3 ms·

It seems lots of pain was inflicted on many people because of the patent system. Usually drugs are upheld as the prime example of why patent systems are necessa

It seems lots of pain was inflicted on many people because of the patent system. Usually drugs are upheld as the prime example of why patent systems are necessary. This seems more than questionable, given this example. Combined with the fact that companies have no conscience, it would be nice to have better ways to do expensive research than a) in companies and b) for patents.

maxerickson 11y ago
Medically reasonable alternatives have been on the market since 1950 (hydrocodone for example). Patents didn't drive the use of Oxycontin. The article is even about the supposed justification of choosing Oxycontin, the 12 hour dosing, not being sufficient or even harmful.
- auggierose 11y ago
  The patent system drove that company to develop something to stay ahead of the game, and when it wasn't good enough on its own merits, they cheated. So yes, it was partially the fault of the patent system.
- makomk 11y ago
  The entire reason the manufacturer was pushing Oxycontin's 12-hour dosing so hard was because they had a patent on it, and if it required more frequent dosing the patent gave no advantage over the cheaper patent-free formulations. That's why it was so important to them that doctors stuck to the official 12-hour dosing interval even if it led to a higher overall dosage and ineffective pain relief.
  - maxerickson 11y ago
    Yes, I understand the dynamic. I refuse to see doctors as the hapless victims of a corporation.
- vinceguidry 11y ago
  Your dismissiveness is unwarranted and wrong. The whole reason the drug was developed because their patent on their current flagship drug was expiring. It's right there in the article. Oxycontin is essentially hydrocodone with a time-release mechanism. You need to demonstrate significant distance from existing medication in order to get a new patent. The entire debacle, soup to nuts, was driven by the patent system. Without it, a) the drug wouldn't have even gotten developed, and b) the 12 hour marketing claim would not have been politically and economically necessary for Purdue.
  - maxerickson 11y ago
    The patent and the marketing didn't make hydrocodone less viable as an alternative. I mean, the doctors can see that information coming from the company can be problematic and be cautious of it. I guess they ideally shouldn't have to be, but that's not the world. Personally, I'd be fine dismantling Purdue for something like this. We need to start recognizing that large institutions make mistakes for reasons that can't be fixed.
    - vinceguidry 11y ago
      I'm not opposed to that, but you also need to fix broken systems, otherwise the problem will recur.
      - maxerickson 11y ago
        To me the big flaw is that FDA approval and the associated studies were enough to drive the prescriptions. It would be pretty easy for the healthcare system to systematically run their own comparative studies on new drugs (during the course of normal care). There's some ethical mumbo jumbo around best possible care to look at, but I think being cautious about unfamiliar products is probably a nice offset to those concerns. I find myself thinking back to this discussion: https://news.ycombinator.com/item?id=11627213 https://news.ycombinator.com/item?id=11627213 Where I quoted Peter Pronovost (the checklist guy) saying: The fundamental problem with the quality of American medicine is that we’ve failed to view delivery of health care as a science. The tasks of medical science fall into three buckets. One is understanding disease biology. One is finding effective therapies. And one is ensuring those therapies are delivered effectively. That third bucket has been almost totally ignored by research funders, government, and academia. It’s viewed as the art of medicine. This is literally a case of boxes 1 and 2 being checked, with little attention to box 3.

maxerickson 11y ago

Medically reasonable alternatives have been on the market since 1950 (hydrocodone for example). Patents didn't drive the use of Oxycontin. The article is even about the supposed justification of choosing Oxycontin, the 12 hour dosing, not being sufficient or even harmful.

auggierose 11y ago
The patent system drove that company to develop something to stay ahead of the game, and when it wasn't good enough on its own merits, they cheated. So yes, it was partially the fault of the patent system.
makomk 11y ago
The entire reason the manufacturer was pushing Oxycontin's 12-hour dosing so hard was because they had a patent on it, and if it required more frequent dosing the patent gave no advantage over the cheaper patent-free formulations. That's why it was so important to them that doctors stuck to the official 12-hour dosing interval even if it led to a higher overall dosage and ineffective pain relief.
- maxerickson 11y ago
  Yes, I understand the dynamic. I refuse to see doctors as the hapless victims of a corporation.
vinceguidry 11y ago
Your dismissiveness is unwarranted and wrong. The whole reason the drug was developed because their patent on their current flagship drug was expiring. It's right there in the article. Oxycontin is essentially hydrocodone with a time-release mechanism. You need to demonstrate significant distance from existing medication in order to get a new patent. The entire debacle, soup to nuts, was driven by the patent system. Without it, a) the drug wouldn't have even gotten developed, and b) the 12 hour marketing claim would not have been politically and economically necessary for Purdue.
- maxerickson 11y ago
  The patent and the marketing didn't make hydrocodone less viable as an alternative. I mean, the doctors can see that information coming from the company can be problematic and be cautious of it. I guess they ideally shouldn't have to be, but that's not the world. Personally, I'd be fine dismantling Purdue for something like this. We need to start recognizing that large institutions make mistakes for reasons that can't be fixed.
  - vinceguidry 11y ago
    I'm not opposed to that, but you also need to fix broken systems, otherwise the problem will recur.
    - maxerickson 11y ago
      To me the big flaw is that FDA approval and the associated studies were enough to drive the prescriptions. It would be pretty easy for the healthcare system to systematically run their own comparative studies on new drugs (during the course of normal care). There's some ethical mumbo jumbo around best possible care to look at, but I think being cautious about unfamiliar products is probably a nice offset to those concerns. I find myself thinking back to this discussion: https://news.ycombinator.com/item?id=11627213 https://news.ycombinator.com/item?id=11627213 Where I quoted Peter Pronovost (the checklist guy) saying: The fundamental problem with the quality of American medicine is that we’ve failed to view delivery of health care as a science. The tasks of medical science fall into three buckets. One is understanding disease biology. One is finding effective therapies. And one is ensuring those therapies are delivered effectively. That third bucket has been almost totally ignored by research funders, government, and academia. It’s viewed as the art of medicine. This is literally a case of boxes 1 and 2 being checked, with little attention to box 3.