3 ms·
> Would be great if the proven natural remedies were compiled into a clean, peer-reviewed database, free to use 'Proven' in this context means 'FDA-approved',
by smallnamespace 10y ago
> Would be great if the proven natural remedies were compiled into a clean, peer-reviewed database, free to use
'Proven' in this context means 'FDA-approved', but regulation in the US basically only encourages development of novel, patentable pharmaceutical compounds at the expense of everything else.
Because only novel compounds and formulations can be patented, there is zero incentive for any company to do research on plant medicinals: they wouldn't be able to recoup the cost of the research (people can just go buy the actual plant supplement, even if the company patented a different formulation).
Because only deep-pocketed pharma companies seek FDA approval for drugs, the regulatory apparatus has over time gotten more and more expensive and rigid. I believe even getting a drug to Stage 3 trials is in the tens of millions of dollars. This very high barrier to entry further forces pharmaceutical companies to only invest in drugs that will be highly profitable ('blockbusters'). (http://www.forbes.com/sites/theapothecary/2012/04/25/how-the-fda-stifles-new-cures-part-ii-90-of-clinical-trial-costs-are-incurred-in-phase-iii/#65af6acb41e8 http://www.forbes.com/sites/theapothecary/2012/04/25/how-the...)
Because of the close relationship between pharmaceutical companies and doctors, it's often a large professional risk for a doctor to prescribe a supplement to a patient. If something goes wrong, the local medical board can and will go after doctors for not going with FDA approved guidelines for treatment. That's why to even see a doctor who will prescribe supplements, in the US you often have to look for a 'naturopath'.
TL;DR:
regulation that favors new compounds -> no profit incentive to look at plant compounds -> no group that will lobby for change -> regulation that favors new compounds
Just as a counterpoint, herbal medicines in China are widely available, very cheap, and there is a large amount of government-funded research into which plants have what compounds and what they do. Doctors are also allowed to prescribe them and routinely do. Obviously, it helped that there was a developed system of medicine in China before Western medicine arrived.
This is somewhat similar to the status of Kampo medicine in Japan ('Kampo' literally means 'Han prescription'), except Kampo medicine isn't under as active development.
By no means is the system in China is perfect -- there's probably under-regulation of the 'patent medicine' system and a lot of low quality crap sold to the public. But at the end of the day, a large class of pharmaceutically active and relevant medicinal compounds aren't simply excluded because they don't mesh well with the basic assumptions of the regulatory apparatus.
- dharma1 10y agoYeah. I don't think FDA-approved will ever happen for a majority of the substances, since it's too expensive. Perhaps "proven" could just be several independent studies showing something works in a certain way. Even if most doctors were not able to use the database initially in their daily work, it would still be valuable to researchers. TCM - I'm not overly familiar with it, but I think an ideal system today would need to be subject to much more rigorous scientific examination in terms of what works and what doesn't. Traditional medicine and folklore can greatly reduce the search space of plant compounds, but probably isn't enough on it's own.