On her desk there’s a framed quote of Nelson Mandela: "It always seems impossible until it is done." She got it from her kids for mother’s day. The quote fits. Professor Carin Uyl-de Groot, of Erasmus School of Health Policy & Management, has a clear mission: honest medicine pricing and better medical accessibility for everyone. Earlier this year Volkskrant called her the ‘promise of 2018’. It’s a title that she lives up to: she’s managed to get as far as the European Parliament.
What’s your research about?
"I’ve been researching cancer medicine for about a year now. In a particular I’ve been looking into access patients have to these medicines. The last twenty years the costs of these medicines has multiplied by twenty. Treating one patient can sometimes cost up to a hundred-twenty thousand euro – and that’s for a three months life extension. And when there’s a lot of patients, you can imagine that there’s a problem in insuring it all. At the same time it’s the pharmaceutical industry that cashes in the big money. For comparison: banks make a profit of about ten percent, the pharmaceutical industry – twenty. Some pharmaceutical companies claim, "We haven’t made a profit." But their CEO makes about 17 million a year."
How is it possible that the profit margin is that big?
"The producer of every new medicine has its patent, which means a monopoly. With a monopoly you can ask for whatever price you want. The pharmaceutical companies feel pressured by stakeholders – they need to make a large profit. We also see that when the rights to a patent end, the producers find ways to still keep it running, keeping the prices up. Sometimes old medicines are rebranded in order to get them a new patent that’ll last another twenty years."
"The tricky thing is that we’re dealing with a lot of lobbyists who want to keep the prices the way they are"
-Carin Uyl-de Groot
Wouldn’t anyone in their right mind say that we shouldn’t want that?
"I’m in talks with everyone including the European Parliament to see what we can do about this. The tricky thing is that we’re dealing with a lot of lobbyists who want to keep the prices the way they are. The pharmaceutical industry has people everywhere."
You say that the pharmaceuticals have lobbyists in politics – isn’t that a bit cynical?
"It’s just the truth. So we also have to lobby. As citizens we have a right to be healthy, a right to get treatment. This isn’t quite yet reality in Netherlands, but in some Eastern-European countries the scales have completely tipped. Everyone can see it. Eventually the tides will have to turn."
Will they?
"Of course they will. I’m not doing this research on my own – at Erasmus I have twelve PhD students, we’re a whole team. Also doctors and patient organizations are participating. The KWF, for example. But I do think we’re going to be playing the long game here. It’s mostly the injustice of it that bothers me. For example: a lot of medical research is funded by the people, but then at some point it’s bought up by a pharmaceutical. They’ll be charging for production costs, but in truth those have already been paid for – by us."
Is your solution to put a stop to the free market?
"No, but there needs to be a certain transparency when it comes to production costs. Companies can do whatever they want. My formula is: by all means take on the development costs, the failures, the profit too – but be transparent about the costs."
You can continue to read the full interview in the November issue of Erasmus Alumni Magazine
Text: Pauline Bijster
Photo: © Claudia Broekhoff
- CV
Name: Carin Uyl-de Groot
Study: Health Sciences, PhD in Health Economics
Carreer: Professor of Health Technology Assessment at Erasmus University Rotterdam. Director of the institute for Medical Technology Assessment. Analyses cost efficiency of expensive medicine for the Health Institute. Has been a member of the Oncological Aids Review Committee since 2013, and has been a member of the Health Council since 2015.
