Mad Mat said it all. Pharmaceutical companies are not in the business of curing people, they are in the business of helping people manage whatever illness they have. If the pills have side effects, they will just give you another pill. If they actually cured people(and let's be honest, medical technology could most likely cure most ails at this juncture), their profits would dry up. Because they have shareholders that they are 'legally beholden' to, they don't even have to have a guilty conscience about impeding the progress of society just to make some money.
And this is an example of the problem we've been discussing...this is what people apparently believe when it really couldn't be further from the truth. That parenthetical statement of yours, in particular, blows my mind.
If you'll excuse me, I need to get back to lab today and just cure something.
On Patents: I'll agree that Pharmaceuticals is one of the few fields where strong patent law makes perfect sense. Drugs have a very high development cost, and a very, very low reproducibility cost. In order to incentivize drug R&D in a capitalistic world, patents are completely necessary. As R&D costs and profitability change, there will always be debate over how strong is strong enough, but I think much of that hatred stems from patent law in other fields where it's not really necessary. *Cough* software *cough* where everything has low development costs and most patents are on small incremental improvements to existing patents rather than actual innovation, and patents are on integrated pieces instead of single, finished products. But I digress, that's another topic entirely. *Ahem.* Anyway, that hatred leaks over to Pharmaceuticals where it's not really warranted.
On Unsavory Business Practices: I don't think patents are the only thing that really gets to people though. I think, ultimately, big pharma companies leave a bad taste in people's mouths because they are run like all other huge corporations, while people are used to expecting the medical field to function as a public service.
No, I don't think big pharma tries to keep people sick, but they DO spend tons of money on advertising and courting doctors, all in order to increase prescriptions for their drugs. In many cases for symptoms it wasn't even designed for. Plus the lobbying to reduce their development costs by lowing safety requirements in clinical trials. This has been getting better over time, so a lot of these are feelings might be holdovers from when big pharma companies were not kept as... friendly as they are now. Even so, most big pharma running costs ARE marketing and lobbying, not their "huge" development costs.
TLDR; Helping people plays second fiddle to making huge profits. Big pharma spends way more on marketing and lobbying than actual R&D and production costs. That doesn't necessarily mean big pharma is doing anything immoral, but it does mean they definitely aren't your friend.
Part of the problem is that pharma companies do not make a profit from curing or relieving people's ailments. They make a profit from selling pharmaceuticals. If these pharmaceuticals are particularly effective, their sales pretty much dry up (hence, they have a strong incentive not to make too effective products).
I'm going to stop you right there. You clearly have no idea how the drug discovery process works. This is the problem with a scientifically illiterate public. They think somehow drugs can magically be discovered which completely cure diseases but the pharmaceutical companies are withholding such drugs to boost profit. Discovering new drugs doesn't work like you think it does. Most of the time it involves finding a potential drug receptor and beginning a lengthy process of research on it. Remember, 95% of these projects will fail.
So at this point if you happen to be really lucky you may actually know the structure or function of the receptor. Most of the time though you don't know it, so you have to screen up to literally a million different compounds to see if you get a hit. Even if you do know the structure, there is no easy path to a good drug. There are certain structures that are known to be good potential drugs, but at this point it is really good a shot in the dark using high throughput screening.
So now you get some hits that give activity. At this point you optimize these hits by changing their structure. A drug with high activity may have poor pharmacokinetic properties, meaning it can't get to the drug site, or it is metabolized before it gets there, etc. So they take hundreds of compounds and change small parts of the structure and study the changes. Then they may take these drugs and start in vivo tests on mice to see how it works in a living organism. This includes figuring out toxicity. Because guess what? Most drugs are toxic, and a large part of the drug discovery process is trying to maximize the dosage you would need for it to be toxic while minimizing the dosage you need for an effective physiological effect. Then you start clinical trials, etc. like I talked about above. Overall you go from a potential drug target that will fail 95% of the time and go through millions of compounds trying to get activity that will likely not be well understood. It is more like shooting in the dark than it is sitting down and thinking about what molecule would be a good drug and designing one from scratch.
Again, if you buy into this scientifically ignorant conspiracy theory that pharma companies have no incentive to make good drugs you are wrong. Just dead wrong. Where exactly in that process do you think they are making the decision to lower the therapeutic index of a drug? Where exactly do you think a drug company is ignoring a potential groundbreaking discovery to treat a disease? Let me know and I'll tell you why you are wrong.
Quote from Cyan »
If the pills have side effects, they will just give you another pill.
I actually just read a paper about the challenges of dealing with a public that doesn't understand why drugs have side effects. It's interesting because the public doesn't know how drugs are discovered or how they work, so they wrongly think that side effects are just poor design. Wrong. Every drug has side effects. Much of the process of making a new drug is changing the structure to get rid of side effects while maintaining the therapeutic effect.
If they actually cured people(and let's be honest, medical technology could most likely cure most ails at this juncture), their profits would dry up.
More scientifically illiterate nonsense showing that you really don't know what you're talking about.
Also LogicX, buzzed my father briefly earlier today - and he was lucidish today - something he reminded me of, that hasn't been covered in this - is that remember that generics still have to go through (simplified admittedly) trials as well.
Trumping up their costs as relevant because of the costs of trials is a farcical thing at best. Additionally he quoted Lipitor's cost breakdown as 20% R&D/70% advertising from what he remembered before retirement. It was abnormally advertising heavy however - but just goes to show how much some get. [I'd bet Viagra is similarly advertising heavy]
And to add to what Mad Mat said - it only really applies to "first world nations" however - and that is that it's absolutely happened with the treatment of some diseases in Africa. Since there's no profit to be had in trying to kite them along for years, they tend to get much more aggressive pharmaceuticals than are even produced for US consumption.
(For the disease in question, although I can't recall which offhand - the African treatment cost something like $2 every six months, whereas the US treatment for the same condition was something like $120/mo - yes, there was some benefits to the US treatment, like less nausea - but considering the drastic cost difference, I'm pretty sure some US folks would like the option if it was given to them)
I think that some of the reason there is so much hate is because they are unwilling when patients die from their drugs to own up and say "our bad." Now this comes down to making as much profit as possible, but when someone dies, they do act heartless.
This is because these drugs aren't researched enough. There is tremendous pressure to get a drug to market and the drug companies simply don't know enough. People die as a result
It is not a 'conspiracy theory'. It is a logical assessment of the average person today. I'm not saying that random scientists/lab techs don't want to invent cures. I'm saying that huge pharmaceutical companies don't. They don't care. They care about making money. The end. I would go so far as to say that they probably actively discourage people from developing these cures by just throwing money at them(no matter who you are, everyone has a price). I mean like..if your company makes 10 billion dollars/yr off of some medicine and someone comes up with a gene therapy or shot that prevents them from getting that illness at all, what are you going to do? Sit by while you lose billions in yearly revenue? Nope, you are just going to pay that person off. And if you offer enough money, they are going to take it.
I mean come on. Big Pharma is what, the most profitable industry in existence? This is not a coincidence. And yet, people still get 'flu shots' every single year. I'm not saying that these companies actively make people sick, but I am saying that they don't want anyone to develop ways to permanently prevent future illness. You think that these executives(whom have shares in the company, and responsibilities to stockholders, etc) care primarily are aiding people that are ill. I don't think that this is the case at all. I think that they care about making money, and realize that this is one of the best industries in which to do so.
It is not a 'conspiracy theory'. It is a logical assessment of the average person today. I'm not saying that random scientists/lab techs don't want to invent cures. I'm saying that huge pharmaceutical companies don't. They don't care. They care about making money. The end. I would go so far as to say that they probably actively discourage people from developing these cures by just throwing money at them(no matter who you are, everyone has a price). I mean like..if your company makes 10 billion dollars/yr off of some medicine and someone comes up with a gene therapy or shot that prevents them from getting that illness at all, what are you going to do? Sit by while you lose billions in yearly revenue? Nope, you are just going to pay that person off. And if you offer enough money, they are going to take it.
I mean come on. Big Pharma is what, the most profitable industry in existence? This is not a coincidence. And yet, people still get 'flu shots' every single year. I'm not saying that these companies actively make people sick, but I am saying that they don't want anyone to develop ways to permanently prevent future illness. You think that these executives(whom have shares in the company, and responsibilities to stockholders, etc) care primarily are aiding people that are ill. I don't think that this is the case at all. I think that they care about making money, and realize that this is one of the best industries in which to do so.
What you've described is, very literally, a conspiracy theory.
Regardless of whether or not anyone would agree with that logic, that is still textbook conspiracy theory material.
While technically accurate - it at least has a logic train to it - one that is reinforced in the market quite a bit.
Look at how much cancer treatment research versus cancer cure research there is - and look at what the breakdown between one's that are sponsored by pharmaceuticals versus those that are sponsored by the Fed (or rarely private donors).
It's more economical for the companies to not "waste their resources" on cures in the case of cancer as an absolute - even though they'll all jump on board to tear at the carcass of the felled beast when a cure is found.
So, just to be clear, your totally logical assessment is that whenever anyone anywhere comes up with a cure for a disease that some company is making money from, the following occurs:
1) That person tells no one.
2) The pharmaceutical company finds out about the cure, but no one else does.
3) The pharmaceutical company gives them a huge stack of cash.
4) Not a single one of these people ever turns down the cash, or tells anyone about the offer.
5) The pharmaceutical companies never run into trouble explaining how millions and millions of dollars disappeared.
6) None of the friends, families, colleagues etc. of the cure discoverer, who surely knew what they had been working on, has any question about why they suddenly aren't working on it anymore, and are now a multi-millionaire.
Yeah, this makes total sense. I'm glad you've thought this through all the way before sharing it with us.
Mr. Scientist, you're leaving out Mr. Market and Mr. Advertiser which they take about 20% to 50% cut along with Mr. Telecom Industry, which the cost for advertising is passed along to the consumer. Whereas our socialist friends have banned advertising in the manner we do for drugs, and have since seen sharper drops in prices whereas we see a larger price spikes during the patent cycle.
I would suggest that you read the book Hard Sell: The Evolution of a Viagra Salesman, which talks about how Pharma does sales. It's short, it's funny and memorable. Bit on the raunchy side, so NSFW and be warned. Not exactly totally explicit sex, but to make one quote there are conversations that talk about sex. where an example is:
Quote from Oral sex description[/quote »
"Sure just let me sneeze into your mouth and you swallow.
As an aside, there's some side bar discussions about men vs. women on sales and business, as well as corporate culture indoctrination.
With that said, there's also the FDA which is the "EPA of medicine," and to be honest is the actual problem when it comes to implementing new technologies and is often both underfunded but also overly cautious even by European standards and has helped to ship scientist jobs overseas because of that. The EPA isn't as big of a boogeyman as it is actually made to be because of China's decline in coal consumption has caused ripple effects through the resource industry, but the FDA is the real culprit in driving up costs but conservatives often are slow to pick up that sort of thing.
With that said, there's also the FDA which is the "EPA of medicine," and to be honest is the actual problem when it comes to implementing new technologies and is often both underfunded but also overly cautious even by European standards and has helped to ship scientist jobs overseas because of that. The EPA isn't as big of a boogeyman as it is actually made to be because of China's decline in coal consumption has caused ripple effects through the resource industry, but the FDA is the real culprit in driving up costs but conservatives often are slow to pick up that sort of thing.
I was waiting for someone to bring up the Food and Drug Administration. The test trials and the safety tests are strenuous, but is anyone here really mad at the FDA for putting them in place?
Or generics. Does anyone really fault the government for allowing generic alternatives when branded medicine patents run out?
Mr. Scientist, you're leaving out Mr. Market and Mr. Advertiser which they take about 20% to 50% cut along with Mr. Telecom Industry, which the cost for advertising is passed along to the consumer. Whereas our socialist friends have banned advertising in the manner we do for drugs, and have since seen sharper drops in prices whereas we see a larger price spikes during the patent cycle.
Med reps are like Santa Claus. They give free stuff (ranging from pens/pads to subscriptions to journals to tickets/accommodations to conferences in another country) like confetti. And there can be a half dozen or so of the blighters in a corridor at any given time, in every hospital.
Can't help but feel if they cut down on the advertising they can also cut down on the costs of medicine.
the FDA is the real culprit in driving up costs but conservatives often are slow to pick up that sort of thing.
This is going to need a bit of explanation. How do you justify this claim? Do you reject that the lion's share of big pharmaceutical running costs are spent on marketing, advertising, lobbying, and overhead administrative costs? And comparatively, a much smaller percentage is spent on R&D and meeting FDA clinical trial requirements?
Because all sources I've read seem to agree the former is much greater than R&D and trials (though the exact proportions fluctuate depending on the exact product). And if that's the case, this implies the true culprits in driving up costs are exactly the inefficiencies introduced by running pharmaceuticals as a money-focused corporation in the first place. Money is their focus and they want to capture the market. Ultimately, they don't truly care about consumer well-being or providing affordable medicine.
I'm not sure what you're entire post is getting at really. I haven't read "The Hard Sell", but it's description seems to agree precisely with what Valclav and I are saying. You even said yourself that countries restricting advertising for pharmaceuticals see lower prices than we do. Doesn't that just corroborate what we are saying? Maybe I'm misunderstanding your post.
Med reps are like Santa Claus. They give free stuff (ranging from pens/pads to subscriptions to journals to tickets/accommodations to conferences in another country) like confetti. And there can be a half dozen or so of the blighters in a corridor at any given time, in every hospital.
Can't help but feel if they cut down on the advertising they can also cut down on the costs of medicine.
Advertising is sort of a necessary evil, unfortunately. There's too much competition from other companies that offer similar drugs/formulations on the market, that each company needs to ensure their own maximizes profits while they can. I guess there'd have to be a way to limit advertising spending across the board? No idea how that works, I just do lab stuff.
EDIT: Re: The FDA's regulations -- Sure, we could loosen the FDA's regulations on safety and other development requirements, which could lead to cheaper, high-risk/high-reward treatments in less time, but I have a hard time imagining anyone gathering support for those changes. All people are going to hear is "more toxicity."
My mom has Multiple Sclerosis. She's probably going to die well before her time, not because of the disorder, but because the treatment involves a cocktail of chemicals that branch off to deal with each others' crippling side effects. The only companies that do research on dealing with these disorders properly are charities. With all the money big pharmaceuticals makes, a bigger chunk of that should be funding these charity projects.
Med reps are like Santa Claus. They give free stuff (ranging from pens/pads to subscriptions to journals to tickets/accommodations to conferences in another country) like confetti. And there can be a half dozen or so of the blighters in a corridor at any given time, in every hospital.
Can't help but feel if they cut down on the advertising they can also cut down on the costs of medicine.
But then how would they convince physicians to prescribe their medicines? On the basis of scientific merit? Pish-posh.
I was waiting for someone to bring up the Food and Drug Administration. The test trials and the safety tests are strenuous, but is anyone here really mad at the FDA for putting them in place?
Or generics. Does anyone really fault the government for allowing generic alternatives when branded medicine patents run out?
[Page one here - at least as a small subnote]
And Morgan, I'm quite intimately familiar with pharmaceutical marketing - not only my father's history with the FDA which included peaks at the books, but also from my and my mother's working years in a medical office.
I've seen someone (maybe it was you?) on a forum comment on how there's such a thin line between pharmaceutical rep and prostitute for the female ones. Sure they technically don't do anything THAT seedy - but it's really not that far divorced either.
And Vowels: Toxicity is already a regular problem AS IS with current medications - especially those of us unlucky enough to have to deal with neurologic meds like myself and Kryp's mother. Just like photostability of meds is such a largely ignore avenue when it comes to drugs, besides nitroglycerin (which EVERYONE knows) very few people are aware of how many pharmaceutical compounds breakdown rapidly, sometimes into toxic compounds, sometimes into inert ones, and sometimes into something completely different with sometimes as little as one dose of normal band light. [Note: It was a bit of my father's pet project, in case it's not obvious... including the nature of his textbook]
This doesn't have anything to do with what I said. I'm describing the way the market of pharmaceuticals works. It's not even a conspiracy theory, it's just a natural consequence of the way the system is set up currently.
Withholding the magical panacea is not a smart move. What I'm saying is: it's much more economical to try and find new products down the same, downtrodden alley than trying alternative approaches. The pharmaceutical environment is an environment where risk is enormously amplified and poorly rewarded. That is the point. And it's not just the companies that are to blame for this, obviously. Regulators share the blame as well, in particular because they're often affiliated. It makes for much more efficient lobbying with often poor opposition.
I would agree with this. But like you say, the reason for this is risk. And again I would argue that this whole issue puts the onus on government for increased funding of basic research.
Do you think pharmaceutical companies have an incentive to educate people about this?
It would be in their interest, yes. But it probably isn't high on their list of priorities. In the long term it hurts them because when say, a drug recall happens because it turns out it was unsafe, an educated public may not be so reactionary and outraged at the pharmaceutical company.
It would be in their interest, yes. But it probably isn't high on their list of priorities. In the long term it hurts them because when say, a drug recall happens because it turns out it was unsafe, an educated public may not be so reactionary and outraged at the pharmaceutical company.
Why bother? They could just as well spend the money to lobby for tort reform and not have to pay out to victims.
Maybe we've gotten to the need for a required pro-bono phase. If we aren't willing to change the business to make it less profit intensive, then maybe we need to force them to spend a certain percent of their profits (Everything that comes after payroll, R&D, marketing, etc, but before taxes) on developing cures and the like, or something they wouldn't normally do.
The FDA director that was there when my father retired (2004, I think?) was actually trying to lobby Congress (unsuccessfully) to have them be forced to allocate 2% of their funds in extra taxes that would go directly towards government funded research. He lost his position shortly after my father left however - and from my father's quotes, that lobbying was a large part of why.
Pharma's have deep pockets for quashing things they don't like.
It's not so much big pharma, but the leverage that big pharma has on government policy.
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And this is an example of the problem we've been discussing...this is what people apparently believe when it really couldn't be further from the truth. That parenthetical statement of yours, in particular, blows my mind.
If you'll excuse me, I need to get back to lab today and just cure something.
On Unsavory Business Practices: I don't think patents are the only thing that really gets to people though. I think, ultimately, big pharma companies leave a bad taste in people's mouths because they are run like all other huge corporations, while people are used to expecting the medical field to function as a public service.
No, I don't think big pharma tries to keep people sick, but they DO spend tons of money on advertising and courting doctors, all in order to increase prescriptions for their drugs. In many cases for symptoms it wasn't even designed for. Plus the lobbying to reduce their development costs by lowing safety requirements in clinical trials. This has been getting better over time, so a lot of these are feelings might be holdovers from when big pharma companies were not kept as... friendly as they are now. Even so, most big pharma running costs ARE marketing and lobbying, not their "huge" development costs.
TLDR; Helping people plays second fiddle to making huge profits. Big pharma spends way more on marketing and lobbying than actual R&D and production costs. That doesn't necessarily mean big pharma is doing anything immoral, but it does mean they definitely aren't your friend.
I'm going to stop you right there. You clearly have no idea how the drug discovery process works. This is the problem with a scientifically illiterate public. They think somehow drugs can magically be discovered which completely cure diseases but the pharmaceutical companies are withholding such drugs to boost profit. Discovering new drugs doesn't work like you think it does. Most of the time it involves finding a potential drug receptor and beginning a lengthy process of research on it. Remember, 95% of these projects will fail.
So at this point if you happen to be really lucky you may actually know the structure or function of the receptor. Most of the time though you don't know it, so you have to screen up to literally a million different compounds to see if you get a hit. Even if you do know the structure, there is no easy path to a good drug. There are certain structures that are known to be good potential drugs, but at this point it is really good a shot in the dark using high throughput screening.
So now you get some hits that give activity. At this point you optimize these hits by changing their structure. A drug with high activity may have poor pharmacokinetic properties, meaning it can't get to the drug site, or it is metabolized before it gets there, etc. So they take hundreds of compounds and change small parts of the structure and study the changes. Then they may take these drugs and start in vivo tests on mice to see how it works in a living organism. This includes figuring out toxicity. Because guess what? Most drugs are toxic, and a large part of the drug discovery process is trying to maximize the dosage you would need for it to be toxic while minimizing the dosage you need for an effective physiological effect. Then you start clinical trials, etc. like I talked about above. Overall you go from a potential drug target that will fail 95% of the time and go through millions of compounds trying to get activity that will likely not be well understood. It is more like shooting in the dark than it is sitting down and thinking about what molecule would be a good drug and designing one from scratch.
Again, if you buy into this scientifically ignorant conspiracy theory that pharma companies have no incentive to make good drugs you are wrong. Just dead wrong. Where exactly in that process do you think they are making the decision to lower the therapeutic index of a drug? Where exactly do you think a drug company is ignoring a potential groundbreaking discovery to treat a disease? Let me know and I'll tell you why you are wrong.
I actually just read a paper about the challenges of dealing with a public that doesn't understand why drugs have side effects. It's interesting because the public doesn't know how drugs are discovered or how they work, so they wrongly think that side effects are just poor design. Wrong. Every drug has side effects. Much of the process of making a new drug is changing the structure to get rid of side effects while maintaining the therapeutic effect.
More scientifically illiterate nonsense showing that you really don't know what you're talking about.
Trumping up their costs as relevant because of the costs of trials is a farcical thing at best. Additionally he quoted Lipitor's cost breakdown as 20% R&D/70% advertising from what he remembered before retirement. It was abnormally advertising heavy however - but just goes to show how much some get. [I'd bet Viagra is similarly advertising heavy]
Re: People misusing the term Vanilla to describe a flying, unleash (sometimes trample) critter.
(For the disease in question, although I can't recall which offhand - the African treatment cost something like $2 every six months, whereas the US treatment for the same condition was something like $120/mo - yes, there was some benefits to the US treatment, like less nausea - but considering the drastic cost difference, I'm pretty sure some US folks would like the option if it was given to them)
Re: People misusing the term Vanilla to describe a flying, unleash (sometimes trample) critter.
This is because these drugs aren't researched enough. There is tremendous pressure to get a drug to market and the drug companies simply don't know enough. People die as a result
I mean come on. Big Pharma is what, the most profitable industry in existence? This is not a coincidence. And yet, people still get 'flu shots' every single year. I'm not saying that these companies actively make people sick, but I am saying that they don't want anyone to develop ways to permanently prevent future illness. You think that these executives(whom have shares in the company, and responsibilities to stockholders, etc) care primarily are aiding people that are ill. I don't think that this is the case at all. I think that they care about making money, and realize that this is one of the best industries in which to do so.
What you've described is, very literally, a conspiracy theory.
Regardless of whether or not anyone would agree with that logic, that is still textbook conspiracy theory material.
While technically accurate - it at least has a logic train to it - one that is reinforced in the market quite a bit.
Look at how much cancer treatment research versus cancer cure research there is - and look at what the breakdown between one's that are sponsored by pharmaceuticals versus those that are sponsored by the Fed (or rarely private donors).
It's more economical for the companies to not "waste their resources" on cures in the case of cancer as an absolute - even though they'll all jump on board to tear at the carcass of the felled beast when a cure is found.
Re: People misusing the term Vanilla to describe a flying, unleash (sometimes trample) critter.
So, just to be clear, your totally logical assessment is that whenever anyone anywhere comes up with a cure for a disease that some company is making money from, the following occurs:
1) That person tells no one.
2) The pharmaceutical company finds out about the cure, but no one else does.
3) The pharmaceutical company gives them a huge stack of cash.
4) Not a single one of these people ever turns down the cash, or tells anyone about the offer.
5) The pharmaceutical companies never run into trouble explaining how millions and millions of dollars disappeared.
6) None of the friends, families, colleagues etc. of the cure discoverer, who surely knew what they had been working on, has any question about why they suddenly aren't working on it anymore, and are now a multi-millionaire.
Yeah, this makes total sense. I'm glad you've thought this through all the way before sharing it with us.
I would suggest that you read the book Hard Sell: The Evolution of a Viagra Salesman, which talks about how Pharma does sales. It's short, it's funny and memorable. Bit on the raunchy side, so NSFW and be warned. Not exactly totally explicit sex, but to make one quote there are conversations that talk about sex. where an example is:
As an aside, there's some side bar discussions about men vs. women on sales and business, as well as corporate culture indoctrination.
With that said, there's also the FDA which is the "EPA of medicine," and to be honest is the actual problem when it comes to implementing new technologies and is often both underfunded but also overly cautious even by European standards and has helped to ship scientist jobs overseas because of that. The EPA isn't as big of a boogeyman as it is actually made to be because of China's decline in coal consumption has caused ripple effects through the resource industry, but the FDA is the real culprit in driving up costs but conservatives often are slow to pick up that sort of thing.
Ambition must be made to counteract ambition.
Individualities may form communities, but it is institutions alone that can create a nation.
Nothing succeeds like the appearance of success.
Here is my principle: Taxes shall be levied according to ability to pay. That is the only American principle.
I was waiting for someone to bring up the Food and Drug Administration. The test trials and the safety tests are strenuous, but is anyone here really mad at the FDA for putting them in place?
Or generics. Does anyone really fault the government for allowing generic alternatives when branded medicine patents run out?
Med reps are like Santa Claus. They give free stuff (ranging from pens/pads to subscriptions to journals to tickets/accommodations to conferences in another country) like confetti. And there can be a half dozen or so of the blighters in a corridor at any given time, in every hospital.
Can't help but feel if they cut down on the advertising they can also cut down on the costs of medicine.
"Sometimes, the situation is outracing a threat, sometimes it's ignoring it, and sometimes it involves sideboarding in 4x Hope//Pray." --Doug Linn
This is going to need a bit of explanation. How do you justify this claim? Do you reject that the lion's share of big pharmaceutical running costs are spent on marketing, advertising, lobbying, and overhead administrative costs? And comparatively, a much smaller percentage is spent on R&D and meeting FDA clinical trial requirements?
Because all sources I've read seem to agree the former is much greater than R&D and trials (though the exact proportions fluctuate depending on the exact product). And if that's the case, this implies the true culprits in driving up costs are exactly the inefficiencies introduced by running pharmaceuticals as a money-focused corporation in the first place. Money is their focus and they want to capture the market. Ultimately, they don't truly care about consumer well-being or providing affordable medicine.
I'm not sure what you're entire post is getting at really. I haven't read "The Hard Sell", but it's description seems to agree precisely with what Valclav and I are saying. You even said yourself that countries restricting advertising for pharmaceuticals see lower prices than we do. Doesn't that just corroborate what we are saying? Maybe I'm misunderstanding your post.
Advertising is sort of a necessary evil, unfortunately. There's too much competition from other companies that offer similar drugs/formulations on the market, that each company needs to ensure their own maximizes profits while they can. I guess there'd have to be a way to limit advertising spending across the board? No idea how that works, I just do lab stuff.
EDIT: Re: The FDA's regulations -- Sure, we could loosen the FDA's regulations on safety and other development requirements, which could lead to cheaper, high-risk/high-reward treatments in less time, but I have a hard time imagining anyone gathering support for those changes. All people are going to hear is "more toxicity."
But then how would they convince physicians to prescribe their medicines? On the basis of scientific merit? Pish-posh.
[Page one here - at least as a small subnote]
And Morgan, I'm quite intimately familiar with pharmaceutical marketing - not only my father's history with the FDA which included peaks at the books, but also from my and my mother's working years in a medical office.
I've seen someone (maybe it was you?) on a forum comment on how there's such a thin line between pharmaceutical rep and prostitute for the female ones. Sure they technically don't do anything THAT seedy - but it's really not that far divorced either.
And Vowels: Toxicity is already a regular problem AS IS with current medications - especially those of us unlucky enough to have to deal with neurologic meds like myself and Kryp's mother. Just like photostability of meds is such a largely ignore avenue when it comes to drugs, besides nitroglycerin (which EVERYONE knows) very few people are aware of how many pharmaceutical compounds breakdown rapidly, sometimes into toxic compounds, sometimes into inert ones, and sometimes into something completely different with sometimes as little as one dose of normal band light. [Note: It was a bit of my father's pet project, in case it's not obvious... including the nature of his textbook]
Re: People misusing the term Vanilla to describe a flying, unleash (sometimes trample) critter.
I would agree with this. But like you say, the reason for this is risk. And again I would argue that this whole issue puts the onus on government for increased funding of basic research.
It would be in their interest, yes. But it probably isn't high on their list of priorities. In the long term it hurts them because when say, a drug recall happens because it turns out it was unsafe, an educated public may not be so reactionary and outraged at the pharmaceutical company.
Why bother? They could just as well spend the money to lobby for tort reform and not have to pay out to victims.
The FDA director that was there when my father retired (2004, I think?) was actually trying to lobby Congress (unsuccessfully) to have them be forced to allocate 2% of their funds in extra taxes that would go directly towards government funded research. He lost his position shortly after my father left however - and from my father's quotes, that lobbying was a large part of why.
Pharma's have deep pockets for quashing things they don't like.
Re: People misusing the term Vanilla to describe a flying, unleash (sometimes trample) critter.