07/16/2013 08:03 EDT | Updated 09/15/2013 05:12 EDT

A Question For You About Drugs

prescription pain pills...

Usually people respond with positive or negative comments to my blogs each week. This one is different. I'm looking for your opinion on where health care should fall between capitalism and the public good.

I work with hundreds of physicians in regards to their finances and we often discuss what's going on in the medical community. One recent conversation left me feeling confused about our free enterprise system. After thinking about it for a few days I thought I'd get your opinion on something that happens in the pharmaceutical industry that few people know about.

A pharmaceutical company will spend a lot of money on research to find new drugs. When they have something they know they can market, they get it approved along with the patent rights on that drug. If it's a good drug, they can make a lot of money during that patent period.

When the patent period expires, other pharmaceutical companies are allowed to mass produce the drug with few (or no) variations to the formula. There are a number of tests and requirements that are in place to ensure that the generic drug and the original drug do the same job, but there can be slight differences.

Once the drug is mass-produced, the profit margin for the pharmaceutical companies is drastically reduced because the exclusive nature of the patent no longer exists. It's a simple matter of supply. I assume up to this point you see nothing disconcerting. Neither did I until I found out what happens when the drug becomes so available and so cheap that no one is making money off it -- generic or brand name.

Apparently everyone stops making it and they go on to something else. Imagine you're a patient and you've been on the same medication for years. Say the only thing that works for you is Ergotamine. You, like thousands of other Canadians, suffer from severe migraines.

Twenty years ago after numerous failed attempts your physician tries Ergotamine and finally you find some relief. Now after 20 years your physician tells you that Ergotamine is no longer available because everyone has stopped making it. Does that seem reasonable or fair to you?

Should the government be allowed to force pharmaceutical companies to continue manufacturing drugs that are no longer profitable, if these drugs are in the public best interest?

I'm really struggling with this one. I believe in free enterprise but I'm not sure about companies being allowed to produce something that helps people and then being allowed to stop whenever it suits their bottom line. Do companies have a moral obligation to the public? Should the government have that kind of control over a business?

I'm interested to know what you think, and would also like to hear your story if you've been affected by this.

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