6 ms·

Medicine in America will never do this, at least not for the foreseeable future. They moved from 'cures' decades ago. Plus add a big heaping spoonful of the F

Medicine in America will never do this, at least not for the foreseeable future. They moved from 'cures' decades ago. Plus add a big heaping spoonful of the FDA and the red-tape that must be jumped through. Anytime someone ingests something, someone, somewhere, will die from it. When you work in pharma, you learn that there are teams of lawyers and budgets just to deal with the inevitable deaths. Just getting to human trials during the experimentation phase takes years. I'd say look more toward real-working natural cures and improving our lifestyles and environments would be more realistic in the short term.

nradov 7y ago
That's obviously false. See sofosbuvir for a recent counter example.
- thepaperone 7y ago
  Such a good example! It only costs ~$84,000 to take a full coarse of sofosbuvir in the United States......................................................................... ... .....
  - trimbo 7y ago
    Counterpoint: Sovaldi was basically a miracle drug for a widespread, expensive disease and even priced at $84K, that represented huge savings for the US healthcare system. At the time it came out, the destiny for a Hep C patient was a $1M liver transplant. And that's not even including all of the other costs and misery Hep C patients incur as their liver fails. Now those people are treated quickly, saving tons of money and time, as well as improving their lives. Also, because of the high price, it inspired competition and innovation. Within a couple years of Sovaldi and Harvoni, several other improved and cheaper drugs appeared on the market. The cost dropped to a quarter of the price of Harvoni and with half of the treatment cycle and better cure rates (Mavyret).
postpawl 7y ago
“According to industry watchdogs, reducing clinical trial costs will not help curb list prices because those prices are not determined by investment costs; they’re determined by what the makers think the market can bear, which helps explain why profit margins are so high.” https://www.nytimes.com/2018/06/08/opinion/drug-approval-cutting-prices.html https://www.nytimes.com/2018/06/08/opinion/drug-approval-cut...
- vibrio 7y ago
  isn't that a bit circular? If investment costs (lets include capital, time, and risk)were low, wouldn't there be a influx of motivated innovators to create a greater selection of new drugs, which would either drive down price of equivalent drugs (or produce better drugs with are more efficacious/less toxic)? If investment costs/risk aren't limiting abundant new drugs, what is?
  - g00s3_caLL_x2 7y ago
    The FDA. IIRC approval time takes about 10 years minimum. Then you have 20 years to cash that cow out before the patent runs out.
    - vibrio 7y ago
      So the FDA should be more lax on requirements for approval? Should they reduce the Preclicnal PharmTox requirements? How long should a cancer trial take if it has 500 brain cancer patents to enroll and it measures improvements in survival that takes over a year? Should Pharma just one study or should they do a coulple of serially run clinical studies to understand the toxicities and how the drug works best? I'd love for development timelines to be quicker, but I need a Gantt chart to better understand where the time savings would come from without compromising the safety and data supporting efficacy. Help me understand. Also. Most substantial patents are filed way before the approval of the drug. Rarely if ever has a drug had, for example, a composition of matter patent for 20 years after approval-- even with the extensions for regulatory delay that the USPTO allows. Not to say that Pharma don't extensively engage in product life-cycle management, sometimes very questionably extending exclusivity of products, and that is something that should be addressed.
maxxxxx 7y ago
"improving our lifestyles and environments would be more realistic in the short term" Unfortunately not realistic but it would be very desirable. For some reason it's accepted that people live very unhealthy lives and have big medical expenses but it's not accepted to change things like exercise and eating habits which would be very cheap and simple.
- g00s3_caLL_x2 7y ago
  From the aspect of what would happen first, this would be more realistic than getting more companies on board for curing and preventing vs maintaining. Having a regional or even global movement for healthier lifestyles would be easier done than convincing shareholders to make less money. Sad, but true.
vibrio 7y ago
GO find one of the children that has been helped by the new Cystic Fibrosis drugs (or their parents) and have a chat about this.
- g00s3_caLL_x2 7y ago
  I'm not saying I agree with this, I'm saying this is how pharama business works. I've worked for some of the biggest players globally, and I can tell you they are not in the business for cures.
  - vibrio 7y ago
    I'm also familiar with the industry. At what level are the cure being limited? Are Pharma scientists not looking for curative potentially approaches? or maybe ditching promising candidates precinically? are Pharma ClinDev folks designing studies for cures to intentionally fail maintaining demain for their chronic drugs? Did GIlead miss the opportunity to break cure they spent all that cash on? the I'm having a hard time understanding the specifics of how this strategy is executed. There is MUCH wrong with the pharma industry.The noise of conspiracy theories can dilute legitimate criticisms that could lead to corrective pressures.

nradov 7y ago

That's obviously false. See sofosbuvir for a recent counter example.

thepaperone 7y ago
Such a good example! It only costs ~$84,000 to take a full coarse of sofosbuvir in the United States......................................................................... ... .....
- trimbo 7y ago
  Counterpoint: Sovaldi was basically a miracle drug for a widespread, expensive disease and even priced at $84K, that represented huge savings for the US healthcare system. At the time it came out, the destiny for a Hep C patient was a $1M liver transplant. And that's not even including all of the other costs and misery Hep C patients incur as their liver fails. Now those people are treated quickly, saving tons of money and time, as well as improving their lives. Also, because of the high price, it inspired competition and innovation. Within a couple years of Sovaldi and Harvoni, several other improved and cheaper drugs appeared on the market. The cost dropped to a quarter of the price of Harvoni and with half of the treatment cycle and better cure rates (Mavyret).

postpawl 7y ago

“According to industry watchdogs, reducing clinical trial costs will not help curb list prices because those prices are not determined by investment costs; they’re determined by what the makers think the market can bear, which helps explain why profit margins are so high.” https://www.nytimes.com/2018/06/08/opinion/drug-approval-cutting-prices.html https://www.nytimes.com/2018/06/08/opinion/drug-approval-cut...

vibrio 7y ago
isn't that a bit circular? If investment costs (lets include capital, time, and risk)were low, wouldn't there be a influx of motivated innovators to create a greater selection of new drugs, which would either drive down price of equivalent drugs (or produce better drugs with are more efficacious/less toxic)? If investment costs/risk aren't limiting abundant new drugs, what is?
- g00s3_caLL_x2 7y ago
  The FDA. IIRC approval time takes about 10 years minimum. Then you have 20 years to cash that cow out before the patent runs out.
  - vibrio 7y ago
    So the FDA should be more lax on requirements for approval? Should they reduce the Preclicnal PharmTox requirements? How long should a cancer trial take if it has 500 brain cancer patents to enroll and it measures improvements in survival that takes over a year? Should Pharma just one study or should they do a coulple of serially run clinical studies to understand the toxicities and how the drug works best? I'd love for development timelines to be quicker, but I need a Gantt chart to better understand where the time savings would come from without compromising the safety and data supporting efficacy. Help me understand. Also. Most substantial patents are filed way before the approval of the drug. Rarely if ever has a drug had, for example, a composition of matter patent for 20 years after approval-- even with the extensions for regulatory delay that the USPTO allows. Not to say that Pharma don't extensively engage in product life-cycle management, sometimes very questionably extending exclusivity of products, and that is something that should be addressed.

maxxxxx 7y ago

"improving our lifestyles and environments would be more realistic in the short term" Unfortunately not realistic but it would be very desirable. For some reason it's accepted that people live very unhealthy lives and have big medical expenses but it's not accepted to change things like exercise and eating habits which would be very cheap and simple.

g00s3_caLL_x2 7y ago
From the aspect of what would happen first, this would be more realistic than getting more companies on board for curing and preventing vs maintaining. Having a regional or even global movement for healthier lifestyles would be easier done than convincing shareholders to make less money. Sad, but true.

vibrio 7y ago

GO find one of the children that has been helped by the new Cystic Fibrosis drugs (or their parents) and have a chat about this.

g00s3_caLL_x2 7y ago
I'm not saying I agree with this, I'm saying this is how pharama business works. I've worked for some of the biggest players globally, and I can tell you they are not in the business for cures.
- vibrio 7y ago
  I'm also familiar with the industry. At what level are the cure being limited? Are Pharma scientists not looking for curative potentially approaches? or maybe ditching promising candidates precinically? are Pharma ClinDev folks designing studies for cures to intentionally fail maintaining demain for their chronic drugs? Did GIlead miss the opportunity to break cure they spent all that cash on? the I'm having a hard time understanding the specifics of how this strategy is executed. There is MUCH wrong with the pharma industry.The noise of conspiracy theories can dilute legitimate criticisms that could lead to corrective pressures.