[VIEWPOINT]The high cost of overcoming disease

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[VIEWPOINT]The high cost of overcoming disease

In a government survey, half of Korea put good health at the top of their New Year's wish lists. It is difficult to know whether what they wished for was just to be rid of physical disease and disability, or achieve better mental and social wellness, as defined by the World Health Organization. Nonetheless, if one drinks a bottle of soju every other day and smokes a pack of cigarettes every single day - 68 percent of Korean adult males smoke daily - it will be hard to realize the wish.

The best way to gain good health is to prevent disease, so quitting drinking and smoking would be the first step in disease prevention. Seeking medical treatment from doctors after becoming ill would be the second step.

Because unhappy people often have more problems, disease appears frequently among low-income families. Moreover, obesity is more common among less affluent people and those who have histories of malnutrition. This is why the World Health Organization selected social wellness as one of the re-quisites for good health. If people cannot recover from a disease or a disability, they will need others' help, and that will cause public welfare costs to rise.

This is why Rudolf Virchow, a celebrated pathologist, declared that politics is part of the enormous reach of medical science, because medicine and politics share similarities. Winners of the Nobel Prize in medical science can be considered the best physicians in the world in that sense, thus Luc Montagnier, who isolated the AIDS viruses, and Lee Ho-wang, who isolated the Hanta- virus (the etiologic agent of Korean hemorrhagic fever), can be said to have saved many lives, and the discoveries deserve a Nobel Prize in medicine.

Due to a lack of understanding of basic science in Korea, including medical science, there is not enough investment in disease prevention or in the preservation of health. In turn, a budget for disease prevention is far less compared to medical expenses, including medical insurance and a welfare budget.

This imbalance has caused biologists and basic medical scientists to state that health care and preservation of health is a leading industry of the future, and the biologists and scientists are the main force of that industry. That industry is biotechnology.

Glivec, a well known medicine used to treat leukemia, costs more than 20,000 won ($15) per tablet, and leukemia patients need to take five to six tablets every day for at least two months. Discontinuing the medicine could lead to a recurrence of leukemia.

Novartis, a Swiss-based pharmaceutical company and the developer of Glivec, is likely making an astronomical amount of money. ImClone, an American pharmaceutical company, is testing a medicine to treat cancer of the large intestine. If the medicine works, and if it comes to Korea, where stomach cancer is one of the leading causes of death among males, it is scary to think how much the medicine will cost. A large number of new medicines such as Viagra, Zocor and Avandia are being developed or have been developed, and technological evolvement in the life sciences is improving the quality of life and extending the average life expectancy. Preservation of health and medical treatment is an industry that saves lives, but it is also a heartless industry: The developer of Glivec has not made the cost affordable to less-affluent patients.

People expect doctors to practice medicine by making the preservation of life their top priority. The problems related to medical reform of allowing only medical practitioners to issue prescriptions and the reorganization of the National Health Insurance Corp.'s finances have not yet been solved.

Even as a physician, it is not particularly cheering for me to sit by and watch the emergence of miraculous medicines that will result from future development of technologies such as the Genome project, which recently had a breakthrough.

The reality is that we cannot just follow the American way of prescribing expensive drugs like Glivec. The government has invested in fundamental industries like steel, shipbuilding and construction in the past, even though we have suffered from hunger. In order to make the No. 1 New Year's wish come true, we need to get our priorities straight.


The writer is a professor of endocrinology at Seoul National University.

by Lee Hong-kyu

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