Cheaper alternatives are challenging big pharma

David Crow’s analysis of the US market for pharmaceuticals illustrates how oligopoly control of the health system has led to exorbitant pricing, what President Donald Trump describes as “getting away with murder” (“ Trump is losing the war on drug prices”, August 2).

Pharmaceutical manufacturers face another long-term challenge: the de facto legalisation of marijuana for medicinal use across North America. In addition, the use of psilocybin (the active ingredient in magic mushrooms) is being adopted by the psychiatric profession, as just one or two treatments can provide an alternative to chronic use of antidepressants. The total US pharmaceutical market for pain control, multiple sclerosis, antidepressants, epilepsy, eczema and rheumatoid arthritis totals $50bn. Migration from expensive pharmaceuticals to generic extracts of cannabis and psilocybe mushrooms represents a considerable competitive threat to proprietary treatments.

The Journal of the American Medical Association reports that opioid prescriptions are already falling in states that have recently enacted medical cannabis laws. The 7-Eleven group is introducing cannabis extract oil in half of its estate of 8,000 stores in the US. Natural food shops report booming demand for cannabidiol extracts such as CBD oil. Vape shops in the UK find CBD oil is outselling nicotine extracts.

Cheap and effective medications with minimal side-effects are increasingly available. The pharmaceutical industry can raise its prices, but if demand falls away, that leaves it in a position that price hikes won’t resolve.

Craig Sams
Hastings, E Sussex, UK


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