4 ms·

Ben Goldacre has been pushing to fix this. See his campaign site: http://www.alltrials.net/ http://www.alltrials.net/ His blog/news site: http://www.badscienc

by nodata 14y ago

Ben Goldacre has been pushing to fix this. See his campaign site: http://www.alltrials.net/ http://www.alltrials.net/ His blog/news site: http://www.badscience.net/ http://www.badscience.net/ His Ted talk: http://www.ted.com/talks/ben_goldacre_what_doctors_don_t_know_about_the_drugs_they_prescribe.html http://www.ted.com/talks/ben_goldacre_what_doctors_don_t_kno...

pygy_ 14y ago
The problem goes deeper than that. "Healthcare industry" is an oxymoron. The incentives of pharmaceutical firms and patients are not aligned, and will not for the foreseeable future (not that I have a better model to offer :-/).
- danpalmer 14y ago
  One suggested solution is to remove all patenting on drugs. That way, competition will force prices down, and result in two things. In countries with national healthcare such as the UK, the NHS bill could be drastically reduced, and the government could give grants to drug companies for R&D purposes. In countries with no healthcare system like the US, the general population will have much more money, and so taxes could be increased (hopefully not all the way back up) and grants could be given again. For those who think that drug companies need high prices for recouping R&D costs, their marketing budgets are far greater than R&D budgets, so this isn't really true. In the UK they aren't allowed to market to end-users, so the advertising costs are generally much lower here.
  - grandinj 14y ago
    Their R&D budgets are still pretty huge. And how exactly do you compete when your competitors can clone your product with ease? And the NHS spends < 10% of drugs, most of which are already available as generics, so there is not a lot of scope for cost reduction. I'm not saying that aren't improvements that can be made, but people need to wake up and realise that there are no simple answers.
    - Create 14y ago
      a substantial part of their R&D budget is "market development"
    - wnight 14y ago
      Their costs would have been paid for the R&D so it wouldn't be their drug being ripped off, it w would be our drug being second sourced. Also, their costs would be much lower because we'd be paying for the clinical trials and there wouldn't be marketing costs.
      - grandinj 14y ago
        Ah, so basically you are saying we should shift the entire cost burden of creating new drugs from the free market to the government. Glad to have that cleared up.
        wnight 14y ago
        Absolutely. So glad you understand. It hasn't been a free market since we created the FDA (and I'm not looking to get rid of it), and with patents and advertising law, etc, it's never going to be free. So why don't we change the accounting? Instead of making drugs companies advertise and exploit to be able to pay the regulatory costs, and R&D, etc, why not recognize that they create drugs for us and this is our hurdle - not theirs. We want the product, so we shouldn't dump costs on the drug companies and pretend we've dealt with them. So we should pay for the regulatory testing. 100%. But that leaves an inventive to push expensive and unneeded or dangerous drugs through the system because they don't pay and yet get rewarded. So we need to make these our drugs - by paying for the R&D up front, so that there's no need to game our own system. Now there's no need for secrecy so there's no need for patents to reward letting it go, and everything gets simpler again. When you strip the patents, the marketing, and the legal games, our drugs would get a lot cheaper and more reliable. We'd still be paying for all, maybe even more, tests, but at least we wouldn't have to trust someone whose motive clearly (and reasonably in this system) is to rush to market.
        14y ago
  - Create 14y ago
    Australia's National Medicines Policy aims to 'meet medication and related needs, so that both optimal health outcomes and economic objectives are achieved for Australians'.3 In response to the rising cost of the Pharmaceutical Benefits Scheme (PBS), the Australian Government has introduced policies to encourage the use of generic drugs. Probably the most significant of these to date have been the Brand Premium Policy (1990) and the Brand Substitution Policy (1994).4 Under the Brand Premium Policy, pharmaceutical manufacturers were allowed to set their own prices for the different brands of the same medicine. The PBS subsidy was determined by the lowest priced brand, the so-called 'benchmark brand'. Patients must pay the difference between the price of the dispensed drug and the benchmark brand. The Brand Substitution Policy allows pharmacists to substitute bioequivalent generic medicines without seeking advice from prescribers, unless otherwise indicated on the prescription. http://www.australianprescriber.com/magazine/27/4/80/1 http://www.australianprescriber.com/magazine/27/4/80/1
  - wnight 14y ago
    The solution to many problems is eliminating patents, and not just in one area. We, collectively, act as if we're enriching inventors when probably we're hurting them with these laws. If we really cared about rewarding invention we'd pay inventors. But instead all we do is give them a letter of marque and tell them to steal it from others. Those who can, do. Those who can't, pass a law to confiscate it.
  - DanBC 14y ago
    Patents for health are probably okay. But the abuse of the patent system really does need to stop. Companies engaging in illegal, anti-competitive behaviour such as "pay to delay"[1] need to have some realistic punishment applied. [1] (http://www.npr.org/2013/03/25/175043758/supreme-court-hears-pay-to-delay-pharmaceutical-case?ft=1&f=1014 http://www.npr.org/2013/03/25/175043758/supreme-court-hears-...)
refurb 14y ago
I highly suggest reading some of the critical reviews of Goldacre's work. He gets a lot of things wrong and some of his ideas just simple won't work with the current system. He's writing a book about an industry that everyone loves to hate. Few people question a book when it agrees with their preconceived views.
- DanBC 14y ago
  Could you recommend some of the critical reviews? I've seen some critical reviews that are just nonsense. I don't want to spend time wading through nonsense, but I realise that maybe he's made mistakes, so I'd welcome curated suggestions.
  - refurb 14y ago
    http://www.forbes.com/sites/johnlamattina/2013/02/14/bad-pharma-maybe-but-goldacres-selective-use-of-data-is-wrong/ http://www.forbes.com/sites/johnlamattina/2013/02/14/bad-pha... This is a good critique of only one aspect of Goldacre's book, but it's a good one. However, since was written by a former pharma exec, I'm sure people will dismiss it without reading it.
    - MaysonL 14y ago
      Did you read Goldacre's response on that blog. He seems to make a lot of sense there.
    - v21 14y ago
      I did read it, and I also read Goldacre's rebuttal, which was more persuasive.
    - wpietri 14y ago
      Is it a good one? I read the article and the various replies from Goldacre and the author, including Goldacre's post of the passage in question. I find Goldacre far more persuasive. LaMattina claims that Goldacre is cherry-picking data, and gives his presumably best example. But this example isn't "data"; it's Goldacre explaining the conclusions of a govenmental report about an incident where 6 experimental subjects nearly died. In writing about science for the general public, you need to give examples. This seems like a fine example for people to understand why a culture that promotes publishing everything could save lives.

by nodata 14y ago

pygy_ 14y ago

The problem goes deeper than that. "Healthcare industry" is an oxymoron. The incentives of pharmaceutical firms and patients are not aligned, and will not for the foreseeable future (not that I have a better model to offer :-/).

danpalmer 14y ago
One suggested solution is to remove all patenting on drugs. That way, competition will force prices down, and result in two things. In countries with national healthcare such as the UK, the NHS bill could be drastically reduced, and the government could give grants to drug companies for R&D purposes. In countries with no healthcare system like the US, the general population will have much more money, and so taxes could be increased (hopefully not all the way back up) and grants could be given again. For those who think that drug companies need high prices for recouping R&D costs, their marketing budgets are far greater than R&D budgets, so this isn't really true. In the UK they aren't allowed to market to end-users, so the advertising costs are generally much lower here.
- grandinj 14y ago
  Their R&D budgets are still pretty huge. And how exactly do you compete when your competitors can clone your product with ease? And the NHS spends < 10% of drugs, most of which are already available as generics, so there is not a lot of scope for cost reduction. I'm not saying that aren't improvements that can be made, but people need to wake up and realise that there are no simple answers.
  - Create 14y ago
    a substantial part of their R&D budget is "market development"
  - wnight 14y ago
    Their costs would have been paid for the R&D so it wouldn't be their drug being ripped off, it w would be our drug being second sourced. Also, their costs would be much lower because we'd be paying for the clinical trials and there wouldn't be marketing costs.
    - grandinj 14y ago
      Ah, so basically you are saying we should shift the entire cost burden of creating new drugs from the free market to the government. Glad to have that cleared up.
      - wnight 14y ago
        Absolutely. So glad you understand. It hasn't been a free market since we created the FDA (and I'm not looking to get rid of it), and with patents and advertising law, etc, it's never going to be free. So why don't we change the accounting? Instead of making drugs companies advertise and exploit to be able to pay the regulatory costs, and R&D, etc, why not recognize that they create drugs for us and this is our hurdle - not theirs. We want the product, so we shouldn't dump costs on the drug companies and pretend we've dealt with them. So we should pay for the regulatory testing. 100%. But that leaves an inventive to push expensive and unneeded or dangerous drugs through the system because they don't pay and yet get rewarded. So we need to make these our drugs - by paying for the R&D up front, so that there's no need to game our own system. Now there's no need for secrecy so there's no need for patents to reward letting it go, and everything gets simpler again. When you strip the patents, the marketing, and the legal games, our drugs would get a lot cheaper and more reliable. We'd still be paying for all, maybe even more, tests, but at least we wouldn't have to trust someone whose motive clearly (and reasonably in this system) is to rush to market.
        14y ago
- Create 14y ago
  Australia's National Medicines Policy aims to 'meet medication and related needs, so that both optimal health outcomes and economic objectives are achieved for Australians'.3 In response to the rising cost of the Pharmaceutical Benefits Scheme (PBS), the Australian Government has introduced policies to encourage the use of generic drugs. Probably the most significant of these to date have been the Brand Premium Policy (1990) and the Brand Substitution Policy (1994).4 Under the Brand Premium Policy, pharmaceutical manufacturers were allowed to set their own prices for the different brands of the same medicine. The PBS subsidy was determined by the lowest priced brand, the so-called 'benchmark brand'. Patients must pay the difference between the price of the dispensed drug and the benchmark brand. The Brand Substitution Policy allows pharmacists to substitute bioequivalent generic medicines without seeking advice from prescribers, unless otherwise indicated on the prescription. http://www.australianprescriber.com/magazine/27/4/80/1 http://www.australianprescriber.com/magazine/27/4/80/1
- wnight 14y ago
  The solution to many problems is eliminating patents, and not just in one area. We, collectively, act as if we're enriching inventors when probably we're hurting them with these laws. If we really cared about rewarding invention we'd pay inventors. But instead all we do is give them a letter of marque and tell them to steal it from others. Those who can, do. Those who can't, pass a law to confiscate it.
- DanBC 14y ago
  Patents for health are probably okay. But the abuse of the patent system really does need to stop. Companies engaging in illegal, anti-competitive behaviour such as "pay to delay"[1] need to have some realistic punishment applied. [1] (http://www.npr.org/2013/03/25/175043758/supreme-court-hears-pay-to-delay-pharmaceutical-case?ft=1&f=1014 http://www.npr.org/2013/03/25/175043758/supreme-court-hears-...)

refurb 14y ago

I highly suggest reading some of the critical reviews of Goldacre's work. He gets a lot of things wrong and some of his ideas just simple won't work with the current system. He's writing a book about an industry that everyone loves to hate. Few people question a book when it agrees with their preconceived views.

DanBC 14y ago
Could you recommend some of the critical reviews? I've seen some critical reviews that are just nonsense. I don't want to spend time wading through nonsense, but I realise that maybe he's made mistakes, so I'd welcome curated suggestions.
- refurb 14y ago
  http://www.forbes.com/sites/johnlamattina/2013/02/14/bad-pharma-maybe-but-goldacres-selective-use-of-data-is-wrong/ http://www.forbes.com/sites/johnlamattina/2013/02/14/bad-pha... This is a good critique of only one aspect of Goldacre's book, but it's a good one. However, since was written by a former pharma exec, I'm sure people will dismiss it without reading it.
  - MaysonL 14y ago
    Did you read Goldacre's response on that blog. He seems to make a lot of sense there.
  - v21 14y ago
    I did read it, and I also read Goldacre's rebuttal, which was more persuasive.
  - wpietri 14y ago
    Is it a good one? I read the article and the various replies from Goldacre and the author, including Goldacre's post of the passage in question. I find Goldacre far more persuasive. LaMattina claims that Goldacre is cherry-picking data, and gives his presumably best example. But this example isn't "data"; it's Goldacre explaining the conclusions of a govenmental report about an incident where 6 experimental subjects nearly died. In writing about science for the general public, you need to give examples. This seems like a fine example for people to understand why a culture that promotes publishing everything could save lives.