5 ms·

> What if everyone had an analysis machine that could analyze the medicines, DIY or not, to find out what was in them I can fairly confidently predict this wil

> What if everyone had an analysis machine that could analyze the medicines, DIY or not, to find out what was in them I can fairly confidently predict this will not happen like it did for software. Chemical analysis has been around a long time and remains difficult for experts to do accurately without context, let alone for a layman. Gas chromatography, for example, requires large and expensive machinery and some idea of what the substance is composed of in order to determine the concentration of analytes. Reagent testing is cheap, simple, and straightforward, but it is generally only capable of detecting whether or not some class of substances are present above a particular concentration. You cannot use reagent testing to determine "how pure" a medicine is, let alone whether the impurities (which there will assuredly be) are potentially harmful. As is currently the case for illicit drugs, I imagine there will be an ecosystem to verify that A) the active ingredient is actually present and B) some limited range of problem impurities are not present, but that is a much less stringent form of quality control than pharmaceutical companies perform.

notch656a 5y ago
I'm not arguing with what you're saying, but GC/MS can be bought for like $100 a sample and it's conceivable a system can be invented where private auditors audit the output of an unregulated pharmaceutical manufacturer in such a way that the QC assurances to the consumer are as good or better as in our current system, with much lower regulatory costs.
- nwiswell 5y ago
  In the limit what you are describing is a generic drugmaker. It's certainly possible to audit drug quality by sending it to labs, and people do that for darknet drugs all the time, but there are still problems: 1) There is no way to use ex-post analysis alone to achieve the kind of QA that pharmaceutical companies do; they have visibility into the entire manufacturing process and process control. Put another way, a sample of a drug cannot be used to verify that the process used to manufacture it is safe. 2) There is no assurance that anything you get in the future is made with the same process. The only way I see this working, honestly, is for a rogue jurisdiction to offer safe harbor to "generic pirates". The rogue jurisdiction would offer legitimate regulatory oversight in exchange for tax revenue, and the drugs would be smuggled out of the jurisdiction for sale. To some extent this is already the case in grey markets where brand name drugs which are sold for less in other countries get arbitraged/smuggled back to high-cost markets.
  - notch656a 5y ago
    I think we are seeing the same thing, a system designed to remove corruption/regulatory capture/lobbying as far as possible from the process. I'm seeing a "rogue" auditor that performs the same service, while you are seeing a rogue government. If the outcome is the same, I am fine with either. Your pointed weakness regarding auditing the manufacturing process could be incorporated into either.
    - nwiswell 5y ago
      > I think we are seeing the same thing, a system designed to remove corruption/regulatory capture/lobbying as far as possible from the process Not really. It's more like a system to selectively remove intellectual property rights without destroying the financial incentive to develop drugs.
      - notch656a 5y ago
        Oh. So you don't want a system that removes corruption, regulatory capture, and lobbying as far as possible? I don't want to destroy the financial incentive either, I think it's great people that bring wanted goods to market profit from it. IP is an interesting point, although I'm not convinced that generating the IP is more than a small fraction of the cost of a drug. An aggregate I saw from 2011-2018 puts Research at only 17% of revenue, and only some proportion of that is geared towards generating IP. That is to say, with all else removed you could generate an IP only company for 17% the cost of drug sales.
        nwiswell 5y ago
        > Oh. So you don't want a system that removes corruption, regulatory capture, and lobbying as far as possible? Well, sure. But that's not what this is actually about. The titular anarchists are not inventing new drugs, they're finding alternative ways to get drugs that have already been invented. > That is to say, with all else removed you could generate an IP only company for 17% the cost of drug sales. I am not convinced that accurately reflects the reality of running a pharmaceutical business, even if incentives/competition is somewhat warped in healthcare. There are a lot of penny-stock pharma companies whose only mission is to generate valuable IP. They're notorious for being volatile (since their outcome is basically binary on the results of research), but not for being great investments. If what you are asserting was actually true, those sorts of firms would generate ~5x higher returns, on average.
- LiquidSky 5y ago
  >it's conceivable a system can be invented where private auditors audit the output of an unregulated pharmaceutical manufacturer in such a way that the QC assurances to the consumer are as good or better as in our current system, with much lower regulatory costs. No, it's not. This is ideological libertarian nonsense. There's a reason pharma came to be regulated in the first place. All this will lead to are more injuries and death of consumers.
  - deleted 5y ago
    [deleted]
  - notch656a 5y ago
    >No, it's not. This is ideological libertarian nonsense. If I could flag your post, I would. This is purely political nonsense and a god-like attempt to disprove something through fiat.
kragen 5y ago
Clearly making it happen will require a revolution in manufacturing, which may or may not already be underway, but making it happen for software required decades of continuous revolution in semiconductors and telecommunications. Some kinds of analysis machinery, like GC, ICP, and DSC or DTA, are probably inherently fairly large; other kinds, like FT-IR, other kinds of spectrometry, TLC, HPLC, other kinds of liquid chromatography, XRF, XRD, and NMR, can be miniaturized and mass-produced. There hasn't been much pressure to do this because bio and chem labs don't care if their spectrophotometer costs US$0.12 or US$12000 or whether it weighs 100 mg or 100 kg; they need one to get their work done, they don't need it to be portable, and they aren't going to lose it because it stays in the lab. But that doesn't mean it can't be done. Even Victorian-era-style reagent testing can be made quantitative in some cases!
- nwiswell 5y ago
  > Some kinds of analysis machinery, like GC, ICP, and DSC or DTA, are probably inherently fairly large; other kinds, like FT-IR, other kinds of spectrometry, TLC, HPLC, other kinds of liquid chromatography, XRF, XRD, and NMR, can be miniaturized and mass-produced Many of the types of analysis listed here are elemental analysis only, which are useless for trying to identify pharmaceutical analytes or determine their concentration. Out of all of these, microfluidic liquid chromatography is the least science fiction. There's plenty of literature about it but nobody really "has it working", and the reality is that it's not likely to ever have the same capability as benchtop HPLC.
  - kragen 5y ago
    > Many of the types of analysis listed here are elemental analysis only, which are useless for trying to identify pharmaceutical analytes or determine their concentration. That's mostly true, but if a pill has significant amounts of lead, arsenic, and mercury in it, you know something went wrong, and you shouldn't take it. Even XRF might be enough to allow you to safely use lead-based or arsenic-based catalysts in your synthesis. > Out of all of these, microfluidic liquid chromatography is the least science fiction. There's plenty of literature about it but nobody really "has it working", and the reality is that it's not likely to ever have the same capability as benchtop HPLC. Thanks! Can you think of any other plausibly miniaturizable general-purpose analysis techniques? Those are just the ones I came up with off the top of my head. I think microfluidic liquid chromatography doesn't actually have to run faster than the bear, just faster than color-changing DanceSafe test kits. As for science fiction, https://news.ycombinator.com/item?id=29816434 https://news.ycombinator.com/item?id=29816434 talks a bit about how today's science fiction is tomorrow's old news.
rootusrootus 5y ago
Heck, even the FDA can't guarantee all generics are equivalent to the branded version (some anticonvulsants come to mind). Might be a while before this ability comes to the masses.
R0b0t1 5y ago
A lot of machinery has been getting smaller. You can do GC/MS with a desktop device now.

notch656a 5y ago

I'm not arguing with what you're saying, but GC/MS can be bought for like $100 a sample and it's conceivable a system can be invented where private auditors audit the output of an unregulated pharmaceutical manufacturer in such a way that the QC assurances to the consumer are as good or better as in our current system, with much lower regulatory costs.

nwiswell 5y ago
In the limit what you are describing is a generic drugmaker. It's certainly possible to audit drug quality by sending it to labs, and people do that for darknet drugs all the time, but there are still problems: 1) There is no way to use ex-post analysis alone to achieve the kind of QA that pharmaceutical companies do; they have visibility into the entire manufacturing process and process control. Put another way, a sample of a drug cannot be used to verify that the process used to manufacture it is safe. 2) There is no assurance that anything you get in the future is made with the same process. The only way I see this working, honestly, is for a rogue jurisdiction to offer safe harbor to "generic pirates". The rogue jurisdiction would offer legitimate regulatory oversight in exchange for tax revenue, and the drugs would be smuggled out of the jurisdiction for sale. To some extent this is already the case in grey markets where brand name drugs which are sold for less in other countries get arbitraged/smuggled back to high-cost markets.
- notch656a 5y ago
  I think we are seeing the same thing, a system designed to remove corruption/regulatory capture/lobbying as far as possible from the process. I'm seeing a "rogue" auditor that performs the same service, while you are seeing a rogue government. If the outcome is the same, I am fine with either. Your pointed weakness regarding auditing the manufacturing process could be incorporated into either.
  - nwiswell 5y ago
    > I think we are seeing the same thing, a system designed to remove corruption/regulatory capture/lobbying as far as possible from the process Not really. It's more like a system to selectively remove intellectual property rights without destroying the financial incentive to develop drugs.
    - notch656a 5y ago
      Oh. So you don't want a system that removes corruption, regulatory capture, and lobbying as far as possible? I don't want to destroy the financial incentive either, I think it's great people that bring wanted goods to market profit from it. IP is an interesting point, although I'm not convinced that generating the IP is more than a small fraction of the cost of a drug. An aggregate I saw from 2011-2018 puts Research at only 17% of revenue, and only some proportion of that is geared towards generating IP. That is to say, with all else removed you could generate an IP only company for 17% the cost of drug sales.
      - nwiswell 5y ago
        > Oh. So you don't want a system that removes corruption, regulatory capture, and lobbying as far as possible? Well, sure. But that's not what this is actually about. The titular anarchists are not inventing new drugs, they're finding alternative ways to get drugs that have already been invented. > That is to say, with all else removed you could generate an IP only company for 17% the cost of drug sales. I am not convinced that accurately reflects the reality of running a pharmaceutical business, even if incentives/competition is somewhat warped in healthcare. There are a lot of penny-stock pharma companies whose only mission is to generate valuable IP. They're notorious for being volatile (since their outcome is basically binary on the results of research), but not for being great investments. If what you are asserting was actually true, those sorts of firms would generate ~5x higher returns, on average.
LiquidSky 5y ago
>it's conceivable a system can be invented where private auditors audit the output of an unregulated pharmaceutical manufacturer in such a way that the QC assurances to the consumer are as good or better as in our current system, with much lower regulatory costs. No, it's not. This is ideological libertarian nonsense. There's a reason pharma came to be regulated in the first place. All this will lead to are more injuries and death of consumers.
- deleted 5y ago
  [deleted]
- notch656a 5y ago
  >No, it's not. This is ideological libertarian nonsense. If I could flag your post, I would. This is purely political nonsense and a god-like attempt to disprove something through fiat.

kragen 5y ago

Clearly making it happen will require a revolution in manufacturing, which may or may not already be underway, but making it happen for software required decades of continuous revolution in semiconductors and telecommunications. Some kinds of analysis machinery, like GC, ICP, and DSC or DTA, are probably inherently fairly large; other kinds, like FT-IR, other kinds of spectrometry, TLC, HPLC, other kinds of liquid chromatography, XRF, XRD, and NMR, can be miniaturized and mass-produced. There hasn't been much pressure to do this because bio and chem labs don't care if their spectrophotometer costs US$0.12 or US$12000 or whether it weighs 100 mg or 100 kg; they need one to get their work done, they don't need it to be portable, and they aren't going to lose it because it stays in the lab. But that doesn't mean it can't be done. Even Victorian-era-style reagent testing can be made quantitative in some cases!

nwiswell 5y ago
> Some kinds of analysis machinery, like GC, ICP, and DSC or DTA, are probably inherently fairly large; other kinds, like FT-IR, other kinds of spectrometry, TLC, HPLC, other kinds of liquid chromatography, XRF, XRD, and NMR, can be miniaturized and mass-produced Many of the types of analysis listed here are elemental analysis only, which are useless for trying to identify pharmaceutical analytes or determine their concentration. Out of all of these, microfluidic liquid chromatography is the least science fiction. There's plenty of literature about it but nobody really "has it working", and the reality is that it's not likely to ever have the same capability as benchtop HPLC.
- kragen 5y ago
  > Many of the types of analysis listed here are elemental analysis only, which are useless for trying to identify pharmaceutical analytes or determine their concentration. That's mostly true, but if a pill has significant amounts of lead, arsenic, and mercury in it, you know something went wrong, and you shouldn't take it. Even XRF might be enough to allow you to safely use lead-based or arsenic-based catalysts in your synthesis. > Out of all of these, microfluidic liquid chromatography is the least science fiction. There's plenty of literature about it but nobody really "has it working", and the reality is that it's not likely to ever have the same capability as benchtop HPLC. Thanks! Can you think of any other plausibly miniaturizable general-purpose analysis techniques? Those are just the ones I came up with off the top of my head. I think microfluidic liquid chromatography doesn't actually have to run faster than the bear, just faster than color-changing DanceSafe test kits. As for science fiction, https://news.ycombinator.com/item?id=29816434 https://news.ycombinator.com/item?id=29816434 talks a bit about how today's science fiction is tomorrow's old news.

rootusrootus 5y ago

Heck, even the FDA can't guarantee all generics are equivalent to the branded version (some anticonvulsants come to mind). Might be a while before this ability comes to the masses.

R0b0t1 5y ago

A lot of machinery has been getting smaller. You can do GC/MS with a desktop device now.