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If people stop using these drugs if they're not advertised maybe they're not that useful in the first place? Isn't there enough money to be made selling real tr

by simias 9y ago

If people stop using these drugs if they're not advertised maybe they're not that useful in the first place? Isn't there enough money to be made selling real treatments for real diseases?

jessaustin 9y ago
The answer to your first question is certainly "yes". Unfortunately the answer to the second is "no". No pharma executive ever got a bonus for saving lives.
- simias 9y ago
  That doesn't make sense to me. If life-saving drugs don't make money and pharmas are purely rational actors trying to maximize profit why would they bother investing money into them anyway? Also "life-saving" is a high bar, I was merely talking about "useful". If you figure out a great remedy for baldness you might not save lives but you wont have any issue making billions selling it, advertising or not. If you only way to sell a drug is to convince people they need it in the first place then I think it ought to be illegal, yes. Look at the massive opioid crisis in the USA which stems in great part from pharma pushing drugs people didn't really need and getting them addicted. If that's the only way you can figure out to fund cancer research we have a big problem indeed.
  - jessaustin 9y ago
    Opioids don't need marketing. Opioid aficionados will seek them out at great expense and difficulty. In a sense, that's good, because the question of appropriate pain management is complicated enough even without considering marketing. Physicians who didn't know that opioids were addictive before prescribing them weren't victims of irresponsible marketing; they were poor physicians. That isn't to say that pain shouldn't be treated, rather it is to say that treating pain is difficult and we've done a poor job so far. Part of that is vilification of opioid users, part of it is abdicating all decisions to physicians. When I was 13yo I was capable of saying "no I don't need another shot of Demerol" while barely conscious in a hospital bed. Just the same, as long as I live, I will never forget the first two shots I did receive. They were that great. But that isn't pharma; we've used opioids for centuries. When economic historians of the future consider the current era's pharma industry, they will marvel at how much money was spent for how little benefit. The cure to cancer will not come from pharma. (Quite possibly from biotech, but that's a different thing.) The incentives are wrong: cures are less valuable than indefinite treatments. Look how much they have to charge for the hep C cure. If that were a mere treatment, they could amortize their "research costs" over a lifetime. Even better than treatments that work are treatments that might work. One poor suffering patient might be prescribed 15 such, multiple times a day for the rest of her life. Still, for many hep C sufferers even an expensive cure is a good thing. Many other conditions respond in agreeable ways to some medicines for some patients some of the time. Maybe the research costs too much for some of them. One suspects that a more rational FDA process could cut costs for most drugs, but no one who would benefit from that has any control over the process itself. The whole edifice is a bit monstrous. Just the same, if the golden goose requires drug marketing, do we really want to do away with drug marketing?

by simias 9y ago

If people stop using these drugs if they're not advertised maybe they're not that useful in the first place? Isn't there enough money to be made selling real treatments for real diseases?

jessaustin 9y ago

The answer to your first question is certainly "yes". Unfortunately the answer to the second is "no". No pharma executive ever got a bonus for saving lives.

simias 9y ago
That doesn't make sense to me. If life-saving drugs don't make money and pharmas are purely rational actors trying to maximize profit why would they bother investing money into them anyway? Also "life-saving" is a high bar, I was merely talking about "useful". If you figure out a great remedy for baldness you might not save lives but you wont have any issue making billions selling it, advertising or not. If you only way to sell a drug is to convince people they need it in the first place then I think it ought to be illegal, yes. Look at the massive opioid crisis in the USA which stems in great part from pharma pushing drugs people didn't really need and getting them addicted. If that's the only way you can figure out to fund cancer research we have a big problem indeed.
- jessaustin 9y ago
  Opioids don't need marketing. Opioid aficionados will seek them out at great expense and difficulty. In a sense, that's good, because the question of appropriate pain management is complicated enough even without considering marketing. Physicians who didn't know that opioids were addictive before prescribing them weren't victims of irresponsible marketing; they were poor physicians. That isn't to say that pain shouldn't be treated, rather it is to say that treating pain is difficult and we've done a poor job so far. Part of that is vilification of opioid users, part of it is abdicating all decisions to physicians. When I was 13yo I was capable of saying "no I don't need another shot of Demerol" while barely conscious in a hospital bed. Just the same, as long as I live, I will never forget the first two shots I did receive. They were that great. But that isn't pharma; we've used opioids for centuries. When economic historians of the future consider the current era's pharma industry, they will marvel at how much money was spent for how little benefit. The cure to cancer will not come from pharma. (Quite possibly from biotech, but that's a different thing.) The incentives are wrong: cures are less valuable than indefinite treatments. Look how much they have to charge for the hep C cure. If that were a mere treatment, they could amortize their "research costs" over a lifetime. Even better than treatments that work are treatments that might work. One poor suffering patient might be prescribed 15 such, multiple times a day for the rest of her life. Still, for many hep C sufferers even an expensive cure is a good thing. Many other conditions respond in agreeable ways to some medicines for some patients some of the time. Maybe the research costs too much for some of them. One suspects that a more rational FDA process could cut costs for most drugs, but no one who would benefit from that has any control over the process itself. The whole edifice is a bit monstrous. Just the same, if the golden goose requires drug marketing, do we really want to do away with drug marketing?