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male pattern baldness
June 13, 2003 12:58 PM   Subscribe

Curing male pattern baldness is more important then savings somebodies life, because there is no money in saving a person's life. So says a doctor who was cured from a fatal illness by a new drug.
posted by tljenson (44 comments total)

 
I agree with the sentiment in the article that it is a shame that so many millions of people die every year from diseases that are treatable.

I take no position on whether it is the first world's responsibility to help the third world by donating or subsidizing life-saving medicines.

I would like to point out, for the sake of argument, that most of these third world countries where people are dying are run by wealthy, corrupt regimes which could choose to purchase or manufacture the drugs to treat their populations. Instead, they're more concerned with supporting their palaces and armys.

Also, DOWN WITH INTERNATIONAL PATENT LAWS which prevent third world countries from manufacturing their own cheap copies of expensive first-world drugs. Profits before lives is abominable.
posted by PigAlien at 1:25 PM on June 13, 2003


While it won't help the distribution problem cited in the paper, I'm for federally or internationally-funded drug research programs ala NASA (for what that's worth) that develop cures for less profitable diseases. Since the drug companies state research costs as the chief reason for the high prices of drugs, this seems like a tidy solution to me. Thoughts?
posted by tss at 1:26 PM on June 13, 2003


I take no position on whether it is the first world's responsibility to help the third world

I'm saddened that we live in a culture where someone can take no stance on whether the privileged have a responsibility to help the underprivileged. Has the concept of charity as a virtue been completely eliminated by western commercialism?

What would you do if you came across someone standing at the edge of a river watching a child drown? And the person standing there said to you, "I take no position on whether it is my responsibility to stop that kid from drowning." Would you agree with him? Would you maybe think he was being a little . . . I don't know . . . selfish?
posted by vraxoin at 1:44 PM on June 13, 2003


DOWN WITH INTERNATIONAL PATENT LAWS

You are taking a stand, there. It just isn't emotional or value-based, which makes it better and workable, IMHO. Talking about responsibiity makes Westerners feel good. Getting rid of real structural barriers to social justice makes our feelings irrelevant, instead bringing tangible cahnge.
posted by Ignatius J. Reilly at 1:50 PM on June 13, 2003


If drug companies didn't make money, they wouldn't exist.

If everyone who cried and moaned about this would form and fund a charity, perhaps that charity could buy the rights to eflornithine and administer it throughout the third world. The company that developed it could then recoup its development costs, freeing that capital to create new drugs.

How would you feel if you developed an operating system/trading strategy/surgical procedure/killer app, and someone took it from you, without your consent, because it could help someone? I'd be miffed.

On preview, vraxoin: I'd say it's selfish, and I see an ethical responsibility to help the drowning victim-- but I don't think anyone ought to compel/coerce me to jump in the river.
posted by trharlan at 1:50 PM on June 13, 2003


How would you feel if you developed an operating system/trading strategy/surgical procedure/killer app, and someone took it from you, without your consent, because it could help someone? I'd be miffed.

Miffed still beats dead. Sorry, about the miffing and all, but while drug companies are not doctors, the Hyppocratic Oath should stand in principle throughout insitutions of public health (which for my money includes those who make its "tools").
posted by Ignatius J. Reilly at 1:53 PM on June 13, 2003


I posted this on global AIDS awareness day, but this seems like an opportune time for a repost. Medecins Sans Frontieres runs an Access to Essential Medicines Campaign that focuses on overcoming the economic, legal, political, and scientific barriers to providing people with the medicines they need. The FAQ and reports and publications are essential reading, and highly apropos to the present discussion. You should also take a look at the Drugs for Neglected Diseases Initiative.
posted by stonerose at 2:19 PM on June 13, 2003


If drug companies didn't make money, they wouldn't exist.

Exactly. The pharmaceutical business is just that, a business, and they're not going to start giving away their products for free. Even if they did, controversy would ensue: what defines "need"? How poor must someone be to qualify for free drugs? Why give free pills to developing nations, when we have poor people in this country that need them? And on and on.

Drug prices in the US are already sky-high because we're paying for all the countries that have put caps on their pharmaceutical costs.

I just can't see drug companies producing pills with no monetary return; are there any businesses that operate for the sheer good will of it?
posted by Oriole Adams at 2:19 PM on June 13, 2003


How would you feel if you developed an operating system/trading strategy/surgical procedure/killer app, and someone took it from you, without your consent, because it could help someone? I'd be miffed.

If you spent the time and effort to create something that was only of use to people who could not afford it, then it sounds to me like you took a gamble and lost. Just because you lost the gamble doesn't mean you should therefore mean-spiritedly deprive those who would benefit from your invention by sticking your tongue out and saying, "unless you can cover my costs, tough shit, you ain't gettin' it. Oh, and I don't give a shit if you die or not."
posted by PigAlien at 2:19 PM on June 13, 2003


BTW, just so you don't have to go searching, see #17-#32 in the abovementioned FAQ for a good discussion of patents, pricing, and access to essential medicines. trharlan, I'm lookin' at you. :-)
posted by stonerose at 2:24 PM on June 13, 2003


I'd agree with the doctor completely.

But to put it even farther...where's the incentive to find something that cures?

Ex: Why really research a cure for MPB when Propecia is a cash cow?
posted by Yossarian at 2:30 PM on June 13, 2003


are there any businesses that operate for the sheer good will of it?

Goodwill.
posted by Ignatius J. Reilly at 2:31 PM on June 13, 2003


Who thinks life-saving medicines can be researched, developed, and produced at gunpoint?
posted by mw at 2:32 PM on June 13, 2003


mw: Do you believe that everyone is so selfish that they'll only want to work on life saving medicines if they are guaranteed the largest profit? Wake up. Medical researchers today aren't earning fat profits off of their research. They are given a wage just like any other corporate professional. The people making the big bucks have very little to do with research.

I think there are alternative, affordable, and piratical systems paying for drug research other than giving monopolies to money hungry corporations. I think it's high time we investigated some of those alternatives.
posted by betaray at 2:42 PM on June 13, 2003


Short-term solution: if there is an existing drug that cures a life-threatening disease, then I think that helping those in need takes precedence over patents. Cure now, figure out payment later.

Long-term solution:
Work on ways to incentivize and encourage people to work on under-represented life threatening problems. (including working on the problem yourself)

Working to fix the problem yourself and encouraging others to do so is a much better solution than attempting to cajole and force others to do your will.

Open source software is a great example of this. Instead of just complaining about the policies and tactics of companies such as Microsoft, OSS developers took the initiative to solve the problems themselves and to distribute their solutions for free. Open source drug formulas anybody?
posted by jsonic at 2:44 PM on June 13, 2003


A few years ago, didn't the State of Oregon come up with the astoundingly logical solution to health care? You list the 500 top medical treatments, with the top of the list being most effective and cheapest, and the bottom of the list being those that never work and are ridiculously expensive.
They found out, for example, that if you eliminate the medical procedure for heart-lung-and-etc. transplants for very premature infants that didn't work but cost $500,000, you would have enough money to give pre-natal health services to every needy woman in the State. Which would virtually eliminate women giving birth to very premature infants in the first place!
Eventually they decided to eliminate the "bottom 5" procedures, which gave them enough money to enroll thousands more poor people into the system!

(At the time I thought it was brilliant. But outside the state, absolutely *nobody* wanted to reproduce that logic, for god knows what reasons. Mostly greed, I imagine.)

But if you extrapolate it to the pharmaceutical industry, the same logic holds true. For example, remember those very cheap little packets of powder that would stave off dysentery, saving thousands of lives? Or the Vitamin A enriched rice, sent around the world to combat the horrible deficiency disease, keeping thousands from blindness? Also very, very cheap. Even the surgery to correct cleft palate. Very cheap and highly effective.

But what about very expensive AIDS drugs, given to people who refuse to use condoms for religious reasons?
posted by kablam at 2:45 PM on June 13, 2003


Since the drug companies state research costs as the chief reason for the high prices of drugs

That's a drug company lie, plain and simple. Drug companies spend more on advertising and administration than they do on R&D. (And even then, that R&D is mostly funding university researchers to do trials).

If drug companies didn't make money, they wouldn't exist.

Drug companies make about 15% profits per year. The rest of the stock market is about 5% per year. Add the fact that they sue to get their patents extended, and extended, and extended, and I'd say they're doing just fine, and need to quit worrying that they're going out of business any time soon.
posted by gramcracker at 2:45 PM on June 13, 2003


betaray: Anectdotal experience-- when I worked for a major financial services firm in a major Eastern city, I saw many, many six figure checks from medical, pharmaceutical, and biotech firms, made out to chemists and bioscientists for brief consulting gigs. They were usually for help in developing a drug. Just an anecdote-- but a lot of exceptionally bright people are greedy. Just like a lot of exceptionally dumb people are.

"piratical"-- a Freudian typo?
posted by trharlan at 2:47 PM on June 13, 2003


gramcracker: Drug companies make about 15% profits per year. The rest of the stock market is about 5% per year.

That's awfully vague.

FCFF? FCFE? EBIT? EBITDA? ROE? Can you source this?
posted by trharlan at 2:50 PM on June 13, 2003


Medical researchers today aren't earning fat profits off of their research. They are given a wage just like any other corporate professional. The people making the big bucks have very little to do with research.

Often much less than a corporate professional, actually. My girlfriend has a BS in Biology and works in a cancer research lab. She makes about $23k a year. Yes, that's for full-time work. It's a livable wage, but hardly big bucks and I'm sure she could make more as an assitant manager at a store in a mall or something.
posted by Ufez Jones at 2:53 PM on June 13, 2003



How would you feel if you developed an operating system/trading strategy/surgical procedure/killer app, and someone took it from you, without your consent, because it could help someone?


If you accept that violating an existing patent is wrong (which I do, BTW), than you must also accept that extending patents on existing drugs (or any other invention) is just as wrong. But this is exactly what the US government does when it strongarms third world countries into signing the TRIPS agreement.
posted by electro at 2:57 PM on June 13, 2003


trharlan: from the abovementioned FAQ:

" In 1998, the top ten [pharma] companies enjoyed $108.1 billion in sales, of which $34.7 billion was profit — at 32.1%, this is one of the highest average profit margins of any industry worldwide. Finally, it is notable that companies consistently spend more on marketing and administration than on R&D. "
posted by stonerose at 3:01 PM on June 13, 2003


trharlan: Sure. Sorry I didn't in my original post. Profiting from Pain, FamiliesUSA PDF. Table 1 and Table 8. Sorry, everything on FamiliesUSA is a stupid PDF.
posted by gramcracker at 3:06 PM on June 13, 2003


I understand that pharmaceutical companies exist for profit. They are profitable though. If they took the advertising budget that they use to convince the average Joe that they're suffering from some brand new disease (created to generate a market for their new drugs) and applied it to less profitable diseases they could make the world a better place. Instead they spend billions marketing drugs not to doctors, but insecure, overweight and impotent rich people. I applaud countries that step up to the plate and say "Well, screw you and your patents. We'll take your patents and cure our people."

Any country owes it's citizens first, somewhere in the distance are it's obligations to wealthy corporations in other countries.
posted by substrate at 3:09 PM on June 13, 2003


Yossarian: Ex: Why really research a cure for MPB when Propecia is a cash cow?

Because a competitor would love to come up with a cure that people would pay for. Even the manufacturer of Propecia should be interested -- it's a "new" market.
posted by davidmsc at 3:51 PM on June 13, 2003


Are we going to go through the same mental contortions we went through over here? Where I'm the one who points out that repealing patent laws and so forth will completely undercut research, only to be attacked and harrangued by people who disagree, and then ignored when the New York Times releases a story that says that, indeed, I'm right and you're basing your theories on how the world _should_ be rather than how it is? ("You" is the class who says "drugs in the third world shouldn't be held to the constraints of patents because people die and pharma companies are rich anyway.")

Because I'll be happy to rehash all of my posts over there if you want.

If you want lifesaving drugs to be promoted, find a way to pay for it. Otherwise, how do you propose this get accomplished? With what money? Or should scientists work for free? That's called slavery, or they'll exit to other professions. Should drug companies work for free? If not for free, should there be caps on what they can be paid? Should drug company money go into a central research pool overseen by beaurocrats? What's your solution?

If you accept that violating an existing patent is wrong (which I do, BTW), than you must also accept that extending patents on existing drugs (or any other invention) is just as wrong.
How does that follow? Patents are a legal construct, and thus, fluid. If the legal construct changes, why shouldn't the rest change? Yes, there has to be a limit, that's mandated in the constitution.

Gramcracker, got any cites that aren't PACs?
posted by swerdloff at 3:52 PM on June 13, 2003


I'm saddened that we live in a culture where someone can take no stance on whether the privileged have a responsibility to help the underprivileged. Has the concept of charity as a virtue been completely eliminated by western commercialism?

If charity were a responsibility, it wouldn't be a virtue.
posted by kindall at 3:57 PM on June 13, 2003



How does that follow? Patents are a legal construct, and thus, fluid. If the legal construct changes, why shouldn't the rest change?


So if congress decides to shorten or eliminate patent protection, that argument still applies, right? I think that would be wrong, but my point is that limiting and extending existing patent monopolies are morally equivalent.
posted by electro at 4:08 PM on June 13, 2003


If you want lifesaving drugs to be promoted, find a way to pay for it.

Translation: find a way for a few to get fabulously rich, and protect that cashcow for as long as possible, no matter the consequences for the commonweal. And be sure to run up an absolutely astounding budget while you do it...with brand new SUVs and three-piece suits for the drug reps, enormous advertising TeeVee budgets for such globally significant drugs as the latest baldness remedy, payoffs for vest-pocket congresscritters, cloaks and daggers to protect against any disclosure of adverse drug effects, and free dinners for the docs. (Gee....the business model is so very effective at giving people what they really need -- clean air, clean water, clean food, "lifesaving drugs", medical care for all -- isn't it?)

A way to pay for it? Gee, if we could somehow wean our lazy corporations off the Federal tit, maybe we'd have some money to spend on developing more useful drugs. Here's a hint: take a remedial gander at that strange little document called the "Constitution". Maybe you remember that part that goes "We the people..." and "...promote the general welfare...." Those tend to get forgotten by the greedheads in the pharmaceutical and business world who misinterpret that as "We the wealthy...." and "....promote my wallet...."

Oh, and uh, swerdloff? Posting a link to some New York Times article that requires one pay to read it (and which abstract does nothing to support your point, except apparently in your own head) days after the thread you referenced had run its course, then whining that everyone "ignored" you, is really not very bright. And there's really no need for you to rehash your tired arguments from that thread, when I can do it in three words for you and save you one hell of a lot of typing:

Greed is good.
posted by fold_and_mutilate at 4:43 PM on June 13, 2003


F_and_m, good point.

Here's what the article said (paraphrased).

Because Canada has cheaper drugs, Americans go to Canada to get their drugs.

Why is this relevant?

When you give free drugs to the poor in Africa or bust the patents in foreign countries, what's to stop you or I from going to said countries and getting free drugs what have you? A new drug black market. Like Tijuana, only bigger.

That threat posited that people wouldn't exit based on something as insignificant as lower cost drugs. The article, if you read it, says exactly the opposite - that in the real world, they do.

C'est tout.
posted by swerdloff at 6:16 PM on June 13, 2003


swerdloff:
maybe you don't think the world needs another Tijuana.
posted by Ignatius J. Reilly at 6:34 PM on June 13, 2003


"It's been coming for years," Frank said harshly, his tongue loosened by the faces of his old friends. "Even before the treatment life expectancy in the rich countries was nearly double that in the poor. Think about that! But in the old days the poor were so poor they hardly knew what life expectancy was, the day itself was their whole concern. Now every corner shop has a TV and and they can see what's happening-that they've got AIDS while the rich have the treatment. It's gone way beyond a difference in degree, I mean they die young and the rich live forever! So why should they hold back? They've got nothing to lose."

--- Frank Chalmers, Burroughs, Mars, 2059
[Kim Stanley Robinson, Red Mars]
posted by MzB at 6:52 PM on June 13, 2003


I don't know why, but I have the suspicion that if all the profit were removed from drugs and all the major international pharmaceutical companies left the business that the world would not suddenly stop and that we wouldn't all die and that we'd still have new drugs. However, I could be wrong.
posted by PigAlien at 7:06 PM on June 13, 2003


Corporations are not people. It should be no more surprising that corporations work only for profit than it is that bacteria reproduce. It's what they do. To expect corporations to do something that would hurt profits is not logical, since that is the only driving force. if you do not wish work to be done in proportion to its likelihood to yield profits what you do not like is not the pharmaceutical industry, but capitalism.

The term "corporate greed" is possibly good marketing against corporations, but it's certainly not very useful real language. It's repetitive, that's what corporations do, and if that force is balanced by the government, which is supposed to look after what the people want, then corporations have the possibility of creating things that are useful. The government does have to control the corporations through general regulations though, and, I think, that's what we have lost.
posted by rhyax at 7:42 PM on June 13, 2003


Corporations are not people.... if you do not wish work to be done in proportion to its likelihood to yield profits what you do not like is not the pharmaceutical industry, but capitalism.

Corporations are an artifact of a legal system whose intend is to provide limited liability to the directors of the corporation. It is not an element of capitalism per se, only a legislative means of promoting certain values within the free market. You ascribe a certain "loyalty to the market" to corporations that they don't have. The pharmaceutical industry is perfectly happy to manipulate the legal system to promote its own wealth, just as one would accuse an individual favoring regulation of manipulating the legal system for his own ends (in this case, his life or the lives of others). Am I willing to accept that this legal system will cause me to be unable to access certain luxuries? Sure. Would I be willing to die rather than have this legal system changed? No, I would not. It is precisely because corporations are not people that I consider my life more important than the legal system that props up the corporation's existence.

Fortunately, corporations whose concerns are driven primarily by health issues will, at times, realize that their core values are focused on promoting public health, such as when Merck donated a drug that cured river blindness to Africa, despite the fact that there was no profitable market for the drug. As described by Dr. Rockefeller, another corporation made a different, more damnable, decision.

We have a legal system that promotes certain values from certain pharmaceutical companies. The corporations do not exist in a vacuum. They are only reacting to a legal structure that we created. We can change the legal system to promote values which we would prefer.
posted by deanc at 9:45 PM on June 13, 2003


The solution is to have government labs that are paid for by the taxpayers to work on such projects. Capitalism is just not an effective system to address this type of problem. Of course if such a lab in the course of looking for cures for diseases with a low profit potential stumbled on to a blockbuster product with wide ranging benefits. The corporations would be screaming that it was unfair competition.
posted by onegoodmove at 12:33 AM on June 14, 2003


Should drug company money go into a central research pool overseen by beaurocrats?

Why not? The bloat -- the portion of money the pharmacudical industry doesn't spend on research -- is far over 50% right now; it couldn't possibly get worse.
posted by Tlogmer at 2:41 AM on June 14, 2003


Gramcracker: Pharma has traditionally been a defensive move for investors - steady, slow and certain returns when the exciting stuff elsewhere looks a bit too scary. Pfizer has a deeply dull p/e ratio of 22.5, Merck's EPS is 3.19 against a current price of almost USD60, and GSK is such a complete mess that shareholders have just voted to deny the boss a raise. If this is corporate plunder, then it's a subtle and understated kind. For you to claim excessive profits is simply downright disingenuous. That's not to say that they behave reprehensibly on occasion but that's not the same thing as the 'excess profits' soundbite that the anti-globalisation movement likes to trumpet.

I'm not an expert in the field but AstraZeneca are a former client of mine. While the big boys of pharma enjoy tremendous profits and hefty political clout much of the cutting edge research that enables new treatments to be developed is subcontracted out to a clutch of really very small firms indeed such as Cyprotex, Biofocus and Tranxenogen.

These firms struggle to remain solvent, and are not the evil bogey of simplistic depictions of the corporate world as the 'other'. One only has to see the travails of British Biotech for this to be evident. Crush these outfits with heavy-handed international patent law reform and there are going to be very few new therapies developed.

That said, I'm inclined to agree with onegoodmove's point that the research into healthcare should be considered a collective good and the with-profits arrangement is sub-optimal. Perhaps drug companies should be forced to restructure into not-for-profit entities, with no shareholders but with commercial paper available for all comers (similar in structure to Network Rail) for those who want to take a stake in research. No dividends, no shareholders, a steady and secure capital base. All the capitalist benefits and none of the shortcomings. It would mean that drugs could be developed on a on need rather than on market basis. Contrarily then, perhaps the argument would then be for longer and stricter pharma patents but coupled with enforcement contingent on certain development criteria being met.

Besides, this argument is all crap anyway. The developing world doesn't need expensive pharma treatments, it needs clean water, antimalarials and those little sachets Dioralyte.

See also: Dying for Drugs
posted by dmt at 5:28 AM on June 14, 2003


the New York Times releases a story that says that, indeed, I'm right and you're basing your theories on how the world _should_ be rather than how it is?

Oh, so, you're allowed to post an archived NYT article and claim that you're totally right, and when I post research from health reform advocates (NOT PACs), my evidence can just be ignored?

\If you want lifesaving drugs to be promoted, find a way to pay for it.

We have a pretty good way to pay for. It's called the NIH. They give out over $20 billion in grants every year to researchers.

For you to claim excessive profits is simply downright disingenuous.

So are my numbers wrong? I'm not forcing them to spend more on administration and marketing than on R&D. 18% profit rate, yes, and high expenses, yes. (CEO Salaries of $40 million. That's excessive.) Pfizer's not getting much of my pity.
And trust me, they behave irreparably on more than just "occasion."

I realize the little guys are generally not the bad guys, and it's Big Phrma that's the problem, but it's pretty common for the little guys to do all the work, and for Big Phrma to just buy them out. Nice work if you can get it.
posted by gramcracker at 6:25 AM on June 14, 2003


The developing world doesn't need expensive pharma treatments, it needs clean water, antimalarials and those little sachets Dioralyte.

Thank you.
posted by techgnollogic at 6:46 AM on June 14, 2003


The solution is to have government labs that are paid for by the taxpayers to work on such projects. Capitalism is just not an effective system to address this type of problem.

Which country is more capitalist than any other? Which has been responsible for developing and producing the majority of life-saving drugs? Is it plausible, do you think, to regard this as a mere coincidence?
posted by mw at 8:56 AM on June 14, 2003


I'd say that the fact that the US has so many world-class research universities has more to do with it than how "capitalist" it is. (It's interesting that you identify patent protection, which is a form of government interference in the market, with capitalism, by the way.) This article argues that even if patent monopolies are currently the most effective way to finance drug development, the economic inefficiencies associated with them grow more quickly than those associated with direct government funding. So, eventually, the latter will be cheaper than the former.
posted by electro at 9:27 AM on June 14, 2003


Crush these outfits with heavy-handed international patent law reform and there are going to be very few new therapies developed.

How did you arrive at this conclusion? You make the argument that the smaller research companies aren't struggling to stay in the black, but somehow a system that gives the lions share of the rewards to the multinational corporations that market the drugs is still the best for them?

Inventors, researchers, and "developers" of all breeds are penalized in our current system. In thinking about this I've realized that the premise of this comment, is flawed:

How would you feel if you developed an operating system/trading strategy/surgical procedure/killer app, and someone took it from you, without your consent, because it could help someone? I'd be miffed.

If you work for a corporation and you do develop anything like the above, then the corporation that you work for probably does own it. They will take it and they, and you will not profit from it.
posted by betaray at 2:46 PM on June 14, 2003


How did you arrive at this conclusion?

Logically.

You make the argument that the smaller research companies aren't struggling to stay in the black

No, I argue that the smaller researcher companies are struggling to stay in the black. I quote: "much of the cutting edge research that enables new treatments to be developed is subcontracted out to a clutch of really very small firms indeed such as Cyprotex, Biofocus and Tranxenogen. These firms struggle to remain solvent"

somehow a system that gives the lions share of the rewards to the multinational corporations that market the drugs is still the best for them?

Hence my proposed reform in the following paragraph. Feel free to read half my comment and misconstrue it before commenting on it though.
posted by dmt at 1:05 AM on June 16, 2003


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