2 ms·

Drug approvals are currently much better than nutrition studies. Your suggestion of allowing not-known-to-work "medicine" to be sold would return us to the era

Drug approvals are currently much better than nutrition studies. Your suggestion of allowing not-known-to-work "medicine" to be sold would return us to the era of patent medicines, which killed a lot of people. You can look at the supplements market to see people dying from a similar policy right now.

BurningFrog 10y ago
Like anything else, you have to look at both costs and benefits of the alternatives. The current extremely tough FDA approval process has the benefit you mention: Fewer people are injured by unsafe drugs. But it also has a big (but harder to observe) cost: If disease X kills 1000 people/year, then each year a cure is delayed kills 1000 people. The main argument against the current system is that it weighs the deaths of people in the first category vastly more than those in the second. How many people the FDA process kills this way is hard to calculate, and you can find wildly different estimates. But most discussion assumes it doesn't even exist...
- greglindahl 10y ago
  The FDA has stricter rules now about drugs because of previous problems where some approved drugs killed people, and others were ineffective, and some were both. So we already have experience with some alternatives to the current scheme.
- generj 10y ago
  The problem is that we also don't know how many people might be killed by an unsafe drug. It's impossible to know in advance what could fail with a drug - hence the testing. We have no concept of the upper bound of possible deaths. If a major drug is released without enough drug trials and widely prescribed we could lose thousands. See Voixx for an example. Almost 40,000 people died [0]. This was with a comprehensive drug trial under the FDA process. We would have many more incidents like this if not for drug trials required by regulatory agencies. On the other hand national statistics on deaths caused by various diseases have been compiled for decades. We can know with certainty the upper bound of people killed per year (which in your example isn't 1000 but some fraction of that - no drug is 100% effective). Also, many drugs don't prevent deaths but merely comfort the patient or remove some symptoms. Many drugs have alternates which could be taken. Many drugs have an upper bound of deaths prevented of 0. Why should we risk any lives for a drug which cannot save any additional lives? In general humans prefer taking a known risk with known odds rather than an unknown risk with unknown odds. If an informed consumer wants to make a different choice than the FDA, nobody is stopping them from traveling to a country where the drug is already available. [0] http://www.npr.org/templates/story/story.php?storyId=5470430 http://www.npr.org/templates/story/story.php?storyId=5470430

BurningFrog 10y ago

Like anything else, you have to look at both costs and benefits of the alternatives. The current extremely tough FDA approval process has the benefit you mention: Fewer people are injured by unsafe drugs. But it also has a big (but harder to observe) cost: If disease X kills 1000 people/year, then each year a cure is delayed kills 1000 people. The main argument against the current system is that it weighs the deaths of people in the first category vastly more than those in the second. How many people the FDA process kills this way is hard to calculate, and you can find wildly different estimates. But most discussion assumes it doesn't even exist...

greglindahl 10y ago
The FDA has stricter rules now about drugs because of previous problems where some approved drugs killed people, and others were ineffective, and some were both. So we already have experience with some alternatives to the current scheme.
generj 10y ago
The problem is that we also don't know how many people might be killed by an unsafe drug. It's impossible to know in advance what could fail with a drug - hence the testing. We have no concept of the upper bound of possible deaths. If a major drug is released without enough drug trials and widely prescribed we could lose thousands. See Voixx for an example. Almost 40,000 people died [0]. This was with a comprehensive drug trial under the FDA process. We would have many more incidents like this if not for drug trials required by regulatory agencies. On the other hand national statistics on deaths caused by various diseases have been compiled for decades. We can know with certainty the upper bound of people killed per year (which in your example isn't 1000 but some fraction of that - no drug is 100% effective). Also, many drugs don't prevent deaths but merely comfort the patient or remove some symptoms. Many drugs have alternates which could be taken. Many drugs have an upper bound of deaths prevented of 0. Why should we risk any lives for a drug which cannot save any additional lives? In general humans prefer taking a known risk with known odds rather than an unknown risk with unknown odds. If an informed consumer wants to make a different choice than the FDA, nobody is stopping them from traveling to a country where the drug is already available. [0] http://www.npr.org/templates/story/story.php?storyId=5470430 http://www.npr.org/templates/story/story.php?storyId=5470430