6 ms·

While the eyebrow example is wrong, let's assume that the gist was correct. In general, folks tend to produce things that other people are willing to pay for.

by anamax 17y ago

While the eyebrow example is wrong, let's assume that the gist was correct. In general, folks tend to produce things that other people are willing to pay for. Why should pharma be any different? And why is this wrong? You want more drugs that save peoples lives? Great! So do I. Here's how we do it. Make it possible for folks to get rich on drugs that save people's lives. Note - cost controls won't do it (unless we're talking about controlling regulatory costs).

rsheridan6 17y ago
Here's another way - socialize medical research funding, at least for antibiotics. Antibiotics are inherently less profitable than other drugs because doctors try to avoid using new ones so that the bugs don't develop resistance to them. By the time they're freely used, the patent might have expired, as patents of the kidney-killing drugs mentioned in this article have decades ago. I don't really see a good market-based solution here.
- gort 17y ago
  And even if they do get used they heal the patient; whereas the most profitable drugs are the ones requiring continued use.
camccann 17y ago
In general, folks tend to produce things that other people are willing to pay for. Why should pharma be any different? And why is this wrong? Because having individuals with limited resources independently pursuing their own goals doesn't necessarily maximize overall utility, or even any actual individual's utility. It's entirely possible to have a scenario where, say, nobody would individually pay for something to be researched, but everyone would be willing to chip in a small portion of the cost if everyone else did the same. Since it's difficult to ensure wide-scale cooperation, it doesn't happen and the result is that everyone is worse off. I don't understand the mindset that sees a problem that, by elementary game theory, doesn't have an optimal outcome reachable by simple self-interest, and proposes that what we need is more self-interest.
- anamax 17y ago
  > Because having individuals with limited resources independently pursuing their own goals doesn't necessarily maximize overall utility, or even any actual individual's utility. If folks would rather spend their money on Viagra than antibiotics.... > It's entirely possible to have a scenario where, say, nobody would individually pay for something to be researched, but everyone would be willing to chip in a small portion of the cost if everyone else did the same. The problem with that theory is that it doesn't account for the claimed observation that eyelash extenders get funding while antibiotics don't. So, either the theory or observation is wrong. > I don't understand the mindset that sees a problem that, by elementary game theory, doesn't have an optimal outcome reachable by simple self-interest, and proposes that what we need is more self-interest. Are you actually claiming that the vast majority of people have more self-interest in eyelash extenders that antibiotics?
yummyfajitas 17y ago
Another advantage to lifestyle drugs is that they are unlikely to be taken away by politicians. Politicians are likely to nationalize/cost control/otherwise interfere with lifesaving drugs. Standing up to those greedy people trying to make money by preventing people's suffering is just good media exposure. On the other hand, cost controls for an eyelash extender? Seems less likely.
JunkDNA 17y ago
You've hit the nail on the head. I spent several years in one of the biggest antibiotics research centers in big pharma. I watched as they systematically disbanded it. The business folks had decided that there was no money in antibiotics. The reason? The FDA (and similar agencies in other countries) are pretty much guaranteed to make any new, very successful antibiotic a "drug of last resort". This means you can only give it to an individual who has failed all the standard line therapy. From a business perspective, why develop something if you are never going to be able to sell it in decent enough quantities to make a profit? Now, you could argue that at some point in the future, that drug will become standard line therapy when all the current front line drugs are completely useless. Unfortunately, by that time the drug is off patent and generic competition will ensure there won't be much profit. This is a complex situation, and I'm not pretending that there is an easy solution. It seems there are a confluence of regulations and politics that conspire to prevent serious attempts at new antibiotics development. The situation is changing somewhat, and my hope is that once the problem becomes more acute, the necessary incentives will be aligned.
- jrockway 17y ago
  "Hi, we're the government. Instead of bombing Iraq, we would like to buy the IP for this critical drug you developed." It's already developed, and they don't want to commercialize it, so why not sell the IP to the government or a charity. (The government could even theoretically compel the agreement via eminent domain. Or, the pharmaceutical company could donate the drug to the public domain and take a massive tax write off.)
  - JunkDNA 17y ago
    Drug companies do sell or give away IP from time to time. But even in the scenario you suggest, with finite resources, why put money into antibiotics development? Why not just fund cancer research at a higher level? I think most pharmas wouldn't want to take the risk that the governmnt would leave them holding the bag. Contrary to the popular meme, drug companies don't generally want to sit on a drug that is ready to go. But all that aside, there is nothing stopping the NIH from starting a research program and developing their own antibiotics (or any academic institution). This happens a bit already, but then it comes time to run the clinical trials and develop the research compound into an actual medicine. This requires expertise and infrastructure that does not exist in the public sector at a sufficient level to get the job done.

by anamax 17y ago

rsheridan6 17y ago

Here's another way - socialize medical research funding, at least for antibiotics. Antibiotics are inherently less profitable than other drugs because doctors try to avoid using new ones so that the bugs don't develop resistance to them. By the time they're freely used, the patent might have expired, as patents of the kidney-killing drugs mentioned in this article have decades ago. I don't really see a good market-based solution here.

gort 17y ago
And even if they do get used they heal the patient; whereas the most profitable drugs are the ones requiring continued use.

camccann 17y ago

In general, folks tend to produce things that other people are willing to pay for. Why should pharma be any different? And why is this wrong? Because having individuals with limited resources independently pursuing their own goals doesn't necessarily maximize overall utility, or even any actual individual's utility. It's entirely possible to have a scenario where, say, nobody would individually pay for something to be researched, but everyone would be willing to chip in a small portion of the cost if everyone else did the same. Since it's difficult to ensure wide-scale cooperation, it doesn't happen and the result is that everyone is worse off. I don't understand the mindset that sees a problem that, by elementary game theory, doesn't have an optimal outcome reachable by simple self-interest, and proposes that what we need is more self-interest.

anamax 17y ago
> Because having individuals with limited resources independently pursuing their own goals doesn't necessarily maximize overall utility, or even any actual individual's utility. If folks would rather spend their money on Viagra than antibiotics.... > It's entirely possible to have a scenario where, say, nobody would individually pay for something to be researched, but everyone would be willing to chip in a small portion of the cost if everyone else did the same. The problem with that theory is that it doesn't account for the claimed observation that eyelash extenders get funding while antibiotics don't. So, either the theory or observation is wrong. > I don't understand the mindset that sees a problem that, by elementary game theory, doesn't have an optimal outcome reachable by simple self-interest, and proposes that what we need is more self-interest. Are you actually claiming that the vast majority of people have more self-interest in eyelash extenders that antibiotics?

yummyfajitas 17y ago

Another advantage to lifestyle drugs is that they are unlikely to be taken away by politicians. Politicians are likely to nationalize/cost control/otherwise interfere with lifesaving drugs. Standing up to those greedy people trying to make money by preventing people's suffering is just good media exposure. On the other hand, cost controls for an eyelash extender? Seems less likely.

JunkDNA 17y ago

You've hit the nail on the head. I spent several years in one of the biggest antibiotics research centers in big pharma. I watched as they systematically disbanded it. The business folks had decided that there was no money in antibiotics. The reason? The FDA (and similar agencies in other countries) are pretty much guaranteed to make any new, very successful antibiotic a "drug of last resort". This means you can only give it to an individual who has failed all the standard line therapy. From a business perspective, why develop something if you are never going to be able to sell it in decent enough quantities to make a profit? Now, you could argue that at some point in the future, that drug will become standard line therapy when all the current front line drugs are completely useless. Unfortunately, by that time the drug is off patent and generic competition will ensure there won't be much profit. This is a complex situation, and I'm not pretending that there is an easy solution. It seems there are a confluence of regulations and politics that conspire to prevent serious attempts at new antibiotics development. The situation is changing somewhat, and my hope is that once the problem becomes more acute, the necessary incentives will be aligned.

jrockway 17y ago
"Hi, we're the government. Instead of bombing Iraq, we would like to buy the IP for this critical drug you developed." It's already developed, and they don't want to commercialize it, so why not sell the IP to the government or a charity. (The government could even theoretically compel the agreement via eminent domain. Or, the pharmaceutical company could donate the drug to the public domain and take a massive tax write off.)
- JunkDNA 17y ago
  Drug companies do sell or give away IP from time to time. But even in the scenario you suggest, with finite resources, why put money into antibiotics development? Why not just fund cancer research at a higher level? I think most pharmas wouldn't want to take the risk that the governmnt would leave them holding the bag. Contrary to the popular meme, drug companies don't generally want to sit on a drug that is ready to go. But all that aside, there is nothing stopping the NIH from starting a research program and developing their own antibiotics (or any academic institution). This happens a bit already, but then it comes time to run the clinical trials and develop the research compound into an actual medicine. This requires expertise and infrastructure that does not exist in the public sector at a sufficient level to get the job done.