5 ms·

Lowe has a point, but the FDA has painted itself into a corner by (a) forcing up the costs and the various bureaucratic demands associated with clinical trials,

Lowe has a point, but the FDA has painted itself into a corner by (a) forcing up the costs and the various bureaucratic demands associated with clinical trials, (b) allowing drug advertising , but then forcing those comical "may cause death" disclaimers, both of which have become totally ubiquitous, and (c) inconsistently following its own rules, and in some cases flouting its own rules. At this point, broscience is considered no less valid than actual clinical trials, and the FDA should blame itself for this. Not "human nature being what it is in this fallen world" in a sort of general or abstract sense. Another point I could raise is that telemedicine has turned the entire prescription system into nothing more than a parasitic middleman/gatekeeper. FDA reform is very badly necessary. That ought to come before harsher enforcement, and I think that much of the populace already intuitively understands this.

jmye 7mo ago
> Another point I could raise is that telemedicine has turned the entire prescription system into nothing more than a parasitic middleman/gatekeeper. I’m curious what you mean by this. I’m not sure what you mean by “prescription system” specifically.
- tastyfreeze 7mo ago
  Go to doctor, get prescription for restricted medicine, pick up prescription. If you can call up a teledoc and they give you a prescription based on your description why could you not just go buy the meds yourself without a prescription. You have essentially diagnosed yourself and just asked the doctor for permission to buy the drug you want.
  - jmye 7mo ago
    That’s… not how actual telemedicine works. That’s how jackasses “disrupt” healthcare for very specific drugs. Mostly birth control, ED meds, and various hair regrowth meds. It’s really clear that some of you are really mad about something you don’t understand.
- A_D_E_P_T 7mo ago
  I'll give you a case in point. This article was discussed the other day: > https://www.nytimes.com/2026/04/02/technology/ai-billion-dollar-company-medvi.html https://www.nytimes.com/2026/04/02/technology/ai-billion-dol... People want GLP-1 drugs. They can't get them without a prescription. They pay $$$ to a "telemedicine" "doctor", recite a list of well-known symptoms, and buy the prescription. The system is that you can't buy these drugs without the piece of paper, and the piece of paper is basically something that anybody can buy regardless of whether or not they actually need the drug. Wanting it is usually enough.
  - hombre_fatal 7mo ago
    I think access is a good thing. The issue isn't with telemedicine but the fact that there's a prescription wall for helpful meds like GLP-1 in a country where we've failed people by creating one of the worst food environments. Also, most doctor's visits aren't any different from getting it if you want it except it's gated on the mood/attitude of the doctor, maybe your ability to sell some sob story. And then you book a different doctor until you get it. Telemedicine just makes the process easier an arbitrary system.
    - kube-system 7mo ago
      GLP-1 prescriptions are easy to get in the US. It's filling the prescription that is the problem, because insurance rarely covers it and it is beyond the disposable income of most Americans. The prescription hurdle is absolutely necessary -- these are not drugs that anyone can safely take without guidance. It's the price that needs to be fixed.
      - hombre_fatal 7mo ago
        I know a lot of people on GLP-1 meds and even took a dose myself out of curiosity. You take a dose every two weeks. And if you accidentally double dose because you misread 1U to mean 1 dose, it just gives you some nausea. Are we going to pretend it's hard to take this drug now too? Or that the doctor has some magical insight into your getting-on? Remember to eat. That's it. I guess a few people might need the doctor to go "you're eating, right?" but I don't believe in infantilizing everyone over that.
- ai_critic 7mo ago
  I take certain medications--nothing interesting, nothing controlled, nothing abusable. I have to deal with a whole thing just to get refills, because my PCP forces me to come in every time--and even that is now just a telehealth call that is annoying. In Mexico, for meds like mine, you can just buy them at the pharmacy. There's no reason for all this nonsense. (Edit: same PCP refused to prescribe GLP-1s early, without any scientific or medical reason not to. Delayed my weightloss by months until I found a place that would.)
- pedalpete 7mo ago
  The "perscription system" used to be that you'd have to go see a doctor, the doctor knew who you were, and would make decisions on what prescriptions/medications you should be given. Due to drug advertising rules, the prescription system has been turned on its head, and the patient now goes to their doctor asking for a specific prescription. Telemedicine took advantage of this and has effectively removed the middleman (the doctor) in many cases and you just sign-up look at a person on a camera, and get your drugs sent to you.
  - jmye 7mo ago
    > Telemedicine took advantage of this and has effectively removed the middleman (the doctor) in many cases and you just sign-up look at a person on a camera, and get your drugs sent to you. This is only true for a handful of drugs that are basically OTC already (or that have OTC formulations). Additionally, telemedicine didn’t take advantage of drug advertising- that’s an odd assertion.
    - pedalpete 7mo ago
      The system changed from the doctor deciding what drugs you should take to the patient asking for the drug by name from the doctor. I think this enabled telemedicine to work in the way it does not. The patient says "I want wegovy" and the telemedicine platform says "ok, here you go". Would telehealth pill-pushers exist without this mentality?
- phil21 7mo ago
  > I’m curious what you mean by this. I’m not sure what you mean by “prescription system” specifically. They basically operate as a "pay for a prescription" service. Figure out what drug you want, google the drug name and telehealth. You will be marketed in a wink wink sort of manner over how easy it is to get them, just hours away! Then if you are not a total idiot, you answer certain questions in the right manner on the intake form, the doctor (usually NP/PA or similar for most things) will quickly run through that and expect you to answer correctly - perhaps guide you a bit if you don't. 5 minutes later you have a prescription in the web portal and it's sent to your pharmacy of choice. It really shows how the whole "permission slip" program is BS. I've used these services a couple times vs. my normal doctor just to save time and expense of an office visit. If I can click some buttons, have a call 30 minutes later, and be on my way to the pharmacy for $50 it's sometimes the path I take now vs. traditional route. Someone used to the traditional doctor/patient relationship thing and prescriptions being "holy" would be shocked at how easy and gamed it all is.
  - cycomanic 7mo ago
    Well that's a problem with the profit driven US health system (although admittedly other countries have similar problems to varying degrees) not prescriptions in general though? In particular the take home from this should be to make it more difficult to get the prescriptions not to do away with prescriptions.
cwmoore 7mo ago
When medicine ignores nutrition entirely, and nutrient supplements are still complete unknowns, you have to wonder who the FDA is working for.
- Simulacra 7mo ago
  But there's a core problem with this, in many states doctors are legally forbidden to give nutrition advice. The academy of nutrition and dietetics has worked very hard to make it so that only dietitians can provide nutrition advice. Take Ohio for example, a medical doctor in Ohio is legally forbidden and actually in jeopardy of losing their license and going to jail if they were to provide nutrition advice without a dietetics license. Dietitians are not doctors, but the academy of nutrition and dietetics wants you to think they are.
  - secabeen 7mo ago
    Mmmm, regulatory capture and rent seeking. Will it ever end?
  - rootusrootus 7mo ago
    Aren't doctors actually exempted specifically from such regulations in almost all states? AFAIK they can actually give nutritional advice legally in nearly every jurisdiction in the US.
  - tzs 7mo ago
    > Dietitians are not doctors And doctors are not dietitians. Doctors in the US receive an average of under 20 hours of training in nutrition over four years of medical school. What little they do receive is often focused on nutrient deficiencies rather than on meal planning for health and chronic disease prevention. Less than 15% of residency programs include anything on nutrition. To become a registered dietician requires at least a Master's degree in dietetics or nutrition or a related field, and at least 1000 hours of supervised internships. PS: before any Europeans hold this up as an example of the poor US health care system, doctors in Europe average 24 hours of nutrition training.
- hammock 7mo ago
GenerWork 7mo ago
To your first point, if you know where to look, you can get tens of vials of GLP-1s that have much higher dosing per vial for cheaper than you can get a third of the amount on the grey market. A lot of these sites even have purity testing to soothe consumers worries that they're getting garbage. For your third point, you have the FDA limiting HGH, yet you can buy the growth horomone releasing factor peptides (tesamorelin, sermorelin, ipamorelin) after doing a simple Google search. As for broscience, moving into peptides was a logical next step after exhausting anabolic steroid "research". In fact, I'd say that biohackers are actually behind the bros when it comes to trying various peptides out and documenting experiences.
- Zetaphor 7mo ago
  Many of us would appreciate if you could share one of those reputable vendors with such cheap prices
  - chhxdjsj 7mo ago
    https://t.me/qsctgchannel https://t.me/qsctgchannel https://t.me/c/2680146932/9 https://t.me/c/2680146932/9
  - dotancohen 7mo ago
    My Gmail username is the same as my HN username, for anybody who needs a reliable source with lab test results.
7e 7mo ago
The FDA didn’t push up clinical trial costs, thalidomide did.
- mft_ 7mo ago
  So you are stating that there has been no change in how clinical trials are required to be run, and the associated costs, since the changes immediately following the thalidomide catastrophe?
JumpCrisscross 7mo ago
> prescription system into nothing more than a parasitic middleman/gatekeeper Agree. Unless it's addictive or in short supply, you should be able to buy it OTC.

jmye 7mo ago

> Another point I could raise is that telemedicine has turned the entire prescription system into nothing more than a parasitic middleman/gatekeeper. I’m curious what you mean by this. I’m not sure what you mean by “prescription system” specifically.

tastyfreeze 7mo ago
Go to doctor, get prescription for restricted medicine, pick up prescription. If you can call up a teledoc and they give you a prescription based on your description why could you not just go buy the meds yourself without a prescription. You have essentially diagnosed yourself and just asked the doctor for permission to buy the drug you want.
- jmye 7mo ago
  That’s… not how actual telemedicine works. That’s how jackasses “disrupt” healthcare for very specific drugs. Mostly birth control, ED meds, and various hair regrowth meds. It’s really clear that some of you are really mad about something you don’t understand.
A_D_E_P_T 7mo ago
I'll give you a case in point. This article was discussed the other day: > https://www.nytimes.com/2026/04/02/technology/ai-billion-dollar-company-medvi.html https://www.nytimes.com/2026/04/02/technology/ai-billion-dol... People want GLP-1 drugs. They can't get them without a prescription. They pay $$$ to a "telemedicine" "doctor", recite a list of well-known symptoms, and buy the prescription. The system is that you can't buy these drugs without the piece of paper, and the piece of paper is basically something that anybody can buy regardless of whether or not they actually need the drug. Wanting it is usually enough.
- hombre_fatal 7mo ago
  I think access is a good thing. The issue isn't with telemedicine but the fact that there's a prescription wall for helpful meds like GLP-1 in a country where we've failed people by creating one of the worst food environments. Also, most doctor's visits aren't any different from getting it if you want it except it's gated on the mood/attitude of the doctor, maybe your ability to sell some sob story. And then you book a different doctor until you get it. Telemedicine just makes the process easier an arbitrary system.
  - kube-system 7mo ago
    GLP-1 prescriptions are easy to get in the US. It's filling the prescription that is the problem, because insurance rarely covers it and it is beyond the disposable income of most Americans. The prescription hurdle is absolutely necessary -- these are not drugs that anyone can safely take without guidance. It's the price that needs to be fixed.
    - hombre_fatal 7mo ago
      I know a lot of people on GLP-1 meds and even took a dose myself out of curiosity. You take a dose every two weeks. And if you accidentally double dose because you misread 1U to mean 1 dose, it just gives you some nausea. Are we going to pretend it's hard to take this drug now too? Or that the doctor has some magical insight into your getting-on? Remember to eat. That's it. I guess a few people might need the doctor to go "you're eating, right?" but I don't believe in infantilizing everyone over that.
ai_critic 7mo ago
I take certain medications--nothing interesting, nothing controlled, nothing abusable. I have to deal with a whole thing just to get refills, because my PCP forces me to come in every time--and even that is now just a telehealth call that is annoying. In Mexico, for meds like mine, you can just buy them at the pharmacy. There's no reason for all this nonsense. (Edit: same PCP refused to prescribe GLP-1s early, without any scientific or medical reason not to. Delayed my weightloss by months until I found a place that would.)
pedalpete 7mo ago
The "perscription system" used to be that you'd have to go see a doctor, the doctor knew who you were, and would make decisions on what prescriptions/medications you should be given. Due to drug advertising rules, the prescription system has been turned on its head, and the patient now goes to their doctor asking for a specific prescription. Telemedicine took advantage of this and has effectively removed the middleman (the doctor) in many cases and you just sign-up look at a person on a camera, and get your drugs sent to you.
- jmye 7mo ago
  > Telemedicine took advantage of this and has effectively removed the middleman (the doctor) in many cases and you just sign-up look at a person on a camera, and get your drugs sent to you. This is only true for a handful of drugs that are basically OTC already (or that have OTC formulations). Additionally, telemedicine didn’t take advantage of drug advertising- that’s an odd assertion.
  - pedalpete 7mo ago
    The system changed from the doctor deciding what drugs you should take to the patient asking for the drug by name from the doctor. I think this enabled telemedicine to work in the way it does not. The patient says "I want wegovy" and the telemedicine platform says "ok, here you go". Would telehealth pill-pushers exist without this mentality?
phil21 7mo ago
> I’m curious what you mean by this. I’m not sure what you mean by “prescription system” specifically. They basically operate as a "pay for a prescription" service. Figure out what drug you want, google the drug name and telehealth. You will be marketed in a wink wink sort of manner over how easy it is to get them, just hours away! Then if you are not a total idiot, you answer certain questions in the right manner on the intake form, the doctor (usually NP/PA or similar for most things) will quickly run through that and expect you to answer correctly - perhaps guide you a bit if you don't. 5 minutes later you have a prescription in the web portal and it's sent to your pharmacy of choice. It really shows how the whole "permission slip" program is BS. I've used these services a couple times vs. my normal doctor just to save time and expense of an office visit. If I can click some buttons, have a call 30 minutes later, and be on my way to the pharmacy for $50 it's sometimes the path I take now vs. traditional route. Someone used to the traditional doctor/patient relationship thing and prescriptions being "holy" would be shocked at how easy and gamed it all is.
- cycomanic 7mo ago
  Well that's a problem with the profit driven US health system (although admittedly other countries have similar problems to varying degrees) not prescriptions in general though? In particular the take home from this should be to make it more difficult to get the prescriptions not to do away with prescriptions.

cwmoore 7mo ago

When medicine ignores nutrition entirely, and nutrient supplements are still complete unknowns, you have to wonder who the FDA is working for.

Simulacra 7mo ago
But there's a core problem with this, in many states doctors are legally forbidden to give nutrition advice. The academy of nutrition and dietetics has worked very hard to make it so that only dietitians can provide nutrition advice. Take Ohio for example, a medical doctor in Ohio is legally forbidden and actually in jeopardy of losing their license and going to jail if they were to provide nutrition advice without a dietetics license. Dietitians are not doctors, but the academy of nutrition and dietetics wants you to think they are.
- secabeen 7mo ago
  Mmmm, regulatory capture and rent seeking. Will it ever end?
- rootusrootus 7mo ago
  Aren't doctors actually exempted specifically from such regulations in almost all states? AFAIK they can actually give nutritional advice legally in nearly every jurisdiction in the US.
- tzs 7mo ago
  > Dietitians are not doctors And doctors are not dietitians. Doctors in the US receive an average of under 20 hours of training in nutrition over four years of medical school. What little they do receive is often focused on nutrient deficiencies rather than on meal planning for health and chronic disease prevention. Less than 15% of residency programs include anything on nutrition. To become a registered dietician requires at least a Master's degree in dietetics or nutrition or a related field, and at least 1000 hours of supervised internships. PS: before any Europeans hold this up as an example of the poor US health care system, doctors in Europe average 24 hours of nutrition training.
hammock 7mo ago

GenerWork 7mo ago

To your first point, if you know where to look, you can get tens of vials of GLP-1s that have much higher dosing per vial for cheaper than you can get a third of the amount on the grey market. A lot of these sites even have purity testing to soothe consumers worries that they're getting garbage. For your third point, you have the FDA limiting HGH, yet you can buy the growth horomone releasing factor peptides (tesamorelin, sermorelin, ipamorelin) after doing a simple Google search. As for broscience, moving into peptides was a logical next step after exhausting anabolic steroid "research". In fact, I'd say that biohackers are actually behind the bros when it comes to trying various peptides out and documenting experiences.

Zetaphor 7mo ago
Many of us would appreciate if you could share one of those reputable vendors with such cheap prices
- chhxdjsj 7mo ago
  https://t.me/qsctgchannel https://t.me/qsctgchannel https://t.me/c/2680146932/9 https://t.me/c/2680146932/9
- dotancohen 7mo ago
  My Gmail username is the same as my HN username, for anybody who needs a reliable source with lab test results.

7e 7mo ago

The FDA didn’t push up clinical trial costs, thalidomide did.

mft_ 7mo ago
So you are stating that there has been no change in how clinical trials are required to be run, and the associated costs, since the changes immediately following the thalidomide catastrophe?

JumpCrisscross 7mo ago

> prescription system into nothing more than a parasitic middleman/gatekeeper Agree. Unless it's addictive or in short supply, you should be able to buy it OTC.