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What's to stop "innovative drug companies" from buying fake reviews to boost their numbers? It already happens in places like TrustPilot and others.

kyledrake 10y ago
It will frown on fake reviews, but there will be an option to pay to remove bad reviews posted by the widows of the deceased stating that their loved ones died from complications of a foodborne illness at that establishment. The widows were more "adventurous" and thus survived. When do I get my board seat?
Taek 10y ago
Right now, not much. The internet and academia both lack a good solution to information manipulation. A robust decentralized reputation system would go a very long way in solving a huge number of problems. I don't think anyone is that close though. I feel like we are just one major breakthrough away, but that breakthrough is likely to take a form that nobody is expecting.
- mattnewton 10y ago
  The way to solve it is to have different branches with checks and balances. The FDA is one such branch that should, in theory, not care about anything other than consumer safety, the legislative branch limits it's powers so it doesn't go too far and stop innovation, and the researchers try and beat the best of FDA's powers with evidence that their drug is safe. If something is broken there, it's because of leaky incentives (ie, people not really caring about the consumer on the FDA because of a revolving door with industry) or because it's imbalanced (the FDA has too much power and it can shut down drugs with legitimate evidence of safety, for example, or not enough power, or drug companies don't have enough money anymore to convince the FDA, etc)
  - snrplfth 10y ago
    The leakiest incentive is that the FDA gets in a huge amount of trouble if it lets through a drug that has unforseen negative side effects, but faces essentially zero consequences for holding up the approval of a worthwhile drug indefinitely, and requiring billions of dollars to be spent on its development.
    - anigbrowl 10y ago
      What wonder drugs are on the market in other developed countries that US consumers are dying to get hold of? If this is a big problem it should be easy to name several.
      - snrplfth 10y ago
        I didn't say they were on the market in other developed countries, since the drug approval bodies in those countries tend to face similar incentives. My point is that the process which requires drugs, even many existing generics, to go through extremely extensive testing for each possible application, is a problem because it means that only very large companies have the financial wherewhithal to get drugs through approval, and there is a strong incentive to focus on drugs which will be big sellers in a large market, rather than drugs for smaller markets. The trouble is that one does not see what was prevented from existing.
        anigbrowl 10y ago
        Then I'd say the primary problem is to reduce the cost of an access to clinical trials or improved flexibility in the trial requirements proportional to the size and plight of the patient population. The 'similar incentives' you mention are wanting to avoid public-health crises of the sort we have experienced many times in the past. The trouble is that one does not see what was prevented from existing. Opportunity cost is a basic fact of economics. It seems to me that people put a higher premium on reliability than novelty in this sphere; that is to say, the cost to society of people dying from terminal disease is less than that of people dying unexpectedly after treatment for less deadly conditions. Also, your statement assumes those cures will never be discoverable.
DoodleBuggy 10y ago
Fake reviews are part of the innovation.

kyledrake 10y ago

It will frown on fake reviews, but there will be an option to pay to remove bad reviews posted by the widows of the deceased stating that their loved ones died from complications of a foodborne illness at that establishment. The widows were more "adventurous" and thus survived. When do I get my board seat?

Taek 10y ago

Right now, not much. The internet and academia both lack a good solution to information manipulation. A robust decentralized reputation system would go a very long way in solving a huge number of problems. I don't think anyone is that close though. I feel like we are just one major breakthrough away, but that breakthrough is likely to take a form that nobody is expecting.

mattnewton 10y ago
The way to solve it is to have different branches with checks and balances. The FDA is one such branch that should, in theory, not care about anything other than consumer safety, the legislative branch limits it's powers so it doesn't go too far and stop innovation, and the researchers try and beat the best of FDA's powers with evidence that their drug is safe. If something is broken there, it's because of leaky incentives (ie, people not really caring about the consumer on the FDA because of a revolving door with industry) or because it's imbalanced (the FDA has too much power and it can shut down drugs with legitimate evidence of safety, for example, or not enough power, or drug companies don't have enough money anymore to convince the FDA, etc)
- snrplfth 10y ago
  The leakiest incentive is that the FDA gets in a huge amount of trouble if it lets through a drug that has unforseen negative side effects, but faces essentially zero consequences for holding up the approval of a worthwhile drug indefinitely, and requiring billions of dollars to be spent on its development.
  - anigbrowl 10y ago
    What wonder drugs are on the market in other developed countries that US consumers are dying to get hold of? If this is a big problem it should be easy to name several.
    - snrplfth 10y ago
      I didn't say they were on the market in other developed countries, since the drug approval bodies in those countries tend to face similar incentives. My point is that the process which requires drugs, even many existing generics, to go through extremely extensive testing for each possible application, is a problem because it means that only very large companies have the financial wherewhithal to get drugs through approval, and there is a strong incentive to focus on drugs which will be big sellers in a large market, rather than drugs for smaller markets. The trouble is that one does not see what was prevented from existing.
      - anigbrowl 10y ago
        Then I'd say the primary problem is to reduce the cost of an access to clinical trials or improved flexibility in the trial requirements proportional to the size and plight of the patient population. The 'similar incentives' you mention are wanting to avoid public-health crises of the sort we have experienced many times in the past. The trouble is that one does not see what was prevented from existing. Opportunity cost is a basic fact of economics. It seems to me that people put a higher premium on reliability than novelty in this sphere; that is to say, the cost to society of people dying from terminal disease is less than that of people dying unexpectedly after treatment for less deadly conditions. Also, your statement assumes those cures will never be discoverable.

DoodleBuggy 10y ago

Fake reviews are part of the innovation.