Why Cure When Treatment Is More Profitable? A Confession from the Industry

 Why Cure When Treatment Is More Profitable? A Confession from the Industry

I’m about to tell you something that most people in the pharmaceutical industry won’t say out loud, but it’s the truth many of us know: curing diseases doesn’t make money. What makes money is treatment—ongoing, long-term treatment. While it may sound harsh, the pharmaceutical industry, like any other industry, thrives on repeat customers, and a one-time cure simply doesn’t provide that. Let’s break this down.

The Business of Illness

At its core, the pharmaceutical industry is a business, and like any business, profitability is key. Here’s the thing: a cure for a disease—whether it’s cancer, diabetes, or chronic heart disease—means that once the patient is cured, they stop buying our products. They no longer need their medications, treatments, or follow-up care. In contrast, treatments create long-term customers who keep coming back, ensuring a steady stream of revenue.

Take, for instance, Type 2 diabetes. There’s no permanent cure, but there are countless treatments—insulin, metformin, SGLT2 inhibitors, and GLP-1 agonists, to name a few. In 2021, the global market for diabetes drugs was valued at over $50 billion. Why would the industry rush to find a cure for diabetes when the ongoing management of this disease is generating tens of billions every year?

Here’s the kicker: if a company were to release a cure, it would cause a major disruption to this market. Billions of dollars in treatment revenue would dry up. Meanwhile, the cost of researching and developing that cure might not even be recouped. It’s a high-risk, low-reward scenario in business terms.

Treatment: A Lucrative Revenue Stream

Consider the best-selling drugs of all time. It’s no surprise that most of them are treatments, not cures. Look at Humira, a drug used to treat autoimmune diseases like rheumatoid arthritis and Crohn’s disease. Since its launch, it has become one of the highest-grossing drugs, with peak annual sales of over $20 billion. What makes Humira so profitable is that patients must take it continuously, often for the rest of their lives.

Contrast this with something like Sovaldi, a drug that cures Hepatitis C. While Sovaldi was a breakthrough in medicine, it’s not making the same kind of long-term profits as treatments like Humira. Why? Because Sovaldi cures the disease in a short period of time, typically 12 weeks, after which the patient no longer needs the drug. Sure, the price tag on Sovaldi was high—around $84,000 for a 12-week course—but the company quickly saw diminishing returns as more people were cured and fewer needed the drug.

Another great example is cancer treatment. The cancer drug market was valued at approximately $150 billion in 2020 and is expected to grow steadily. Many treatments involve rounds of chemotherapy, radiation, and targeted drugs that need to be administered over the course of months or years. These treatments cost tens of thousands, sometimes hundreds of thousands, of dollars. A one-time cure? That might make headlines, but it won’t make sustainable revenue.

Recurring Revenue: The Lifeblood of the Industry

As a business model, treatment offers recurring revenue, which is the foundation of any profitable company. It’s simple: patients with chronic illnesses—whether it’s hypertension, high cholesterol, asthma, or HIV—need ongoing medications to manage their conditions. Every time they refill their prescriptions, we make money. Every time they need a new version or combination of drugs, we make money.

Think about it from a purely business perspective. If the goal of a pharmaceutical company is to increase revenue year after year, we need patients to continue needing our products. Developing treatments for chronic conditions guarantees that patients remain customers for life. This is why most R&D dollars are spent on treatments rather than cures. It’s not necessarily because cures are impossible, but because from a financial standpoint, treatments make far more sense.

The numbers back this up. According to a report by IQVIA, global spending on medicines is projected to reach $1.6 trillion by 2025, with most of that coming from ongoing treatment of chronic conditions. For the pharmaceutical industry, this means continuous revenue growth driven by patients who need long-term care.

The Hard Truth: Cure vs. Treatment

If you think about it, developing a cure is like creating a product that a customer buys once and never needs again. That might sound noble from a medical or ethical standpoint, but from a business perspective, it’s not sustainable. Let’s say we develop a cure for cancer. The initial market might be huge, but once everyone who needs the cure gets it, the market will shrink dramatically. Meanwhile, the costs of developing the cure (clinical trials, regulatory approval, marketing) will remain high, and there’s no guarantee the company will even break even.

Now, compare that to a cancer treatment like chemotherapy or immunotherapy. Patients undergoing these treatments require months, sometimes years, of medication. The longer the treatment, the more profitable it becomes. Each new innovation in cancer treatment adds another revenue stream, keeping the cash flow steady.

This isn’t to say that cures aren’t developed—of course they are. But they are the exception, not the rule. The industry is built around long-term treatments because they guarantee recurring revenue. It’s the same logic you’ll find in other industries: subscription-based services like Netflix or Spotify are more profitable than one-time purchases. In the pharmaceutical world, treatments are the subscriptions, and cures are the one-time purchases.

Conclusion: Why Treatment Is King

In the pharmaceutical industry, profitability comes from managing diseases, not eliminating them. It’s not because we don’t care about patients—we do—but the reality is that businesses need recurring revenue to survive. The most profitable drugs are the ones that treat chronic conditions because they create long-term customers. Drugs that offer cures may make headlines, but they don’t keep the money flowing in the same way treatments do.

So, as long as the business of illness remains as profitable as it is, expect to see more treatments than cures. It’s just how the system works.