Professor
Division of Advanced Science and Biotechnology
Graduate School of Engineering, Osaka University

堀 雄一郎  准教授