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Re: [RangeVoting] Do-it-yourself testing of possibly hazardous products

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  • Raph Frank
    ... The FDA is overly conservative. They balance safety/risk against politics, rather based on death rate. One news story about a person who died due to a new
    Message 1 of 4 , Oct 1, 2010
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      On Thu, Sep 30, 2010 at 1:29 AM, Stephen Unger <unger@...> wrote:
      > The
      > pharmaceutical industry makes the tobacco industry look like amateurs
      > when it comes to getting harmful products into the marketplace and
      > delaying efforts to halt their sales.

      The FDA is overly conservative. They balance safety/risk against
      politics, rather based on death rate.

      One news story about a person who died due to a new product they let
      through is worth 100's (or more) of news stories about someone who
      died because there was no cure for their disease.

      People who die due to releasing a new treatment to late are just as
      dead as those who die because it was released one to soon.

      From your page:
      > It is important to understand that, as is the case with every other for-profit
      > company, a company manufacturing prescription drugs is not in business
      > to help people. It has an obligation to its stockholders to maximize profits.

      Right, this is true for most businesses. However, they still provide benefits
      to the people. In fact, the free market is one of the best ways to get people
      to do that.

      > So, for example, it is not likely to invest a lot of money to develop a drug
      > that will cure some serious disease afflicting a small fraction of the population.
      > Potential sales would be small.

      Right, and as harsh as it sounds to the people with the rare disease,
      that *is* what you want them to do.

      If you were managing a non-profit that has 100 researchers working for
      it, would you have them work on a disease that affects 1 million
      people or one that only affects 1,000 people (assuming that they were
      both believed to be equally difficult to cure and were equally
      damaging to health)?

      Your non-profit does most benefit by helping the 1 million.

      The ideal split is that cure for 1 million people should be developed
      so that it is very safe, as there are lots of people who will receive
      the treatment. Less effort should be spent on the 1000 person
      disease.

      The effect is that the cure for the 1 million person disease gets
      produced to a high standard, and the cure for the 1000 person disease
      isn't quite so good.

      However, since it costs so much to get FDA approval, the same standard
      of quality applies to both cures. Your non-profit wouldn't even be
      allowed to give the cure for rare disease away for free and it
      wouldn't be worth going through the steps for approval.

      A compromise position is labelling laws, rather than a ban.

      The 1 million person cure might decide to go through the steps get the
      highest quality rating, while the 1000 person cure might go through
      basic testing.

      Someone with the 1000 person disease would have to decide if it was
      worth it, especially, since there is no other treatment. Even a low
      chance of fatal side effects might be acceptable, if the disease
      itself was a fatal disease.

      > The most profitable medications are those that alleviate the symptoms of,
      > not cure, a chronic, nonfatal, disease with a great many victims.

      This is an issue, it is caused by a the way the market is set up.

      Longer term medical insurance could help here. If medical insurance
      was for say 10-20 years, then your medical insurance company would
      have an incentive to ensure that you are healthy.

      What you want to do is pay for health, rather than pay for treatment.
    • Stephen Unger
      The issue Raph raises about the point at which the value of a medication in curing a disease should be considered as justifying its use despite its harmful
      Message 2 of 4 , Oct 1, 2010
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        The issue Raph raises about the point at which the value of a
        medication in curing a disease should be considered as justifying its
        use despite its harmful side effects is an important one that I touched
        on only lightly. But it can't be properly dealt with under our present
        circumstances because it requires valid information about both the
        efficacy of the drugs and the extent of their harmful side
        effects. The main point of my article (with respect to medications) is
        that the pharmaceutical industry has corrupted the whole process of
        evaluating drugs to such a degree that we cannot get reliable
        information on either factor.

        Steve
        ............

        Stephen H. Unger
        Professor Emeritus
        Computer Science and Electrical Engineering
        Columbia University
        ............

        On Fri, 1 Oct 2010, Raph Frank wrote:

        > On Thu, Sep 30, 2010 at 1:29 AM, Stephen Unger <unger@...> wrote:
        >> The
        >> pharmaceutical industry makes the tobacco industry look like amateurs
        >> when it comes to getting harmful products into the marketplace and
        >> delaying efforts to halt their sales.
        >
        > The FDA is overly conservative. They balance safety/risk against
        > politics, rather based on death rate.
        >
        > One news story about a person who died due to a new product they let
        > through is worth 100's (or more) of news stories about someone who
        > died because there was no cure for their disease.
        >
        > People who die due to releasing a new treatment to late are just as
        > dead as those who die because it was released one to soon.
        >
        > From your page:
        >> It is important to understand that, as is the case with every other for-profit
        >> company, a company manufacturing prescription drugs is not in business
        >> to help people. It has an obligation to its stockholders to maximize profits.
        >
        > Right, this is true for most businesses. However, they still provide benefits
        > to the people. In fact, the free market is one of the best ways to get people
        > to do that.
        >
        >> So, for example, it is not likely to invest a lot of money to develop a drug
        >> that will cure some serious disease afflicting a small fraction of the population.
        >> Potential sales would be small.
        >
        > Right, and as harsh as it sounds to the people with the rare disease,
        > that *is* what you want them to do.
        >
        > If you were managing a non-profit that has 100 researchers working for
        > it, would you have them work on a disease that affects 1 million
        > people or one that only affects 1,000 people (assuming that they were
        > both believed to be equally difficult to cure and were equally
        > damaging to health)?
        >
        > Your non-profit does most benefit by helping the 1 million.
        >
        > The ideal split is that cure for 1 million people should be developed
        > so that it is very safe, as there are lots of people who will receive
        > the treatment. Less effort should be spent on the 1000 person
        > disease.
        >
        > The effect is that the cure for the 1 million person disease gets
        > produced to a high standard, and the cure for the 1000 person disease
        > isn't quite so good.
        >
        > However, since it costs so much to get FDA approval, the same standard
        > of quality applies to both cures. Your non-profit wouldn't even be
        > allowed to give the cure for rare disease away for free and it
        > wouldn't be worth going through the steps for approval.
        >
        > A compromise position is labelling laws, rather than a ban.
        >
        > The 1 million person cure might decide to go through the steps get the
        > highest quality rating, while the 1000 person cure might go through
        > basic testing.
        >
        > Someone with the 1000 person disease would have to decide if it was
        > worth it, especially, since there is no other treatment. Even a low
        > chance of fatal side effects might be acceptable, if the disease
        > itself was a fatal disease.
        >
        >> The most profitable medications are those that alleviate the symptoms of,
        >> not cure, a chronic, nonfatal, disease with a great many victims.
        >
        > This is an issue, it is caused by a the way the market is set up.
        >
        > Longer term medical insurance could help here. If medical insurance
        > was for say 10-20 years, then your medical insurance company would
        > have an incentive to ensure that you are healthy.
        >
        > What you want to do is pay for health, rather than pay for treatment.
        >
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