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beskeptigal
SFN Die Hard
USA
3834 Posts |
 Posted - 04/22/2007 : 00:18:44 [Permalink]
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quote:
Originally posted by fc1001
I don't feel like providing a logical argument against "big pharma" here, but I'd like to tell you a little more about the disease, Crohn's disease, that Kieranct is talking about.
Remicade is one of the drugs of choice. It is protected by strong patents. The avg patient pays $5000-10,000 per month. That includes friends of mine. Despite this, Johnson and Johnson is now being investigated by the Federal Government for overcharging for this drug. They are also being charged with encouraging physicians to "pad" infusion costs. They are also suing a competitor's treatment, citing patent infringement.
That said, these drugs kill. A review of trial data showed that Remicade treatment cause mortality in the range of 2 to 2.8%. That is quite bad. The side effects of these drugs are unbelievable. Lupus, lymphomas. My friend Mike was diagnosed with Lymphoma shortly after starting Remicade.
Not only do the drugs kill, but nobody knows what their long term side effects are. Most of all, they don't want to know.
Another drug, naltrexone, is too old to patent. No drug company will pursue it. University esearchers applied for funding through our patient advocacy group, the CCFA, and were denied. Coincidentally the vast majority of funding to the CCFA comes from drug companies. And that is why only 15% of CCFA spending goes towards research, for a disease with no cure. Ironically, this drug shows the same effectiveness as Remicade in their early clinical trials.
I could go on and on...I understand the opposing viewpoints. Unforuntately, medicine and the free market were not meant to be. Corporations cannot unload "externalities" onto their patient population. This represents "market failure". Yes, I am an economics major in college, heh. I hate to sound like someone ranting about "the corporations", but when you have this disease, have spoken with researchers outside of the US and spoken with doctors who admit that "its all about the money", well, this is a very real problem.
I won't even tell you how many Crohn's patients have died in drug trials. Immune suppression is probably the most dangerous, scary treatment out there. Your body falls apart in every way imaginable.
Just to take a different track here. Were I treating a patient with Crohn's, I wouldn't start with the latest drug treatment, I'd start by looking at all the available research and treatment options such as one might find in the Cochrane reviews. (There are other sources to review as well.)
Cochrane Review, Inflammatory Bowel Disease and Functional Bowel disorders
To just look at the latest advertised 'Big Pharma' marketing campaign is not the approach most providers take. In addition, there are many diseases for which we do not have the treatments one would like to have. I do not hold that against the pharmaceutical industry.
The problems with pharmaceutical corporate goals not necessarily matching what's best for society needs to be addressed, and their marketing tactics need to be regulated. But one must be careful implying the pharmaceutical companies are responsible for public health (in this case responsible to the Crohn's patient population.)
Research in treatment for Crohn's needs to be funded as other diseases do. The funds should come from public and private sources.
When a drug company does market a treatment, we need to hold them accountable for honest discussion of the drug's risks and benefits. It is then up to the provider and patient to decide if the benefits outweigh the risks and how to best monitor the patient taking the drugs.
While Big pharma doesn't have a perfect record, and they need oversight, one must also be careful not to demonize the whole industry. Great gains in health and longevity have come from the pharmaceutical industry.
Bottom line, regulate the corporations, make sure they have proper oversight, but don't forget the benefits and the fact there are real people working there, everyone isn't corrupt. The current US president isn't helping matters. He's lowered the standard considerably. So I am advocating citizens let the pharm companies know the citizens aren't going to take risks just so CEOs and stockholders can get rich. But don't fall into the trap of seeing such companies as evil. It is oversimplified and it isn't a completely supportable position.
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| Edited by - beskeptigal on 04/22/2007 00:19:27 |
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ahbeeleeve
New Member
1 Post |
Posted - 05/14/2007 : 17:59:53 [Permalink]
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| Well said. Oversight and citizen involvement will be extremely important also if we are to reap the benefits of the 'other' medicine, the alternative or holistic treatments which are not evidence-based. Anecdotal evidence should not be ignored but a concerted public effort will be necessary to wrest integrative or alternative medicine away from the new age purveyors of cosmic debris. It would be nice to see big pharma (as well as the gov) invest a little more R&D into these treatments to separate the wheat from the chaff. |
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Dude
SFN Die Hard
USA
6891 Posts |
Posted - 05/14/2007 : 19:16:35 [Permalink]
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ahbeeleeve said:
| It would be nice to see big pharma (as well as the gov) invest a little more R&D into these treatments to separate the wheat from the chaff. |
First, "big pharma" is a ridiculous phrase. The pharmacutical industry is comprised of dozens of companies engaged in extreme competition with one another. They are all trying to find cures, remedies, and treatments for any number of things that plague the human race.
Second, R&D by all these companies, and basic research funded by our government, use an evidence based system (also called the scientific method) because it is the best way we know to discover new things and to test the validity of claims.
These "alternative" medicines are called "alternative" for a reason. There is no evidence, in most cases, to suggest they actually do anything.
No rational person would possibly believe that "big pharma" would leave these "alternative" medicines and therapies sitting out there in the public domain if there was any reasonable chance they could make a legitimate profit from them. |
Ignorance is preferable to error; and he is less remote from the truth who believes nothing, than he who believes what is wrong.
-- Thomas Jefferson
"god :: the last refuge of a man with no answers and no argument." - G. Carlin
Hope, n.
The handmaiden of desperation; the opiate of despair; the illegible signpost on the road to perdition. ~~ da filth |
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Dave W.
Info Junkie
USA
26022 Posts |
Posted - 05/14/2007 : 19:43:48 [Permalink]
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Originally posted by Dude
These "alternative" medicines are called "alternative" for a reason. |
Yeah, it's a political reason, too: to make people think that those treatments are valid and equal alternatives to modern medical treatments. The same political motivation is behind the "complementary" and "integrative" labels. They're all shams to get people to think that all sorts of different (and even contradictory) treamtent modalities - collectively - are on the same footing as medical science. Ensuring that the zillions of unlicensed and uninsured "natural healing" practitioners and suppliers can reap a profit from human misery.
And the worst part of it is that any of the "big pharma" companies with a halfway-competent marketing staff and lack of scruples has already jumped on the "alt-med" bandwagon to ensure they're getting their share of the big pie (if in no other way than by making vitamin and mineral supplements). For example, GlaxoSmithKline makes Alluna, "a non-habit forming herbal sleeping aid. It safely promotes a healthy sleeping pattern without side effects" (a nice piece of fear-mongering right there). GSK is thereby seen as "alternative friendly" and will get more of the money of the desperate. |
- Dave W. (Private Msg, EMail)
Evidently, I rock!
Why not question something for a change?
Visit Dave's Psoriasis Info, too. |
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JEROME DA GNOME
BANNED
2418 Posts |
Posted - 05/14/2007 : 20:27:28 [Permalink]
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Kieranct---I have yet to read all the posts, so I hope this has not come up.
"Firstly i think that drug research should be part of the welfare state, i.e. funded by government and not corporations. This could be legislated in such a way that cures are rewarded over symptom treatment."
1. Incentive is taken away
2. Funding in government tends to go to friends of those in power or those with the loudest voice.
I am not suggesting that the current system is the correct way to go; these are just the problems i see with the above idea.
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What a man believes upon grossly insufficient evidence is an index into his desires -- desires of which he himself is often unconscious. If a man is offered a fact which goes against his instincts, he will scrutinize it closely, and unless the evidence is overwhelming, he will refuse to believe it. If, on the other hand, he is offered something which affords a reason for acting in accordance to his instincts, he will accept it even on the slightest evidence. The origin of myths is explained in this way. - Bertrand Russell |
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beskeptigal
SFN Die Hard
USA
3834 Posts |
Posted - 05/14/2007 : 21:01:56 [Permalink]
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Originally posted by ahbeeleeve
Well said. Oversight and citizen involvement will be extremely important also if we are to reap the benefits of the 'other' medicine, the alternative or holistic treatments which are not evidence-based. Anecdotal evidence should not be ignored but a concerted public effort will be necessary to wrest integrative or alternative medicine away from the new age purveyors of cosmic debris. It would be nice to see big pharma (as well as the gov) invest a little more R&D into these treatments to separate the wheat from the chaff.
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It's a mistake to think anecdotal evidence is dismissed out of hand. When we say anecdotal evidence is not evidence of a medicine or supplement's effectiveness, it's because the anecdotes were not systematically collected or are insufficient to have any evidential value.
No one just dismisses out of hand, people's personal experiences. But people frequently believe they know something had an effect on their symptom or ailment, when in reality they are mistaken. So to find out if the treatment, supplement or medication actually did have an effect when you get anecdotal reports that some people believe the effect occurred, you test it in a more systematic way.
If you believe some untested medicine actually works, if you are going to waste money on it, if you are going to take it instead of something that might work better, don't you want to know the stuff actually works? If the anecdotes are true and not just coincidences which were mis-interpreted, then the research will confirm the effect.
Sometimes the research is simply collecting the anecdotal evidence in a more systematic way. I could give half the group the medicine and half the group a placebo. I still might simply collect anecdotes then from the group and see if the people taking the test medicine report improvement. But instead of one person telling me they are convinced, I can find out if they were correct to believe the medicine worked or if they were mistaken and something else really made them better, (usually time).
Are you aware the same pharmaceutical companies you call big pharma make the supplements for sale as well?
Are you aware lots of research dollars do not come from drug companies? There are many foundations which fund research for whatever cause the foundation is interested in. University research often is funded by grants which come from many different sources, often non-profit groups.
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Dr. Mabuse
Septic Fiend
Sweden
9688 Posts |
Posted - 05/14/2007 : 21:08:27 [Permalink]
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Originally posted by JEROME DA GNOME
"Firstly i think that drug research should be part of the welfare state, i.e. funded by government and not corporations. This could be legislated in such a way that cures are rewarded over symptom treatment."
1. Incentive is taken away |
Incentive will be taken away, if where is only a black-or-white option. Either/or.
But that is a false asumption, there are many options in the middle that will work just fine.
| 2. Funding in government tends to go to friends of those in power or those with the loudest voice. |
That presumes that there will be no controlling agency in place to monitor and audit the research grants. Such control must be transparent, with official and public records that anyone can read. Anyone misusing the power would be hung out to dry...
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Dr. Mabuse - "When the going gets tough, the tough get Duct-tape..."
Dr. Mabuse whisper.mp3
"Equivocation is not just a job, for a creationist it's a way of life..." Dr. Mabuse
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Send them unarmed civilians for target practice..
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beskeptigal
SFN Die Hard
USA
3834 Posts |
Posted - 05/14/2007 : 21:09:51 [Permalink]
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Originally posted by JEROME DA GNOME
Kieranct---I have yet to read all the posts, so I hope this has not come up.
Originally posted by kieranct
Firstly i think that drug research should be part of the welfare state, i.e. funded by government and not corporations. This could be legislated in such a way that cures are rewarded over symptom treatment....
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1. Incentive is taken away
2. Funding in government tends to go to friends of those in power or those with the loudest voice.
I am not suggesting that the current system is the correct way to go; these are just the problems i see with the above idea.
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Do you know how to use the quote function?
Re#1, what incentive are you referring to? Someone still has to manufacture the drugs.
Re #2, I agree and this is not the best way to fund all research. There is however, some public health research that is best done by public funding. Orphan drugs and new antibiotics are two examples. We need them both and drug companies are less interested because return is small with the first example or delayed and capital is tied up in the case of the antibiotics.
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| Edited by - beskeptigal on 05/14/2007 21:14:02 |
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kieranct
New Member
9 Posts |
Posted - 05/15/2007 : 07:30:36 [Permalink]
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Glad to see the debate continues, i think everyone is agreed that the current system has its flaws, debate is probably the best way to start solving them....
I think low does nalterxone is a very good example of how a drug with lots of potential but not much profit struggles to get funding. In this case, the voluntary sector appears to be stepping in in order to bring the product to market, but how many others fail to do so. I think it contradicts the economic argument posted back on page 1 on how pharma co's will always produce drugs that will sell, patent available or not. Aspirin may be, there is already a market, but not when a market needs to be developed.
Remicade is prime example of one of the major problems with "big pharma" (hehe). Originally dismissed by australian health authorities as not being cost effective, the manufacturer and crohn's groups appealed - they have obviously not read the tragedy of commons. No doubt we are going to see more of this with the latest cancer drugs. As long as these decision making bodies rdecisions are transparent they should be free from political or other manipulation.
My position has changed a bit since my first post. Yes i truly believe in the scientific method, however i don't believe its current fit with the free market in the pharmaceutical company is working for the people (no doubt it is achieving its primary endpoint of maximising shareholder value.) What has changed is that i accept "alternative" medicine isn't the answer, instead where the free market fails the government needs to step in, be that in the form of additional funding into non-patentable or "alternative" treatment (using the scientific method) or increasing legislation.
The problem is i can't see that happening, as much as it interests (and annoys) me, I can't see it being a news or political worthy issue, especially not if you want to get the dollars needed to get reelected from the pharmaceutical companies. |
| Edited by - kieranct on 05/15/2007 07:31:27 |
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Dr. Mabuse
Septic Fiend
Sweden
9688 Posts |
Posted - 05/15/2007 : 10:56:19 [Permalink]
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Originally posted by kieranct
My position has changed a bit since my first post. Yes i truly believe in the scientific method, however i don't believe its current fit with the free market in the pharmaceutical company is working for the people (no doubt it is achieving its primary endpoint of maximising shareholder value.) |
That cannot be attributed to any flaw on the part of the scientific method, but on the political and economical system.
Science is only a tool, and as such it is pure, and neutral of intent.
The problem is i can't see that happening, as much as it interests (and annoys) me, I can't see it being a news or political worthy issue, especially not if you want to get the dollars needed to get reelected from the pharmaceutical companies.
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From where I sit, in a country where general health care is ensured to everyone by the state "Universal health care insuerance", it seems to me that more "lefties" politics in the US might bring along what you're looking for. So get politically active.
Just think what could be done, in pharmaceutical research, for only one percent of the money spent making war on Iraq. |
Dr. Mabuse - "When the going gets tough, the tough get Duct-tape..."
Dr. Mabuse whisper.mp3
"Equivocation is not just a job, for a creationist it's a way of life..." Dr. Mabuse
Support American Troops in Iraq:
Send them unarmed civilians for target practice..
Collateralmurder. |
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kieranct
New Member
9 Posts |
Posted - 05/16/2007 : 01:05:48 [Permalink]
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it seems to me that more "lefties" politics in the US might bring along what you're looking for. So get politically active.
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I agree, i'm in the UK though, not quite as right wing as the current US admin but getting there.....
However these are long term problems in the healthcare system, any changes wouldn't see the benefit for many years (i.e. once more clinical trials had been done using government funding) and unfortunately long term issues, climate change being another example, aren't in the interest of getting reelected as they involve short term sacrifices (p#ssing of the pharmaceutical industry / increased government spending (cutbacks in other areas such as defense)) for long term gains. Hence why i think benevolent dictatorship is the only solution for humanity  |
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Dr. Mabuse
Septic Fiend
Sweden
9688 Posts |
Posted - 05/16/2007 : 01:50:37 [Permalink]
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Originally posted by kieranct
it seems to me that more "lefties" politics in the US might bring along what you're looking for. So get politically active.
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I agree, i'm in the UK though... |
I stand corrected. |
Dr. Mabuse - "When the going gets tough, the tough get Duct-tape..."
Dr. Mabuse whisper.mp3
"Equivocation is not just a job, for a creationist it's a way of life..." Dr. Mabuse
Support American Troops in Iraq:
Send them unarmed civilians for target practice..
Collateralmurder. |
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Trish
SFN Addict
USA
2102 Posts |
Posted - 06/02/2007 : 21:49:24 [Permalink]
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Hmm, just reading this tonight. I wanted to point out a misconception about pharmacy companies when some of them extend patents on their medications. Patents are issued for approximately 5 years on a new medication. Patents are extended to allow the pharmaceutical to recoup some of their R&D costs on these medications. The thing that gets me though, is when the pharmaceuticals redesign an existing drug with a slight change to the formula or apply for OTC authorization for their drug to block out the generic industry. Generic pharmaceuticals only require bioequivalncy can not produce the product for sale as a prescription medication - thus costing the generic pharmaceutical and the consumer both. This will tend to drive up the cost of generics. I saw over a million dollars of the generic version of Claratin destroyed by the drug going OTC. That doesn't count the lost R&D costs either - just the drug.
AS for the original post, I wonder if there is way to encourage sharing of private research into some of the cures for previously mentioned diseases. However, research done through grants from NIH is public domain and open to all who want access to the information. |
...no one has ever found a 4.5 billion year old stone artifact (at the right geological stratum) with the words "Made by God."
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"Say what you will about the sweet miracle of unquestioning faith. I consider the capacity for it terrifying and vile!"
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Commandant of the Marine Corps, 1943
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Evidenced based medicine
