Big Pharma’s Benevolent Racism

I thought we were all the same.

Ethnic Drugs: Do Partake!

A heart disease treatment specifically aimed at African Americans turns out to be nothing more than an old pill in new packaging.

BiDil is the brand name for a combination of two generic drugs that have been around for decades. The drug has a checkered past - but not because the combination doesn’t work for heart patients. The drug’s mix of hydralazine and isosorbide dinitrate (H/I for short) works, and in fact, the combination is one of the oldest treatments around. It just doesn’t work as well as other, relatively newer treatments, like ACE inhibitors, though doctors will prescribe the generic two-fer if heart patients do not respond to other treatments. Because the combination couldn’t be patented (you can’t patent existing generics) and because it was not as successful as ACE inhibitors in two landmark studies, the profitability of the drug has been puny. It wasn’t until the combination was designed to be prescribed in a particular method that a patent was granted - and BiDil was born. Still, it didn’t go anywhere. Remember? ‘Cuz other treatments work better! Bummer.

The obvious solution? Segregate and conquer.

After some fun retrospective dredging of said landmark studies (you can read the full account in all its detailed glory here), it was found that a totally insignificant number of African Americans participating benefited from the H/I combo. 49 whole people. Um, okay.

Amazingly, despite the fact that there was no statistical significance and the study was not even designed with the correct parameters necessary to establish a specific racial variation, the dredging was enough to get one Jay Cohn a new patent to stave off the BiDil frittering for a few more years.

Cohn, who had been working with a company called Medco, then relicensed this glowing statisticness to NitroMed and initiated a new, larger (read: slightly more reasonable) study of 1,050 self-reported African Americans (ding ding ding red flag) to examine whether or not African Americans - who suffer from greater rates of heart disease - could specifically benefit from BiDil.

The study proved that, low and behold, when compared with a placebo treatment, participants did benefit! The only trouble was that BiDil wasn’t compared against other drugs in this study that have already been shown to be more effective…for everybody.

It gets better: no other races were included in the study. It really gets better: all evidence to date shows conclusively that the H/I combination is equally effective no matter how much melanin you happen to be sporting in your skin. But why let a little thing like that stand in the way of profits, people? Besides, as long as racism is benevolent, it’s totally okay!

What’s really messed up about this? Aside from the shoddy science in service of commerce, you can thank BiDil for helping to establish a race-based precedent for the federal government. I guess they forgot about a little thing called segregation.

Even more ricoculous is the fact that there is no such thing as race. The genetic differences in people of the very same race are far greater than any genetic differences in people of so-called “different” races. As Scientific American puts it, grouping people by race is about as scientific as grouping tigers and zebras together because they are stripey.

So let’s sum this bad boy up:

1. BiDil has been around forever. It’s just two generics mixed together. The only way to extend the patent and attempt to shill this sucker is to remarket it as a drug for a specific group.
2. BiDil is not the best heart medication, though it is helpful.
3. BiDil works equally well on everyone regardless of race.
4. Other drugs work better on everyone, including African Americans.
5. Oh yeah: there are no significant genetic differences among “races” that could meaningfully be construed to differentiate heart treatments.
6. The reason African Americans suffer from higher rates of heart disease is due to socioeconomic factors. But whatever.
7. Now the federal government can make medical decisions based upon the unscientific standard of race.

Give it up for BiDil!