“We want to maximize the number of new prescriptions...”
“We want to identify people at risk at the earliest possible point...”
Pharmaceutical marketers want to maximize the number of prescriptions in order to maximize profits. They see clinical trials as investments whose purpose was to increase sales of medicines, “Important clinical studies to conduct from a scientific or medical perspective are sometimes not important studies to conduct from a drug development perspective.” Pharmaceutical researchers openly express their unhealthy predicament: “One of the significant problems for the Pharma industry is that of the 400 disease entities identified, only 40 are commercially attractive by today’s requirements of return on investment (ROI).” They see patients as points of resistance, “Pharma’s New Enemy: Clean Living”.
It looks therefore like pharmaceutical companies have found a way to grow health via clinical trials, redefining health as treatment, in part by expropriating the means of diagnosing illness, through screening tests that tell us and the doctor that we need treatment. This means they have no interest in reducing treatments but in increasing them. No matter how obvious this might seem now, I didn’t see the connections right away, even when pharmaceutical researchers said it directly: “No one is thinking about the patients, just market share” (Bartfai & Lees 2006, 73).
Just a few substitutes and these marketers could be quoting Capital. This was not surprising in the sense that Marx was quoting the industrialists of his day. What has shifted are the terms: it is Illness as Value that is being maximized, and Health of Patients rather than their Labor that is being exploited. There is a parallel of form: perhaps marketers see unproductive health the ways capitalists saw unproductive labor. That is, marketers see clinical trials as investments increasing the extent and intensity of prescriptions the way capitalists saw machinery as investments in creasing the extent and intensity of labor hours. The grammar and logic of capitalists that Marx studied in Capital, in other words, seem to be mirrored by strategies of pharmaceutical executives and marketers.
run The_Biomarx_Experiment.prog in all [marx.works]: replace [Capital] with [Biomedicine]
Dumit, Joseph. 2012. “Prescription Maximization and the Accumulation of Surplus Health in the Pharmaceutical Industry: The_Biomarx_Experiment” in Lively Capital, edited by Kaushik Sunder Rajan. Durham: Duke University Press.