3 ms·

I’m bothered that medical research has seen influence by the MBAs. Ie. we don’t research looking for cures anymore because then you’ll only sell the drug once.

by josho 7y ago

I’m bothered that medical research has seen influence by the MBAs. Ie. we don’t research looking for cures anymore because then you’ll only sell the drug once. Instead research management therapy so that you can have lifelong customers that need your product (pill) daily for the rest of their life.

tptacek 7y ago
This is popular narrative, especially on message boards, but is there any evidence that drug researchers are somehow biased towards medications that manage rather than cure conditions? Or is it just that cures are harder to discover than mitigations? If you look at a list of current blockbuster drugs, you'll find that they are not primarily lifetime scripts. For instance, the second best-selling drug of 2015, Gilead's Harvoni, cures Hep C in a couple months. Most anti-cancer agents, which dominate the blockbuster lists, are not taken permanently. Humira, AbbVie's arthritis med, has topped the charts for years, and is taken long-term, but it seems unlikely to me that if AbbVie or some other pharma found a way to permanently cure arthritis that they wouldn't sell the hell out of that product.
- giardini 7y ago
  Given a cure (not a "maintenance" drug), companies would "sell the hell out of" that product until there were no more customers; then the market would collapse and the corporation would go bankrupt. The medical market is slightly more "graceful" in that new customers enter the market each generation. This is not "popular narrative", it's established economic reality for any good that can be either rented or sold. Compare selling vs renting a software package. Once a market is saturated no more sales can be made and the seller's company will likely collapse. In contrast, a renter collects each year until the software is superceded (but can add improvements each year to postpone that) or no longer useful. I once worked for a company that sold a software package for a one-time (large) purchase fee plus a trivial annual maintenance fee. The employees walked the halls puzzling "What happens when we sell our last package?". Answer: company saw the light and tried to change from a purchase model to a rental model. All customers revolted and some threatened to sue (for software support ad infinitum). The company collapsed. Luckily I was gone by then. And yes, the MBAs are responsible largely: they do good b/c they can tell you what business model to use to achieve your goals. Few industries are more concerned about how to make money than the pharmaceutical industry: https://duckduckgo.com/?q=business+models+for+pharmaceuticals https://duckduckgo.com/?q=business+models+for+pharmaceutical... But we also need corporations that are willing to develop true cures instead of "managements". Most MBA's aren't interested in that; maybe government can help by providing better incentives.
  - deleted 7y ago
    [deleted]
  - Tomte 7y ago
    That's all great, but we're not talking about software, and you haven't addressed your parent poster's point in the slightest. Of course someone could prioritize "management". That's not interesting. Interesting is the question whether they actually do, and you cannot argue that from first principles, philosophy-style. You need observations, news reportings, whatever. But facts, not "I could imagine...".
- josho 7y ago
  Admittedly I don’t have a resource to site. A quick google is easy to find all sorts of ways that the pharma industry has performed with their interests taking precedence over patients (eg price gouging, selectively publishing research). But, yes it’s proving to be a little hard to find specific details that show the industry prioritizes research that yields long term use drugs over cures. To counter your point the existence of short term (& high cost) drugs doesn’t contradict that research prioritizes medications that maximize profit not patient lifestyle.
  - tptacek 7y ago
    That's not evidence. Here's some evidence --- it's not dispositive, but it's more compelling than "this is how it seems like the pharma industry would act based on their other behavior" --- more dollars are spent on research on combating malignant neoplasms than on any other condition, and the most lucrative anti-cancer drugs tend not to be lifetime prescriptions. Both statements are easily confirmed with Google. But it's also not responsive to the original argument, which is that MBAs have directed researchers to discover only mitigations and not cures to disease --- that the industry is actively avoidant of curative discoveries. That's an extraordinary claim.

by josho 7y ago

tptacek 7y ago

This is popular narrative, especially on message boards, but is there any evidence that drug researchers are somehow biased towards medications that manage rather than cure conditions? Or is it just that cures are harder to discover than mitigations? If you look at a list of current blockbuster drugs, you'll find that they are not primarily lifetime scripts. For instance, the second best-selling drug of 2015, Gilead's Harvoni, cures Hep C in a couple months. Most anti-cancer agents, which dominate the blockbuster lists, are not taken permanently. Humira, AbbVie's arthritis med, has topped the charts for years, and is taken long-term, but it seems unlikely to me that if AbbVie or some other pharma found a way to permanently cure arthritis that they wouldn't sell the hell out of that product.

giardini 7y ago
Given a cure (not a "maintenance" drug), companies would "sell the hell out of" that product until there were no more customers; then the market would collapse and the corporation would go bankrupt. The medical market is slightly more "graceful" in that new customers enter the market each generation. This is not "popular narrative", it's established economic reality for any good that can be either rented or sold. Compare selling vs renting a software package. Once a market is saturated no more sales can be made and the seller's company will likely collapse. In contrast, a renter collects each year until the software is superceded (but can add improvements each year to postpone that) or no longer useful. I once worked for a company that sold a software package for a one-time (large) purchase fee plus a trivial annual maintenance fee. The employees walked the halls puzzling "What happens when we sell our last package?". Answer: company saw the light and tried to change from a purchase model to a rental model. All customers revolted and some threatened to sue (for software support ad infinitum). The company collapsed. Luckily I was gone by then. And yes, the MBAs are responsible largely: they do good b/c they can tell you what business model to use to achieve your goals. Few industries are more concerned about how to make money than the pharmaceutical industry: https://duckduckgo.com/?q=business+models+for+pharmaceuticals https://duckduckgo.com/?q=business+models+for+pharmaceutical... But we also need corporations that are willing to develop true cures instead of "managements". Most MBA's aren't interested in that; maybe government can help by providing better incentives.
- deleted 7y ago
  [deleted]
- Tomte 7y ago
  That's all great, but we're not talking about software, and you haven't addressed your parent poster's point in the slightest. Of course someone could prioritize "management". That's not interesting. Interesting is the question whether they actually do, and you cannot argue that from first principles, philosophy-style. You need observations, news reportings, whatever. But facts, not "I could imagine...".
josho 7y ago
Admittedly I don’t have a resource to site. A quick google is easy to find all sorts of ways that the pharma industry has performed with their interests taking precedence over patients (eg price gouging, selectively publishing research). But, yes it’s proving to be a little hard to find specific details that show the industry prioritizes research that yields long term use drugs over cures. To counter your point the existence of short term (& high cost) drugs doesn’t contradict that research prioritizes medications that maximize profit not patient lifestyle.
- tptacek 7y ago
  That's not evidence. Here's some evidence --- it's not dispositive, but it's more compelling than "this is how it seems like the pharma industry would act based on their other behavior" --- more dollars are spent on research on combating malignant neoplasms than on any other condition, and the most lucrative anti-cancer drugs tend not to be lifetime prescriptions. Both statements are easily confirmed with Google. But it's also not responsive to the original argument, which is that MBAs have directed researchers to discover only mitigations and not cures to disease --- that the industry is actively avoidant of curative discoveries. That's an extraordinary claim.