Thread by @PeterKolchinsky

Consider controversy whether pharma sales & marketing is necessary. For COVID, gov’t distributes vax w/o companies doing marketing. Data are out there. People still unclear, say gov’t isn’t teaching right. New drugs w/o understanding of their utility are a wasted effort. 1/13

In some cases, it seems marketing can be harder than R&D. The drug industry does spend more on R&D than on sales & marketing, but that’s arbitrary & shouldn’t be seen as inherently right. They aren’t relative expenses. They are each essential. 2/

We should spend what we must on R&D, and we should spend what we must to ensure all the right people are informed and suitably convinced of the utility of each new medicine. Only then will innovation have made a difference. 3/

I’m a biotech investor and am aware of a tremendous amount of promising new developments in science & technology. We’ll have much better screening tests for cancer that allow complete cures, but people have to know to get screened. 4/

We have treatments for rare types of obesity that also require people get screened. We have drugs for infectious diseases, heart failure, & diabetes that people need to appreciate should be taken religiously, w/o skipping doses. 5/

We have treatments for high blood pressure (BP), though nearly all are generic, so you don’t see ads much for that. And yet, unless you go see your doctor, you might not realize you have high BP & could have an avoidable stroke. Being aware of what medicines can do is essential.

There are misleading ads, for sure. And there are inappropriate sales tactics. Those are all policed & laws are there to be enforced. So let’s not sacrifice the good to eliminate all bad. It’s not like we lower the speed limit to 5mph or ban cars b/c of harms of speeding. 7/

Some may recoil at company having profit motive in promoting a medicine. But consider how delicate US gov has been about vaccines in face of this rising delta variant. At this point, I would like to see what Madison Avenue could do to drive adoption. Lives still depend on it. 8/

And not just lives. When people don’t take medicines that could help them, the consequences can be expensive. Whether COVID vaccines or blood pressure meds, the cost of hospitalizations from both taking them is greater & borne by everyone paying taxes & premiums. 9/

Therefore the healthy should want to see more effective promotion of medicines to help avert more expensive care. And when investors & innovators see that new drugs are being used and paid for, they look for other problems that can be solved. 10/

Consider all we’ll end up spending on everything from Alzheimer’s to future pandemics unless we have new drugs, diagnostics, & other technologies to bend those cost curves down. So the commercial success of new drugs from their appropriate utilization encourages progress. 11/

And bringing it make to marketing, if a great new drug is invented but sells poorly b/c of some noble seeming policy or price controls meant to cut the industry’s marketing spend, that would lead to the kind of incomplete uptake we’ve seen w/ vaccines… 12/

…reducing benefits to patients, sometimes higher costs to society from more hospitalizations, & reduced interest in inventing more such medicines. But more interest in building hospitals to deal with all the (avoidable!) hospitalizations. 13/13

Ug. Spotting typo in 9 too late. Should be: Whether COVID vaccines or blood pressure meds, the cost of hospitalizations from NOT taking them is greater & borne by everyone paying taxes & premiums.