Quite possible the largest alternative health scam ever.

[rory_20_uk]

Companies make things to make a profit? Say it ain't true!!!!

Ever bought a graphics card or a CPU? They sell the same thing at different price points, often by crippling functions on the cheaper models! And they try hard to stop people turning on the features - back in the day one could use a graphite pencil to alter it - no more!

Cars have engines which have been "tuned" differently for different price points - paying hundreds more for a small code!

Any more examples of companies doing despicable things to make money?

The rules on registering a new chemical entity or biological get stricter - often by the year. And guess what? This costs a load of money. Which is increasingly difficult to get back, because governments have made making copies a lot easier with special new legislation on both biosimilars and generics!

Doctors also are very happy to use off lisence - although technically illegal and unethical as it is untested. But if there's money to be saved, why worry? Sure, the drug with an indication spent tens of millions to get that - but the price is higher for reasons we don't care about so we'll use the cheap stuff.

And can you believe it? There is less R&D done in the West than there used to be! Just because the cost of development has increased, interactions with clinicians is stricter by the year and there are pressures on pricing they go and do their work elsewhere...

[a completely inoffensive name]

And can you believe it? There is less R&D done in the West than there used to be! Just because the cost of development has increased, interactions with clinicians is stricter by the year and there are pressures on pricing they go and do their work elsewhere...

What is the solution? How do you reconcile the public's need for cheap drugs with the fact that making new drugs (regulations or not) is very expensive. Seems to be an unavoidable clash.

[Husar]

Ever bought a graphics card or a CPU? They sell the same thing at different price points, often by crippling functions on the cheaper models! And they try hard to stop people turning on the features - back in the day one could use a graphite pencil to alter it - no more!

So drugs can be held to the same ethical standards as entertainment devices?

[rory_20_uk]

So drugs can be held to the same ethical standards as entertainment devices?

Yes - or provide massive subsidies to companies that work on drugs to compensate them for the increased standards. Or governments should start manufacturing these drugs that need to be made from an "ethical" standpoint.

What other things should have the same high ethical standpoint?

Water purifiers?
Tents
Solar power - hell why not all renewable technology?
Communication, that's key to a modern society. Invalidate all patents on comunications, fibre optics etc to help others.
Medical training for doctors and other clinical staff? Better set up bursaries for poorer countries - that's ethical.

So, in fact medicines are only one of many things required. Either all are special or none are.

[HoreTore]

All are special - nationalize the lot of them.


And ban the snake oil salesmen.

[rory_20_uk]

All are special - nationalize the lot of them.

How many new chemical entities for human theraputic use have been developed by governments - anywhere?

One of the few governments that could even attempt this would be Norway (due to costs)... yet they've not done so.

If it is so easy to make these things and companies are oh so greedy with what they make and what they charge I'm surprised that there hasn't been more competition.

[HoreTore]

How many new chemical entities for human theraputic use have been developed by governments - anywhere?

Penicillin?

But no, Universities tend not to make products ready for sale - they just do all the research needed.

I can't really see why Oxford, Cambridge or whatever should be unable to produce a medicine.

[rory_20_uk]

Penicillin?

But no, Universities tend not to make products ready for sale - they just do all the research needed.

I can't really see why Oxford, Cambridge or whatever should be unable to produce a medicine.

We rarely, if ever use penicillin as is created by the mould, as the spectrum of activity is very low and it has to be given intravenously. I think "developed" is a rather flattering term for "accidentally found after poor sterile technique on a petri dish".

Universities do set up spin off biotechs which again tend to do the pre-clinical work by themselves and then team up with a large(r) company to do Phase I-III trials / license and market the product.

Universities don't have the hundreds of millions / billions to spare to get one registered - odds of a molecule getting between phase I and the market are something like 1 in 100. Big (bad, eeeeeevil) companies get money on the ones they sell to invest in R&D which more often than not goes nowhere.

Then even when registered, most healthcare professionals demand vastly more trial data than purely to register a product - and guess what? That costs further millions now which might be paid back later.

[Husar]

Yes - or provide massive subsidies to companies that work on drugs to compensate them for the increased standards. Or governments should start manufacturing these drugs that need to be made from an "ethical" standpoint.

Now you sound like a lobbyist, but nationalizing them all will solve the subsidy problem.

What other things should have the same high ethical standpoint?

Food and housing, especially housing prices are monitored and sometimes capped by the government here anyway.

So, in fact medicines are only one of many things required. Either all are special or none are.

How long can someone who has a flu survive without electronic communication devices?
How long can the same person survive without water?

We are certainly dependent on electric energy nowadays, so you may want to add that to the list, but you also forgot that not all of the things you mention have a stable demand and have an inelastic demand as one of my links also explained.

If you cannot afford a chemo therapy that's not the same as not being able to afford a new smartphone.
You may lose your job if you cannot afford to get your knee fixed and tumble into poverty, but that is unlikely to happen if you cannot afford to buy Rome 2.
Unhealthy people are also a macroeconomic concern because they cost society money unless you're going to say we might also kill the ones who cannot afford to have their bodies fixed and have become useless to society.

[rory_20_uk]

Now you sound like a lobbyist, but nationalizing them all will solve the subsidy problem.



Food and housing, especially housing prices are monitored and sometimes capped by the government here anyway.



How long can someone who has a flu survive without electronic communication devices?
How long can the same person survive without water?

We are certainly dependent on electric energy nowadays, so you may want to add that to the list, but you also forgot that not all of the things you mention have a stable demand and have an inelastic demand as one of my links also explained.

If you cannot afford a chemo therapy that's not the same as not being able to afford a new smartphone.
You may lose your job if you cannot afford to get your knee fixed and tumble into poverty, but that is unlikely to happen if you cannot afford to buy Rome 2.
Unhealthy people are also a macroeconomic concern because they cost society money unless you're going to say we might also kill the ones who cannot afford to have their bodies fixed and have become useless to society.

Nationalising companies is either extremely expensive or causes levels of capital flight that no Western country could countenance.

There are many types of food and housing. Does the system ensure that the best food and housing is as cheap as the worst? Given that these variables are also linked to health they should be to ensure equality.

Chemo is probably more neccecary for society than smartphones. So... it comes to that level before there are things that can be chosen which are not essential?
People with damaged knees can do many - if not most - jobs. Surgery might help some of them continue the jobs they were doing.

Unhealthy people are a macroeconomic cost. And the "logic" that making people healthier was part of the dream when the NHS started that after the initial high costs, things would get cheaper as people became more healthy. Clearly that didn't happen - and is one of the reasons why most countries run massive current account debts as costs for retired people are balooning as the longer they live the more they cost - and we can pay more for them to live longer.

Focusing resources on getting people back to work as quickly as possible then looking after everyone else would make economic sense - as the economy would be a lot bigger, meaning there is more money to spend on the health service - but of course is electoral suicide. Best we all pretend that year on year increases to health expenditure are sustainable... When a Government runs a Ponzi scheme it is OK for some reason.

[Husar]

Nationalising companies is either extremely expensive or causes levels of capital flight that no Western country could countenance.

There are many types of food and housing. Does the system ensure that the best food and housing is as cheap as the worst? Given that these variables are also linked to health they should be to ensure equality.

Chemo is probably more neccecary for society than smartphones. So... it comes to that level before there are things that can be chosen which are not essential?
People with damaged knees can do many - if not most - jobs. Surgery might help some of them continue the jobs they were doing.

Unhealthy people are a macroeconomic cost. And the "logic" that making people healthier was part of the dream when the NHS started that after the initial high costs, things would get cheaper as people became more healthy. Clearly that didn't happen - and is one of the reasons why most countries run massive current account debts as costs for retired people are balooning as the longer they live the more they cost - and we can pay more for them to live longer.

Focusing resources on getting people back to work as quickly as possible then looking after everyone else would make economic sense - as the economy would be a lot bigger, meaning there is more money to spend on the health service - but of course is electoral suicide. Best we all pretend that year on year increases to health expenditure are sustainable... When a Government runs a Ponzi scheme it is OK for some reason.

So basically death panels, because money > people?

[rory_20_uk]

So basically death panels, because money > people?

No, free treatment for everyone for everything!!!!

Resources are finite. Health needs can be almost infinite - you can always have more safety checks, longer trials, more treatment for more conditions.

Some would prefer to try really hard to pretend that there are no restrictions rather than face that healthcare is, was and probably always will be rationed: there are not enough organs for the doners that require them - so people are on a list; expensive drugs are not given to everyone, but only those who will see the best benefit.

Germany is a great example which is so keen in pushing down prices they even demand some that are so low to be unprofitable... then whinge when companies don't sell them. However, there appears to be no system in making all BMWs cost the same as Skodas as they are all cars after all.

[Montmorency]

And the "logic" that making people healthier was part of the dream when the NHS started that after the initial high costs, things would get cheaper as people became more healthy. Clearly that didn't happen - and is one of the reasons why most countries run massive current account debts as costs for retired people are balooning as the longer they live the more they cost - and we can pay more for them to live longer.

In fact, people have become healthier. It's one of the reasons they're living longer. Long enough to incur complementary chronic health issues. But that hardly means the enterprise of modern healthcare has failed - quite the opposite, in fact.

Some drugs and treatments are more important than others. For instance, if corporations are unwilling to develop new antibiotics due to the expense, then they should step aside and abdicate all responsibility for development of antibiotics in particular to states. They can continue on with their lesser product lines as previously.

[rory_20_uk]

States do.

And so Uni's do. If we give it to them and tell them how to spend it.

But they haven't. Nothing stopping them. Companies do create these things. If govenments / universities can do it better - then they are completely able to do so.

In fact, people have become healthier. It's one of the reasons they're living longer. Long enough to incur complementary chronic health issues. But that hardly means the enterprise of modern healthcare has failed - quite the opposite, in fact.

Some drugs and treatments are more important than others. For instance, if corporations are unwilling to develop new antibiotics due to the expense, then they should step aside and abdicate all responsibility for development of antibiotics in particular to states. They can continue on with their lesser product lines as previously.

People live longer and don't die wich chronic diseases. I never said that this is a failing of modern healthcare - but the fact is it costs a lot more and money is not infinite. There is unlikely to be a point where the costs are lower as almost everything that is found is to alleviate things to do with chronic disease - not cure.

Ok, several points to clarify here:

1) Companies have developed many antibiotics - but they don't get licenses since the standard is they have to work better than existing ones rather than providing an alternative. There are many, many antibiotics such as this. The failing is therefore that of the FDA / EMA not companies. This goes for both classes of antibiotics as well as new antibiotics in classes.
2) Countries are more than able to develop them as well - but they haven't
3) Lesser priorities... oh, such as dementia, diabetes, asthma cancer and so on...
4) No company has the responsibility to create any particular product since they receive no grants to do so.

In short - you want more antibiotics then alter the process to enable entibiotics to be lisenced with warnings in sections 4.3, 4.4 and 4.5 as appropriate. Many would rarely be used unless new resistances appear. But sadly State regulatory bodies don't appear to have this foresight.