SCIENCE+CULTURE
Psychedelics: Threat Or Opportunity For Big Pharma?
Breaking the stigma around psychedelics and mental health
The psychedelic renaissance, backed by established scientific institutions, poses a huge threat to Big Pharma and here’s why:
“Big Pharma” is the widely used term to describe the massive companies dominating the pharmaceutical industry. Companies like Johnson & Johnson or Pfizer (valued at $422B & $235B respectively) are two of the many included in this group.
These companies make money by selling drugs to sick people. The more people who are sick and stay sick, the more money these companies make.
It sounds a little pessimistic I know, but it’s the sad truth of this current industry. Curing people of their diseases or conditions reduces revenues and profits being made.
Like many other businesses, they need returning customers. And for that reason alone, pharmaceutical giants prefer not to develop drugs that cure illnesses. Instead, they target drug development that merely treats symptoms.
We often see this happen with mental health treatment. One might argue that there is no cure for mental illnesses. However, we’re recently discovering that pharmaceutical industries were either looking in the wrong places, or not looking at all. Current methods of treatment are often unsatisfactory, leaving people with no hope.
But before we get into how psychedelics might change all of that, let’s look into the current most common method to fight mental health disorders.
Antidepressants
Currently, the most common method of mental health treatment relies on the use of antidepressants. Can they temporarily reduce symptoms? Yes. Can they cure the condition? No.
Antidepressants often fail to show lasting results. Their “short pockets of relief” require people to consistently take them, often trapping them into a vicious cycle where they now rely on the drug.
In addition, they take weeks or months to kick in, if they do at all. Even then, people experience adverse side-effects, including the risk of withdrawal when they attempt to stop taking them.
This doesn’t mean that antidepressants don’t work or aren’t effective. They’re just super inefficient. Studies involving adults with moderate and severe depression show that antidepressants only reduced symptoms in about 20% of people.
What are psychedelics and their role in treating mental illnesses?
Psychedelics are a class of psychoactive drugs that are proven to be most effective in getting to the root cause of many mental illnesses. They alter mood and perception, allowing people to gain new insights on the world and learn to appreciate new experiences. Some of the more popular psychedelics like LSD, MDMA, or psilocybin may ring a bell.
These substances stimulate the serotonin 2A receptor, the receptor responsible for mediating learning, cognition, and hallucinations. They are also known to suppress the brain’s default mode network, resulting in a ‘rebooting’ effect and the occurrence of neural plasticity (the creation of new neural pathways).
Compared to current commercial antidepressants, psychedelics do a much better job in treating mental illnesses. They produce remarkably faster effects, sometimes even effective with just one dose. On top of that, they’re proven to have a much longer-lasting effect that could potentially last a lifetime. A study published earlier this year demonstrates that for major depression, a couple doses of psilocybin alongside therapy is effective for up to a whole year.
“Compared to standard antidepressants, which must be taken for long stretches of time, psilocybin has the potential to enduringly relieve the symptoms of depression with one or two treatments.” — Roland R. Griffiths, Ph.D.
The psychedelic renaissance
For the longest time, the stigma behind psychedelics challenged its attempts to obtain medical recognition. Throughout the ‘60s to the ‘90s many psychedelics were abused as street and party drugs, causing many people to hold a strong bias against them today.
In 1971, President Richard Nixon signed the Controlled Substances Act that placed psychedelics under Schedule I (prescription-requiring). Some believe that they were prohibited as a matter of public health and safety. Others believe that it was because they contradict mainstream religion and influenced many to follow the Anti-Vietnam War Movement.
However, despite the past enforcements that were made, and the stigma around the drug, we’re slowly seeing it being introduced to healthcare settings. In recent years, psychedelics and their ability to cure mental illnesses, have received lots of medical recognition. One of which is MDMA.
MDMA
MDMA (3,4-Methylenedioxymethamphetamine) is a synthetic drug that has both stimulant and psychedelic properties. On August 16, 2017, the FDA granted breakthrough therapy designation for MDMA-assisted psychotherapy.
After multiple clinical trials, they are now being used in therapeutic settings to effectively treat post-traumatic stress disorder (PTSD). These treatments are “safe and well-tolerated, even in those with comorbidities.” The trials found that after a year of MDMA-assisted therapy, 67% of people reported that they no longer met the criteria for PTSD. 88% reported a “clinically significant improvement” in symptoms. On the flip side, sertraline and paroxetine, which are FDA-approved first-line antidepressants for PTSD, only had a 40–60% response in treatment.
Another study published in the research journal PLOS ONE found that healthcare cost savings of MDMA-assisted psychotherapy are estimated to be greater than $103.2 million with a return of 5,553 Quality-of-Life years per 1,000 patients.
Psilocybin
Psilocybin is another popular psychedelic compound that is naturally produced by certain species of fungi. The substance itself is biologically inactive, but when converted into psilocin in our bodies, it produces euphoric effects and can alter one’s perception. Similarly to MDMA, the FDA has also designated psilocybin as “breakthrough therapy” for the treatment of major depressive disorder (MDD).
A clinical trial done in 2021 reported that psilocybin-assisted therapy has remarkably great effects on the treatment of depression. The study shows that with just one or two doses alongside psychotherapy, substantial antidepressant effects occur at very high rates. 71% of treatment response and 54% of remission were reported.
Another clinical trial demonstrated high efficacy of psilocybin for the treatment of anxiety. Clinician-rated measures reported an overall rate of 83% in treatment response and 57% in remission.
How will Big Pharma react?
Although psychedelics have been proven to cure many mental illnesses and lower the cost of healthcare, they are seen as a huge threat to Big Pharma. Like many other businesses, Big Pharma companies rely on returning customers.
Curing illnesses with one or two doses won’t make them much profit. Thus, the incredibly reduced cost of psychedelic treatment is what makes them such a big threat to Big Pharma.
In the past, Big Pharma faced a similar threat with the uprising of medical marijuana. They reacted not by investing more in research and development (R&D), but by doing everything in their power to prevent the drug from going mainstream. However, they failed in doing so, and now the cannabis industry is booming with success.
This time with psychedelics, Big Pharma may have to respond differently to prevent the same mistake from happening again.
In order for Big Pharma to actually keep up with psychedelics, they’ll have to make fundamental changes to their businesses. The first being where they put their money.
Big Pharma companies tend to invest a much larger portion of their money into marketing rather than R&D. In 2018, companies such as Merck have invested nearly $8 billion USD more on marketing and sales versus R&D.
Not much has changed since then, in fact it’s worse. In 2021, the top R&D-spending Big Pharma companies only invested around one-fifth of their revenue towards R&D, which is incredibly underwhelming as compared to the additional $36 billion USD (+37%) invested in marketing.
In order to stay in the game, they’ll need to start investing heavily in research, clinical trials, and distribution plans.
That being said, they would also have to change their intentions of service, from maximizing revenue to bettering patient care. At the end of the day, it’s the health and wellbeing of our people that really matters.
