Table Of ContentThe World’s Health Care Crisis
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The World’s Health Care
Crisis
From the Laboratory Bench to the
Patient’s Bedside
By
Ibis Sánchez-Serrano
AMSTERDAM • BOSTON • HEIDELBERG • LONDON • NEW YORK • OXFORD
PARIS • SAN DIEGO • SAN FRANCISCO • SINGAPORE • SYDNEY • TOKYO
Elsevier
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First edition 2011
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Notices
Knowledge and best practice in this field are changing constantly. As new research and
experience broaden our understanding, changes in research methods, professional
practices, or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge
in evaluating and using any information, methods, compounds, or experiments described
herein. In using such information or methods, they should be mindful of their own safety
and the safety of others, including parties for whom they have a professional responsibility.
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ISBN: 978-0-12-391875-8
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show color figures where appropriate.
I dedicate this book to my family, with all my love. Like any Latin family,
they have been there for me in the joyful moments and in the difficult times,
feeling always very proud of whatever I did, even if they did not quite understand
what I was doing. And to my friend Daniel Morand, who has been not only a friend,
but also an older brother to me. He has done for me what few people nowadays are
capable of doing for others.
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When you set out on your journey to Ithaca,
pray that the road is long,
full of adventure, full of knowledge.
The Lestrygonians and the Cyclops,
the angry Poseidon—do not fear them:
You will never find such as these on your path,
if your thoughts remain lofty, if a fine
emotion touches your spirit and your body.
The Lestrygonians and the Cyclops,
the fierce Poseidon you will never encounter,
if you do not carry them within your soul,
if your soul does not set them up before you.
Pray that the road is long.
That the summer mornings are many, when,
with such pleasure, with such joy
you will enter ports seen for the first time;
stop at Phoenician markets,
and purchase fine merchandise,
mother-of-pearl and coral, amber and ebony,
and sensual perfumes of all kinds,
as many sensual perfumes as you can;
visit many Egyptian cities,
to learn and learn from their sages.
Always keep Ithaca in your mind.
To arrive there is your ultimate goal.
But do not hurry the voyage at all.
It is better to let it last for many years;
and to anchor at the island when you are old,
rich with all you have gained on the way,
not expecting that Ithaca will offer you riches.
Ithaca has given you the beautiful voyage.
Without her you would have never set out on the road.
She has nothing more to give you.
And if you find her poor, Ithaca has not deceived you.
Wise as you have become, with so much experience,
you must already have understood what Ithacas mean.
—Konstantinos P. Kavafis, Ithaca (1911)
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Contents
Preface xiii
Acknowledgments xix
Introduction xxi
Part I The Global Health Care Crisis 1
1 The World’s Health Care Crisis: The United States’ Leadership 3
The US Health Care Crisis 6
The US Health Care System 9
2 The Health Care Crisis in Other Parts of the World 29
The French Health Care System 30
The UK Health Care System 32
Private Insurance Use in Europe 35
Other Industrialized Nations 38
The Developing World: In Search of Hope 38
The Pharmaceutical Industry 41
Part II Understanding the Biopharmaceutical Business 45
3 A Brief Commercial History of the Biopharmaceutical Industry
up to the Year 2000 47
The Pharmaceutical Industry Begins 48
The Swiss Pharmaceutical Industry 51
The English Pharmaceutical Players 52
The United States Enters the Scene 53
Impact of World War I (1914–18) 55
Impact of World War II (1939–45) 57
The Biotechnology Era 60
Regulatory Pathways for Biotechnology 64
4 T he Biopharmaceutical Industry in the Twenty-first Century:
Titanic Challenges Ahead 71
The Biotechnology Business Crisis 87
The Biopharmaceutical Industry’s Short-Term Solutions to the Crisis 92