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mindmetoo
Joined: 02 Feb 2004
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 Posted: Fri Feb 02, 2007 5:38 am Post subject: |
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| some waygug-in wrote: |
Researchers, John McKinlay and Sonja McKinlay came to similar conclusions. They showed that medical intervention only accounted for between 1 and 3.5 per cent of the increase in the average lifespan in the United States since 1900. (49) |
I dunno. Infant mortality rates weren't anything to write home about until medicine tackled pneumonia and diarrhea (the leading killers of infants). |
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mindmetoo
Joined: 02 Feb 2004
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| Posted: Fri Feb 02, 2007 4:24 pm Post subject: |
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*bump*
Grimalkin how do we remedy the problems inherent in private drug companies seeking a profit? Are the benefits of having private money risked to develop helfpful drugs smaller compared to the damage they do? Without them, where will our drugs come from? |
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Grimalkin
Joined: 22 May 2005
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| Posted: Sat Feb 03, 2007 1:15 am Post subject: |
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| Grimalkin how do we remedy the problems inherent in private drug companies seeking a profit? |
I wish I could answer that. I can't.
I often had doctors complain to me about the exorbitant prices that the company I worked for, charged for it's drugs. My answer was always the same.
1)It's pointless complaining to me because I have absolutely no influence in the pricing of my company's drugs.
2)I will pass on your complaint as best I can but that will have no effect either.
3) The company line on their pricing policy is that they have to price the drug within guidelines to allow for:
a) the cost of research and development that went in to producing the drug.
b) The various costs that are involved in selling the drug
c) covering the losses that were made in researching and developing other drugs that for one reason or another, never made it on to the market.
d) making enough of a profit to give shareholders a satisfactory dividend and to have money available as well that can be reinvested in research and development.
4) My personal view, as opposed to the company line, is that the company can do all of the above and still provide the drugs at a cheaper cost but they won't because they always want to maximise the profit.
5) All you can do is accept that it's the nature of the beast. In the end of the day pharmaceutical companies are not charitable organisations, they are commercial enterprises.
6) If there was not a profit to be made in producing drugs we would not have the range of effective drugs we do have.
7) I sympathise entirely with your point of view.
The above was the only response I had when I received those complaints.
I wish there was a way of forcing companies to bring to the market effective drugs even when they are not profitable.
I wish there was a way of stopping companies from suppressing effective drugs that threaten their own market.
I wish there was a way of bringing to market effective drugs without being reliant on profit making organisations.
However none of the above was part of my original point.
My original point was that having worked in the pharmaceutical industry I could understand the OP saying this
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You've probably never heard of it because it simply doesn't fit into the plans the drug companies. It has no patent. |
I would further say...
a) Pharmaceutical companies are routinely unethical and unscrupulous ( I would have no difficulty proving this). I am not saying they are the only type of business that is like this (think arms manufacturers and tobacco companies and many many more)
b) They routinely break the law in pursuit of profit (I know this but I would not be very confident about being able to prove this).
As an example of a)
In the mid 1990's in the UK a major pharmacetical company marketed a drug for a group of chronically ill patients (some of whom were terminally ill).
They did this even tho' they had numerous clinical trials that showed that this drug was no more effective than placebo in this group of patients.
They did this knowing that this drug would probably be prescribed instead of another drug that was to some extent effective in alleviating symptoms in this group of patients.
(Yes it's true. They drew up a strategy to take the market from an effective drug with a drug they knew was to all intents and purposes a dud.)
Here's the punchline.....
....they did this without breaking a single law (unscrupulous, unethical but they didn't break a single law!). |
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mindmetoo
Joined: 02 Feb 2004
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| Posted: Sat Feb 03, 2007 7:22 am Post subject: |
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| Grimalkin wrote: |
My original point was that having worked in the pharmaceutical industry I could understand the OP saying this
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You've probably never heard of it because it simply doesn't fit into the plans the drug companies. It has no patent. |
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Well, we've never heard of it for the same reason we don't hear of 99.99% of drugs that show some promise in animal tests.
I don't recall the scientist ever once claiming the future of this drug was doomed because of the drug companies. A TV reporter claimed that. Wouldn't one of the companies that makes the drug be interested in sponsoring a small phase 1 trial? If the phase 1 results are so dramatic as that short news clip led us to believe, you think it will still be ignored?
Anyway, you see no private or public solution? In your opinion, does society benefit more by the current status quo or do the drugs that fall through the cracks and the opportunities for abuse outweigh what drug companies deliver? |
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Grimalkin
Joined: 22 May 2005
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| Posted: Sat Feb 03, 2007 1:40 pm Post subject: |
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| mindmetoo wrote: |
Well, we've never heard of it for the same reason we don't hear of 99.99% of drugs that show some promise in animal tests. |
It's a common marketing strategy for companies to generate 'noise' about promising new drugs even before they enter clinical trials.
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| I don't recall the scientist ever once claiming the future of this drug was doomed because of the drug companies. A TV reporter claimed that. |
There are expensive drugs on the market for the treatment of cancer. They only offer an extension of life expectancy of an extra few months. The companies successfully sell them by saying that you can't put a value on life and the thousands they cost is thus warrented. These companies would be threatened if the drug we're discussing proved to be successful.
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| Wouldn't one of the companies that makes the drug be interested in sponsoring a small phase 1 trial? |
Why?
With no patent, any number of companies could produce the drug. They could also use the clinical trials paid for by that company in their marketing. The competition would be unlimited and the price they could charge for the drug would be very small.
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| Anyway, you see no private or public solution? In your opinion, does society benefit more by the current status quo or do the drugs that fall through the cracks and the opportunities for abuse outweigh what drug companies deliver? |
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| 6) If there was not a profit to be made in producing drugs we would not have the range of effective drugs we do have. |
What I've quoted above (like all the things in my response to doctors) I sincerely believed.
I also believe that (in common with a lot of big businesses) pharmaceutical companies tend to be inherently untrustworthy.
Don't get me wrong...I believe in capitalism.
I also believe in consumer watchdog organisations! |
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Grimalkin
Joined: 22 May 2005
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| Posted: Sat Feb 03, 2007 2:09 pm Post subject: |
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I wish I could answer that. I can't.
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I haven't been completely honest here.
I do have a lot of ideas about this. The reasons that I don't want to articulate them are as follows:
I) It wasn't my intention to get into a discussion about them when I responded to the OP.
2) It would take to long to go into all of them here.
3) While some of my ideas are probably good some of them might not be so good.
4) I find the discussions here very adversarial and I feel that if some of my ideas were discredited, other good points that I'd made would be tainted by that.  |
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mindmetoo
Joined: 02 Feb 2004
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| Posted: Sat Feb 03, 2007 4:52 pm Post subject: |
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| Grimalkin wrote: |
| mindmetoo wrote: |
Well, we've never heard of it for the same reason we don't hear of 99.99% of drugs that show some promise in animal tests. |
It's a common marketing strategy for companies to generate 'noise' about promising new drugs even before they enter clinical trials. |
Maybe 3 or 4 make the popular media a year. Can you name more than 3 pre phase 1 drugs that have made the popular media this year?
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| I don't recall the scientist ever once claiming the future of this drug was doomed because of the drug companies. A TV reporter claimed that. |
There are expensive drugs on the market for the treatment of cancer. They only offer an extension of life expectancy of an extra few months. The companies successfully sell them by saying that you can't put a value on life and the thousands they cost is thus warrented. These companies would be threatened if the drug we're discussing proved to be successful. |
That doesn't really answer the point I made. The OP is basing an opinion not on the opinion of the scientist interviewed (a proper appeal to authority) or a drug company representative (another proper appeal to authority). The OP is basing an opinion on the word of a CTV reporter. That's an improper appeal to authority.
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| Wouldn't one of the companies that makes the drug be interested in sponsoring a small phase 1 trial? |
Why? |
Because we're talking a relatively low cost initial trial. We come back to this "nobel prize for the cure for cancer" notion. Seems terribly good publicity. And the company stands to be first to market. Oats are undifferentiated products and yet we still get someone to make them. There are many other undifferentiated products out there with as many customers as there are people suffering from cancer.
More to the point ASA still gets made. Who paid for the clinical trials about ASA's efficacy for strokes? It's a terribly inexpensive drug, widely made, that has benefits comparable to expensive drugs on the market. No? Who paid for the clinical trials of using antibiotics for ulcers? Wasn't that a huge, huge cash cow? Or what about zinc lozenges for the common cold. There has been a good double blind clinical study done on zinc. I remind you we're talking about a very very common element. Zinc lozenges are certainly for sale at the pharmacy.
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| 4) I find the discussions here very adversarial and I feel that if some of my ideas were discredited, other good points that I'd made would be tainted by that. |
I certainly understand that. We're not going to resolve this problem for all the good people on earth. I debate the points because they're fun to debate, it makes me research and chase down information I'd not normally look at. But I also like to figure out the odds of having a Korean fall on you from the sky on your walk to the subway station. I'm sick that way. But at the end of the day, if the negatives outweigh the positives of the wet towel slapping debates we have around here, it's a good a choice. |
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Grimalkin
Joined: 22 May 2005
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| Posted: Sat Feb 03, 2007 7:58 pm Post subject: |
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| mindmetoo wrote: |
| Grimalkin wrote: |
| mindmetoo wrote: |
Well, we've never heard of it for the same reason we don't hear of 99.99% of drugs that show some promise in animal tests. |
It's a common marketing strategy for companies to generate 'noise' about promising new drugs even before they enter clinical trials. |
Maybe 3 or 4 make the popular media a year. Can you name more than 3 pre phase 1 drugs that have made the popular media this year? |
Even assuming that by 'this year' you mean 'within the last year' as opposed to 'since the beginning of 2007', the answer is no I can't.
Why not?
The company doesn't name the products before they enter clinical trials and usually not until the trials are almost completed. At most in the popular media they are identified by a serial number (and I don't have a particularly good memory for serial numbers) but often they are not even identified by that. Usually as well not even the company is not even identified. Often independent scientists make the original discovery. They patent it. They know they cannot afford the cost of further research and development of it if necessary, the cost of clinical trials (especially in the end it proves not to be viable. nor the cost of bringing the drug to the market. They sell the patent to a pharmaceutical company.
The 'noise' I referred to (I'm using 'noise' in the marketing sense) happens more like this.
The headline of a newspaper article refers to for example,
NEW HOPE FOR ALZHEIMER SUFFERS
It will then go on to give rudimentary details about how this came about.
(the source and purpose of these articles can be quite varied depending on the objective they are supposed to achieve).
| mindmetoo wrote: |
| Grimalkin wrote: |
| mindmetoo wrote: |
I don't recall the scientist ever once claiming the future of this drug was doomed because of the drug companies. A TV reporter claimed that. |
There are expensive drugs on the market for the treatment of cancer. They only offer an extension of life expectancy of an extra few months. The companies successfully sell them by saying that you can't put a value on life and the thousands they cost is thus warrented. These companies would be threatened if the drug we're discussing proved to be successful. |
That doesn't really answer the point I made. The OP is basing an opinion not on the opinion of the scientist interviewed (a proper appeal to authority) or a drug company representative (another proper appeal to authority). The OP is basing an opinion on the word of a CTV reporter. That's an improper appeal to authority. |
I wasn't trying to answer that point per se, that was part of a post where I was trying to explain that is hardly inconceivable that drug companies would suppress new drugs that threatened their own. Sorry if I misrepresented your post while doing that.
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| Wouldn't one of the companies that makes the drug be interested in sponsoring a small phase 1 trial? |
Why? |
Because we're talking a relatively low cost initial trial. We come back to this "nobel prize for the cure for cancer" notion. Seems terribly good publicity. |
A relatively low cost initial trial is not going to win any Nobel prizes. the drug would have to be a well established cure for cancer before it was even considered. You know the saying "There's many a slip 'twixt cup and lip". They stand a good chance of losing too much on a long shot!
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| Oats are undifferentiated products and yet we still get someone to make them. There are many other undifferentiated products out there with as many customers as there are people suffering from cancer. |
I'm betting you can answer this one yourself. 
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| More to the point ASA still gets made. Who paid for the clinical trials about ASA's efficacy for strokes? It's a terribly inexpensive drug, widely made, that has benefits comparable to expensive drugs on the market. No? Who paid for the clinical trials of using antibiotics for ulcers? Wasn't that a huge, huge cash cow? Or what about zinc lozenges for the common cold. There has been a good double blind clinical study done on zinc. I remind you we're talking about a very very common element. Zinc lozenges are certainly for sale at the pharmacy. |
I won't take this point by point unless you insist (I'm getting lazy). You agree that generally a company will only market something if it's in some way profitable for them to do so?
I once worked for a company that produced an anti-psychotic for schizophrenia. They also found evidence that it was effective for treating people with anorexia nervosa. They could have done trials to get the licence to promote it for this use as well but they felt that the trials were too expensive and the population group too small.
(I remember the marketing manager making the joke 'anorectics are to thin on the ground'.)
If you have a reasonably cheap product with a high turnover rate it's profitable. Zinc lozenges I presume are OTC products and not subject to the same price controls as prescription medications.
It was Astra Zeneca who did the trials on the triple therapy for ulcers. Their product losec was coming off patent so facing generic competition as well as competition from new proton pump inhibitors. Triple therapy is quite expensive. Part of this is because the antibiotic used is also expensive (tho' whether this is because it got a price increase (due to having a new indication) or that was it's original price I don't know). The point is that it was worth it to Astra to do the trials as it gave their product a new lease of life.
The use of ASA I'll have to research but I'm sure I'll come up with an equally logical (from the financial point of view) reason for this as well.
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| 4) I find the discussions here very adversarial and I feel that if some of my ideas were discredited, other good points that I'd made would be tainted by that. |
I certainly understand that. We're not going to resolve this problem for all the good people on earth. I debate the points because they're fun to debate, it makes me research and chase down information I'd not normally look at. But I also like to figure out the odds of having a Korean fall on you from the sky on your walk to the subway station. I'm sick that way. But at the end of the day, if the negatives outweigh the positives of the wet towel slapping debates we have around here, it's a good a choice. |
To be honest I respect you as a poster (tho' most of my impressions I have formed are from the evolution threads). I know you do your research and expect others who engage you, to be able to back up what they say.
To be fair to myself (and I do like to be fair to myself!) I wouldn't put forward an argument I didn't believe in, but with other posters I might be more prepared to say something I wasn't able to back up, expecting or supposing that they will take my word for it.
Not so with you!  |
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mindmetoo
Joined: 02 Feb 2004
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| Posted: Wed Oct 03, 2007 5:56 am Post subject: |
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The so-called "cure for cancer" that would never get tested is moving to a phase ii trial:
http://scienceblogs.com/terrasig/2007/10/dichloroacetate_dca_phase_ii_t.php
If you remember part of the debate was the drug would never get tested because drug companies couldn't make all kinds of money off of it and how evil Big Pharma is. Oddly, lots of people have since lined their pockets selling DCA to desperate cancer patients. And it wasn't big pharma. It was the anti-pharma types. Some how people are content to believe that those that oppose big pharma couldn't have their own personal profit motive. |
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Kuros
Joined: 27 Apr 2004
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| Posted: Wed Oct 03, 2007 6:18 am Post subject: |
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I don't think Big Pharma is evil. But its certainly not a progressive force.
Big Pharma has no incentive to cure diseases/conditions/afflications. It makes more money from treating them.
It doesn't matter as far as I'm concerned. I could afford treatment. But can those suffering from AIDS in the 3rd world afford treatment?
Its not all Big Pharma's fault. They haven't made the patent laws. They're just sucking every cent out of it. And it isn't as if I haven't invested in Big Pharma. Lets face it, their stocks make great returns!
Here's my question. Have the medical advances for cures of afflictions (not treatments) kept up with parallel technological advances in other fields? |
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mindmetoo
Joined: 02 Feb 2004
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| Posted: Wed Oct 03, 2007 3:39 pm Post subject: |
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| Kuros wrote: |
| I don't think Big Pharma is evil. But its certainly not a progressive force. |
The profit motive is not a progressive force if you mean "equalizing". Many people don't have clean water in this world because they can't afford to pay for it, for example.
If we want truly safe and effective meds and we impose 3 phase trials + extensive data collection and analysis post approval, then that costs money. Private industry can bear the cost or we can fund all drug research via taxes. And we can all pay that way.
It is telling big pharma is moving into the supplement / complimentary / alternative medicine (SCAM) industry, buying up the big makers, because people seem happy to pay large amounts of money for substances that simply don't have to be proven effective or even meet truth in labeling requirements. That bottle says it's x% yubba root but is it? Who knows. No testing, no q/a, no expensive isolating active ingredients, just slap it in a pretty bottle and sell it for $20. That's pure profit.
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| Big Pharma has no incentive to cure diseases/conditions/afflications. It makes more money from treating them. |
Remember hospitals were once filled with polio wards. By this logic, there should have never been a polio vaccine. Ulcer sufferers were profitably maintained on various drugs until the discovery of h.pylori. Hospitals made a lot of money curing angina by tying off blood vessels (a procedure that eventually led to the discovery of the placebo effect).
Also, big pharma is not a monolith. If company A has a maintenance treatment and your company thinks it can develop a cure and you can't muscle in on their treatment business, what is your best business plan?
It's also important to note that the standard of care is actually set in academia and in the academic literature, not by the drug companies and not even by the doctors running private clinics. It is a complicated three way balance and not at all perfect. However, one should not think big pharma is the only player.
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| Here's my question. Have the medical advances for cures of afflictions (not treatments) kept up with parallel technological advances in other fields? |
That's kind of a nebulous question. How do you compare medical advances with advances in IC development? The human body isn't as well understood as solid state physics, for example. It's a hugely complicated machine we didn't design.
Here's a wonderful example of something on the horizon:
http://www.mdausa.org/research/070423dmd_ptc_124.html
There are more than a thousand of genetic diseases that are a result because when the body is making proteins (ie building part of us) it sees a premature stop codon (a kind of "end of file" marker) in the DNA. So instead of building the whole protein, it builds only part of it. There's a drug on the horizon (promising in animal models) that will let the body read through this false stop codon. The caveat that what works in one model (test tube, animal) doesn't work in humans. But if it does, it has the potential of basically curing 1,800 diseases in one shot. |
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Kuros
Joined: 27 Apr 2004
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| Posted: Thu Oct 04, 2007 7:45 am Post subject: |
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| mindmetoo wrote: |
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| Big Pharma has no incentive to cure diseases/conditions/afflications. It makes more money from treating them. |
Remember hospitals were once filled with polio wards. By this logic, there should have never been a polio vaccine. Ulcer sufferers were profitably maintained on various drugs until the discovery of h.pylori. Hospitals made a lot of money curing angina by tying off blood vessels (a procedure that eventually led to the discovery of the placebo effect).
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Yes, exactly. You've made my point. The polio vaccine was discovered over 50 years ago.
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| If company A has a maintenance treatment and your company thinks it can develop a cure and you can't muscle in on their treatment business, what is your best business plan? |
Right. Big Pharma is hardly evil for pursuing treatment over cures. But for that reason private health care has not advanced as far for the common good as say, private software or private computing has advanced. |
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mindmetoo
Joined: 02 Feb 2004
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| Posted: Thu Oct 04, 2007 2:55 pm Post subject: |
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| Kuros wrote: |
| Right. Big Pharma is hardly evil for pursuing treatment over cures. But for that reason private health care has not advanced as far for the common good as say, private software or private computing has advanced. |
I'm just curious how do you measure that? How do you even equate the two? I would think, however, in terms of biomedical science, most biomedical researchers would say they've made amazing advances. Consider PCR (dna amplification) or gene silencing.
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| Yes, exactly. You've made my point. The polio vaccine was discovered over 50 years ago. |
I'm not sure how I made your point with my 3 examples. Big Pharma wasn't profit driven 50 years ago? Company B wouldn't make a cure in competition with Company A making an expensive maintenance therapy? Look at Lasik surgery, for example. Eye glasses is hugely profitable. People have to buy them every few years. But someone developed a simple inexpensive surgery in the spirit of competition.
Last edited by mindmetoo on Fri Oct 05, 2007 3:27 am; edited 1 time in total |
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cbclark4
Joined: 20 Aug 2006
Location: Masan
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| Posted: Thu Oct 04, 2007 5:22 pm Post subject: |
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650 million people are infected with Malaria each year.
DDT prevents Malaria, yet the FDA prohibits the use of DDT.
Why?
http://en.wikipedia.org/wiki/DDT |
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mindmetoo
Joined: 02 Feb 2004
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| Posted: Thu Oct 04, 2007 7:05 pm Post subject: |
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| cbclark4 wrote: |
650 million people are infected with Malaria each year.
DDT prevents Malaria, yet the FDA prohibits the use of DDT.
Why?
http://en.wikipedia.org/wiki/DDT |
I think it's just politically unpopular. Hurts the condor shells. DDT resonates almost as badly with the public as as thalidomide. |
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