Stem Cells and Biologicals

 A reader asks: "My question was, with the advent of cures for chronic diseases and other maladies, brought about by advances in stem cell based treatment, will the cost of the U.S. health care system decrease in the foreseeable future?"

Todays' New York Times describes the acquisition of stem cell (for treatment of inflammatory bowel disease) development rights from Athersys by Pfizer. New stem cell products, along with other biologicals which depend on genetic development (a number of which are already on the market for treatment of arthritis, neurologic disorders, bowel diseases and other immune-mediated disorders) have the promise of effectiveness (and some significant side-effects) at a very high price, amounting to many thousands of dollars a year for each patient treated and the likelihood that treatment will have to be continued for extended periods, guaranteeing income streams to those pharmaceutical companies.

While some of these products may "cure" the diseases which they target, many will be controllers which require prolonged continued use. It is understandable that pharmaceutical producers interested in the areas of stem cells and other biologicals for treatment of serious diseases have pressured Congress to extend patent protection to protect their investments and their streams of revenue and are setting their prices high to generate corporate profits.

While some of these products have social value, may keep people working and paying taxes, and sometimes produce more effective results than existing treatments, with relief from pain, deformity, debilitating disease and delay or prevention of imminent death, I see no reason to believe that they will lower the percentage of gross domestic product devoted to pharmaceutical costs and health care expenditures. The market will permit maximization of pharmaceutical companies' pricing and profit structure and foster pharmaceutical companies' choices, as to the stem cell and biological products they produce, to support drugs which are expensive and chronically used. The question is whether their use lowers other health care costs (i.e., physician and nursing services, hospital utilization, physical therapy, radiologic and therapeutic services) for a net reduction in health care expenditures.

If the net cost of all services is reduced because these new products promote efficiency, the nation will benefit. If stem cell and other biologic therapies simply add to an existing inefficient economic structure, the nation and you, the reader, as a health care purchaser will lose.