Child health care is not only geared towards keeping a child healthy; it also concerns the care and treatment of a child after disease has stricken. Children in infancy, toddlers, and elementary schoolers are constantly getting sick, usually by some common flu or disease that strikes most kids. Care usually means a few days in the bed, soup, cough medicine, and home remedies that have worked since the Revolutionary War. These mild illnesses are to be expected: our immune systems develop resistance after exposure, but exposure comes first. By the time we are adults, our immune system has thousands of resistances, and it’s only the flu and those major diseases that endanger us. Despite the seeming susceptibility of children to common diseases, when compared to adults, children are simply more healthy. Child health care seems not to be as high a priority as adult health care. For example, every year, a million American adults are diagnosed with cancer, but no more than 13,000 children under 19 receive the same diagnosis. As might be expected, health care dollars will be directed to those million, but with little directed towards those 13,000 children with the same ailment.
This inequity in child health care makes sense if you look at it from the view of the pharmaceutical industry. There’s more money to be made developing drugs that will treat those million then to be made developing drugs for 13,000 children. This is clearly demonstrated by the variety of drugs that are available for the treatment of sick children. More than likely, if your child is taking a medical drug, it’s one that was tested and labeled for use by adults. Two thirds of all pharmaceuticals used on children fit into this category. Pharmaceutical medicines are just not created with children in mind.
Part of the problem of developing medicine to be used for child health care is that, as mentioned above, children are more healthy than adults. To test a drug, you need sick people, but with so few sick children, it’s difficult to gather enough for testing and study. With a disease like cancer, you’ve got a very small population indeed. That’s why 93 percent of cancer stricken children are being treated with at least one drug that is not approved for pediatric use. To overcome this shortage of child test subjects, national and international networks have been established to combine geographically separate groups of ill children, primarily those with cancer, to form a large enough group to test.
Most pharmaceuticals that work for adults will work for children as well, but few will come with dosage requirements for children. The attending physician will normally calibrate the correct amount for the child and determine the appropriate dose. This works, to some extent, but administering drugs to children that have not been tested for children is still a dubious practice. Children may suffer side effects that adults will not.
Because the pharmaceutical companies lack the economic incentives to develop drugs for child health care, the Federal government has passed laws forcing them to do so. In 1998, the FDA required drug companies to test drugs that would be used on children, but in 2002 the requirement had to be dropped when it was determined the FDA did not have such authority. Recognizing that drug manufacturers are moved more by a profit potential than by compassion, Congress passed the Pediatric Research Equity Act of 2003 and the Best Pharmaceutical for Children Act in 2007. Drug companies that develop drugs for child health care under this act are rewarded with a six month extension on exclusive marketing.
Unfortunately, these incentives did not inspire drug companies. A study showed that while some drugs for children made the fast track to approval, there was little increase in the number of drugs available. The most cynical reason for not manufacturing drugs for child health care is that the drug manufacturer reduces liability, because it is left to the physician to determine dose and schedule. From this brief overview of the performance of pharmaceutical manufacturers with regard to child health care, we can safely conclude, with such companies, not all to be sure, profit is a higher priority than the health and life of a child. Perhaps it’s time for government to force these companies to care for children too.