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An opinion on pharmaceutical patents

The recent global COVID-19 pandemic has prompted us to look inward to reflect. One aspect subject to this reflection is none other than our healthcare system. More specifically, Covid has presented an opportunity to investigate the shortcomings and advantages of our current healthcare system, especially as it operates within the market/mixed economy ecosystem in modern American life. In this examination, a key ethical issue emerges: pharmaceutical abuse of patents. 

The practice of medical research in pharmaceuticals is all but new. Yet, due to the very nature of research and innovation, research practices give rise to many smaller infant industries. Each discovery for a new drug or treatment creates a micro industry for itself, carving out its own section of the greater pharmaceutical industry for the taking. Each new drug then captures the demand of patients in that section, hopeful that the drug will be the cure for what ails them.  

Pharmaceutical companies that have developed a new drug can apply for a patent for it, which gives them exclusive access to the licensure, manufacturing, and distribution of their drug for 12 years. (12 years itself, I may add, is a nontrivial amount of time, especially for those suffering with a degenerative disease, but patents may be stacked on top of each other, leading to exclusive ownership for far upwards of the initial 12 year mark.) Patents effectively create a monopoly for the micro infant industry. Patents allow pharmaceutical companies to set their own prices. For life-saving medication though, this price-setting can seem to hold patients hostage, and the hefty ransom price tag can loom over them.

Some examples of this monopolistic and often exploitative behavior are the following, from the Association for Accessible Medicines:

  1. “The world’s top-selling brand drug, Humira, treats arthritis and other chronic conditions. On the market since 2002, 132 patents block competition for up to 39 years.”
  2. “One of the most prescribed cancer treatments, Revlimid, was approved by the FDA in 2005. The patent thicket consists of 96 patents providing potentially 40 years without competition.”
  3. “Diabetes patients who rely on the insulin treatment, Lantus, may not see a generic alternative for 37 years due to the 49 patents issued.”

The issue of access to affordable medicine has incredibly high stakes when we consider the desperation of the ill, especially those with terminal illness. It reaches far beyond the issue of paying more for brand name drugs as opposed to generics. But why are these mini monopolies allowed to exist? Why are there patents to begin with?

Patents incentivise innovation and research because they provide a “light at the end of the tunnel” for what is a long, arduous research process. Research requires a lot of upfront investment. Suppose Company A researches and tests a drug. Company A invests years of work and millions of dollars. Without rights to their intellectual property, Company B can swoop in after the research and testing is finished and sell the drug on the market. So why did Company A invest all of that just to be undercut? Patents disallow this story to take place. 

A further advantage of patents is that in creating the public and formal tie of ownership, they create a relationship of accountability between the company and the product. If and when things go wrong, consumers know who to turn to (or who to sue, as the case may be). Intellectual property relationships allow for consumers to air their grievances, as demonstrated by many personal injury lawyers, class-action lawsuits and even individual cases like that of the biomedical startup Theranos or that against the oral contraceptive brand Yaz. Theranos failed to deliver on its promise to accurately test low volume blood samples. Yaz was proven an ineffectual contraceptive. We are capable of knowing this now in part because of the relationships that patents formalize and reinforce. 

Patents have clear benefits. But, just as clearly, there is a trade-off between their benefits and disadvantages. We must negotiate this trade-off.

It would be quite easy for an ethicist with no more than a cursory understanding of this issue of patent abuse to draw overly simplistic conclusions. “Free healthcare for all” and “Healthcare is a human right” are slogans thrown about in modern political discourse that only begin to touch on the issues at hand. The simple and “equitable” solution that those uneducated on the topic come to is that patents should be waived completely. But if healthcare is paid for by the government, then why does the price of drugs matter? Who’s to say the government will pay for name brand drugs rather than waiting for patents to expire to qualify them for coverage? 

Another possible solution a non-expert ethicist may propose is for the government to seize control of the pharmaceutical industry, subsidizing their research and therefore owning their intellectual property. But doesn’t that just shift the monopoly from one entity (the companies) to another (the government)? And how much of our tax dollar will we allot for medical research? 

These are just a few of the important questions we need to consider for possible solutions to the patent problem. If there were a simple and effective solution available, we’d have solved the problem already. It is not enough to simply wish for free healthcare or for all the power to be seized from “Big Pharma.” There are many considerations to take into account. 

Alexa Schlaerth is a junior at the University of Notre Dame studying anthropology and linguistics. When she’s not slamming hot takes into her laptop keyboard, she can be found schooling her peers in the daily Wordle and NYT mini crossword, rewatching South Park or planning her next backpacking trip. As an Angeleno, Alexa enjoys drinking overpriced non dairy iced lattes and complaining about traffic because it’s “like, totally lame.” Alexa can be reached on Twitter at @alexa_schlaerth or via email at aschlaer@nd.edu.

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Lessons from our freshmen selves

It is almost 10 p.m. on a cold Sunday evening in December, and I am walking across the quad on my way home from a (somewhat frantic) Principles of Microeconomics TA review sesh, the likes of which I’ve never experienced before. It is chilly and dark, and the campus has a general “stressed out pre-finals” vibe about it. I, myself, have a general “stressed out pre-finals” vibe about me. 

It is 2019. And for some reason, all I can think to play on Spotify as I pace around campus is Juicewrld’s “Ring Ring” and Alanis Morrisette’s “Hand in My Pocket.” See the type of nervous and/or angsty vibe I’m feeling here? You can practically feel it. 

Freshman fall had been a whirlwind of an experience. The new friends and relationships, the different culture, the harsher weather — no one adjustment was too much to handle on its own, but the sum of these had thrown me in for a spin cycle (and paying for laundry was completely new). 

Things felt weighty. Like everything mattered immensely. Maybe some of this can be attributed to the sense of novelty that all my experiences carried along with them. I can still vividly remember the series of “firsts” that happened: my first home game, my first tailgate, my first SYR, my first philosophy paper, my first midterms (though I may wish to forget that last one). But even apart from that, I had a sort of first-year chip on my shoulder, not from any wrongdoing per se, but instead from the mere fact that I knew I had to prove myself. I had to live up to that Notre Dame name I had praised so highly in my admissions essays just a year before. There was a good feeling that came along with the importance I felt in even the most mundane of tasks.

My freshman year abounded with small moments that became big because they were indicative of decisions I was making on my own. I began to really consider my priorities and what truly mattered to me, on even the most minute of a scale: what I wore on Friday, if I woke up early to work out this week, the tone with which I emailed my boss or my professors, the list goes on. 

This obviously amounted to immense stress I felt with every micro-decision I made. After all, did “sincerely” accurately reflect who I was as a person, or was “best regards” a better fit? 

This stress did come along with a lot of self-compassion, though, and somehow I was able to be patient enough with myself and allow myself the time and space to make mistakes, knowing I’d have three more years to fix them and really hone my email sign-offs, amidst other things.

Now, a few years later, I’m learning from different mistakes, and the pressure is still turned to a 10. But I’ve noticed I am a lot less patient with myself. There’s an added “you should know this by now,” a judgment that has tacked on with time that is not conducive to a true growth mindset. 

After this reflection, inspired by when “Hand in My Pocket” came on after shuffling my Spotify liked songs while walking to class, I want to make sure my lessons from my freshman self are not merely constructions of nostalgia or an oversimplification of what times really were like back then. I want to make sure there’s something material I can actually take away from 2019 Alexa. 

And I think that every now and then, it’s important to take a step in the shoes of my freshman self, to adopt the viewpoint of my younger, more nervous and turbulent alter ego to remember a couple things.

Firstly, the small efforts we make here on this campus and here in this world matter. Conversations with a professor in office hours, whether or not we did that one reading for theology, the people we wave to on our way to SDH — these little actions and decisions can carry a small but beautiful weight to them that can leave a mark on us and others long after they’re carried out. They can be a reflection of our integrity and of what we value.

And secondly, although even the little things carry a weight to them, it is important to remember that we are human, and we make mistakes. A cliché at this point, maybe, but remembering to not cast aspersions on myself after erring and just allowing myself to take things in stride has made a huge difference in my life.

Now, if you’ll allow me, I’d like to bring TikTok into this column, as I have oft-done (and as is my right!) When the trend of “being the main character” came about, I dismissed it as some sort of appeal to internal narcissism. But now, after going through this vivid flashback or montage of freshman year, I kind of see the light. Things feel nice and concise when we pretend we’re in a movie.

In the spirit of romanticizing our lives, let’s take this first-year throwback’s lessons into our slightly more mature adult lives. We are, after all, still in the freshman phase of our adulthood. 

Alexa Schlaerth is a junior at the University of Notre Dame studying anthropology and linguistics. When she’s not slamming hot takes into her laptop keyboard, she can be found schooling her peers in the daily Wordle and NYT mini crossword, rewatching South Park or planning her next backpacking trip. As an Angeleno, Alexa enjoys drinking overpriced, non-dairy iced lattes and complaining about traffic because it’s “like, totally lame.” Alexa can be reached on Twitter at @alexa_schlaerth or via email at aschlaer@nd.edu.

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We need to start using people-first language. Here’s why. 

As a new anthropology major, I am eager to explore the various subcategories of discipline, including, but not limited to the sociocultural and linguistic aspects of study. And in this, the first week (or so) of classes, my mind has already been opened to the power behind the language used within the area of study consequences that go beyond the classroom.

Academia has historically led the way in terms of linguistic and cultural shifts. A more recent and hotly-debated emergence is, of course, the creation of Critical Theory in sociology, expansion to Critical Race Theory (CRT) in legal studies in law schools across the country, and its (more controversial) recent adaptation and adoption in elementary, middle and high schools. 

While I recognize that imposing standard habits of the practice onto any external group may be met with opposition, I think the case can be made that the benefits outweigh the disadvantages in changing one particular linguistic norm: identity-first language. 

In the realm of discussing disability, we have in the past labeled people with their disability first. “Blind people.” “Austistic person.” “Disabled person.”  It had even been common practice to omit the term “person” or “people” altogether in favor of using the disability identifier as a noun (i.e. “a paraplegic”). Identity-first language can have the effect of limiting a person’s sense of self to their diagnosis, and that is why it is becoming more and more commonplace to favor people-first language (i.e. a person with a disability). It is important to note here, too, that people-first language does not aim to cast aspersions or pass judgements on things like disability by saying “a victim of autism” or “someone afflicted with blindness.” Its goal is to simply acknowledge the differences in an experience-based way.

I was introduced to this issue of identity-first language in a class centering on the anthropological study of obesity. In this, my very surface-level research, I found that a lot of the messaging on even the WHO and CDC websites to be fascinating, including the framing of obesity as a chronic disease instead of what has typically been a framing of a moral deficiency.  I noticed that obesity, as of late, has been framed in relation to the issue of Covid. The CDC site describes obesity and its effects as comorbidities that could lead to a poor prognosis in the event of a Covid diagnosis. This coupling, the conversation of these two conditions in relation to one another, is what I think has partly driven the expansion of our collective understanding of obesity as something that can be a disability as well as something that is more complex than we had initially thought. This, too, is what I think expands people-first language to this condition. 

So when the CDC and WHO use the newer norm of referring to people experiencing obesity as “people with obesity” instead of “obese people,” I strongly feel that this use of people-first language is much more dignifying in addition to being more accurate. People are not solely defined nor identified by any one aspect of their being, especially if that aspect is a diagnosis. People-first language accounts for this, and it is a long overdue linguistic change. It is high time we change our modes of discussion around disability to acknowledge the individual dignity of every person and their lived experience, however varied from ours. It’s worth the extra syllables.

Alexa Schlaerth is a junior at the University of Notre Dame studying anthropology and linguistics. When she’s not slamming hot takes into her laptop keyboard, she can be found schooling her peers in the daily Wordle and NYT mini crossword, rewatching South Park, or planning her next backpacking trip. As an Angeleno, Alexa enjoys drinking overpriced non dairy iced lattes and complaining about traffic because it’s “like, totally lame.” Alexa can be reached on Twitter at @alexa_schlaerth, or via email at aschlaer@nd.edu.