Tuesday, April 20, 2010

The next all-natural blockbuster drug

Pharmaceutical companies and their shareholders are always looking for the next "blockbuster" drug, the label given to a drug that generates more than $1 billion of revenue per year. Blockbuster drugs don't necessarily have to save many (or any) lives - slick marketing more than compensates for marginal improvements in treatment efficacy - but they do need to target conditions that are common enough that millions of patients will buy them. In adults, such conditions include osteoporosis, high cholesterol, and arthritis.

The reason that there have been few, if any, blockbuster drugs for children is that the vast majority of children are healthy. But what if medical science discovered a drug that was proven conclusively to prevent or reduce the risk of a variety of common and uncommon childhood illnesses, including ear infections, gastroenteritis, respiratory infections, eczema, asthma, diabetes, obesity, and even sudden infant death syndrome? A recent cost analysis published in a leading pediatric research journal suggested that giving this drug to 90% of U.S. children for the first 6 months of life could potentially save the lives of more than 900 infants and $13 billion per year. How much do you think people would be willing to pay for this miracle drug? Enough that it could potentially become the first pediatric blockbuster - that is, if breast milk wasn't already free.

Although the American Academy of Pediatrics recommends that mothers exclusively breastfeed infants for the first 6 months of life, and supports continuing breastfeeding to at least one year of age, data from the 2004-2008 National Immunization Survey document that only 73% of U.S. women attempt to breastfeed after birth, and only 42% and 21% are still breasfeeding at 6 and 12 months of life. The numbers are even more discouraging for Black women: only 54% attempt breastfeeding, and just 27% and 11% are still doing so at 6 and 12 months.

Pediatricians and family physicians work diligently to convince women to breastfeed their babies and to continue as long as they can to reap the numerous health benefits (which include a reduced risk of type 2 diabetes, breast, and ovarian cancer for mom), but they are often frustrated in these efforts by health system and employment obstacles. Hospitals commonly distribute free formula or branded diaper bags (my son, who never drank a drop of infant formula, nonetheless went home with a free bag courtesy of Enfamil) and interrupt critical early attempts at breastfeeding with tests and other procedures. Upon returning to the workplace, many moms find that the only private place to pump and store breast milk is a bathroom. However, a new provision in the health reform bill will for the first time require that U.S. employers (even those with fewer than 50 employees) provide regular breaks and a private space for female employees who need to express breast milk. Small employers who may initially feel that this new requirement is an "undue hardship" should consider the lower health costs (and lower insurance premiums) that should result from more infants consuming this all-natural blockbuster drug.

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