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If you're an American, every time you read a new article on Ketamine for depression your thought should be "Jeese, healthcare is screwed up". Pharma companies d
by TTPrograms 8y ago
If you're an American, every time you read a new article on Ketamine for depression your thought should be "Jeese, healthcare is screwed up". Pharma companies don't benefit from getting Ketamine approved (since it's no longer patent protected), so no one is putting it through FDA for depression. As a result insurance will never cover it (under the current model).
The reason this treatment isn't mainstream isn't because "the research is still out" (though that may still be). It's because there are no financial interests to get it over the hoops into the highly convoluted state that enables affordable medical care.
- tibuma 8y ago> Pharma companies don't benefit from getting Ketamine approved (since it's no longer patent protected), so no one is putting it through FDA for depression. This is incorrect. There are ongoing phase 3 clinical trials for nasally applied esketamine that will lead to FDA approval if succesfully reviewed. These trials are conducted worldwide and are very encouraging. The specific application seems to be patentable. First results should be available around 2019ish or 2020. You can find the trials here: https://clinicaltrials.gov/ct2/results?term=esketamine+depression&Search=Search https://clinicaltrials.gov/ct2/results?term=esketamine+depre... And one of the patent applications here: https://patents.google.com/patent/US20130236573A1 https://patents.google.com/patent/US20130236573A1
- shawnz 8y ago> This is incorrect. There are ongoing phase 3 clinical trials for nasally applied esketamine that will lead to FDA approval if succesfully reviewed. Specifically esketamine, not ketamine, because focusing on this specific isomer was the only way to get a new patent. What if racemic ketamine performs better than esketamine? We'll never know because they won't test that.
- jeffreyrogers 8y agoDo you have a source for that? You can get a patent on a new use for something that already exists if the new use is a non-obvious advance over the prior art.
- TTPrograms 8y agoRacemic ketamine is also dirt cheap, while esketamine might be absurdly expensive after being patented.
- tibuma 8y ago> What if racemic ketamine performs better than esketamine? We'll never know because they won't test that. It's quite likely some public institutions (e.g., universities, public research labs, etc.) or other countries (e.g., in India, China) will test exactly that. It's also in their interest to pubblish the results. So we'll get to know the differences between racemic ketamine, esketamine and arketamine. The question is if different variants will also be approved, which is much more expensive.
- darkkindness 8y agoYes, healthcare sounds pretty screwed up. But even though ketamine for depression might never get FDA approved, I think it's still good that these positive effects are still being reported on. The fact that there are new articles on ketamine shows that there is still some interest. And this interest isn't completely fruitless just because the pharma industry will never support it. Individuals (admittedly, only those who can afford it) can still try to benefit from e.g. off-license prescriptions.
- Brybry 8y agohttps://adisinsight.springer.com/drugs/800037644 https://adisinsight.springer.com/drugs/800037644 The very article you're commenting on directly contradicts what you're saying. Big pharma is actively running studies and trying to get this fast tracked for treatment in the US and Europe. Granted the article is somewhat poor reporting because the title should read "esketamine" not ketamine.
- deleted 8y ago[deleted]
- sneak 8y agoesketamine is simply the S-ketamine stereoisomer. TFA calls it part of the ketamine molecule but it is the ketamine molecule.
- voidmain 8y agoYeah, this is basically a variation of the POTAXOR strategy [1]. Well, whatever it takes to get it into the hands of sick people! But I think it is a commentary on the system that it will take decades after we had good evidence for ketamine's effectiveness. [1] http://slatestarcodex.com/2014/06/15/fish-now-by-prescription/ http://slatestarcodex.com/2014/06/15/fish-now-by-prescriptio...
- TTPrograms 8y agoEsketamine is the patentable isomer they're trying to use to enable this process of patenting + FDA so the drug companies can make a return. So the end result is a very expensive drug that insurance would pay for vs a cheap drug with 90% of the benefits that insurance won't pay for.
- deleted 8y ago[deleted]
- saasthrowaway3 8y agoDo you think something like "FDA-approval of Ketamine" could be successfully crowdfunded?
- wjnc 8y agoWhat I do not understand from a market perspective is why insurers don't cooperate more to fund such research. If a treatment goes from 20k to 1k p.a. the benefits for insurers are clear. They could even fund such research in an equity-fashion, that way steering clear of anti-competition law and free-rider problems (just sell it to the non-cooperators for 20k).
- ergothus 8y agoThat is an incentive to insurers only if they are paying the price or if the lower costs to a specific group of consumers increases their market share. Since most costs are passed on to the consumers and most consumers don't get to pick their insurance (in the U.S.) , the incentives aren't there.
- ada1981 8y agoIt's happened with MDMA via maps.org Why not? Probably need about $25M - $50M Also Ketamine seems to be pallative vs. a cure, if I'm not mistaken.
- 8y ago
- nebstrebor 8y agoGeneric pharma is still big business. And there's patents for novel ways to deliver the medication (e.g., Vyvanse and Concerta in the ADD stimulants space)
- patricius 8y agoGetting a drug approved by the FDA is pretty expensive. Abolishing the FDA, thereby reducing the cost of introducing the drug, might be the real solution here.
- arkades 8y agoI find public health inspectors also make it more expensive to run a restaurant. Perhaps the solution to their tight margins would be to abolish health inspections.
- Fnoord 8y agoWhile you're at it, tax makes it more difficult to run a business and making a living. Let us abolish tax as well.
- patricius 8y agoI agree. Just because a thing exists (the FDA or taxes for instance), doesn't make it a good thing.
- jcora 8y agoWow look, an ancap in 2018!
- patricius 8y agoYeah. I feel pretty lonely here... :'(
- logfromblammo 8y agoAnarcho-capitalism largely depends on a belief that human nature is essentially good, and prone to spontaneous cooperation. It is also heavily dependent on reputation, which scales poorly, or on trustless technologies, which aren't yet mature. I'm still anarchist in 2018, but I haven't been anywhere near the an-cap territory of it since around 2006. Sticking to a political dogma out in the libertarian hinterlands is really only good for pointlessly arguing with other libertarians on the Internet. That can be fun sometimes, but it's not as entertaining as it used to be, what with everyone pointing at Twitler and saying "You see? This is exactly as (insert libertarian variant) predicted!"
- mtgx 8y agoSame with Vitamin D, almost. If it were patent-protected, you'd probably get a big list of features promoted for an almost "miracle pill" that would probably cost a few dollars per pill. But Vitamin D is not patent protected and it's dirt cheap, so not only does Big Pharma have no interest in promoting it, but it would rather you take much more dangerous drugs and much more expensive drugs to cure the same things Vitamin D does. This is what a private healthcare system gets you, where profit is always a bigger priority than the well-being of the patient.
- arkades 8y agoVitD became a fad topic over a decade ago and has been studied endlessly since then. This is a very odd comment thread. Lots of people criticizing our health system for not studying things it actually does study a lot.
- cies 8y agoMaybe Pineapple Fund can come to the rescue, they (he?) chipped in 4M to get MDMA through a clinical trial. http://www.maps.org/news/media/7082-press-release-maps-completes-$4-million-matching-grant-from-pineapple-fund http://www.maps.org/news/media/7082-press-release-maps-compl... I get the feeling this is not a Gates kind of philanthropist, lol.
- agumonkey 8y agoA pair of researchers told me the same about cannabidiol.
- maxerickson 8y agoIs ketamine approved/endorsed for treating depression in some other countries? I would think given compelling enough research that there would be plenty of private foundation dollars to complete trials.
- hssys 8y agoIf that is the case then why is this not widely available in the UK?
- GordonS 8y agoHealthcare in the UK moves at a snail's pace. NICE requires a lot of evidence before they will permit new treatments. The bigger issue though are the "Daily Mail politics" of using drugs that can be abused - it's seen as politically toxic with a particular segment of voters. Take cannabis as an example - it was moved back to class B years ago, purely for political reasons. And as other nations are starting to use it therapeutically, we still seem light years away.