Conservatives who support Donald Trump’s choice of Robert F. Kennedy Jr. to lead the Health and Human Services Department say he will disrupt the healthcare bureaucracy. They may be right. But he could also disrupt access to life-saving medicines and the innovation ecosystem that creates them.
Mr. Trump disrupted the healthcare Leviathan in a good way during his first term. He signed a “right to try” law that expanded access to experimental therapies for the terminally ill. His Food and Drug Administration green-lighted more generic drugs that increased competition to branded medicines and reduced prices.
His administration’s Operation Warp Speed during the pandemic showed how private industry and government can accelerate the development of innovative medicines. Mr. Trump is right to consider the Covid vaccines an achievement even if they didn’t vanquish the virus.
When sick with Covid in 2020, Mr. Trump was treated with Gilead’s antiviral remdesivir — pulled off the shelf from past research on Ebola — and the experimental monoclonal antibody Regeneron. He dubbed the latter a “cure.” He may owe his life to the pharmaceutical industry that RFK Jr. and his allies decry.
They overlook that large drug makers often license or buy drugs pioneered by startups. Medical innovation is iterative, with new treatments building on earlier discoveries and failures. It’s ironic that RFK Jr. touts the anti-parasite drug ivermectin as a treatment for Covid since it was developed by the big, bad pharmaceutical company Merck.
Pharma R&D has fallen with the Inflation Reduction Act’s drug price controls. Manufacturers are slashing riskier programs, often treatments for rare diseases that are less likely to recoup investment. Only 0.02% of drugs that enter preclinical testing end up getting to market, and only 20% to 30% of those earn back their cost.
The danger is that RFK Jr. would use his regulatory power at HHS to further discourage biopharmaceutical investment and undermine innovation. He says he wants to end alleged corruption between drug makers and government — by which he seems to mean curbing pharmaceutical profits by making it harder for medicines to come to market.
Consider the treatments that could get stalled under Secretary Kennedy:
Gene therapies using CRISPR tools and virus vectors that repair defective genes that cause debilitating conditions such as sickle-cell disease and hemophilia. Devices that stimulate electrical impulses in the brain stem and which can cure auto-immune diseases. CAR T-cells re-engineered in test tubes from a cancer patient’s blood that attack tumors.
Antibody drug conjugates that deliver chemotherapy to cancer cells around the body like targeted missiles and don’t damage nearby tissue. Personalized mRNA vaccines that turbocharge the immune system to target particular proteins from a patient’s tumor and prevent recurrences. GLP-1 agonists like Ozempic that also treat drug and alcohol addictions, Parkinson’s, dementia and more.
Mr. Kennedy opposes GLP-1 drugs because he thinks Americans should eat healthier and exercise to lose weight.
That’s fine as far as it goes. But neither exercise nor dietary changes will cure diabetes, and hormonal changes make it difficult for severely obese patients to lose weight without medical interventions.
Many conditions can be treated and prevented without drugs. The next Trump administration could use its bully pulpit to encourage exercise, healthier eating, less screen time and regular screenings for cancer and diabetes.
But vaccines are also essential to preventing disease in children and adults. Childhood vaccines have all but vanquished deadly infectious diseases in the U.S. HPV vaccines have greatly reduced cervical cancer.
Scientists have discovered that latent viruses like Epstein-Barr can trigger auto-immune conditions and cancers later in life, so developing anti-virus vaccines can ward off debilitating diseases.
