Cancer
January 18, 2007 12:52 PM   Subscribe

Cheap, safe drug kills most cancers. That's the good news. The bad news is that because there's no patent and it's so cheap to make, researchers may not be able to get funding from the private sector for further research since the treatment wouldn't make a profit. [Via Hullabaloo.]
posted by homunculus (119 comments total) 12 users marked this as a favorite
 
And on the subject of cancer, Jane at Firedoglake has been diagnosed with breast cancer for the third time. She's in surgery today. Various bloggers are waiting to hear how she's doing and hoping for the best.
posted by homunculus at 12:55 PM on January 18, 2007


So we have a clear promise, but no money to research it further? Isn't this what philanthropists are for?
posted by Faint of Butt at 12:58 PM on January 18, 2007


Isn't this why we have a federal government?
posted by Astro Zombie at 12:59 PM on January 18, 2007


I always knew that your average pharmaceutical company wasn't exactly run by angels, but Jesus fucking Christ.
posted by WinnipegDragon at 1:00 PM on January 18, 2007


They will fund fifty different kinds of boner pills, though.
posted by mr_crash_davis at 1:02 PM on January 18, 2007 [1 favorite]


Why not? Providing for the common good is no longer part of its responsibilities?
posted by Astro Zombie at 1:04 PM on January 18, 2007 [2 favorites]


Jesus H. Christ on a pogo-stick shaped like the staff of Aesculapius! I had hoped that by the time this crap story made it to MeFi from the usual sources, the retarded conspiracy-theory laced editorial would have at least been stripped off. FYI, the NIH alone funds approximately $25billion for precisely this type of research, and there is no shortage of university researchers who are out there studying this type of thing. There are tons of chemicals that kill cancer cells in a dish, but rarely if ever do these pan out in live subjects. Why the New Scientist has decided to sensationalize this and add a trash spin is beyond me.
posted by drpynchon at 1:06 PM on January 18, 2007 [7 favorites]


I always knew that your average pharmaceutical company wasn't exactly run by angels, but Jesus fucking Christ.

What, you think that they should be throwing hundreds of millions of dollars away? You act as if big pharma is doing something unethical here, but their responsibility is to their shareholders.
posted by grouse at 1:07 PM on January 18, 2007


I always knew that your average pharmaceutical company wasn't exactly run by angels, but Jesus fucking Christ.

I know big pharma is a popular bogeyman, but can we really expect publically-traded companies to spend hundreds of millions of dollars funding the development of a product they can't sell? I'm with Astro Zombie on this one. And, on preview, drpynchon.
posted by Urban Hermit at 1:07 PM on January 18, 2007


And grouse. Didn't mean to leave you out - was too busy visualizing Christ the Saviour impaled on Asclepius' pogo stick. Or whatever that was.
posted by Urban Hermit at 1:10 PM on January 18, 2007


It's an approved drug; it can be used off-label. It's available to doctors now, without further human clinical trials.

Hell, it's such a simple chemical, you can go ahead and order it yourself.

That said, more research would be nice, and if this as promising as the researcher makes it out to be, I'm sure government funding will be forthcoming. But I don't think there's any need for the full $500 million approval process for a drug that's already been approved.
posted by mr_roboto at 1:10 PM on January 18, 2007


They can still patent time-released, buffered, coated and compounded formulations. They can even patent specific dosage schedules.

If its already approved for safety, the recomended dosages will start appearing on the internet, it will get prescribed "just in case" and over time the efficacy will be established through usage.
posted by StickyCarpet at 1:11 PM on January 18, 2007


Why the New Scientist has decided to sensationalize this and add a trash spin is beyond me.

I've made one attempt at trying to get people to realize how worthless New Scientist is. Its the New York Post of science magazines.
posted by vacapinta at 1:11 PM on January 18, 2007


"but their responsibility is to their shareholders."


Is anyone else sick of hearing this phrase?



I think "but their responsibility is to their shareholders" will be the 21st century's answer to the 20th's

"I vass chust followink orders!"
posted by stenseng at 1:12 PM on January 18, 2007 [4 favorites]


It's no wonder he can't secure the $400-600 million needed to conduct human trials with the medicine - the drug doesn't have the potential to make enough money.

It sounds like the only money to be made in this treatment is by the researcher. At $2 a dose, he's either making a nice income or he plans on testing it on the entire US population.

And I agree with drpynchon...its not like the scientists have been working pro bono up to this point. They've been funded, and if there is any potential in their ideas, they will continue to be funded.
posted by wabashbdw at 1:13 PM on January 18, 2007


Stenseng, I don't think you understand the point of owning stock in a company.

What you're looking for is a charity.
posted by wabashbdw at 1:16 PM on January 18, 2007


Well, it's a good thing the federal government spends billions on cancer research itself then!

Seriously, if it wasn't for the FDA people could market this drug immediately, that isn't to say the FDA isn't a good thing.

Still the federal government spends a lot of money researching cancer cures. And lots of things crop up that are capable of killing cancer cells in a petri dish. Things like this crop up all the time, and a lot of times they don't pan out, othertimes they might become part of a chemotherapy regimine.
posted by delmoi at 1:18 PM on January 18, 2007




You can't blame big pharma. Why would they invest in a sure fire money losing scheme? Explain that to your investors. This is where the NIH is supposed to step in.
posted by caddis at 1:20 PM on January 18, 2007


Seriously, who doesn't ignore any article with a headline that contains the phrase "Miracle Cancer Drug."
posted by Slarty Bartfast at 1:21 PM on January 18, 2007 [2 favorites]


It's an approved drug; it can be used off-label. It's available to doctors now, without further human clinical trials.

Okay, if that's the case why are we even having the discussion? Any doctor can prescribe this to a patent already. What are you all whining about?
posted by delmoi at 1:23 PM on January 18, 2007


"but their responsibility is to their shareholders."

What? none of their shareholders or any of their shareholders' loved ones have ever had cancer?
posted by saulgoodman at 1:24 PM on January 18, 2007


I think the real story here is why didn't the researchers seek patent protection for a new use for an old compound? Perhaps if they had then some pharm company would want to come along and fund the necessary studies in exchange for an exclusive license.
posted by caddis at 1:24 PM on January 18, 2007


delmoi writes "Okay, if that's the case why are we even having the discussion? Any doctor can prescribe this to a patent already. What are you all whining about?"

Well, I'm sure before doctors start prescribing it, they would like to know whether or not it, you know, works.
posted by mr_roboto at 1:24 PM on January 18, 2007


You can't blame big pharma. Why would they invest in a sure fire money losing scheme?

I can just see the Super Bowl ads now.

Pfizer: WE CURED CANCER.
posted by edverb at 1:25 PM on January 18, 2007 [2 favorites]


Hell, it's such a simple chemical, you can go ahead and order it yourself.

Since when do chemical companies sell to individuals? It would be cool if one could order, but these days one gets on a watch list ordering sodium chloride.
posted by rolypolyman at 1:25 PM on January 18, 2007


Well, I'm sure before doctors start prescribing it, they would like to know whether or not it, you know, works.

Have you been to a doctor lately?
posted by scottreynen at 1:26 PM on January 18, 2007


What? none of their shareholders or any of their shareholders' loved ones have ever had cancer?

Sure, but it's not their job to treat the shareholders' cancer. The officers and directors can't be sued for failing to treat the shareholders, just as you can't sue a doctor who isn't paying dividends on your visit fees.

But if the directors blatantly throw money away, their shareholders can sue them for not doing their job. Would you like it if you lost a big chunk of your retirement fund because the manager gave it to charity? If so, then you should just give the money to charity yourself.

Why would it be a particular pharmaceutical company's responsibility to research this drug? Why not Wal-Mart? Or General Motors?
posted by grouse at 1:30 PM on January 18, 2007


1. vapacinta is right: New Scientist is trash.

2. The post says:

"...because there's no patent and it's so cheap to make, researchers may not be able to get funding from the private sector for further research since the treatment wouldn't make a profit."

However, we don't know that at all. That's just the explanation the scientist gives, apparently in hopes of attracting high-minded philanthropists. (This kind of publicity will probably work well.) The big pharmaceutical companies aren't saintly, granted, but, as drpynchon mentioned, there have been a dozen 'cancer cures' over the years that didn't pan out; he's asking for 400-600 million dollars for testing, which is not small change. It's also handy to remember that the US government universities provide more funding for medical research than the pharmaceuticals anyhow.
posted by koeselitz at 1:31 PM on January 18, 2007


"US government and American universities" arg
posted by koeselitz at 1:32 PM on January 18, 2007


Stenseng, I don't think you understand the point of owning stock in a company.

What you're looking for is a charity.


Butting in for a minute--I think it's you who doesn't understand, wabashbdw. For many responsible investors, owning stock does in fact mean more than just waiting to rake in the profits. A great many investors want their money to be going to companies whose core mission and values they believe in--companies that behave with a solid sense of corporate responsibility. I'd argue corporations, consequently, have a whole set of non-fiduciary responsibilities to their shareholders in addition to revenue growth.
posted by saulgoodman at 1:32 PM on January 18, 2007 [1 favorite]


Well, I'm sure before doctors start prescribing it, they would like to know whether or not it, you know, works.
Have you been to a doctor lately?


Have you been to an oncologist lately?

Also, add my name to the chorus agreeing with vacapinta.
posted by grouse at 1:33 PM on January 18, 2007


Three words: Off Label Use

This doesn't require action from the Federal Government or a pharmaceutical company.

In fact, in a story with some pretty tight parallels to this, when my mother-in-law had acute leukemia she was involved in a clinical study. Her chemo agent? Near toxic doses of Vitamin A. And she's still with us today. I'm not sure how they funded this, but obviously someone, somewhere was willing to foot the bill.

That being said, I personally have filled up bio-waste tubs with millions of dollars worth of experimetnal medicines that were very effective en vitro. In vivo they were about the same as the current best treatment. Other companies have had even worse results with drugs that looked really good in the bioassay.

And if these guys and foil big pharma's plan to cure cancer, we can, much like Ernst Blofeld, skulk back to our secret lair and work on heart disease, or HIV, or diabetes! Bwahahahahaha!
posted by Kid Charlemagne at 1:34 PM on January 18, 2007


Vacapinta: I've made one attempt at trying to get people to realize how worthless New Scientist is. Its the New York Post of science magazines.

Yeah, well I excitedly sent it to a doctor who has a loved one six months to a year away from death due to colon cancer. And now I suppose he's going to see it's the NewScientist and not even read the damn thing and this chemical compound sounds hugely promising.

I guess the ad for The Dresden Files should've told me something. dammit.
posted by Skygazer at 1:35 PM on January 18, 2007


The officers and directors can't be sued for failing to treat the shareholders, just as you can't sue a doctor who isn't paying dividends on your visit fees.

Ahh--so we're talking legal responsibility, not moral responsibility here. Gotcha.
posted by saulgoodman at 1:35 PM on January 18, 2007


Expecting pharmaceutical companies to fund this is no different than expecting GM, GE, or Microsoft to fund it. It's not the business they're in.
The Cancer Society has more than enough money to fund the trials, and that's the sole reason they exist. Here's hoping they put themselves out of business with this one.
posted by rocket88 at 1:35 PM on January 18, 2007


caddis writes "I think the real story here is why didn't the researchers seek patent protection for a new use for an old compound?"

This is a good question. Lilly effectively extended their Prozac patent by renaming the drug "Sarafem" and filing a method of use patent for its use in treating PMS. As far as I know, that patent has resisted all challenges. Now, of course, doctors can prescribe generic fluoxetine to their patients for the treatment of PMS, but this generic cannot be labeled or marketed for this method of use. So a drug company could patent DCA as a cancer treatment, but this would not eliminate the existing generic formulations of the drug from the market, and doctors might prescribe these formulations off-label to treat cancer. In this sense, a method of use patent isn't nearly as powerful as a compound patent.

That's my understanding, at least.
posted by mr_roboto at 1:39 PM on January 18, 2007


Skygazer, here's the original article. The link will take you to an abstract unless you have ScienceDirect access (which I do). Of note, here is the more even-handed wording from the discussion section of the original article itself:

"Our work identifies the mitochondria-NFAT-Kv channel axis and PDK as critical components of the metabolic-electrical remodeling that characterizes many human cancers and offers a tantalizing suggestion that DCA may have selective anticancer efficacy in patients. The very recent report of the first randomized long-term clinical trial of oral DCA in children with congenital lactic acidosis (at doses similar to those used in our in vivo experiments) showing that DCA was well tolerated and safe (Stacpoole et al., 2006) suggests a potentially easy translation of our work to clinical oncology."
posted by drpynchon at 1:40 PM on January 18, 2007


400 million for trials??? No. No, no, no. You don't even have to go through the rigors of pre-clinical and phase 1 trials with this compound. That is an insane number. I was involved in the planning and execution of a trial a few years ago - about a thousand patients getting hip and knee replacements - total cost was $22 million or so (2000-2001 dollars).

I checked clinicaltrials.gov and there are no trials of dichloroacetate for cancer on the board at this time - several for lactic acidosis and related conditions though (eg, MELAS). These findings are brand spanking new, so it may take a few minutes to organize a proper phase 2 trial. Everyone please take a moment to return The Constant Gardener to NetFlix.
posted by Mister_A at 1:41 PM on January 18, 2007


You are correct mr roboto
posted by caddis at 1:41 PM on January 18, 2007


"Ahh--so we're talking legal responsibility, not moral responsibility here. Gotcha."

Exactly. This is what I'm talking about. There's no longer any sense of doing what is right, or decent, only what you can get away with, without being held legally liable, or being sued.

Is the god of the 21st century a great green eyeshade, and we're all just accounts in a ledger, or files in a database? Is that really what we want from ourselves and eachother? Since when is serving shareholders of greater value than serving humanity?
posted by stenseng at 1:42 PM on January 18, 2007


hips and knees are cheap next to drugs

by the way saulgoodman how much money are you going to donate to these trials?
posted by caddis at 1:44 PM on January 18, 2007


"I've made one attempt at trying to get people to realize how worthless New Scientist is. Its the New York Post of science magazines."

yay vacapinta!

I am not even a scientist and I realized this after 2 free issues. That mag is a joke.
posted by vronsky at 1:46 PM on January 18, 2007


I hope you are joking about the hips and knees there caddis. To clarify, the patients were having total hip or knee arthoplasty (very expensive and dangerous surgery) - but this WAS a drug trial. More than this I can not reveal.
posted by Mister_A at 1:46 PM on January 18, 2007


A great many investors want their money to be going to companies whose core mission and values they believe in--companies that behave with a solid sense of corporate responsibility.

I'm a totally commie usually, but this is retarded. A great many companies can coast on their mission since they make money by being socially responsible. For example, there's mounting evidence that buying carbon credits (in the form of evergreen trees, etc) doesn't work, but the companies that sell them still make out as if they are doing good, when really they are making a whole lot of money planting evergreen trees.

Here's an analogy. Imagine someone says, "We need a bridge over the Sunshine River. It will cost $20 million dollars to build. After it is built, anyone will be able to drive over it and whoever makes it will not get a single cent out of constructing it." Would you want to be the construction company building that bridge?

No, which is exactly why it is that non-profits, charities, and government research funding exists.

Oh, and apparently cancer cures are like mousetraps. There are thousands of solutions out there. I once dated a cancer researcher; she had discovered a way to use microbubbles and ultrasound as a delivery system to send viruses or medicine to a specific part of the body. A friend of her was working on a virus that killed only cancer cells but not healthy cells. I'm not a scientist but it seems to me like once you take cancer cells outside of the human body they start dropping like flies.
posted by Deathalicious at 1:46 PM on January 18, 2007


Hold on; it's no longer clear to me that this is a currently approved drug. When the article said it's been "used for years" to treat metabolic disorders, I assumed so. It seems now, however, that this phrase might be referring to current clinical trials.
posted by mr_roboto at 1:47 PM on January 18, 2007


mr_roboto, a search of the orange book shows no results for dichloroacetate.
posted by Mister_A at 1:52 PM on January 18, 2007


Score another one for the New Scientist! Fucking hacks.
posted by Mister_A at 1:52 PM on January 18, 2007


Original orphan drug research grant for DCA.

Someone should show the internet to those New Scientist writers and editors.
posted by Mister_A at 1:55 PM on January 18, 2007


There's no longer any sense of doing what is right, or decent

There's nothing right or decent about throwing away money that has been entrusted to you.

Since when is serving shareholders of greater value than serving humanity?

That is a fallacious comparison. If you want to serve humanity, don't invest your money in a publicly held stock.

This is all easy for you to say, because it is other people's money you are talking about. But it is real money owned by real people, as real as the money in your bank account. Would you be happy if the bank said, "hey, we're going to take some of your money, but it's okay because some guys on an internet message board said we should give it to charity."

I don't know; maybe it would be okay with you. But I guarantee you it wouldn't be what most people who invested their money there would want. They'd want to decide where and how much money to give to charity on their own. They might need some of that money to live
posted by grouse at 1:56 PM on January 18, 2007 [1 favorite]


The top 3 most generous corporations are pharmaceutical companies. Pfizer tops the list at $1.2B, or 21% of income. More info here.
posted by rocket88 at 1:58 PM on January 18, 2007


I had hoped that by the time this crap story made it to MeFi from the usual sources, the retarded conspiracy-theory laced editorial would have at least been stripped off.

What conspiracy-theory? All I said in the FPP, as per the articles, is that corporations will probably be reluctant to invest in this if they can't make a profit. That's hardly a conspiracy-theory; that's just business as usual. It goes without saying that the NIH and the Cancer Society are going to pursue it if it has merit. I guess I should have pointed that out in the FPP.

But if there's simply no substance to DCA, and I got suckered by New Scientist's sensationalism, well then sorry about that. Grumble.
posted by homunculus at 1:59 PM on January 18, 2007 [3 favorites]


A great many investors want their money to be going to companies whose core mission and values they believe in--companies that behave with a solid sense of corporate responsibility.

Such investors would do a lot better giving their money to a charity that will spend it on their chosen mission, rather than invest it in a corporation that gives a token greenwashing nod to social responsibility.

Seriously, corporations have no social responsibilities beyond obeying the law. That's just not what they're for. It's like asking the police to run an ambulance service - certainly a worthy activity, but done much better by someone else.

The corporation is a machine designed to increase shareholder value within the law. If you don't like that, change the law. But don't futz with the machine.
posted by hoverboards don't work on water at 2:05 PM on January 18, 2007


homunculus, the DCA story is plenty interesting - thank you for bringing it to my attention. It's just unfortunate that the popular press stories you've linked have a slightly hysterical crackpot tone. After all, the study in question was just published in January; it is a bit ridicuous to bitch and moan about lack of funding at this point, before anyone has had a chance to write a proposal to do human trials. Know what I mean?
posted by Mister_A at 2:09 PM on January 18, 2007


The top 3 most generous corporations are pharmaceutical companies.

Only if you include drugs they give away, and who knows how they value those giveaways. And they surely some of the drugs they give away end up improving their bottom line by acting as advertising for the drug. Same with Microsoft, which is only on the list because of software they give away to schools, for example, producing a new generation of people trained on Microsoft products, thereby increasing future revenue.

The first list on that page includes cash donations only, which is probably a better indicator of generosity.
posted by grouse at 2:10 PM on January 18, 2007


So I buy some. Do I drink it or inject it?
posted by A189Nut at 2:20 PM on January 18, 2007


As a pediatric oncologist and translational researcher, may I add my $0.02? drpynchon had it right when he said that many compounds can kill cells in a dish. And that may be the case for DCA. The medical literature is rife with reports of compounds that decrease proliferation, and/or increase apoptosis (programmed cell death) in vitro. Most of these drugs never get through clinical trials (either too toxic, don't work in mice or humans, etc.).

What I believe made the current paper of such interest (and please note that getting a paper into Cancer Cell is no small feat - it's one of the top peer-reviewed basic science journals) has as much to do with the novel proposed mechanism - a shift in metabolic pathways from gycolysis to glucose oxidation - as it does with the fact that this DCA is not a traditional cytotoxic chemotherapeutic. I think that this group made an interesting finding and identified a potentially new target, namely the mitochondrial enzyme pyruvate dehydrogenase kinase (PDK2).

That being said, this report is a looong way from clinical use:

Mr_Roboto: It's an approved drug; it can be used off-label. It's available to doctors now, without further human clinical trials.

While this is true, physicians who use drugs off-label bear the responsibility for the drug's success/failure. If you search MEDLINE for clinical trials of DCA in malignancy you'll find none. Zip. Zilch. So if you're a doctor who chooses to give this compound (at what dose? at what schedule?) instead of the standard-of-care therapy to your colon cancer patient and that patient's disease progresses, you will bear moral and legal responsiblity. No right-thinking physician would just order a bottle of this from Sigma-Aldrich and start giving it out. And no right-thinking patient with treatable disease should go this route at this time.

As for clinical trials:

Mister_A: I checked clinicaltrials.gov and there are no trials of dichloroacetate for cancer on the board at this time - several for lactic acidosis and related conditions though (eg, MELAS). These findings are brand spanking new, so it may take a few minutes to organize a proper phase 2 trial.

Actually, I'd bet that there'd have to be extensive pre-clinical trials in animal models of human cancer first. And don't forget phase I trials to establish the MTD (mean toxic dose). The dose of drug necessary to treat metabolic disorders may not be the same as the dose necessary to treat a malignancy, and if the dose needed to kill a tumor is higher than the toxic threshhold, then you'd probably want to know that before moving on to larger phase 2 (efficacy) trials.
posted by scblackman at 2:20 PM on January 18, 2007 [13 favorites]


The corporation is a machine designed to increase shareholder value within the law. If you don't like that, change the law. But don't futz with the machine.

Actually, some people have tried to change the laws. But other people keep finding ways to violate the spirit of the laws without violating the letter of those laws. In fact, I've seen it argued persuasively that the modern corporate legal entity was created specifically for that purpose--to get around antitrust law.
posted by saulgoodman at 2:22 PM on January 18, 2007


What? none of their shareholders or any of their shareholders' loved ones have ever had cancer? -- saulgoodman

Most likely, but I’m sure you would find similar cancer rates for shareholders of other types of stock. Why does it matter what the company does?

Exactly. This is what I'm talking about. There's no longer any sense of doing what is right, or decent, only what you can get away with, without being held legally liable, or being sued. -- stenseng

I don't understand what you're getting at though. I mean why should the pharmaceutical companies spend money to research this, any more then any other company should? Why is it more important that Pfizer research this then Ford or Google or ADM or Citi Bank. Why are you criticizing one particular class of corporation for inaction, rather then all corporations?

Also, to those of you complaining, how much money have you donated to cancer research?

Since when do chemical companies sell to individuals? --rolypolyman

Since forever?

The top 3 most generous corporations are pharmaceutical companies. Pfizer tops the list at $1.2B, or 21% of income. More info here.

That's due to an insurance scam where they "donate" money for poor people to buy their drugs at a reduced rate and refund their deductible. The money goes right back into their pockets, and they get a tax break at the same time!
posted by delmoi at 2:31 PM on January 18, 2007 [1 favorite]


Thank you DrPynchon. I'll forward that.
posted by Skygazer at 2:32 PM on January 18, 2007



by the way saulgoodman how much money are you going to donate to these trials?

since I sat at my mother's bedside and watched her die of liver cancer a couple of years ago, and since I was a two-pack a day smoker myself for more than 15 years, yeah, if there's promise, I just might donate money to these trials. And if i owned stock in a pharmaceutical, I'd damn well expect them to put some money into it to, if they occupied some crucial position in the market. If corporations are entitled to the benefits of being treated as "people" under the law, then they should be held to the same ethical standards and civic responsibilities as people are. When we allow the most powerful actors in our society to operate without the slightest trace of morally responsibility, how can we pretend to be surprised when the weakest actors act without a sense of moral responsibility? The modern corporation, like it or not, is a civic leader--and civic leaders have to be held to a high moral standard.
posted by saulgoodman at 2:34 PM on January 18, 2007 [3 favorites]


hips and knees are cheap next to drugs

Uh Caddis, I haven't gone out pricing operations in what I'd call a thorough way, but using examples for similar indications, I have heard that bypass surgery is about $50,000 from a family member and have found $75,000 on a blog out there. According to a web page titled, "Lipitor is Expensive" the price listed is $110 per month for the highest dosage.

Assuming these numbers are correct, you can be on Lipitor for 38 to 57 years before you've spent as much as you would on a bypass. With no extended recovery period, no giant scar, and no remodeling of the heart.

How are you figuring any kind of surgery is cheap? DIY?
posted by Kid Charlemagne at 2:40 PM on January 18, 2007


If corporations are entitled to the benefits of being treated as "people" under the law, then they should be held to the same ethical standards and civic responsibilities as people are.

But what are you talking about? People are not forced to pay for medical research, other then what is paid for with tax money. so why should a company with a "some crucial position in the market" have to pay for research into this drug? What does that even mean. A promising new cure for cancer crops up like every six months, and they are researched either by corporations or the government.
posted by delmoi at 2:40 PM on January 18, 2007


Well said scblackman.
posted by Mister_A at 2:41 PM on January 18, 2007


Kid Charlemagne - is that out of pocket cost or total cost?
posted by Mister_A at 2:42 PM on January 18, 2007


FOr the lipitor I mean...

*retires*
posted by Mister_A at 2:42 PM on January 18, 2007


rolypolyman writes "Since when do chemical companies sell to individuals? It would be cool if one could order, but these days one gets on a watch list ordering sodium chloride."

Heh. I suppose it is surprising, but there are plenty of (legal, easy) ways for an individual to get a hold of research chemicals. sciencelab.com looks like a good source, but I've never used them. And I don't know about watch lists...
posted by mr_roboto at 2:48 PM on January 18, 2007


But what are you talking about? People are not forced to pay for medical research, other then what is paid for with tax money. so why should a company with a "some crucial position in the market" have to pay for research into this drug?

You just blurred two different concepts into one with the turn of phrase "why should a company... have to pay". I tried to make it clear I was talking about the moral responsibility (not the legal responsibility) of a corporate entity here. Just because something is a moral imperative doesn't mean it should be legislated. I never said that. If the volitional behaviors of individuals can be judged in terms of their morality or immorality without regard to their legality, why shouldn't the volitional behaviors of corporations be judged in the same way?
posted by saulgoodman at 2:54 PM on January 18, 2007


saulgoodman writes "You just blurred two different concepts into one with the turn of phrase 'why should a company... have to pay'. I tried to make it clear I was talking about the moral responsibility (not the legal responsibility) of a corporate entity here. Just because something is a moral imperative doesn't mean it should be legislated. I never said that. If the volitional behaviors of individuals can be judged in terms of their morality or immorality without regard to their legality, why shouldn't the volitional behaviors of corporations be judged in the same way?"

Are you arguing that everyone is morally obligated to donate money to drug trials? How isn't this handled through taxation to fund agencies that in turn fund medical research? If it isn't handled through taxation, I guess I'm an immoral person, since I've never donated to fund a drug trial. Or is it only this specific (hypothetical) trial that brings with it a moral obligation?
posted by mr_roboto at 3:02 PM on January 18, 2007


In order to lower substantially costs for patented drugs to be used in poor countries, some companies in Europe found a simple solution: change a few molecules around so that it is essentially the same drug but can now be claimed to be unpatented. This is already being done.

I am sure that if no US company is willing to develop this potential life saver, some foreign country will.
posted by Postroad at 3:08 PM on January 18, 2007


That's due to an insurance scam where they "donate" money for poor people to buy their drugs at a reduced rate and refund their deductible. The money goes right back into their pockets, and they get a tax break at the same time!

So what you're saying is that the money is just a distraction and at the end of the day Pfizer is really giving drugs away or selling them on the cheap to poor people who are ill. Those BASTARDS!

How do I sign up to be defrauded like this?

(In all fairness, I work for Pfizer. That being said, the reason it's money that they hand out instead of just handing out drugs is that we probably can't legally do it.)
posted by Kid Charlemagne at 3:11 PM on January 18, 2007


Amazingly left wing blog this.

Dude argues that a corporation (which has the expertise and background) that could profit by selling a safe drug at a less than premium price (and cure cancer!) if it did some research is castigated on the so-called liberal blog Metafilter.com

I really hope that some philanthropist, government or pharma, picks up on this. It doesn't matter what their nationality is. It needs to be done though.
posted by dash_slot- at 3:27 PM on January 18, 2007


I really hope that some philanthropist, government or pharma, picks up on this.

The research team (or most of it) is located down the street from me at the University of Alberta in Edmonton (Canada). As for funding, our outgoing premier a few months ago announced a billion dollars (Canadian) of provincial money was to be earmarked for "cancer research" (no specifics at the time). Sounds like this is exactly the sort of thing that might attract some of that cash.
posted by hangashore at 3:41 PM on January 18, 2007


Are you arguing that everyone is morally obligated to donate money to drug trials?

No, but anyone in a unique position to help out (as in a record-profit making Pharmaceutical company might be) would be. It's long been an accepted rule of polite society that a guy standing on a bridge with a rope is morally obligated to at least try to throw it down to the guy drowning in the water, even if he doesn't know them. A similar moral principle might apply in this case.

And, going back to the old trope about a corporations only responsibility being serving the interests of its shareholders: If that's so, shouldn't any extra profits a corporation earns that aren't specifically set aside for infrastructure and other growth related investments, be returned to the shareholders be returned to them in the form of dividends, rather than used to boost executive benefits and salaries? The truth is, corporations don't serve the shareholders interests anymore: They serve the interests of market speculators who stand to make money off of the sale or purchase of the stock. The holder of a stock only sees any real return when they divest themselves of their holdings--in other words, corporations now primarily serve the interests of market speculators, not shareholders.
posted by saulgoodman at 3:45 PM on January 18, 2007 [1 favorite]


drpynchon and others have dismissed this because it "kills cells in a dish" but the NS article states early that Tumours in rats deliberately infected with human cancer also shrank drastically when they were fed DCA-laced water for several weeks.

Sure, a doctor has no guide on a dosage for using it for cancer, but it's not true to say it just kills cells in a dish.
posted by Listener at 4:03 PM on January 18, 2007


More on this story, updated today, by the Economist.
- Fingers crossed.
posted by grahamwell at 4:34 PM on January 18, 2007


Kid, my point was that clinical trials necessary for clinical approval are cheap for orthopedic devices compared to pharmaceuticals, even for Class III implantable devices. Someone cited $22 million as a cost for a clinical trial. No way a cancer drug is getting approved for that, more like hundreds of millions.
posted by caddis at 5:09 PM on January 18, 2007


saulgoodman, your initial comments suggested that a pharm company not taking on the multi-hundred million dollar burden to get approval for a drug in which they could never recoup their costs was was immoral. Now you just seem to be suggesting that they devote some money. Which is it? Also, why this? Why not some other worthy cause?
posted by caddis at 5:12 PM on January 18, 2007


Postroad - I am sure that if no US company is willing to develop this potential life saver, some foreign country will.

From the article that drpynchon pointed to, it appears that the research group are Canadians.
posted by porpoise at 5:26 PM on January 18, 2007


So what you're saying is that the money is just a distraction and at the end of the day Pfizer is really giving drugs away or selling them on the cheap to poor people who are ill. Those BASTARDS!

"donation" that goes right back into your pocket is not the same thing as an actual donation.

(In all fairness, I work for Pfizer. That being said, the reason it's money that they hand out instead of just handing out drugs is that we probably can't legally do it.)

What could possibly be illegal about donating a drug? What law could possibly be violated?

Meanwhile insurance companies (hardly paragons of virtue themselves) have to do co-pays equivalent to to the full price of the drug.

The point is, calling Pfizer the "most charitable corporation" is ridiculous.
posted by delmoi at 5:41 PM on January 18, 2007


No, but anyone in a unique position to help out (as in a record-profit making Pharmaceutical company might be) would be.

I still don't understand why the word "Pharmaceutical" is in that sentace. Why does a pharmaceutical company have more moral responsibility to fund cancer research then any other company? Why shouldn't they donate their money to help the poor in Africa, where it could do a lot more good per capita?

Also why should they fund this research above all other cancer research? I mean lots of promising cures for cancer come out all the time, this is hardly unique its promise. In fact, this is the second "Cancer breakthrough" story on meta filter this month. Cancer research involves funding lots and lots of studies and avenues, not just one like a bunch of 5 year olds playing soccer.
posted by delmoi at 5:47 PM on January 18, 2007


And yes, this does more then kill cancer in a dish, it kills it in rats. This could be a much bigger breakthrough then many.
posted by delmoi at 5:47 PM on January 18, 2007


OK, my misunderstanding. I though you were talking about on a per case to the consumer basis.

One assumes that this would require a truncated study as it is already supposed to be a drug, so process development costs, reg tox and phase 1 would be eliminated, but yeah, depending on how many different indications you wanted on your label at launch, a hundred million might do it. And of course somebody somewhere will insist that you redo some portion of the stuff they previously accepted.

I'd love to see a thorough untangling of the intelectual properties issues surrounding this whole thing (which is not my forte). Who had the patent, when did it expire, what has been approved for when and where, and is there really no way to use IP law to recoup your costs on this.

Also, has anybody repeated this guys work?
posted by Kid Charlemagne at 5:50 PM on January 18, 2007


the so-called liberal blog Metafilter.com

Um.

MeFi is LGF with better manners. Marginally better manners.
posted by Wataki at 5:58 PM on January 18, 2007


Well. Much better manners. But seriously, is it supposed to be liberal?
posted by Wataki at 6:06 PM on January 18, 2007


is there really no way to use IP law to recoup your costs on this

Well, the results do seem freshly published. Although such disclosure, with some very specific exceptions, will prevent you from obtaining a patent in most of the world, in the United States you have a one year grace period from the date of your first public disclosure in which to file a patent. Since the compound is old, they can not patent that. However, this new use (a method for treatment of cancer) is potentially patentable, depending upon what else might have been published in this area in the past. One would have to assume that if they could have patented it they would have; it's the best way to ensure that you can get funding and frankly most universities share royalties quite liberally with professors.

If the drug is really the wonder drug (doubtful, how many times have we heard this story before) then the public would benefit most from the NIH funding the clinical trials. Prove safety and efficacy and then let some generic drug manufacturers sell the stuff. They will all compete with each other and it will be cheap. Yes, the NIH will have to spend mucho moola to do the study, but if it works the government will make it back in spades through reduced payouts in government sponsored health plans etc.
posted by caddis at 6:08 PM on January 18, 2007


The idea that one drug company with a team of researchers would do a better or faster job than all the government funded researchers in the world, unfettered by a patent, is absurd. Those governments are paying for cancer treatment right now and have incentive to offer funds.
posted by Brian B. at 6:10 PM on January 18, 2007


well, it's blue
posted by tehloki at 6:21 PM on January 18, 2007


saulgoodman, your initial comments suggested that a pharm company not taking on the multi-hundred million dollar burden to get approval for a drug in which they could never recoup their costs was was immoral.

I don't think I said all that. All I meant to say is that a company that develops a cure for cancer is serving the interests of its shareholders, whether the eventual return to the shareholders is in the form of a monetary gain or in the form of the economic benefits associated with not having to pay hospital bills and medical costs for themselves or loved ones who might be stricken with cancer. IMO, it's tunnel vision (and borderline insanity) not to count something as clearly intrinsically valuable as an accessible cure for cancer as a return on an investment in its own right. Now, if you want to be petty about it, you could argue, well, in that case, only the shareholders should benefit--or they should get preferential treatment or something--but it doesn't have to be a zero sum game.

Money is an abstract representation of the market value of tangible goods and services, not something with intrinsic value. Treating money as if it had intrinsic value--seeing wealth accumulation as an end in itself--just seems like a really glaring conceptual error to me. Sort of like seeing the word 'Apple' printed on a piece of paper and thinking it actually is an apple, and then trying to eat the piece of paper.

That said, it's obviously also a kind of thinking that serves some people's interests really well.
posted by saulgoodman at 6:26 PM on January 18, 2007


Here's the home university's web piece on it from a couple of days ago. Nothing you haven't read already, except for maybe this bit:
Michelakis' research is currently funded by the CIHR, the Canada Foundation for Innovation, the Canada Research Chairs program and the Alberta Heritage Foundation for Medical Research.
(where CIHR = Canadian Institutes of Health Research.) No NIH or American pharma industry funding there. Being located in a province that seems to be swimming in budget surpluses lately and is showing a new enthusiasm for cancer research should keep the researchers in cash if the results continue to be promising.
posted by hangashore at 6:44 PM on January 18, 2007


Thanks so much homunculus for this post. As I've mentioned here in MF before, I have late stage uterine cancer and stage 1 fallopian cancer. Naturally, innovations in treating cancer are of interest to me.

I waited all afternoon to read the comments in this thread, hoping there would be an intelligent, informed discussion and I was not disappointed. Thank you all and especially scblackman for your educated thoughts on the matter.

Whatever happens with dichloroacetate, it's heartening to read in the Economist article that Dr Michelakis's study seems to be going in a constructive direction.

Other articles on the topic.

Michelakis's research is currently funded by the CIHR, the Canada Foundation for Innovation, the Canada Research Chairs program, and the Alberta Heritage Foundation for Medical Research.

Dr. E. Michelakis can be reached through his assistant, Linda Webster, at 780-407-3285 or directly by e-mail at emichela@cha.ab.ca.
posted by nickyskye at 6:46 PM on January 18, 2007 [1 favorite]


*should have previewed, lol.
posted by nickyskye at 6:47 PM on January 18, 2007


"donation" that goes right back into your pocket is not the same thing as an actual donation.

Say you sold cars and you gave me $20,000 that I could only spend at your car lot. So I take the $20,000 and find a nice 2002 Volvo XC that you want $22,000 for. I hand you your $20,000 (right back into your pocket) plus $2000 more of my own money and drive of in the Volvo. Maybe I'm really naive, but despite the fact that you had $2000 more than when you started out, I think I'd feel like I just got a hell of a donation.

What could possibly be illegal about donating a drug? What law could possibly be violated?

I don't know all the ramifications, but when you get right down to it I have a vague remembrance of the Schrödinger wave equation and a pharmacist has a certificate with gothic lettering. He can sell drugs and I can't. Well, I could. Hell, I could do it on the corner by the grade school. I just don't think I'd get to do it for long. Who actually puts your pills in a bottle and hands them to you matters to someone out there.

Also, there's the issue of convienence. If you can just go to the local drug store it's a lot easier than mailing your perscription somewhere and when waiting a couple days for your drugs to show up.

Meanwhile insurance companies (hardly paragons of virtue themselves) have to do co-pays equivalent to the full price of the drug.

I think the idea is to help people in need (most of whom probably don't have much in the way of insurance). Cutting the price the insurance company pays doesn't do much for the people and, given a finite amount of money to throw into the program I would tend to discount the price that more of the people pay. I suspect they don't get a lot of requests from impoverished insurance companies.
posted by Kid Charlemagne at 6:53 PM on January 18, 2007


Update on Jane Hamsher.
posted by homunculus at 7:27 PM on January 18, 2007


If the researches had been smart they could have filed for a business method patent (using this existing drug as a cancer treatment). It could have funded further r&d and allowed the investors to recoup their investments in marketing and promoting the treatment (the real cost of drug development). Of course the moment someone does this we'll see all kinds of internet outrage.
posted by humanfont at 7:46 PM on January 18, 2007


Our society's job one is not political freedom or religious freedom. It is the freedom to pursue profits (even politicians and religious leaders know that). It should therefore come as no surprise to anyone that anything that diminishes the power base's ability to fully pursue profits will be made illegal (see pot) and labeled as evil (see socialism). I'm just saying.
posted by a_day_late at 7:49 PM on January 18, 2007


A non-patented drug with limited proof of effectiveness, off-label on the chance that it does work? Clearly, the NIH will study this, along with any number of universities, and hospitals will have access without problem if and when it proves effecacious. This isn't the purview of big pharma.

On the other hand, let there be no mistake of how evil big pharma is, and how purely bullshit a lot of the justifications for them have been.

Wal-Mart, Microsoft and Sony aren't responsible for funding this sort of research, but they don't lobby for tax credits and write-offs to keep as much gov't health funding in their pockets as possible, and out of the hands of non-profits and the NIH. Merck and Pfizer and all the others are publicly held corporations, beholden to their stockholders, for sure, but under this same guise they wreck the alternatives for better leverage. The public and private sectors don't have a concrete wall between them, and anyone who tries to justify the actions of corporations who decide that their own fortune is more important than the health of their consumers is clearly being dishonest.
posted by Navelgazer at 8:17 PM on January 18, 2007


If the researches had been smart they could have filed for a business method patent (using this existing drug as a cancer treatment).

The researchers may have possibly, um, found a cure for cancer. I think this puts them at least on the same page as 'smart.'

It could have funded further r&d

Right now this province is hip-deep in government budget surpluses, so the funding stream is probably safe for now.

and allowed the investors to recoup their investments in marketing and promoting the treatment (the real cost of drug development).

"CHEAP CURE FOR CANCER**" wouldn't need an advertising campaign.

**speaking hypothetically, of course.
posted by hangashore at 8:24 PM on January 18, 2007


So it kills cancer cells in vitro, big shoop. And it's shown efficacy in xenografts in rats, again not exactly huge news. I've worked with a number of compounds which have done the same, some probably did even more than that, and yet they failed clinical trials (note: I've also worked with some compounds that are doing great in clinical trials and which I fully expect to succeed). Thinking that this makes it a 'cure for cancer' is just silly (a single cure for all cancer types is unlikely anyway, physiological targeting probably has the widest application and even that's limited).

The new mechanism shown by this drug, now that's interesting. That's an avenue for further research and will probly yeild patents and new compounds. And there are plenty of options for funding non-patentable drugs, this will be picked up if it fulfils it's potential. It looks like it has the right kind of funding so far, this beat up is designed to get more. There are also thousands of other non-patentable compounds that are equally as promising, should big pharma be trying to test all of them?

As for the rest, scblackman already said it very well. That's the comment you should read, not the trashy spin from New Scientist and their ilk.
posted by shelleycat at 8:44 PM on January 18, 2007


big shoop

That should be big whoop. I really should give up for the day.
posted by shelleycat at 8:46 PM on January 18, 2007


If the researches had been smart they could have filed for a business method patent (using this existing drug as a cancer treatment).

Really?
posted by Brian B. at 8:58 PM on January 18, 2007


Our society's job one is not political freedom or religious freedom. It is the freedom to pursue profits (even politicians and religious leaders know that).

I took the liberty in adding the phrase to the preamble:

We the People of the United States, in order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, to pursue profits, and secure the Blessings of Liberty, to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.
posted by Brian B. at 9:09 PM on January 18, 2007


Yeah, from what I understand, the patenting of a new use for an existing drug is problematic. How could a huge price tag for a cancer drug be justified (or even enforced), when the same drug is available cheaply for other disorders?

Sent the news links to the cancer researcher down the hall. His comment was:
If there's no IP attached to something, it'll never be used in patients. That's why, these days, it is a big mistake NOT to patent something you think might be useful. If you disclose it to the public domain, no-one will profit from it so no-one will put up the cash to get it through the approval process (needs about $100 million per drug). That's the capitalist system for you.

It's already common practice for the IP on a treatment to be bought and buried by drug companies. So have no doubts that there are plenty of potentially better therapies for a lot of disorders out there that will never see the light of day. This is just another one to add to the list.
posted by kisch mokusch at 9:16 PM on January 18, 2007


You act as if big pharma is doing something unethical here, but their responsibility is to their shareholders.

and yet, when something goes wrong, and it often does, it's the executives running the company who get the gold and the shareholders who get the shaft

funny how that works, isn't it?

if all these corporations are responsible to their shareholders why is it that from about 1990 the price to earnings ratio of stock has been so high? ... wouldn't it be more in the shareholder's interest if they were low? ... or doesn't it matter because buying stock is a form of legalized gambling and the shareholders are the bettors in the world's biggest casino?

and if that's so, since when is a casino's fiscal responsibility to its bettors?

conclusion - the next time a company says it has a responsibility to its shareholders, the shareholders better watch out
posted by pyramid termite at 9:29 PM on January 18, 2007


The Corporation
posted by homunculus at 9:52 PM on January 18, 2007 [1 favorite]




Thanks for The Corporation GoogleVideo link homunculus. What an excellent movie that is.
posted by nickyskye at 1:59 AM on January 19, 2007


I don't get it.

Isn't this precisely why we have universities? If this is really a miracle drug, I'm sure thousands of new research lab students are going to want to experiment around with it for their PhD, since naturally anyone who ends up finding the right dosage and administration method to treat something like Lung Cancer is going to win a Nobel Prize.

Which looks great on resumes.
posted by Civil_Disobedient at 3:21 AM on January 19, 2007


If the researches had been smart they could have filed for a business method patent (using this existing drug as a cancer treatment).

Really?


Yup, that would just be a regular old method patent, not one of those newfangled, patent 2.0, business method patents.
posted by caddis at 4:43 AM on January 19, 2007


When I first saw this story, I immediately discounted it simply because the source was New Scientist. What a bunch of useless hacks.
posted by Coventry at 4:54 AM on January 19, 2007


I don't have a dog in this fight, but...

Say you sold cars and you gave me $20,000 that I could only spend at your car lot. So I take the $20,000 and find a nice 2002 Volvo XC that you want $22,000 for. I hand you your $20,000 (right back into your pocket) plus $2000 more of my own money and drive of in the Volvo. Maybe I'm really naive, but despite the fact that you had $2000 more than when you started out, I think I'd feel like I just got a hell of a donation.

You may have, but the crux of the argument (at least for those of us not on an irrational bender) is whether handing you $20,000 so you can immediately turn around and hand back $22,000 to compensate me for a car that actually cost me $16,500 is counted as my giving you $20,000 or $14,500.

Certainly either is generous and counts for something, but I do think it's reasonable to say that the above situation should not be qualified as an act with equivalent generosity to giving a charity $20,000 to spend however they need/choose.
posted by phearlez at 7:48 AM on January 19, 2007


Another update on Jane Hamsher.
posted by homunculus at 5:35 PM on January 19, 2007


if all these corporations are responsible to their shareholders why is it that from about 1990 the price to earnings ratio of stock has been so high? ... wouldn't it be more in the shareholder's interest if they were low? ... or doesn't it matter because buying stock is a form of legalized gambling and the shareholders are the bettors in the world's biggest casino?

The corporations don't set the stock prices. Markets do that. And one reason that P/Es are historically high is that interest rates are so low, and that's (for the most part) where the denominator in a DCF comes from.

Making a passing acquaintance with Freshman-level finance-- should you ever choose to try to understand what you deride so inanely-- would clear this up for you.
posted by Kwantsar at 9:40 PM on January 19, 2007


And, Kid Charlemagne, while I have quite a bit of sympathy for the pharmas, I'm not sure your argument holds, unless this generous dealer had a magical machine that enabled him to produce Volvos at a marginal cost of pennies per unit.
posted by Kwantsar at 9:43 PM on January 19, 2007


I take the $20,000 and find a nice 2002 Volvo XC that you want $22,000 for. I hand you your $20,000 (right back into your pocket) plus $2000 more of my own money and drive of in the Volvo. Maybe I'm really naive, but despite the fact that you had $2000 more than when you started out, I think I'd feel like I just got a hell of a donation.

You would, but cars don't cost 10¢ to make.

I'm not saying it's not good for the consumer, it is. But if the drug companies just offered straight up discounts, they would not be considered "donations" at all.
posted by delmoi at 9:26 AM on January 20, 2007






bahaha

"Sanctity of Human Life"

more like "Sanctity of the life of the foetus, the president, and the adult white upper-class republican male."

foetus? he thinks you should be protected at all costs.

president? he thinks he can do whatever he wants. after all, he's the decider.

adult white upper-class republican male? You've got every right you could possibly conceive of with that brain of yours, especially the right to low taxes and upper-class-white-republican neighbours.

everybody else? sorry, but your rights to habeas corpus, freedom from unreasonable search and seizure, freedom of assembly, freedom of speech, freedom of the press, freedom of and freedom from religion, and pretty much everything else in the constitution are looking mighty outdated to this administration.
Oh, except the right to bear arms. Can't take away them guns; them's votes.
posted by tehloki at 11:14 PM on January 25, 2007


Oh, and I just used the leading article of this post for a Biology critique. Huzzah, metacollege.
posted by tehloki at 11:15 PM on January 25, 2007


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