What’s Your Treasure?

© Iryna Denysova | 123rf.com

© Iryna Denysova | 123rf.com

There is a great scene in The Hobbit: The Battle of the Five Armies where Thorin Oakenshield realizes that the golden treasure of Smaug had captured his heart. He forgot the simple truth of Matthew 6:19-24, that whatever he treasured controlled his heart; and whatever controlled his heart would control his behavior. “A treasure such as this cannot be counted in lives lost. It is worth all the blood we can spend.” He finally realized that he’d been blinded by his greed for Smaug’s earthly treasure and had turned against everything he valued. “You sit here in these vast halls with a crown upon your head, and yet you are lesser now than you have ever been.” Tossing aside his crown, which was a symbol of what ruled his heart, he joined in the battle against the Orcs, helping to turn a defeat into victory.

Do not lay up for yourselves treasures on earth, where moth and rust destroy and where thieves break in and steal, but lay up for yourselves treasures in heaven, where neither moth nor rust destroys and where thieves do not break in and steal. For where your treasure is, there your heart will be also. “The eye is the lamp of the body. So, if your eye is healthy, your whole body will be full of light, but if your eye is bad, your whole body will be full of darkness. If then the light in you is darkness, how great is the darkness! “No one can serve two masters, for either he will hate the one and love the other, or he will be devoted to the one and despise the other. You cannot serve God and money. (Matthew 6:19-24)

Both within The Hobbit and the Matthew passage, the metaphor of treasure is used to illustrate the consequences of allowing earthly treasure to rule our heart. Jesus cautioned his listeners to not hoard (lay up) treasures on earth. Rather they should strive to do the things that result in (lay up) treasures in heaven. Hoarding earthly treasure will not protect it from being corrupted and consumed. Investing in heavenly treasure provides a storehouse of wealth beyond the reach of earthly corruption. Paul Tripp, in Instruments in the Redeemer’s Hands, said:

There are only two kinds of treasures, earthly and heavenly, and whatever treasures we choose will become our rulers. They exercise control over us, for if something is your treasure, you will live to gain, maintain and enjoy it. Sadly, we often fail to see this in ourselves, though we can see it in others. One of the most tragic things that could happen to a human being is to invest his life in pursuit of the wrong treasure.

There is a parallel here between the “heart” in verse 21, and the “eyes” of verses 22 and 23. In his commentary on Matthew, Craig Blomberg commented that just as the heart represents the center of our psychic life, the eyes enable us to see the world around us. “Good and bad eyes probably parallel a good and bad heart and thus refer, respectively, to storing up treasures in heaven versus storing them up on earth.” So if that which should lead to good (the light in you) actually causes evil (darkness), “the person is truly perverse.”

So there is an association here to the blindness and heart issues discussed in Luke 6:39-45 and Ezekiel 14:1-11 (See “Diagnosing Spiritual Heart Problems” and “Spiritual Heart Problems” respectively). There cannot be a bad tree that bears good fruit or a good tree that bears bad fruit. The idol in our heart has a stumbling block that will trip us up, even as we come to seek the Lord. “The things we set our hearts on never remain under our control. Instead, they capture, control, and enslave us.”

There are only two options open.  Each person must choose between the competing treasures of heaven and earth, God and money. Using the institution of slavery to illustrate his point, Jesus stated that service to God was antithetical to hoarding earthly treasure. In other words, there is a binary relationship between God and wealth. If you are ruled by one, you will be devoted to it and love it. You will also hate and despise the other. “You cannot serve both God and money.”

Although the immediate context of the passage addresses material wealth, the lessons learned here apply to all other areas of our lives. Earthly treasure will not last, while heavenly treasure will. Whatever you treasure controls your heart. You can’t serve God and anything else at the same time. And whatever controls your heart, controls your behavior.


Pharma and Its Golden Hoard

© Chrisjeanes | Dreamstime.com - Smaug - The Hobbit Photo

© Chrisjeanes | Dreamstime.com – Smaug – The Hobbit Photo

The debate over the cost of drug development goes all the way back to the late 1950s. The then Chairman of the U.S. Senate’s Anti-Trust and Monopoly Subcommittee said that the pharmaceutical industry had: 1) predatory pricing and excessive margins related to their patents; 2) that extravagant increases in costs and prices were due to large expenditures in marketing; and 3) most of the industry’s new products were no more effective than the ones already on the market. It seems that little has changed over the past fifty-five years.

An often-quoted 2003 study on the cost of drug development by DiMasi et al., “The Price of Innovation,” concluded that it cost an estimated $802 million in 2000 dollars to bring a new drug to market. The 2014 profile released by PhRMA, the advocacy group for the U.S. pharmaceutical industry, estimated that it cost $1.2 billion to develop a new drug. PhRMA noted that: “some more recent studies estimate the cost to be even higher.” In contradiction of the higher R&D estimates of DiMasi and PhRMA, Light and Warburton suggested that: “R&D costs companies a median of $43.4 million per new drug.” This is less than 1/18th of the $802 million estimate by DiMasi et al.

Deciding whose figures to trust can be tricky. For example, Light and Warburton pointed out that the Tufts Center for the Study of Drug Development, where the DiMasi study was conducted, has received “substantial industry funding for years.” Among the concerns they had with the DiMasi study were: inflated costs for drug trials; exaggerated time for R&D; corporate financial risk for R&D was much lower than reported; average costs based on “means” and not “medians,” leading to inflated figures. Using the median trial costs reported by DiMasi (74% of the mean trail costs), they said: “the $802 million figure would have been reduced to $593 million had median costs been used.”

Scott Gavura in “What Does a New Drug Cost” part 1 looked at both the DiMasi study and its critique by Light and Warburton. Gavura said he found the Light and Warburton figure “implausibly small.” In “What Does a New Drug Cost” part 2, he elaborated, saying that he thought their estimates “were based on a sequence of highly implausible assumptions;” the average drug development cost would be higher in the real world. He asked if the low-hanging fruit in drug development is gone. “A growing concern with the pharmaceutical industry is its overall productivity in delivering new drugs.” Gavura concluded his article by stating that he thought criticism of the pharmaceutical industry was justified, if it was done for the right reasons.

Being skeptical of R&D estimates is wise. Data on individual drugs is not transparent, and estimates must incorporate a number of assumptions which have the potential to bias the conclusions.  This lack of transparency fuels suspicion of the process. But we should also be equally skeptical of arguments that dismiss or diminish the growing problems with R&D. There is good evidence to suggest that drug development is a risky, expensive endeavor, and that this work is getting harder.

In a 2008 article published in PLOS Medicine, “The Cost of Pushing Pills,” Gagnon and Lexichin explored the reported expenditures of the pharmaceutical industry and concluded that: “pharmaceutical companies spend almost twice as much on promotion as they do on R&D.”  Their estimate was made from highly reliable sources, one of them being IMS Health, a company relied upon by both the federal government and the pharmaceutical industry for information on the healthcare industry.

Their revised estimates for promotional spending in the US for 2004 was $57.5 billion, twice that of IMS Health. This compares to the $31.5 billion reported by the National Science Foundation for domestic industrial pharmaceutical R&D in 2004. “These numbers clearly show how promotion predominates over R&D in the pharmaceutical industry, contrary to the industry’s claim.”

Allen Frances, the chair of the DSM-IV, has become an outspoken critic of modern psychiatry, the DSM-5, and “Big Pharma.” He reported in Saving Normal that worldwide pharmaceutical sales exceed $700 billion each year. Half of that figure is spent in North America and another one fourth in Europe. Rick Newman reported that Pharma’s profit margin was 16.4 percent, the seventh highest among the industries tracked by Morningside, an independent investment research firm.

The justification of high prices and huge profits by pharmaceutical companies was “mostly fluff,” according to Frances. “Drug pricing has no relation to real cost or value and instead reflects Pharma’s monopoly position in the market and its dominance over politicians.”  At its worst, he said that pharmaceutical research is a “deceptive shell game” meant to seduce and mislead doctors and the public. “The claim that drugs are so expensive because they require so much research is pure smoke screen.”

In The Desolation of Smaug, the final scene shows the dragon Smaug rising up out of molten gold. Goaded by the unsuccessful attempt of the dwarves to destroy him, he flies off to take his revenge on the unsuspecting Lake-town of Esgaroth. Over the past sixty years we have allowed Pharma to gather a golden hoard through its profits from drug development. Like Smaug, Pharma jealously guards its hoard. If we take on a quest to right this injustice, we must be careful not to loose an angry, vengeful dragon upon an unsuspecting humanity by mistake.