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An anarchist takes on Big Pharma by teaching patients to make their own meds

371 points by anarbadalov 9y ago

leggomylibro 9y ago
That seems both super dangerous, and super awesome. It's not something that we should have to consider. But this is the world we live in, now; legitimate supply lines of life-saving medicine have collapsed for a fair number of people. I understand why people might be troubled by someone actively going out and advocating this as opposed to simply making the information available, but if you're offered medicine with 95% efficacy that you can afford and use vs. a well-regulated 99.99% that only exists theoretically...well, come on.
- nkrisc 9y ago
  Consider this story that mades the rounds recently as well: people using antibiotics marketed for fish because they can't afford or get access to anything else. https://motherboard.vice.com/en_us/article/bjxwma/people-are-buying-fish-antibiotics-because-they-cant-afford-human-ones https://motherboard.vice.com/en_us/article/bjxwma/people-are...
  - miguelrochefort 9y ago
    Also very popular amongst survivalists.
- JumpCrisscross 9y ago
  When drug companies issue patents, do they not also publicise production methods?
  - vonmoltke 9y ago
    Generally, no. Even if they did, based on my experience with process-sensitive non-pharmaceutical products it takes a lot of experimentation and refinement to execute the process correctly.
  - vqc 9y ago
    It depends on the scope of the patent. But to some extent, kind of. See, e.g., the patent for an adalimumab (Humira) formulation https://patents.google.com/patent/US9085619B2/en https://patents.google.com/patent/US9085619B2/en. The patent discloses materials and methods for creating a formulation of the drug. The real issue is probably that there are so many moving parts, especially when you get to the more complex drugs (e.g. antibodies). You would have to go through a million patents to find all the information required to create the actual molecule and also get it in a state to put into your body. And even with all the information, it is unlikely anyone is sufficiently resourced (whether it's money, tools, or know-how) to actually make something viable.
  - sigstoat 9y ago
    as vonmoltke suggests, even if you've got some chemical synthesis procedure laid out in a peer reviewed journal, you are, in the best case, expert man hours away from successfully duplicating it. and you'll only know you've successfully duplicated it if you can run the result through really expensive analytical equipment to confirm that 1) you made the stuff you wanted to make and 2) it doesn't have impurities that are problematic. (as a minor defense of the pharma companies, you're paying them not just to do a bunch of organic synthesis for you, but also to do ongoing QA that the synthesis process is working correctly. and not all processes are equally easy/amenable to industrial-scale duplication.)
    - drvdevd 9y ago
      Obviously this is true. There’s much that goes into industrial synthesis that someone with a setup like his at home just can’t currently reproduce, and safely. What I find most dubious about the article is the lack of attention to synthetic biology. Because QA in that sense can become say, “this modified organism can produce the drug in question under most conditions and all future populations will carry the new genes with X% assurance” - ONCE -and you’re done. This is quite possibly the real Pharma killer, IMO.
      - vqc 9y ago
        But only kind of. Even if you could get a strain of yeast to produce a specific antibody 100% of the time, how reliably could you get the yeast to grow? If you can get it to grow, how reliably can you extract a enough of the antibody to form just one dose? If you can extract, can you get it into a formulation that is pharmaceutically viable? Its not just about synthesis. There's so much tooling and expertise that goes into front end, back end, deployment, db, QA, etc ,etc, etc just to get one app going. Why would would drug deployment be any different?
        drvdevd 9y ago
        Well, yes you’re correct, there are associated complexities I’ve glossed over. My point however is simply that all of these complexities only really need to be solved once by an expert or team of experts such that non-experts can then utilize such a biotechnology (“yeast strain”) to produce some medicinal compound or other useful engineered metabolite. A yeast strain that can’t be reliably cultivated by a non-expert with relative ease and safety (in a non-laboratory) wouldn’t make the cut, in theory. Also the same semi-synthetic organism could be applied in traditional pharmaceutical process settings as well, if for no reason other than cost reduction (and probably workforce reduction as well). So even “big pharma” has some incentive to contribute to this sort of technology.
  - mandevil 9y ago
    It isn't even the basics of the synthesis chain that are difficult. Most (small molecule) stuff a lab chemist could whip up a batch of given a bit of time and reasonable access to precursors. But this is exactly like saying "Reddit is just a few SQL queries, a reasonable programmer could whip up their own version in a weekend." Just like there is only one reddit/StackOverflow/Facebook even though plenty of people have the same basic idea, even knowing the chemical formula doesn't help that much. The trick is in the execution: generating reliable quantities of reliable strength and without any contaminants. There is a whole field, process engineers, devoted to this quite difficult problem.
- dannyw 9y ago
  Agreed. When you actively advocate for this, do you face moral responsibility when someone prepares it wrong and dies? (I’m pretty sure the legal answer would be yes on so many fronts)
  - deleted 9y ago
    [deleted]
  - wavefunction 9y ago
    I don't know that the legal system necessarily cares about morality or moral responsibility. It seems like the only criteria that would matter would be legal responsibility, whatever that standard might be.
    - QAPereo 9y ago
      If you take actions which a reasonable person would expect to cause harm to others, there is a legal dimension there ranging from civil liability, to the extreme of 2nd degree murder via “depraved indifference” statutes.
      - wavefunction 9y ago
        Good points.
    - steveeq1 9y ago
      Or the criteria: "which moral stance makes me the most profit?"
    - LeifCarrotson 9y ago
      It isn't always about whether the legal system cares. They're asking whether or not moral people should care. Those can be very different.
  - Y_Y 9y ago
    If you don't misrepresent it then I can hardly see how. Does the writer of a recipe book incur blame if someone undercooks their chicken?
- WalterSear 9y ago
  The cost of medicine I require to be functional enough to hold down a job has risen so much that the copay is the equivalent of the entire out-of-pocket cost from a few years ago. The medication was discovered in 1969. The application method, which is the shitty excuse for the patents protecting its $2,200/month price tag, was first approved for use by the FDA in 1979. The drug has been for sale in it's current form for over a decade.
  - octaveguin 9y ago
    Enbrel? They just received another patent extension, too. This is what government granted monopolies look like.
    - dv_dt 9y ago
      This is what the breakdown of working competitive markets look like, and in this case it takes both government monopolies, as well as well as overwhelming short-term greed on the part of the private companies. Long term don't these companies think that charging outrageous prices for drugs will cause a future voter/government backlash of some sort... or maybe they think they should extract profits now because of a chance of drug price regulation coming to the US in the future?
      - Sangermaine 9y ago
        >Long term don't these companies think that charging outrageous prices for drugs will cause a future voter/government backlash of some sort No, because it demonstrably won't. People say they're angry and then do nothing about it. The US has an entire political party angrily decrying any effort to regulate healthcare as socialist slavery. The drug companies know they'll be just fine. Maybe some token slaps on the wrist and public performance of cosmetic changes to appease people now and then, but nothing will happen to them.
        dv_dt 9y ago
        Perhaps, though I think I'm more energized personally voting & with campaign involvement in the upcoming elections this year than ever before. And part of that is knowing that it might help Medicare for all or other universal healthcare options - maybe not this election or the even the next - but personally I feel it has to happen and is worth working towards.
- Sangermaine 9y ago
  >but if you're offered medicine with 95% efficacy that you can afford But it's not clear at all this is the case here. The article itself notes that it's unknown whether anyone has ever used any of these DIY medicines/medical devices, let alone how well they actually work. For all we know he could be pushing complete nonsense that kills people.
  - pizza 9y ago
    He could be, but.. it's not as if all federally-sanctioned medicines are not complete nonsense that (don't) kill people, either. Let alone merely having greater iatrogenics than benefits. Relatedly, when doctors strike, mortality rates decrease [0]. Plus, very useful medicines that are deemed too unsafe to become publicly consumed may be totally safe for subsets of the general population, e.g. based on differing expression of enzymes, or other phenotypic differences. If you are (more or less) coping just fine with a health problem, (most often) you shouldn't really take any medicine whatsoever, regardless of whether or not it is approved. Only if you are distressed and desperate can you (a priori) expect medicine to do more good than harm. And if you are in that category, and the medicines that exist officially did not help, then you must make other attempts to rectify the problem in order to avoid danger. Admittedly it's not much of a source of relief, but the good thing about the nature of hobbyist tinkering networks is that information about dangers spreads fast, as well as information about discovered panaceas (both when the results are replicated in their favor, and when they falsify the panacea). [0] https://www.ncbi.nlm.nih.gov/pubmed/18849101 https://www.ncbi.nlm.nih.gov/pubmed/18849101
- agumonkey 9y ago
  It's dangerous so far. I'm still all for better information and more diy. People will understand their health and real value of products better.
- nylonstrung 9y ago
  I think a middle ground is sourcing them from private chemists on Alibaba and then getting spectrometry tests done to verify purity
- random023987 9y ago
  > super awesome. This is not super-awesome. Humans have made incredible progress by specializing and optimizing, and this process improves productivity, efficiently, and (most importantly when it comes to medicine) safety. The idea that we will have people taking the risk of getting sick or dying because they are not able to manufacture drugs with the same purity and potency as pharmaceutical companies shows there is a huge problem with the status quo.
  - leggomylibro 9y ago
    Yes, that also seems pretty clear. But we are here, and this is now. Complaining is easy and feels good, but let's talk practical solutions.
- tritium 9y ago
  Collapsed? Or were supply lines selectively destroyed by market-cornering adversaries, knowingly, according to the degree of “demand” which might be extracted?
- losername 9y ago
  If this is anything like open source in software (in the beginning) then many either never get to compile the dependencies needed to build from the source or run into hardware incompatibilities and incompatible derivate packages with all the ensuing bugs like blindness, deafness, and more serious malfunctions. And when it works the functionality will be severely limited. I'm half joking, but this will need a huge caveat emptor.
Overtonwindow 9y ago
DIY pharmaceuticals is ....well it sounds immensely dangerous. Not only is the chemistry frightening but quality and chemical availability. It reminds me of Naturopaths and herboligists claiming to cure and treat ailments with supplements. As much as I hate the pharmaceutical industry, I think it's best for now to leave the drug making to them.
- joering2 9y ago
  DIY pharmaceuticals sounds dangerous. Sure! So is eating 47 teaspoon of salt, 480 bananas, or drinking 179 expressos [1]. If you happen to be unable to afford so much coffee, just rent a car and smash into a tree at 100 miles per hour. So driving cars is also immensely dangerous! I really hate that nany state we are living in where an average 16 year old is lawfully allowed to drive 5,000 pounds metal machine and kill people at even limited speeds of 50 mph, but yet when it comes to DIY pharmaceuticals we immediately see a vision of most population dying at home because they mixed something wrong. https://gizmodo.com/how-many-x-would-you-need-to-eat-to-die-1684237567 https://gizmodo.com/how-many-x-would-you-need-to-eat-to-die-...
  - Overtonwindow 9y ago
    You didn't read the article did you...
    - ZephyrP 9y ago
      Pressure on all sides to maintain HN norms here. "You don't insinuate someone didn't read the article on HN", it's in the guidelines in fact, take a look when you have some free time: https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html Otherwise, I think you'll agree that the threat of PhD level chemists making and giving these drugs out isn't exactly critical.
Florin_Andrei 9y ago
Next up - DIY Lasik surgery.
- maxxxxx 9y ago
  In German but here is a DIY dentist: https://www.youtube.com/watch?v=MrbyL6yMyn0 https://www.youtube.com/watch?v=MrbyL6yMyn0
- Overtonwindow 9y ago
  I got LASIK at 21. It was a miracle. It wore off at 31. I must've gotten it too soon. Back to glasses.
  - kemiller 9y ago
    Nah, it just does that sometimes. I got it at 35 and it started to wear off 6 years later.
- zokier 9y ago
  Isn't the actual surgery in LASIK-style operations pretty much fully automated anyways? Feels actually quite a bit safer than DIY pharmaceuticals. And the failure-modes of LASIK seem kinda less worse than in pharmaceuticals too.
fhood 9y ago
Honest question: What does it even mean to be an anarchist these days? What is the default "anarchist"? Because Wikipedia isn't really helping.
- jchanimal 9y ago
  “”” Noam Chomsky: Well, anarchism is, in my view, basically a kind of tendency in human thought which shows up in different forms in different circumstances, and has some leading characteristics. Primarily it is a tendency that is suspicious and skeptical of domination, authority, and hierarchy. It seeks structures of hierarchy and domination in human life over the whole range, extending from, say, patriarchal families to, say, imperial systems, and it asks whether those systems are justified. It assumes that the burden of proof for anyone in a position of power and authority lies on them. Their authority is not self-justifying. They have to give a reason for it, a justification. And if they can’t justify that authority and power and control, which is the usual case, then the authority ought to be dismantled and replaced by something more free and just. And, as I understand it, anarchy is just that tendency. “”” http://www.alternet.org/civil-liberties/noam-chomsky-kind-anarchism-i-believe-and-whats-wrong-libertarians http://www.alternet.org/civil-liberties/noam-chomsky-kind-an...
  - fhood 9y ago
    Thanks, that was an excellent answer.
    - eeZah7Ux 9y ago
      Erich Fromm's quote about rational VS irrational authority is helpful: http://fromm-online.org/en/autoritaet/ http://fromm-online.org/en/autoritaet/
  - kemiller 9y ago
    Vs the classical conservative world view in which order, even if it's unjust, is usually better for everyone, even the people on the bottom, than chaos; and that dismantling power structures, if done suddenly or without care, is more likely to result in chaos than in a new, more just, order. I've been wondering lately if there is room for the notion of a conservative anarchist, who questions hierarchy but dismantles carefully and incrementally.
wccrawford 9y ago
>Then he took another sip from a flute of Taittinger Champagne. What? >Swaggering, charismatic, and complex, Gag me. >Michael Laufer has become a fixture in the growing biohacker movement ever since he published plans last year for a do-it-yourself EpiPencil — a $35 alternative to the pricey EpiPen. That couldn't possibly go wrong, eh? >It’s not clear whether anyone has actually ever used a homemade EpiPencil to prevent anaphylactic shock. So nobody's quite crazy enough to try? >But that seems almost an afterthought to Laufer’s bigger goal — trying to build a DIY movement to attack high pharma pricing and empower patients. Or, judging by the tone of this article, his attempt to build his own ego. This is ridiculous and crazy. It's incredibly dangerous to claim to have produced something life saving but not have any actual testing to back it up. Even lesser drugs that are just designed to lessen symptoms or relieve pain could go horribly wrong if they aren't prepared properly. We have such strict medical requirements because of that.
- kentosi 9y ago
  Agreed that the article is a little too flattering to his ego, but what about people desperate for medical aid, can't afford it, and would probably end up with pain/death without this as an alternative? What should they do?
  - deleted 9y ago
    [deleted]
  - nradov 9y ago
    Most people who are desperate and too poor to afford medications are also too poor to afford the tools and supplies necessary to make their own medications. I don't think this will solve the problem of drug affordability.
  - Sangermaine 9y ago
    Not listen to this guy. As the article notes none of his ideas or creations have ever been tried by anyone, including himself, and require fairly sophisticated ability to set up and make. In fact from the article it's not clear at all what exactly this guy is offering or how it helps anyone beyond his self-aggrandizing bluster.
jfarlow 9y ago
Open Insulin @ Counter Culture Labs: https://experiment.com/projects/open-insulin https://experiment.com/projects/open-insulin If you want to look at templates for your own immunotherapy, CRISPR, optogenetic tools etc.: https://serotiny.bio/notes/proteins/ https://serotiny.bio/notes/proteins/ Which, once built can be then be ordered as DNA, shapeways-style using: https://serotiny.bio/notes/pinecone/ https://serotiny.bio/notes/pinecone/ The cure for certain kinds of blindness, just approved by the FDA yesterday is, in total, a well-delivered sequence of ~10,000 base pairs of DNA (mfg cost @ 7¢/bp = $700): http://www.businessinsider.com/spark-therapeutics-hereditary-blindness-gene-therapy-advisory-committee-2017-10 http://www.businessinsider.com/spark-therapeutics-hereditary...
- burger_moon 9y ago
  Regarding Counter Culture Labs. It looks like they post update videos periodically, but do they have something on the market yet? What does their insulin cost per IU?
- moh_maya 9y ago
  Oh man. I agree with your sentiment, but this is a remarkable over simplification! The sequence may cost 700$ to synthesise. But it's delivery vector is a virus. Synthesizing the DNA, encapsulating the DNA in the virus.. not trivial stuff. While I agree that drug prices in the US are absurd beyond comprehension or justification, and I've had a ring side view of life sci research, drug development as well as the drug pricing; to posit that, hah, a path breaking gene therapy product just costs a few hundreds or a couple of thousands to produce is misrepresenting the complexity as well as the significance of the achievement. The amount of research (largely public funded but for the clinical trials, which may also have been public funded: no idea) to get to this point is staggering. the company also likely invested large amounts to Shepard a lab possibility into a viable treatment. FDA approval is a big deal because they are, justifiably, exceedingly strict. It is an arduous process. There has to be a better solution, which would start with allowing the US CMS / Medicare & Medicaid to negotiate drug prices with the manufacturers. The problem is policy.
  - jfarlow 9y ago
fabian2k 9y ago
Synthesizing some simpler drugs sounds feasible even with amateur equipment, but still far from trivial. But I can't see that working reliably without the ability to do proper analytics on all steps. And regular people don't just have an NMR spectrometer at home. Chemical reactions usually don't have a single product, other side reactions are possible. And they also don't use up 100% of the educt, so you have to get rid of that as well. Purifying your products and making sure they're actually what you want is essential. Getting the dose right is also hard if you don't know how pure your product is, and if you don't have analytical scales (or work at a very large scale that a kitchen scale is enough).
- zokier 9y ago
  > And regular people don't just have an NMR spectrometer at home. I've only watched NurdRage videos, but it seems like sending samples to commercial NMR labs is pretty feasible as he does that regularly. So that might not be as big of an issue.
louithethrid 9y ago
The day anyone can get dna-programmable yeast and a reactor to grow it- big pharma is goone. What a nice woody sort of word.
- goatlover 9y ago
  Because I'm going to trust the kid's medicine down the street with no oversight? Isn't this kind of like the day 3D printers become affordable, mass manufacturing is done?
  - blacksmith_tb 9y ago
    If 3D printers were not just affordable but infallible, yes. It would be easier to have a bioreactor bubbling away to synthesize your pharmaceuticals than to try and make a lab-in-a-box kit that was equally robust (more like brewing kombucha in your kitchen than Breaking Bad for Dummies), but either way you still need to assay the results...
    - goatlover 9y ago
      > If 3D printers were not just affordable but infallible, yes. Infallible and easy to use. But you still need to buy the raw materials, unless we're talking Star Trek energy-matter conversion, which isn't on the horizon. Otherwise, why would an average consumer think that buying the raw material and feeding it to their 3D printer is that much more convenient than just stopping by Walmart or ordering off Amazon? And would it even be cheaper, since the consumer loses the economy of scale in their individualized production?
- toufka 9y ago
  You mean a homebrew kit and some $100 DNA from Twist? https://www.twistbioscience.com/ https://www.twistbioscience.com/ Why not start with spider-silk dresses: https://boltthreads.com/ https://boltthreads.com/
intro-b 9y ago
I can't imagine the size of the overlap between people savvy/interested/experimental enough to attempt this sort of remedy and those desperately poor AND ill enough to do so. While the idea of bio-hacking as a hobbyist or proof-of-concept is becoming less and less uncommon, and people generally appreciate efforts to raise awareness toward a broken and inefficient healthcare and insurance system, attempting to "market" that DIY process using a fancy name, logo, and "mad scientist hacker anarchist intellectual" persona seems disingenuous at best, and potentially dangerous.
heydenberk 9y ago
Flash Forward did an excellent (as usual) episode about this, just a week or so ago: https://www.flashforwardpod.com/2017/10/03/piraceuticals/ https://www.flashforwardpod.com/2017/10/03/piraceuticals/
45h34jh53k4j 9y ago
I watched Michael present one of the most engaging and exciting talks at HOPE11 in NYC last year. On stage, he proceeded to make Deraprim (The pharma bro's jacked up price anti-toxiplasmosis drug) live on stage and then throw it in the audience. He then called Martin live and said he was his arch rival. Brilliant! Michael you are a legend and hero for our new dystopian pharma world.
- zokier 9y ago
  > On stage, he proceeded to make Deraprim (The pharma bro's jacked up price anti-toxiplasmosis drug) live on stage and then throw it in the audience I'm not familiar with the case, but I feel like probably NurdRages "cake mix" comment probably applies: https://www.youtube.com/watch?v=Rd7hXFnSHZc https://www.youtube.com/watch?v=Rd7hXFnSHZc The question always is that when you are making something, what are your dependencies, where are you starting from. Afterall, to make an apple pie from scratch you need to invent the universe.
jaggederest 9y ago
For people who are interested, it's referenced in the article, but NurdRage did a synthesis of Pyrimethamine "from scratch". Only took 2 years and ~$22k, but of course, replicating his synthesis would be a little bit easier... for another PhD Chemist. https://www.youtube.com/watch?v=ddCuWX4vtOA&list=PLU79801KtVAU1XsTwHaKkqQoBgz_VYmPS https://www.youtube.com/watch?v=ddCuWX4vtOA&list=PLU79801KtV...
- jmiserez 9y ago
  Not only “from scratch”, he even did it from widely available household products. I think he said in the last video that it would have been cheaper and faster if he had bought some of the precursor chemicals directly instead of having to make them first.
  - jaggederest 9y ago
    Well, from my limited 100-level-chemistry-plus-youtube education, he could have just bought the immediate precursors directly for pyrimethamine itself, i.e. possibly even 2-(p-chlorophenyl)-3-oxopentanenitrile, guanadinium chloride, and Trimethyl Orthoformate, which would make it a 3-step synthesis instead of a 17-step synthesis, so yeah, pretty easy. At the very least he could cut out ~2/3rds of those steps for a 7-step or 6-step synthesis. So cheaper by easily an order of magnitude, possibly ~$100 a batch or less. Of course, if you want FDA grade instead of technical grade your prices for everything skyrocket and your workup has to improve a bunch.
Sir_Cmpwn 9y ago
There's a guy who has a chemistry YouTube channel and synthesized Pyrimethamine recently, check it out: https://www.youtube.com/watch?v=5kZi3J2S52E https://www.youtube.com/watch?v=5kZi3J2S52E
dnautics 9y ago
>A decade ago, while he was volunteering with aid workers in El Salvador, Laufer said a nurse at a remote health outpost told him she’d run out of antibiotics and birth control pills — cheap, generic medicines that even her suppliers couldn’t immediately replenish. “This is ridiculous. They should be able to build their own simple lab” to make the pills, he recalled thinking at the time. This is pure crazy. If these drug were generic (versus patented), the problem of getting them to El Salvador is not a price problem, it's a supply chain/infrastructure/corruption and theft/political (in the case of birth control in a very Catholic country) problem. Some of these drugs are highly complex and building, supplying, and feedstocking chemicals for a lab to make them is even harder than finding the money for a $5/pop or less prescription
- steve19 9y ago
  I would be horrified to think what kind of havoc DIY birth control pill, s that were not manufactured correctly, might do. I would say a better solution would be to start a not for profit manufacturer, but when India produces dirt cheap genetics, there does not seem much point.
iskander 9y ago
There's also a much more conservative and narrowly scoped effort to help late stager cancer patients make their own therapeutic peptide vaccines: http://alunglife.com/goal-cure-cancer-method/ http://alunglife.com/goal-cure-cancer-method/
Chiba-City 9y ago
I imagine a curate Wiki of credible home non-invasive therapies and management regimens would garner more positive response than "anarchic" direct confrontations. There are tons of such therapies underwritten by medical researchers across countries. These infantile theatrics mostly subtract from sound cost containment.
rayiner 9y ago
> “To deny someone access to a lifesaving medication is murder,” he said. And “an act of theft [of intellectual property] to prevent an act of murder is morally acceptable.” I agree with the conclusion, but for a different reason. "Theft" is the wrong way to think about IP. The economic function of IP is not to protect producers from consumers, but to protect producers from free-riding by other producers.[1] Thus, for example, stealing pills does not offend a drug creator's IP monopoly. Teaching people to make their own pills, who couldn't afford pills anyway, does not really do so either. It doesn't implicate the real purpose of the patent monopoly, which is to keep some other company from profiting by free-riding on the R&D of the original drug creator. [1] To use a copyright analogy, copyright does not exist to protect content creators from downloaders, but to protect them from companies like Youtube, which make their profits by selling other peoples' content.
- occultist_throw 9y ago
  > I agree with the conclusion, but for a different reason. "Theft" is the wrong way to think about IP. The economic function of IP is not to protect producers from consumers, but to protect producers from free-riding by other producers.[1] Thus, for example, stealing pills does not offend a drug creator's IP monopoly. Teaching people to make their own pills, who couldn't afford pills anyway, does not really do so either. It doesn't implicate the real purpose of the patent monopoly, which is to keep some other company from profiting by free-riding on the R&D of the original drug creator. I've always wondered about this line of reasoning. Drug is made that could save a life, but is put behind an access and paywall that would prevent person from living. So one steals this drug or makes it in violation of patent rights. Now, logically theft is illegal and stealing it is theft. However we also have another area of law called "Justification" - it "because committing the crime advanced some social interest or vindicated a right of such importance that it outweighs the wrongfulness of the crime." (source: https://en.wikipedia.org/wiki/Justification_(jurisprudence) https://en.wikipedia.org/wiki/Justification_(jurisprudence) ) . This topic came up with the recent ex-marine who "stole" a truck to drive the shooting victims to the hospital, at the Vegas Massacre. On the face, he stole a vehicle. However it was to save lives, which is justification. So yes, it is theft or violation of patent. However this is in the face of living or dying. Whomever would state this defense would have to admit complete guilt to the court, and rely on this as the defense. But if this won, it would say that everyone has the right to life-saving drugs, but those that can afford it have to pay.
zackmorris 9y ago
We used to have government-funded research programs at universities, now we have for-profit big pharma which by definition creates treatments that cost more. It could be argued that this was by design. So open sourcing cures like this is a natural free market reaction to that. Since most of the cost of any new medication today is research, we should decouple that cost from production. The main reason this doesn't happen is that conservatives preach personal responsibility, so want people with hepatitis C to pay for their own treatment at $80,000 a pop. But even if the cost to develop that cure was a billion dollars, that's a tiny amount for the government to absorb. We should be having a space race to cure the worst diseases and then give those cures to the world for free (or nearly free), much like penicillin or the polio vaccine. Please keep in mind that I'm not politicizing this - it's already been politicized. I'm just explaining what happened.
- aero142 9y ago
  You are arguing with a straw man. The other side doesn't believe that a dollar spent by the government is as effective as a dollar spent by the private sector.
  - enugu 9y ago
    If that is the primary obstacle, you can have a design which assigns money to a private research organization to develop drugs for government. Also, current pharma will be biased against any cost effective solutions as this will cut their margins. There's got to be some alternative path to research and bring in these treatments to the public.
    - beisner 9y ago
      I 100% support a drug bounty program, where the government puts up a huge bounty (I.e. $1-3bn) for diseases where cures/treatments are needed, and pharma companies compete for those bounties. Victors would get the full bounty, and the govt would get the rights to the drug. Would allow the public to incentivize treatments that are best for public health, since companies are incentivized to create long-lasting, expensive treatments vs 1-off cures. And would decouple end-user price. For instance, i think we would have found a vaccine for HIV by now if antiretrovirals weren’t so damn profitable over the lifespan of a patient.
AlexCoventry 9y ago
I'm a bit skeptical about this. You should see what it takes to manufacture useful amounts of clinical-grade penicillin. It's fairly capital-intensive, and requires a special strain of the mold.
- graciouspants 9y ago
  The solution? Don't make penicillin. Even if one particular drug is out of reach, there are plenty of other useful drugs that may not be.
ithilglin909 9y ago
I like the idea. And I can't possibly see how this could go badly...
AKifer 9y ago
Given the level of education nowadays and the wide access to knowledge, I'm convinced that it's legitimate that the average person should at least have the basic medical knowledge, let's say equal to what a doctor in the 30's had known, and be able to treat 90% of the diseases that he/she encounter in his life.
0xbear 9y ago
Just push Trump to do what he promised to do during his campaign: allow the importation of drugs. The rest of the world is mostly paying more reasonable prices, it’s only us, USians who are getting reamed by the pharma cartel.
dreta 9y ago
This is an article written by the biggest fan of a guy with an inflated ego, a child-like view of the world, and nothing to show.
trevorhartman 9y ago
Related: If you want to understand how and why the American Healthcare system is broken, read the excellent book An American Sickness: How Healthcare Became Big Business and How You Can Take It Back by Elisabeth Rosenthal.
computator 9y ago
Interesting assertion from the FAQ on Michael Laufer's website[1]: > Q: What about quality control? A: It’s important to know that making small quantities of a chemical is vastly different than making it on an industrial scale. The chemistry isn’t even the same. This is a big reason why chemical engineering is an entire field of study. With smaller reactions, while you do have to be more precise in your measurements sometimes. There are fewer things to go wrong. Why would making small quantities be vastly different than making it on an industrial scale? I've heard the same thing about cooking and baking. Supposedly, if a recipe calls for 1 tablespoon of baking powder, then you scale it up 50 fold, you can't simply use 50 tablespoons of baking powder. The claim was that you had to use way more baking powder or much less (I forget which). It sounded like nonsense, but now I'm wondering. [1] https://fourthievesvinegar.org/faq https://fourthievesvinegar.org/faq
- okreallywtf 9y ago
  I'm also curious about that, the only reason I can think would have to do with an incomplete reaction because of the size of the batch although that would mean the ability to mix a batch of X depended on the amount and I don't know why that would be.
- fabian2k 9y ago
  Large scale production has very different requirements than small scale synthesis in the lab. Getting rid of heat is much easier on a small scale, and not all methods that work on a small scale can be scaled up. It's a ridiculous answer to the question of quality control, though. It doesn't really have anything to do with that.
- deleted 9y ago
  [deleted]
- jcranmer 9y ago
  The most obvious element is heat: heat production grows at the same rate as volume, but heat dissipation grows at the same rate as surface area. So larger scales invariably end up running hotter (particularly when energetic exothermic reactions are involved), and temperature plays a major role in the kinematics of chemical reactions. The same surface area/volume issue in bulk also plays into reactions that happen at the margins of materials rather than the bulk--metal-catalyzed reactions are a common example.
trapperkeeper74 9y ago
Wow. Cool. I wonder how hard are the synthesises of the useful antidepressants like mirtazapine. Also, I found ASX-05 (Phase III) uses a DM metabolite that is retained much more by the addition of brupropion. DM is the stuff in some cough syrups.
- nv-vn 9y ago
  Well, mirtazapine isn't scheduled in the US so you can probably get some precursors with relative ease. You can find the synthesis info online [1] and at least some of the chemicals used in the synthesis are available online [2], though for the price it seems like it might be more economically feasible to just buy a pill from a pharma company. [1] http://www.arkat-usa.org/get-file/22868/ http://www.arkat-usa.org/get-file/22868/ [2] http://www.sigmaaldrich.com/catalog/product/aldrich/648434?lang=en&region=US http://www.sigmaaldrich.com/catalog/product/aldrich/648434?l...
mirimir 9y ago
Let's say that you need some pharmaceutical that's not available at a reasonable price. Perhaps because there's no generic available. Or because there are only licensed generics, priced just marginally less than the brand. And/or because you have crappy health insurance, or none at all. Depending on the drug, the best option is either an equivalent from a compounding pharmacy, or one from a low-price country, such as India, Mexico, etc. Making your own is only worth the hassle and risk if neither of those options is workable. The EpiPen is an unrepresentative example, because it's mostly about mechanics. With most drugs, you need to bulk out the active ingredient(s) to get a reasonably sized capsule or tablet. For capsules, with mannitol or whatever. For tablets, that plus binding agent(s). The challenge is that thorough mixing is nontrivial.
mnm1 9y ago
This brings to mind a very common ethics 101 class dilemma. Do you steal medicine to keep your loved one from dying? Of course, the answer to that is extremely obvious. I only wish we could help people steal more.
shadowtree 9y ago
People struggle to cook food for themselves. Just saying.
ncds42 9y ago
WHAT a fucking badass
ar-nelson 9y ago
DIY pharmaceuticals will never be safe, unless the recipes are regulated, at which point there's no point to them anyway. Imagine this situation: you Google for a recipe for a drug, and find two different recipes. Recipe A is the real one, while Recipe B will kill you instantly. The troll who posted Recipe B went around the internet claiming that Recipe B is real and Recipe A will kill you. There's no authoritative source to consult, because the actual recipe is patented. How do you know which is real?
- jws 9y ago
  Make them both, sell them on the dark web, see which has repeat customers?
- neilparikh 9y ago
  Aren't patents published publicly? So you could just check the patent (Although it may require some knowledge of biology/chemistry to understand).
zipwitch 9y ago
Sci-fi is increasingly struggling to keep up with reality. Here's a novel with a similar premise (but more SF setting) that isn't even out yet: https://www.tor.com/2017/09/18/excerpts-annalee-newitz-autonomous/ https://www.tor.com/2017/09/18/excerpts-annalee-newitz-auton...
- kanzure 9y ago
  my thinking on this is that science fiction authors are lazy and are not often scientifically trained; so they haven't been thinking about these topics at all. This is why science fiction is so dry and boring compared to neuroanatomy, molecular biology, neurophysiology, computational neuroscience, synthetic biology, etc.
phkahler 9y ago
What if he instead made a more reliable setup and recipe? Then someone could make a lab and rent it out to people wanting to make their own stuff. It would still be DIY but it would be in a more controlled environment. This model does involve some risk to the lab, but hey have the renter agree to binding arbitration or something.
rubatuga 9y ago
The premise in the article, that denying access to medicine is essentially murder is completely untrue. The following premise that people should be able steal is therefore not necessarily true.
a3n 9y ago
Something like this will be needed in the event of a civilizational reboot.
moonbug22 9y ago
TL,DR Merkin heathcare sucks.
arthurjj 9y ago
If anyone's interested in a fiction that partially explores this try Corey Doctorow's new novel Walk Away [1]. It's about people who 'walk away' from regular society. They to create their own high tech society because they completely ignore IP rights, and instead aggressively share techniques using the wiki model. 1. http://amzn.to/2ymP8EM http://amzn.to/2ymP8EM
tyingq 9y ago
"He’s developing a desktop lab and a recipe book meant to equip patients to cook up a range of medicines, including a homemade version of the expensive hepatitis C drug Sovaldi, on their kitchen counters." Any chemists here? Is it really plausible to synthesize C22H29FN3O9P at home?
microcolonel 9y ago
Lots of medicines are straightforward to manufacture, and as long as you're careful and follow the same sorts of risk-mitigating procedures and quality assurance steps that you would expect from a manufacturer, you would be served no worse by your own generic brand. That said, ideally we could fix the medicine-specific patent law craziness (and the regulatory inefficiency which necessitates it). Obviously, the specifics are much more complicated than anyone with a side to pick is willing to admit.
Mz 9y ago
Can anyone give me any insights into how stuff like this (and Goop) gets any traction?
flour_power 9y ago
only in america...
quickben 9y ago
If a person doesn't have access to medicine and dies: - in the East, that's a victim of Communism. - in the West, that's a poor lazy bum. In both cases, the person is gone and the society failed him. So, this guy rebels. Let's not paint him in political colors.

371 points by anarbadalov 9y ago

That seems both super dangerous, and super awesome. It's not something that we should have to consider. But this is the world we live in, now; legitimate supply lines of life-saving medicine have collapsed for a fair number of people. I understand why people might be troubled by someone actively going out and advocating this as opposed to simply making the information available, but if you're offered medicine with 95% efficacy that you can afford and use vs. a well-regulated 99.99% that only exists theoretically...well, come on.

nkrisc 9y ago
Consider this story that mades the rounds recently as well: people using antibiotics marketed for fish because they can't afford or get access to anything else. https://motherboard.vice.com/en_us/article/bjxwma/people-are-buying-fish-antibiotics-because-they-cant-afford-human-ones https://motherboard.vice.com/en_us/article/bjxwma/people-are...
- miguelrochefort 9y ago
  Also very popular amongst survivalists.
JumpCrisscross 9y ago
When drug companies issue patents, do they not also publicise production methods?
- vonmoltke 9y ago
  Generally, no. Even if they did, based on my experience with process-sensitive non-pharmaceutical products it takes a lot of experimentation and refinement to execute the process correctly.
- vqc 9y ago
  It depends on the scope of the patent. But to some extent, kind of. See, e.g., the patent for an adalimumab (Humira) formulation https://patents.google.com/patent/US9085619B2/en https://patents.google.com/patent/US9085619B2/en. The patent discloses materials and methods for creating a formulation of the drug. The real issue is probably that there are so many moving parts, especially when you get to the more complex drugs (e.g. antibodies). You would have to go through a million patents to find all the information required to create the actual molecule and also get it in a state to put into your body. And even with all the information, it is unlikely anyone is sufficiently resourced (whether it's money, tools, or know-how) to actually make something viable.
- sigstoat 9y ago
  as vonmoltke suggests, even if you've got some chemical synthesis procedure laid out in a peer reviewed journal, you are, in the best case, expert man hours away from successfully duplicating it. and you'll only know you've successfully duplicated it if you can run the result through really expensive analytical equipment to confirm that 1) you made the stuff you wanted to make and 2) it doesn't have impurities that are problematic. (as a minor defense of the pharma companies, you're paying them not just to do a bunch of organic synthesis for you, but also to do ongoing QA that the synthesis process is working correctly. and not all processes are equally easy/amenable to industrial-scale duplication.)
  - drvdevd 9y ago
    Obviously this is true. There’s much that goes into industrial synthesis that someone with a setup like his at home just can’t currently reproduce, and safely. What I find most dubious about the article is the lack of attention to synthetic biology. Because QA in that sense can become say, “this modified organism can produce the drug in question under most conditions and all future populations will carry the new genes with X% assurance” - ONCE -and you’re done. This is quite possibly the real Pharma killer, IMO.
    - vqc 9y ago
      But only kind of. Even if you could get a strain of yeast to produce a specific antibody 100% of the time, how reliably could you get the yeast to grow? If you can get it to grow, how reliably can you extract a enough of the antibody to form just one dose? If you can extract, can you get it into a formulation that is pharmaceutically viable? Its not just about synthesis. There's so much tooling and expertise that goes into front end, back end, deployment, db, QA, etc ,etc, etc just to get one app going. Why would would drug deployment be any different?
      - drvdevd 9y ago
        Well, yes you’re correct, there are associated complexities I’ve glossed over. My point however is simply that all of these complexities only really need to be solved once by an expert or team of experts such that non-experts can then utilize such a biotechnology (“yeast strain”) to produce some medicinal compound or other useful engineered metabolite. A yeast strain that can’t be reliably cultivated by a non-expert with relative ease and safety (in a non-laboratory) wouldn’t make the cut, in theory. Also the same semi-synthetic organism could be applied in traditional pharmaceutical process settings as well, if for no reason other than cost reduction (and probably workforce reduction as well). So even “big pharma” has some incentive to contribute to this sort of technology.
- mandevil 9y ago
  It isn't even the basics of the synthesis chain that are difficult. Most (small molecule) stuff a lab chemist could whip up a batch of given a bit of time and reasonable access to precursors. But this is exactly like saying "Reddit is just a few SQL queries, a reasonable programmer could whip up their own version in a weekend." Just like there is only one reddit/StackOverflow/Facebook even though plenty of people have the same basic idea, even knowing the chemical formula doesn't help that much. The trick is in the execution: generating reliable quantities of reliable strength and without any contaminants. There is a whole field, process engineers, devoted to this quite difficult problem.
dannyw 9y ago
Agreed. When you actively advocate for this, do you face moral responsibility when someone prepares it wrong and dies? (I’m pretty sure the legal answer would be yes on so many fronts)
- deleted 9y ago
  [deleted]
- wavefunction 9y ago
  I don't know that the legal system necessarily cares about morality or moral responsibility. It seems like the only criteria that would matter would be legal responsibility, whatever that standard might be.
  - QAPereo 9y ago
    If you take actions which a reasonable person would expect to cause harm to others, there is a legal dimension there ranging from civil liability, to the extreme of 2nd degree murder via “depraved indifference” statutes.
    - wavefunction 9y ago
      Good points.
  - steveeq1 9y ago
    Or the criteria: "which moral stance makes me the most profit?"
  - LeifCarrotson 9y ago
    It isn't always about whether the legal system cares. They're asking whether or not moral people should care. Those can be very different.
- Y_Y 9y ago
  If you don't misrepresent it then I can hardly see how. Does the writer of a recipe book incur blame if someone undercooks their chicken?
WalterSear 9y ago
The cost of medicine I require to be functional enough to hold down a job has risen so much that the copay is the equivalent of the entire out-of-pocket cost from a few years ago. The medication was discovered in 1969. The application method, which is the shitty excuse for the patents protecting its $2,200/month price tag, was first approved for use by the FDA in 1979. The drug has been for sale in it's current form for over a decade.
- octaveguin 9y ago
  Enbrel? They just received another patent extension, too. This is what government granted monopolies look like.
  - dv_dt 9y ago
    This is what the breakdown of working competitive markets look like, and in this case it takes both government monopolies, as well as well as overwhelming short-term greed on the part of the private companies. Long term don't these companies think that charging outrageous prices for drugs will cause a future voter/government backlash of some sort... or maybe they think they should extract profits now because of a chance of drug price regulation coming to the US in the future?
    - Sangermaine 9y ago
      >Long term don't these companies think that charging outrageous prices for drugs will cause a future voter/government backlash of some sort No, because it demonstrably won't. People say they're angry and then do nothing about it. The US has an entire political party angrily decrying any effort to regulate healthcare as socialist slavery. The drug companies know they'll be just fine. Maybe some token slaps on the wrist and public performance of cosmetic changes to appease people now and then, but nothing will happen to them.
      - dv_dt 9y ago
        Perhaps, though I think I'm more energized personally voting & with campaign involvement in the upcoming elections this year than ever before. And part of that is knowing that it might help Medicare for all or other universal healthcare options - maybe not this election or the even the next - but personally I feel it has to happen and is worth working towards.
Sangermaine 9y ago
>but if you're offered medicine with 95% efficacy that you can afford But it's not clear at all this is the case here. The article itself notes that it's unknown whether anyone has ever used any of these DIY medicines/medical devices, let alone how well they actually work. For all we know he could be pushing complete nonsense that kills people.
- pizza 9y ago
  He could be, but.. it's not as if all federally-sanctioned medicines are not complete nonsense that (don't) kill people, either. Let alone merely having greater iatrogenics than benefits. Relatedly, when doctors strike, mortality rates decrease [0]. Plus, very useful medicines that are deemed too unsafe to become publicly consumed may be totally safe for subsets of the general population, e.g. based on differing expression of enzymes, or other phenotypic differences. If you are (more or less) coping just fine with a health problem, (most often) you shouldn't really take any medicine whatsoever, regardless of whether or not it is approved. Only if you are distressed and desperate can you (a priori) expect medicine to do more good than harm. And if you are in that category, and the medicines that exist officially did not help, then you must make other attempts to rectify the problem in order to avoid danger. Admittedly it's not much of a source of relief, but the good thing about the nature of hobbyist tinkering networks is that information about dangers spreads fast, as well as information about discovered panaceas (both when the results are replicated in their favor, and when they falsify the panacea). [0] https://www.ncbi.nlm.nih.gov/pubmed/18849101 https://www.ncbi.nlm.nih.gov/pubmed/18849101
agumonkey 9y ago
It's dangerous so far. I'm still all for better information and more diy. People will understand their health and real value of products better.
nylonstrung 9y ago
I think a middle ground is sourcing them from private chemists on Alibaba and then getting spectrometry tests done to verify purity
random023987 9y ago
> super awesome. This is not super-awesome. Humans have made incredible progress by specializing and optimizing, and this process improves productivity, efficiently, and (most importantly when it comes to medicine) safety. The idea that we will have people taking the risk of getting sick or dying because they are not able to manufacture drugs with the same purity and potency as pharmaceutical companies shows there is a huge problem with the status quo.
- leggomylibro 9y ago
  Yes, that also seems pretty clear. But we are here, and this is now. Complaining is easy and feels good, but let's talk practical solutions.
tritium 9y ago
Collapsed? Or were supply lines selectively destroyed by market-cornering adversaries, knowingly, according to the degree of “demand” which might be extracted?
losername 9y ago
If this is anything like open source in software (in the beginning) then many either never get to compile the dependencies needed to build from the source or run into hardware incompatibilities and incompatible derivate packages with all the ensuing bugs like blindness, deafness, and more serious malfunctions. And when it works the functionality will be severely limited. I'm half joking, but this will need a huge caveat emptor.

Overtonwindow 9y ago

DIY pharmaceuticals is ....well it sounds immensely dangerous. Not only is the chemistry frightening but quality and chemical availability. It reminds me of Naturopaths and herboligists claiming to cure and treat ailments with supplements. As much as I hate the pharmaceutical industry, I think it's best for now to leave the drug making to them.

joering2 9y ago
DIY pharmaceuticals sounds dangerous. Sure! So is eating 47 teaspoon of salt, 480 bananas, or drinking 179 expressos [1]. If you happen to be unable to afford so much coffee, just rent a car and smash into a tree at 100 miles per hour. So driving cars is also immensely dangerous! I really hate that nany state we are living in where an average 16 year old is lawfully allowed to drive 5,000 pounds metal machine and kill people at even limited speeds of 50 mph, but yet when it comes to DIY pharmaceuticals we immediately see a vision of most population dying at home because they mixed something wrong. https://gizmodo.com/how-many-x-would-you-need-to-eat-to-die-1684237567 https://gizmodo.com/how-many-x-would-you-need-to-eat-to-die-...
- Overtonwindow 9y ago
  You didn't read the article did you...
  - ZephyrP 9y ago
    Pressure on all sides to maintain HN norms here. "You don't insinuate someone didn't read the article on HN", it's in the guidelines in fact, take a look when you have some free time: https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html Otherwise, I think you'll agree that the threat of PhD level chemists making and giving these drugs out isn't exactly critical.

Florin_Andrei 9y ago

Next up - DIY Lasik surgery.

maxxxxx 9y ago
In German but here is a DIY dentist: https://www.youtube.com/watch?v=MrbyL6yMyn0 https://www.youtube.com/watch?v=MrbyL6yMyn0
Overtonwindow 9y ago
I got LASIK at 21. It was a miracle. It wore off at 31. I must've gotten it too soon. Back to glasses.
- kemiller 9y ago
  Nah, it just does that sometimes. I got it at 35 and it started to wear off 6 years later.
zokier 9y ago
Isn't the actual surgery in LASIK-style operations pretty much fully automated anyways? Feels actually quite a bit safer than DIY pharmaceuticals. And the failure-modes of LASIK seem kinda less worse than in pharmaceuticals too.

fhood 9y ago

Honest question: What does it even mean to be an anarchist these days? What is the default "anarchist"? Because Wikipedia isn't really helping.

jchanimal 9y ago
“”” Noam Chomsky: Well, anarchism is, in my view, basically a kind of tendency in human thought which shows up in different forms in different circumstances, and has some leading characteristics. Primarily it is a tendency that is suspicious and skeptical of domination, authority, and hierarchy. It seeks structures of hierarchy and domination in human life over the whole range, extending from, say, patriarchal families to, say, imperial systems, and it asks whether those systems are justified. It assumes that the burden of proof for anyone in a position of power and authority lies on them. Their authority is not self-justifying. They have to give a reason for it, a justification. And if they can’t justify that authority and power and control, which is the usual case, then the authority ought to be dismantled and replaced by something more free and just. And, as I understand it, anarchy is just that tendency. “”” http://www.alternet.org/civil-liberties/noam-chomsky-kind-anarchism-i-believe-and-whats-wrong-libertarians http://www.alternet.org/civil-liberties/noam-chomsky-kind-an...
- fhood 9y ago
  Thanks, that was an excellent answer.
  - eeZah7Ux 9y ago
    Erich Fromm's quote about rational VS irrational authority is helpful: http://fromm-online.org/en/autoritaet/ http://fromm-online.org/en/autoritaet/
- kemiller 9y ago
  Vs the classical conservative world view in which order, even if it's unjust, is usually better for everyone, even the people on the bottom, than chaos; and that dismantling power structures, if done suddenly or without care, is more likely to result in chaos than in a new, more just, order. I've been wondering lately if there is room for the notion of a conservative anarchist, who questions hierarchy but dismantles carefully and incrementally.

wccrawford 9y ago

>Then he took another sip from a flute of Taittinger Champagne. What? >Swaggering, charismatic, and complex, Gag me. >Michael Laufer has become a fixture in the growing biohacker movement ever since he published plans last year for a do-it-yourself EpiPencil — a $35 alternative to the pricey EpiPen. That couldn't possibly go wrong, eh? >It’s not clear whether anyone has actually ever used a homemade EpiPencil to prevent anaphylactic shock. So nobody's quite crazy enough to try? >But that seems almost an afterthought to Laufer’s bigger goal — trying to build a DIY movement to attack high pharma pricing and empower patients. Or, judging by the tone of this article, his attempt to build his own ego. This is ridiculous and crazy. It's incredibly dangerous to claim to have produced something life saving but not have any actual testing to back it up. Even lesser drugs that are just designed to lessen symptoms or relieve pain could go horribly wrong if they aren't prepared properly. We have such strict medical requirements because of that.

kentosi 9y ago
Agreed that the article is a little too flattering to his ego, but what about people desperate for medical aid, can't afford it, and would probably end up with pain/death without this as an alternative? What should they do?
- deleted 9y ago
  [deleted]
- nradov 9y ago
  Most people who are desperate and too poor to afford medications are also too poor to afford the tools and supplies necessary to make their own medications. I don't think this will solve the problem of drug affordability.
- Sangermaine 9y ago
  Not listen to this guy. As the article notes none of his ideas or creations have ever been tried by anyone, including himself, and require fairly sophisticated ability to set up and make. In fact from the article it's not clear at all what exactly this guy is offering or how it helps anyone beyond his self-aggrandizing bluster.

jfarlow 9y ago

Open Insulin @ Counter Culture Labs: https://experiment.com/projects/open-insulin https://experiment.com/projects/open-insulin If you want to look at templates for your own immunotherapy, CRISPR, optogenetic tools etc.: https://serotiny.bio/notes/proteins/ https://serotiny.bio/notes/proteins/ Which, once built can be then be ordered as DNA, shapeways-style using: https://serotiny.bio/notes/pinecone/ https://serotiny.bio/notes/pinecone/ The cure for certain kinds of blindness, just approved by the FDA yesterday is, in total, a well-delivered sequence of ~10,000 base pairs of DNA (mfg cost @ 7¢/bp = $700): http://www.businessinsider.com/spark-therapeutics-hereditary-blindness-gene-therapy-advisory-committee-2017-10 http://www.businessinsider.com/spark-therapeutics-hereditary...

burger_moon 9y ago
Regarding Counter Culture Labs. It looks like they post update videos periodically, but do they have something on the market yet? What does their insulin cost per IU?
moh_maya 9y ago
Oh man. I agree with your sentiment, but this is a remarkable over simplification! The sequence may cost 700$ to synthesise. But it's delivery vector is a virus. Synthesizing the DNA, encapsulating the DNA in the virus.. not trivial stuff. While I agree that drug prices in the US are absurd beyond comprehension or justification, and I've had a ring side view of life sci research, drug development as well as the drug pricing; to posit that, hah, a path breaking gene therapy product just costs a few hundreds or a couple of thousands to produce is misrepresenting the complexity as well as the significance of the achievement. The amount of research (largely public funded but for the clinical trials, which may also have been public funded: no idea) to get to this point is staggering. the company also likely invested large amounts to Shepard a lab possibility into a viable treatment. FDA approval is a big deal because they are, justifiably, exceedingly strict. It is an arduous process. There has to be a better solution, which would start with allowing the US CMS / Medicare & Medicaid to negotiate drug prices with the manufacturers. The problem is policy.
- jfarlow 9y ago

fabian2k 9y ago

Synthesizing some simpler drugs sounds feasible even with amateur equipment, but still far from trivial. But I can't see that working reliably without the ability to do proper analytics on all steps. And regular people don't just have an NMR spectrometer at home. Chemical reactions usually don't have a single product, other side reactions are possible. And they also don't use up 100% of the educt, so you have to get rid of that as well. Purifying your products and making sure they're actually what you want is essential. Getting the dose right is also hard if you don't know how pure your product is, and if you don't have analytical scales (or work at a very large scale that a kitchen scale is enough).

zokier 9y ago
> And regular people don't just have an NMR spectrometer at home. I've only watched NurdRage videos, but it seems like sending samples to commercial NMR labs is pretty feasible as he does that regularly. So that might not be as big of an issue.

louithethrid 9y ago

The day anyone can get dna-programmable yeast and a reactor to grow it- big pharma is goone. What a nice woody sort of word.

goatlover 9y ago
Because I'm going to trust the kid's medicine down the street with no oversight? Isn't this kind of like the day 3D printers become affordable, mass manufacturing is done?
- blacksmith_tb 9y ago
  If 3D printers were not just affordable but infallible, yes. It would be easier to have a bioreactor bubbling away to synthesize your pharmaceuticals than to try and make a lab-in-a-box kit that was equally robust (more like brewing kombucha in your kitchen than Breaking Bad for Dummies), but either way you still need to assay the results...
  - goatlover 9y ago
    > If 3D printers were not just affordable but infallible, yes. Infallible and easy to use. But you still need to buy the raw materials, unless we're talking Star Trek energy-matter conversion, which isn't on the horizon. Otherwise, why would an average consumer think that buying the raw material and feeding it to their 3D printer is that much more convenient than just stopping by Walmart or ordering off Amazon? And would it even be cheaper, since the consumer loses the economy of scale in their individualized production?
toufka 9y ago
You mean a homebrew kit and some $100 DNA from Twist? https://www.twistbioscience.com/ https://www.twistbioscience.com/ Why not start with spider-silk dresses: https://boltthreads.com/ https://boltthreads.com/

intro-b 9y ago

I can't imagine the size of the overlap between people savvy/interested/experimental enough to attempt this sort of remedy and those desperately poor AND ill enough to do so. While the idea of bio-hacking as a hobbyist or proof-of-concept is becoming less and less uncommon, and people generally appreciate efforts to raise awareness toward a broken and inefficient healthcare and insurance system, attempting to "market" that DIY process using a fancy name, logo, and "mad scientist hacker anarchist intellectual" persona seems disingenuous at best, and potentially dangerous.

heydenberk 9y ago

Flash Forward did an excellent (as usual) episode about this, just a week or so ago: https://www.flashforwardpod.com/2017/10/03/piraceuticals/ https://www.flashforwardpod.com/2017/10/03/piraceuticals/

45h34jh53k4j 9y ago

I watched Michael present one of the most engaging and exciting talks at HOPE11 in NYC last year. On stage, he proceeded to make Deraprim (The pharma bro's jacked up price anti-toxiplasmosis drug) live on stage and then throw it in the audience. He then called Martin live and said he was his arch rival. Brilliant! Michael you are a legend and hero for our new dystopian pharma world.

zokier 9y ago
> On stage, he proceeded to make Deraprim (The pharma bro's jacked up price anti-toxiplasmosis drug) live on stage and then throw it in the audience I'm not familiar with the case, but I feel like probably NurdRages "cake mix" comment probably applies: https://www.youtube.com/watch?v=Rd7hXFnSHZc https://www.youtube.com/watch?v=Rd7hXFnSHZc The question always is that when you are making something, what are your dependencies, where are you starting from. Afterall, to make an apple pie from scratch you need to invent the universe.

jaggederest 9y ago

For people who are interested, it's referenced in the article, but NurdRage did a synthesis of Pyrimethamine "from scratch". Only took 2 years and ~$22k, but of course, replicating his synthesis would be a little bit easier... for another PhD Chemist. https://www.youtube.com/watch?v=ddCuWX4vtOA&list=PLU79801KtVAU1XsTwHaKkqQoBgz_VYmPS https://www.youtube.com/watch?v=ddCuWX4vtOA&list=PLU79801KtV...

jmiserez 9y ago
Not only “from scratch”, he even did it from widely available household products. I think he said in the last video that it would have been cheaper and faster if he had bought some of the precursor chemicals directly instead of having to make them first.
- jaggederest 9y ago
  Well, from my limited 100-level-chemistry-plus-youtube education, he could have just bought the immediate precursors directly for pyrimethamine itself, i.e. possibly even 2-(p-chlorophenyl)-3-oxopentanenitrile, guanadinium chloride, and Trimethyl Orthoformate, which would make it a 3-step synthesis instead of a 17-step synthesis, so yeah, pretty easy. At the very least he could cut out ~2/3rds of those steps for a 7-step or 6-step synthesis. So cheaper by easily an order of magnitude, possibly ~$100 a batch or less. Of course, if you want FDA grade instead of technical grade your prices for everything skyrocket and your workup has to improve a bunch.

Sir_Cmpwn 9y ago

There's a guy who has a chemistry YouTube channel and synthesized Pyrimethamine recently, check it out: https://www.youtube.com/watch?v=5kZi3J2S52E https://www.youtube.com/watch?v=5kZi3J2S52E

dnautics 9y ago

>A decade ago, while he was volunteering with aid workers in El Salvador, Laufer said a nurse at a remote health outpost told him she’d run out of antibiotics and birth control pills — cheap, generic medicines that even her suppliers couldn’t immediately replenish. “This is ridiculous. They should be able to build their own simple lab” to make the pills, he recalled thinking at the time. This is pure crazy. If these drug were generic (versus patented), the problem of getting them to El Salvador is not a price problem, it's a supply chain/infrastructure/corruption and theft/political (in the case of birth control in a very Catholic country) problem. Some of these drugs are highly complex and building, supplying, and feedstocking chemicals for a lab to make them is even harder than finding the money for a $5/pop or less prescription

steve19 9y ago
I would be horrified to think what kind of havoc DIY birth control pill, s that were not manufactured correctly, might do. I would say a better solution would be to start a not for profit manufacturer, but when India produces dirt cheap genetics, there does not seem much point.

iskander 9y ago

There's also a much more conservative and narrowly scoped effort to help late stager cancer patients make their own therapeutic peptide vaccines: http://alunglife.com/goal-cure-cancer-method/ http://alunglife.com/goal-cure-cancer-method/

Chiba-City 9y ago

I imagine a curate Wiki of credible home non-invasive therapies and management regimens would garner more positive response than "anarchic" direct confrontations. There are tons of such therapies underwritten by medical researchers across countries. These infantile theatrics mostly subtract from sound cost containment.

rayiner 9y ago

> “To deny someone access to a lifesaving medication is murder,” he said. And “an act of theft [of intellectual property] to prevent an act of murder is morally acceptable.” I agree with the conclusion, but for a different reason. "Theft" is the wrong way to think about IP. The economic function of IP is not to protect producers from consumers, but to protect producers from free-riding by other producers.[1] Thus, for example, stealing pills does not offend a drug creator's IP monopoly. Teaching people to make their own pills, who couldn't afford pills anyway, does not really do so either. It doesn't implicate the real purpose of the patent monopoly, which is to keep some other company from profiting by free-riding on the R&D of the original drug creator. [1] To use a copyright analogy, copyright does not exist to protect content creators from downloaders, but to protect them from companies like Youtube, which make their profits by selling other peoples' content.

occultist_throw 9y ago
> I agree with the conclusion, but for a different reason. "Theft" is the wrong way to think about IP. The economic function of IP is not to protect producers from consumers, but to protect producers from free-riding by other producers.[1] Thus, for example, stealing pills does not offend a drug creator's IP monopoly. Teaching people to make their own pills, who couldn't afford pills anyway, does not really do so either. It doesn't implicate the real purpose of the patent monopoly, which is to keep some other company from profiting by free-riding on the R&D of the original drug creator. I've always wondered about this line of reasoning. Drug is made that could save a life, but is put behind an access and paywall that would prevent person from living. So one steals this drug or makes it in violation of patent rights. Now, logically theft is illegal and stealing it is theft. However we also have another area of law called "Justification" - it "because committing the crime advanced some social interest or vindicated a right of such importance that it outweighs the wrongfulness of the crime." (source: https://en.wikipedia.org/wiki/Justification_(jurisprudence) https://en.wikipedia.org/wiki/Justification_(jurisprudence) ) . This topic came up with the recent ex-marine who "stole" a truck to drive the shooting victims to the hospital, at the Vegas Massacre. On the face, he stole a vehicle. However it was to save lives, which is justification. So yes, it is theft or violation of patent. However this is in the face of living or dying. Whomever would state this defense would have to admit complete guilt to the court, and rely on this as the defense. But if this won, it would say that everyone has the right to life-saving drugs, but those that can afford it have to pay.

zackmorris 9y ago

We used to have government-funded research programs at universities, now we have for-profit big pharma which by definition creates treatments that cost more. It could be argued that this was by design. So open sourcing cures like this is a natural free market reaction to that. Since most of the cost of any new medication today is research, we should decouple that cost from production. The main reason this doesn't happen is that conservatives preach personal responsibility, so want people with hepatitis C to pay for their own treatment at $80,000 a pop. But even if the cost to develop that cure was a billion dollars, that's a tiny amount for the government to absorb. We should be having a space race to cure the worst diseases and then give those cures to the world for free (or nearly free), much like penicillin or the polio vaccine. Please keep in mind that I'm not politicizing this - it's already been politicized. I'm just explaining what happened.

aero142 9y ago
You are arguing with a straw man. The other side doesn't believe that a dollar spent by the government is as effective as a dollar spent by the private sector.
- enugu 9y ago
  If that is the primary obstacle, you can have a design which assigns money to a private research organization to develop drugs for government. Also, current pharma will be biased against any cost effective solutions as this will cut their margins. There's got to be some alternative path to research and bring in these treatments to the public.
  - beisner 9y ago
    I 100% support a drug bounty program, where the government puts up a huge bounty (I.e. $1-3bn) for diseases where cures/treatments are needed, and pharma companies compete for those bounties. Victors would get the full bounty, and the govt would get the rights to the drug. Would allow the public to incentivize treatments that are best for public health, since companies are incentivized to create long-lasting, expensive treatments vs 1-off cures. And would decouple end-user price. For instance, i think we would have found a vaccine for HIV by now if antiretrovirals weren’t so damn profitable over the lifespan of a patient.

AlexCoventry 9y ago

I'm a bit skeptical about this. You should see what it takes to manufacture useful amounts of clinical-grade penicillin. It's fairly capital-intensive, and requires a special strain of the mold.

graciouspants 9y ago
The solution? Don't make penicillin. Even if one particular drug is out of reach, there are plenty of other useful drugs that may not be.

ithilglin909 9y ago

I like the idea. And I can't possibly see how this could go badly...

AKifer 9y ago

Given the level of education nowadays and the wide access to knowledge, I'm convinced that it's legitimate that the average person should at least have the basic medical knowledge, let's say equal to what a doctor in the 30's had known, and be able to treat 90% of the diseases that he/she encounter in his life.

0xbear 9y ago

Just push Trump to do what he promised to do during his campaign: allow the importation of drugs. The rest of the world is mostly paying more reasonable prices, it’s only us, USians who are getting reamed by the pharma cartel.

dreta 9y ago

This is an article written by the biggest fan of a guy with an inflated ego, a child-like view of the world, and nothing to show.

trevorhartman 9y ago

Related: If you want to understand how and why the American Healthcare system is broken, read the excellent book An American Sickness: How Healthcare Became Big Business and How You Can Take It Back by Elisabeth Rosenthal.

computator 9y ago

Interesting assertion from the FAQ on Michael Laufer's website[1]: > Q: What about quality control? A: It’s important to know that making small quantities of a chemical is vastly different than making it on an industrial scale. The chemistry isn’t even the same. This is a big reason why chemical engineering is an entire field of study. With smaller reactions, while you do have to be more precise in your measurements sometimes. There are fewer things to go wrong. Why would making small quantities be vastly different than making it on an industrial scale? I've heard the same thing about cooking and baking. Supposedly, if a recipe calls for 1 tablespoon of baking powder, then you scale it up 50 fold, you can't simply use 50 tablespoons of baking powder. The claim was that you had to use way more baking powder or much less (I forget which). It sounded like nonsense, but now I'm wondering. [1] https://fourthievesvinegar.org/faq https://fourthievesvinegar.org/faq

okreallywtf 9y ago
I'm also curious about that, the only reason I can think would have to do with an incomplete reaction because of the size of the batch although that would mean the ability to mix a batch of X depended on the amount and I don't know why that would be.
fabian2k 9y ago
Large scale production has very different requirements than small scale synthesis in the lab. Getting rid of heat is much easier on a small scale, and not all methods that work on a small scale can be scaled up. It's a ridiculous answer to the question of quality control, though. It doesn't really have anything to do with that.
deleted 9y ago
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jcranmer 9y ago
The most obvious element is heat: heat production grows at the same rate as volume, but heat dissipation grows at the same rate as surface area. So larger scales invariably end up running hotter (particularly when energetic exothermic reactions are involved), and temperature plays a major role in the kinematics of chemical reactions. The same surface area/volume issue in bulk also plays into reactions that happen at the margins of materials rather than the bulk--metal-catalyzed reactions are a common example.

trapperkeeper74 9y ago

Wow. Cool. I wonder how hard are the synthesises of the useful antidepressants like mirtazapine. Also, I found ASX-05 (Phase III) uses a DM metabolite that is retained much more by the addition of brupropion. DM is the stuff in some cough syrups.

nv-vn 9y ago
Well, mirtazapine isn't scheduled in the US so you can probably get some precursors with relative ease. You can find the synthesis info online [1] and at least some of the chemicals used in the synthesis are available online [2], though for the price it seems like it might be more economically feasible to just buy a pill from a pharma company. [1] http://www.arkat-usa.org/get-file/22868/ http://www.arkat-usa.org/get-file/22868/ [2] http://www.sigmaaldrich.com/catalog/product/aldrich/648434?lang=en&region=US http://www.sigmaaldrich.com/catalog/product/aldrich/648434?l...

mirimir 9y ago

Let's say that you need some pharmaceutical that's not available at a reasonable price. Perhaps because there's no generic available. Or because there are only licensed generics, priced just marginally less than the brand. And/or because you have crappy health insurance, or none at all. Depending on the drug, the best option is either an equivalent from a compounding pharmacy, or one from a low-price country, such as India, Mexico, etc. Making your own is only worth the hassle and risk if neither of those options is workable. The EpiPen is an unrepresentative example, because it's mostly about mechanics. With most drugs, you need to bulk out the active ingredient(s) to get a reasonably sized capsule or tablet. For capsules, with mannitol or whatever. For tablets, that plus binding agent(s). The challenge is that thorough mixing is nontrivial.

mnm1 9y ago

This brings to mind a very common ethics 101 class dilemma. Do you steal medicine to keep your loved one from dying? Of course, the answer to that is extremely obvious. I only wish we could help people steal more.

shadowtree 9y ago

People struggle to cook food for themselves. Just saying.

ncds42 9y ago

WHAT a fucking badass

ar-nelson 9y ago

DIY pharmaceuticals will never be safe, unless the recipes are regulated, at which point there's no point to them anyway. Imagine this situation: you Google for a recipe for a drug, and find two different recipes. Recipe A is the real one, while Recipe B will kill you instantly. The troll who posted Recipe B went around the internet claiming that Recipe B is real and Recipe A will kill you. There's no authoritative source to consult, because the actual recipe is patented. How do you know which is real?

jws 9y ago
Make them both, sell them on the dark web, see which has repeat customers?
neilparikh 9y ago
Aren't patents published publicly? So you could just check the patent (Although it may require some knowledge of biology/chemistry to understand).

zipwitch 9y ago

Sci-fi is increasingly struggling to keep up with reality. Here's a novel with a similar premise (but more SF setting) that isn't even out yet: https://www.tor.com/2017/09/18/excerpts-annalee-newitz-autonomous/ https://www.tor.com/2017/09/18/excerpts-annalee-newitz-auton...

kanzure 9y ago
my thinking on this is that science fiction authors are lazy and are not often scientifically trained; so they haven't been thinking about these topics at all. This is why science fiction is so dry and boring compared to neuroanatomy, molecular biology, neurophysiology, computational neuroscience, synthetic biology, etc.

phkahler 9y ago

What if he instead made a more reliable setup and recipe? Then someone could make a lab and rent it out to people wanting to make their own stuff. It would still be DIY but it would be in a more controlled environment. This model does involve some risk to the lab, but hey have the renter agree to binding arbitration or something.

rubatuga 9y ago

The premise in the article, that denying access to medicine is essentially murder is completely untrue. The following premise that people should be able steal is therefore not necessarily true.

a3n 9y ago

Something like this will be needed in the event of a civilizational reboot.

moonbug22 9y ago

TL,DR Merkin heathcare sucks.

arthurjj 9y ago

If anyone's interested in a fiction that partially explores this try Corey Doctorow's new novel Walk Away [1]. It's about people who 'walk away' from regular society. They to create their own high tech society because they completely ignore IP rights, and instead aggressively share techniques using the wiki model. 1. http://amzn.to/2ymP8EM http://amzn.to/2ymP8EM

tyingq 9y ago

"He’s developing a desktop lab and a recipe book meant to equip patients to cook up a range of medicines, including a homemade version of the expensive hepatitis C drug Sovaldi, on their kitchen counters." Any chemists here? Is it really plausible to synthesize C22H29FN3O9P at home?

microcolonel 9y ago

Lots of medicines are straightforward to manufacture, and as long as you're careful and follow the same sorts of risk-mitigating procedures and quality assurance steps that you would expect from a manufacturer, you would be served no worse by your own generic brand. That said, ideally we could fix the medicine-specific patent law craziness (and the regulatory inefficiency which necessitates it). Obviously, the specifics are much more complicated than anyone with a side to pick is willing to admit.

Mz 9y ago

Can anyone give me any insights into how stuff like this (and Goop) gets any traction?

flour_power 9y ago

only in america...

quickben 9y ago

If a person doesn't have access to medicine and dies: - in the East, that's a victim of Communism. - in the West, that's a poor lazy bum. In both cases, the person is gone and the society failed him. So, this guy rebels. Let's not paint him in political colors.