The issues I'll address in this chapter – basically, the tension between society's desire for better medicine and its aversion to higher healthcare costs – may be familiar. But I hope to offer an angle of view on these issues that may not be so familiar. I want you to look over my shoulder and see how the various choices in the policy environment affect the choices available to a CEO in my industry.
Let me start with a question: Do you believe we already have all the medical innovation we need? That may sound like a purely rhetorical question, but it's not. For one thing, there are some influential commentators who are on record as saying, in essence, “yes.” If actions can be taken as answers, I have to assume that many policymakers, here and in other nations, must agree with that view.
The two most important preconditions for innovation in my industry are market-based pricing and intellectual property protection. But when I look at healthcare systems around the world, I see that policies that support innovation are dwindling, whereas policies that discourage it are proliferating. A third-party observer trying to make sense of this, without access to other data on the motives involved, might reasonably conclude that this amounts to a worldwide campaign against pharmaceutical innovation.
These measures are almost always advocated and adopted in the name of cost control.