3 ms·

Hello pharma industry

cstross 8y ago
Yes but ... Big pharma currently doesn't want to cure medical conditions, it wants to sell drugs continuously. (See also: lack of development of new antibiotics, huge over-investment in anti-depressants, etc.) New medicines are very expensive to develop because of the extreme regulatory environment and relatively short patent duration (two decades from registering a patent on a drug to it going into a free-for-all of cheap generics: development takes 8-16 years and the remaining 4-12 years are all the time the developer has got to amortize their costs and turn a profit). But the regulations and requirements for extensive testing exist for very good reason, to prevent this sort of thing from happening: https://en.wikipedia.org/wiki/Elixir_Sulfanilamide https://en.wikipedia.org/wiki/Elixir_Sulfanilamide (1938: at least 100 dead) https://en.wikipedia.org/wiki/Thalidomide#History https://en.wikipedia.org/wiki/Thalidomide#History (1950s: use for morning sickness caused >2000 deaths, 10,000 born with severe deformities) https://en.wikipedia.org/wiki/Vioxx https://en.wikipedia.org/wiki/Vioxx (2004: 88-140,000 cases of serious heart disease) There's no solution to the problem of complex, emergent, lethal drug side-effects on the horizon. So we have to have expensive clinical trials and statistical tests to rule out a high risk of harm before a new drug can be released. So the pharmaceutical industry has a baked-in incentive to maximize revenue by ignoring certain conditions (brief/acute illnesses, especially those afflicting the poor or the developing world) and prioritize chronic diseases of affluence. There's no fix within the established framework, because the established framework is defective by emergent design. We could tinker with the international intellectual property regime governing pharmaceutical patent duration, but that kicks the ball up to WTO treaty level. Or we could consider non-profit bases for pharmaceutical R&D, but that goes against the current dominant free market ideology.
- Thriptic 8y ago
  > Big pharma currently doesn't want to cure medical conditions, it wants to sell drugs continuously. (See also: lack of development of new antibiotics, huge over-investment in anti-depressants, etc.) I'm so tied of hearing this claim. Gilead created a cure for hep C and tried to charge users X% of the lifetime cost of the existing interfeuron therapy which only managed symptoms but was not a cure. You would expect that this would be received favorably: patient gets cured, insurance companies save money over the long term, Gilead makes a healthy profit. Wrong; people flipped a shit, screaming about how this was price gouging and that a single treatment should never be this expensive. Gilead has been embattled ever since. If you want pharma companies to make cures, inventivize them to do so.
  - deleted 8y ago
    [deleted]
  - hotcrossbunny 8y ago
    +1 for coining the word inventivize. I can't wait to use this for something, even tho I don't yet know what it means
  - rainbowmverse 8y ago
    >> If you want pharma companies to make cures, inventivize them to do so. You stopped just short of a breakthrough. The institution of for-profit healthcare is something we could do without. No one should suffer or die because they couldn't get rich enough before facing a life-limiting illness or injury.
    - sparkzilla 8y ago
      Yeah, let's pay for research using leaves from your magic money tree.
      - marcosdumay 8y ago
        Somehow you can pay for Big Pharma, but not for the same thing done by the government...
      - cstross 8y ago
        Funnily enough, this works just fine here in the UK (where the NHS supports a profitable pharmaceutical private sector).
  - jancsika 8y ago
    X% of lifetime cost isn't meaningful without stating the lifetime cost. What is the lifetime cost?
- nisa 8y ago
  > Or we could consider non-profit bases for pharmaceutical R&D, but that goes against the current dominant free market ideology. Considering the huge costs of healthcare in western countries why don't all the states or maybe EU cooperate? This seems to happen in research but why stop there? Add 1% of tax for it - it's probably worth it - alone on the fact you have an organisation without profit motivation. However even if realized I guess lobbying will destroy any good that might come out of such an initiative before it's even started.
  - maxerickson 8y ago
    There's some amount of government support of medical research: https://www.nih.gov/grants-funding https://www.nih.gov/grants-funding It apparently contributes something or other to the system: http://www.pnas.org/content/early/2018/02/06/1715368115 http://www.pnas.org/content/early/2018/02/06/1715368115 (annual NIH grants are ~$32 billion, NIH funded research contributed to every drug brought to market in the US between 2010 and 2016...)
    - wbl 8y ago
      There is a huge gap between "this does X in a petri dish" and a drug that works in the clinic.
    - SubiculumCode 8y ago
      I think she means help in the final steps of drug approval and production.

Yes but ... Big pharma currently doesn't want to cure medical conditions, it wants to sell drugs continuously. (See also: lack of development of new antibiotics, huge over-investment in anti-depressants, etc.) New medicines are very expensive to develop because of the extreme regulatory environment and relatively short patent duration (two decades from registering a patent on a drug to it going into a free-for-all of cheap generics: development takes 8-16 years and the remaining 4-12 years are all the time the developer has got to amortize their costs and turn a profit). But the regulations and requirements for extensive testing exist for very good reason, to prevent this sort of thing from happening: https://en.wikipedia.org/wiki/Elixir_Sulfanilamide https://en.wikipedia.org/wiki/Elixir_Sulfanilamide (1938: at least 100 dead) https://en.wikipedia.org/wiki/Thalidomide#History https://en.wikipedia.org/wiki/Thalidomide#History (1950s: use for morning sickness caused >2000 deaths, 10,000 born with severe deformities) https://en.wikipedia.org/wiki/Vioxx https://en.wikipedia.org/wiki/Vioxx (2004: 88-140,000 cases of serious heart disease) There's no solution to the problem of complex, emergent, lethal drug side-effects on the horizon. So we have to have expensive clinical trials and statistical tests to rule out a high risk of harm before a new drug can be released. So the pharmaceutical industry has a baked-in incentive to maximize revenue by ignoring certain conditions (brief/acute illnesses, especially those afflicting the poor or the developing world) and prioritize chronic diseases of affluence. There's no fix within the established framework, because the established framework is defective by emergent design. We could tinker with the international intellectual property regime governing pharmaceutical patent duration, but that kicks the ball up to WTO treaty level. Or we could consider non-profit bases for pharmaceutical R&D, but that goes against the current dominant free market ideology.

Thriptic 8y ago
> Big pharma currently doesn't want to cure medical conditions, it wants to sell drugs continuously. (See also: lack of development of new antibiotics, huge over-investment in anti-depressants, etc.) I'm so tied of hearing this claim. Gilead created a cure for hep C and tried to charge users X% of the lifetime cost of the existing interfeuron therapy which only managed symptoms but was not a cure. You would expect that this would be received favorably: patient gets cured, insurance companies save money over the long term, Gilead makes a healthy profit. Wrong; people flipped a shit, screaming about how this was price gouging and that a single treatment should never be this expensive. Gilead has been embattled ever since. If you want pharma companies to make cures, inventivize them to do so.
- deleted 8y ago
  [deleted]
- hotcrossbunny 8y ago
  +1 for coining the word inventivize. I can't wait to use this for something, even tho I don't yet know what it means
- rainbowmverse 8y ago
  >> If you want pharma companies to make cures, inventivize them to do so. You stopped just short of a breakthrough. The institution of for-profit healthcare is something we could do without. No one should suffer or die because they couldn't get rich enough before facing a life-limiting illness or injury.
  - sparkzilla 8y ago
    Yeah, let's pay for research using leaves from your magic money tree.
    - marcosdumay 8y ago
      Somehow you can pay for Big Pharma, but not for the same thing done by the government...
    - cstross 8y ago
      Funnily enough, this works just fine here in the UK (where the NHS supports a profitable pharmaceutical private sector).
- jancsika 8y ago
  X% of lifetime cost isn't meaningful without stating the lifetime cost. What is the lifetime cost?
nisa 8y ago
> Or we could consider non-profit bases for pharmaceutical R&D, but that goes against the current dominant free market ideology. Considering the huge costs of healthcare in western countries why don't all the states or maybe EU cooperate? This seems to happen in research but why stop there? Add 1% of tax for it - it's probably worth it - alone on the fact you have an organisation without profit motivation. However even if realized I guess lobbying will destroy any good that might come out of such an initiative before it's even started.
- maxerickson 8y ago
  There's some amount of government support of medical research: https://www.nih.gov/grants-funding https://www.nih.gov/grants-funding It apparently contributes something or other to the system: http://www.pnas.org/content/early/2018/02/06/1715368115 http://www.pnas.org/content/early/2018/02/06/1715368115 (annual NIH grants are ~$32 billion, NIH funded research contributed to every drug brought to market in the US between 2010 and 2016...)
  - wbl 8y ago
    There is a huge gap between "this does X in a petri dish" and a drug that works in the clinic.
  - SubiculumCode 8y ago
    I think she means help in the final steps of drug approval and production.