October 14, 2008
Merck was one of the largest pharmaceutical companies in the world. • Merck was about to lose patent protection of two of its best selling drugs, which had been a significant part of their $2 billion annual sales. • Merck began putting millions of dollars into research (up to $1 billion) and within three years, Merck was able to discover four powerful medications. • Profits weren’t all that Merck cared about; Merck’s founder believed that “medicine is for people. It is not for the profits.” • He also believed that following the “medicine is for people” philosophy would lead to profits and had yet to fail.• River Blindness is caused by parasitic worms, which can be found in the Middle East, Africa and Latin America.• These places are developing, so many citizens are poor. • The worm larvae can enter the body through fly bites, with some people getting thousands a day. • Worms can cause grotesque growths, but the major problem lies in reproduction when millions of progeny are released in the system. •The resulting itching is so intense the infected have committed suicide. • Eventually, the larvae may cause blindness. • Two existing drugs could kill the parasite, but have serious, potentially fatal, side effects. • The only safe combative measure available was insecticides that eventually lose potency with immunity of the flies. • The average drug takes $200 million in research and 12 years time to produce. • In order for companies to stay in business (and ease human pain), they must make complex decisions about which drugs offer the most promise. • Investing time/money into drugs for rare diseases is risky (because the pool of recipients is small). • There are enough people with river blindness that there wouldn’t be a risk of too few people. • Instead, the problem would be that the infected could not afford the medicine. • Merck tested a drug, ivermectin, which effectively killed parasites/worms in animals. • Ivermectin killed a worm in horses similar to the river blindness worm. • The drug may be adaptable for humans, but would probably not turn a profit for Merck.
Still need to know: How close the scientists truly are to making it feasible for human use. $200 million is the average, but it could lie anywhere on the spectrum. This is especially true if analogous changes to the structure of other chemicals have been published, or if the drug is complex and little previous work exists.
The main ethical dilemma revolves around whether Merck has a responsibility to research ivermectin further. The issues that must be addressed are as follows:
• Should Merck invest time and money in the adaptation of ivermectin if it won’t be profitable?
• Is it a responsibility of Merck to pursue drugs with promise, even if they don’t help those who can pay for them?
• Does Merck have more of a responsibility, because the core of their value system, as outlined by the founder, is to create medicine for people not profits.
• Would it be unethical to pursue a drug that’s risky for the business’ future (since they’ve been so successful in the past and wouldn’t be able to produce more medications to help humans if the company failed due to this research)?
• If they should work with ivermectin, how much time/money should be used before giving up?
• If they make the drug, how much should they charge? And if the people that need it can’t afford it, should they just give it to them?
• If they decide not to pursue the drug in the realm of human care, are they ethically obligated to pass the information about the drug on if another company wishes to pursue it, even though it may be risky for any plans they have for animal care.
Ethical Principles Applicable:
The Deontological theory could be applied in this situation, because determining what the duties and obligations of pharmaceutical...