ABSTRACT
It now seems to be generally accepted that the future path of the pharmaceutical enterprise may well be in the direction dictated by developments in biotechnology. Therefore, in this final chapter1, I wish to explore tentatively “the future” with respect to the relatively recent scientific biotechnological developments that have already preceded this future.2 But, before I do that, I think it is important to consider the interaction of three principal actors in this process in recent past, and their most probable interaction in the future. Accordingly, the first section of this chapter considers the interaction between the mainstream pharmaceutical industry, the biotech industry, and the federal government. It is desirable to consider the nature of this interaction. Critics (Angell 2000; Angell 2004) often castigate the government as favoring and subsidizing the pharmaceutical industry (as opposed to other industries) with the provision of published research results from the National Institutes of Health (NIH), but almost always ignore the fact that government research at the NIH is a basic public good, in the classical economic sense of the word (Mansfield 1997). The next section summarizes the important events in the discovery of the chemical structure of DNA and the unraveling of the human genome. The third section explores the relatively new sciences of proteomics and stem cell research that have emerged from the unraveling of the genome. Included in that section is a short discussion of a once fairly controversial hypothesis (Fries 1980; Leigh and Fries 1994; Fries 2003) that has been called the “compression of morbidity”
paradigm, in which the morbidity associated with chronic disease is postponed and compressed into fewer years at the end of life. The next section explains the present economic and scientific status of the relatively new biotechnological industry (using Amgen as the prime example), which I have purposely ignored up until now (for purposes of the chronological exposition). The final section considers the public policy implications of all of this into the future.
