Stephen Hall, "Prescription for Profit"

Those who work in the pharmaceutical industry are regularly confronted with ethical questions that have life-or-death consequences. On the one hand, the industry is charged with creating and testing the medicinal drugs that ensure the public's health. On the other hand, the industry profits from the illness and suffering of others. Consequently, when those who work in the industry decide which drugs to develop and how much they should cost, their choices inevitably influence public health, the economy, and even, as was made clear after the anthrax attacks in the United States in 2001, national security. How are such decisions made? Why does the pharmaceutical industry elect to test and market one drug rather than another? What, if anything, does the industry do to ensure that real people aren't sacrificed during the pursuit of potential profit? These are the questions that Stephen Hall takes up in "Prescription for Profit," in which he examines the marketing of the antihistamine Claritin and the roles that doctors, scientists, and government regulators have played in making this the best-selling prescription drug of all time.

Hall has written extensively about scientific culture and scientific efforts to discover, explore, and create new knowledge. The author of Invisible Frontiers: The Race to Synthesize a Human Gene (1987), which describes the mapping of the human genome, and A Commotion in the Blood: Life, Death, and the Immune System (1998), which chronicles the medical community's attempts to cure cancer, Hall has tried to advance the public's understanding of the ethical perils and world-altering opportunities afforded by current scientific research projects. Hall has said, though, that he prefers not to be called a "science writer," but rather "a writer who happens to write about science." The distinction reflects Hall's overriding interest in telling stories and his belief that "science offers some of the most interesting stories, not merely in terms of personalities and individuals, but [also because] it is really one of the last cultures in this century of exploration and discovery." With his "biography" of Claritin, Hall gives his readers access to the day-to-day workings, the moral tensions, and the financial concerns of this thriving, and sometimes threatening, culture.

Digital image for the cover to A Commotion in the Blood drawn from the amazon.com web site.
Quotations from Stephen Hall, interview, "Winding Your Way through DNA" Symposium, University of California San Francisco, Fall 1992.

Links to Explore:

Claritin: Schering-Plough's home page for the antihistamine discussed in Hall's essay.

The Center for Drug Evaluation and Research: home page for the Food and Drug Administration department responsible for determining whether drugs are "safe and effective."

Open Secrets: Prescription Drugs: an issue page produced by The Center for Responsive Politics, a non-profit, non-partisan group that "tracks money in politics, and its effect on elections and public policy." This page provides their overview of the different perspectives on how to contain the cost of prescription drugs.

"The Smart Set": an article by Stephen Hall that explores science education at Millwood High School in Brooklyn, NY.

Questions for Learning:

• Anyone visiting the Claritin web site would expect to find information about the drug and about allergies more generally. This web site certainly meets through expectations. Does the web site offer any evidence, one way or the other, with regards to Hall's contention that the drug is, at best, modestly successful in alleviating the inconveniences those with allergies experience? Is the "Understanding Allergy Treatments" section simply a marketing ploy or is this area providing information that would genuinely benefit those likely to visit this site?

• Hall argues in "Prescription for Profit" that Claritin owes a good deal of its success to luck. What role does The Center for Drug Evaluation and Research accord luck in its representation of how it determines whether drugs are "safe and effective"?

• In providing its assessment of the prescription drug issue, The Center for Responsive Politics seeks to provide a balanced assessment of why the pricing of prescription drugs are regulated as they are. What is the "open secret" that the Center seeks to expose about prescription drugs? Has the Center succeeded in achieving its goal of being nonpartisan with its Open Secrets: Prescription Drugs page?

• How does a school produce students who will commit themselves to excelling in the sciences? What does it take to become a part of the group that Hall describes as "The Smart Set"? What are the advantages and what are the costs of embracing what Hall calls, "the gestalt of life as a burgeoning adolescent intellect"?

Questions for Connecting:

• In "Second Proms and Second Primaries," Lani Guinier argues that a commitment to "reciprocity" must lie at the heart of any system that is ethical, just, and fair. Does "reciprocity" have a place in the business of health care? Can one seek a system committed to such reciprocity without sacrificing the ingenuity and creativity that one finds in a system driven by the profit motive?

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