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We need to massively scale back regulatory regimentation in medicine "FDA Deregulation Increases Safety and Innovation and Reduces Prices" https://marginalrev

We need to massively scale back regulatory regimentation in medicine "FDA Deregulation Increases Safety and Innovation and Reduces Prices" https://marginalrevolution.com/marginalrevolution/2022/11/fda-deregulation-increases-safety-and-innovation-and-reduces-prices.html https://marginalrevolution.com/marginalrevolution/2022/11/fd... We will never get the pace of innovation and price reduction in medicine that we see in more market based product classes if we don't.

electriclove 4y ago
Seriously, innovation needs to be encouraged and all the gates hamper that. But being critical of the medical cartel gets flagged/downvoted quickly here. See comment higher up.
yosame 4y ago
It might reduce prices, but I wouldn't trust pharma companies to put safety over profit. We've seen time and time again that pharma companies will do the bare minimum to prove safety, which has lead to a large amount of harm (see Vioxx, Thalidomide, etc). I don't think reducing what safety measures they have to prove will make therapies safer.
- ETH_start 4y ago
  The study on medical devices indicates that safety actually improves with deregulation, due to the combination of a larger market and litigation. In any case it's obvious to me at least that in the long run, if medicine sees the same pace of innovation that, say, smartphones have seen, or even that the cosmetic surgery field has seen, we would have much safer medical products and services just by virtue of them being significantly more sophisticated, less invasive etc. Finally - even if all this weren't true - without price reductions, it will be increasingly the case that the safest and most effective treatments will be out of reach of the masses, due to simple economics/scarcity. I would rather have some lower quality products/services available to the public, and the best quality ones be more accessible, than remove the lower quality offerings but also deprive the public of the best quality ones.
  - candiodari 4y ago
    Why this choice? In the case that a treatment is life-saving the ethics board can approve experimental treatments on a case-by-case basis. Medical laws just don't allow patients to make this choice for themselves.
    - ETH_start 4y ago
      The problem with the centralization (regulation) approach is that it assumes one body can be chosen that will be optimal at risk assessment. In practice, the process of developing good risk analysis frameworks - that strike the right balance between cost, risk and efficacy - is often best discovered through trial and error, and that requires the freedom to try new products in the market.
      - candiodari 4y ago
        There's an ethics board per hospital. And there's different countries. You can in fact shop around if that's what you want to do. You can do this, both as a patient and as a pharmaceutical company. It's just really expensive.
        ETH_start 4y ago
        Even a law requiring an ethics board, with statutory requirements for how that ethics board is constituted, is a one-size-fits all meta-solution, created by one body: the national regulator.
  - worik 4y ago
    > The study on medical devices indicates that safety actually improves with deregulation, due to the combination of a larger market and litigation. I doubt it, very much. Appropriate regulation, not deregulation, is the name of the game.
    - ETH_start 4y ago
      >>Appropriate regulation, not deregulation, is the name of the game. Based on what case studies of industries? Look at the prices in the most regulated sectors. In medicine, it makes the most effective treatments inaccessible to the wider public, with innovation that reduces costs progressing at a glacial pace.
- jojobas 4y ago
  Safety can legitimately be in the backseat when you're trying to cure a disease that has a 50% chance to kill you in a year.
  - bawolff 4y ago
    Its not just safety, but to prevent shady people from taking advantage of desperate people.
  - worik 4y ago
    > Safety can legitimately be in the backseat when you're trying to cure a disease that has a 50% chance to kill you in a year. Yes. Standards are lower in that case. Back in the 1990s when I was up to date, clinical trials for HIV ad cancer treatments were truncated. We saw the rapid development of COVID vaccines recently, much quicker than normal drug development
- concordDance 4y ago
  Sometimes availability is more important than safety. Let the patient decide if they want to take the risk, just mandate they be informed.
- zo1 4y ago
  I'd be curious to see what would happen if reasonable regulations stayed in place but we capped/removed the risk associated with litigation (assuming regulations were followed). I.e. what portion of "adhering to regulation" is reducing the speed of advancement because of fear of litigation, as opposed to just the cost of sticking to the regulation.

electriclove 4y ago

Seriously, innovation needs to be encouraged and all the gates hamper that. But being critical of the medical cartel gets flagged/downvoted quickly here. See comment higher up.

yosame 4y ago

It might reduce prices, but I wouldn't trust pharma companies to put safety over profit. We've seen time and time again that pharma companies will do the bare minimum to prove safety, which has lead to a large amount of harm (see Vioxx, Thalidomide, etc). I don't think reducing what safety measures they have to prove will make therapies safer.

ETH_start 4y ago
The study on medical devices indicates that safety actually improves with deregulation, due to the combination of a larger market and litigation. In any case it's obvious to me at least that in the long run, if medicine sees the same pace of innovation that, say, smartphones have seen, or even that the cosmetic surgery field has seen, we would have much safer medical products and services just by virtue of them being significantly more sophisticated, less invasive etc. Finally - even if all this weren't true - without price reductions, it will be increasingly the case that the safest and most effective treatments will be out of reach of the masses, due to simple economics/scarcity. I would rather have some lower quality products/services available to the public, and the best quality ones be more accessible, than remove the lower quality offerings but also deprive the public of the best quality ones.
- candiodari 4y ago
  Why this choice? In the case that a treatment is life-saving the ethics board can approve experimental treatments on a case-by-case basis. Medical laws just don't allow patients to make this choice for themselves.
  - ETH_start 4y ago
    The problem with the centralization (regulation) approach is that it assumes one body can be chosen that will be optimal at risk assessment. In practice, the process of developing good risk analysis frameworks - that strike the right balance between cost, risk and efficacy - is often best discovered through trial and error, and that requires the freedom to try new products in the market.
    - candiodari 4y ago
      There's an ethics board per hospital. And there's different countries. You can in fact shop around if that's what you want to do. You can do this, both as a patient and as a pharmaceutical company. It's just really expensive.
      - ETH_start 4y ago
        Even a law requiring an ethics board, with statutory requirements for how that ethics board is constituted, is a one-size-fits all meta-solution, created by one body: the national regulator.
- worik 4y ago
  > The study on medical devices indicates that safety actually improves with deregulation, due to the combination of a larger market and litigation. I doubt it, very much. Appropriate regulation, not deregulation, is the name of the game.
  - ETH_start 4y ago
    >>Appropriate regulation, not deregulation, is the name of the game. Based on what case studies of industries? Look at the prices in the most regulated sectors. In medicine, it makes the most effective treatments inaccessible to the wider public, with innovation that reduces costs progressing at a glacial pace.
jojobas 4y ago
Safety can legitimately be in the backseat when you're trying to cure a disease that has a 50% chance to kill you in a year.
- bawolff 4y ago
  Its not just safety, but to prevent shady people from taking advantage of desperate people.
- worik 4y ago
  > Safety can legitimately be in the backseat when you're trying to cure a disease that has a 50% chance to kill you in a year. Yes. Standards are lower in that case. Back in the 1990s when I was up to date, clinical trials for HIV ad cancer treatments were truncated. We saw the rapid development of COVID vaccines recently, much quicker than normal drug development
concordDance 4y ago
Sometimes availability is more important than safety. Let the patient decide if they want to take the risk, just mandate they be informed.
zo1 4y ago
I'd be curious to see what would happen if reasonable regulations stayed in place but we capped/removed the risk associated with litigation (assuming regulations were followed). I.e. what portion of "adhering to regulation" is reducing the speed of advancement because of fear of litigation, as opposed to just the cost of sticking to the regulation.