Leading article: A bitter pill to swallow

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Capitalism has long lived with contradictions. But it is not necessary to attempt to comprehend the complexity of the credit crunch to see that. Consider the polypill. You would have to go a long way to uncover a market failure as striking as that.

This little wonder drug is, in some senses, nothing new. It is a tablet that combines the effective ingredients of five different medications – three different drugs to control blood pressure, a statin to lower cholesterol and aspirin which doctors have long known lowers the risk of heart attacks when taken daily in even small quantities. The combined polypill result lowers the risk of heart attack by a staggering 44 per cent. So much so that many medics have suggested that every man over the age of 50 – and every woman over 60 – should take a polypill a day. The side effects are negligible. So is the cost of the drugs involved, since they are all out of patent now. A packet of polypills would cost pennies to make.

There is the rub. It can be done so cheaply that there is no incentive for the pharmaceutical industry to stump up the money to run the requisite clinical trials. If there will be not that much profit why shell out all that cash? It is the same logic which prevents drug companies from working on a cure for malaria, a disease that kills mainly poor people who could not afford to pay for any treatment even if there was one, while pouring millions into improving indigestion relief medicines to ease the overweight stomachs of the obese rich world.

Six years ago the British Medical Journal hailed the polypill as one of the most important discoveries in recent decades. And yet progress to producing it has been lamentably slow. Leaving it to the market has got us nowhere. But why has the British Government not backed the project? It has been so dilatory that work on the discovery has now passed to Australia, New Zealand and even Iran. If the polypill was available there would, of course, be a necessary debate about whether the mass medication of the entire population would be desirable. But it would be nice to be in a position where such a debate was possible.

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