Nah, Vy, we're NOT good. :lol: Stand up for your beliefs. Occam:zip: Thanks buddy. I used to think this smiley was a smiley chomping on a cigar!! :zip: I'm sorry Lois if my reply seemed snippy. I just don't want to get sucked into the pharma debate.
As an old-school liberal, I'm a fan of stricter regulation of the industry, transparency (such as the work being done at the All Trials] project), more government-funded research in place of industry funding, and laws against fraudulent marketing of quackery. But since Reagan, that ain't gonna happen. Any other ideas?I'm fresh out. Unless we can buy a few members of congress.
Big Pharma makes a lot of money, does a lot of unethical stuff, and produces medications that have saved and improved the lives of billions of people. Easy to hate, but life is never that simple. The question isn't whether or not the system is deeply flawed, because we all know it is. The question is what do we do about it? The woo-woo answer, of course, is to chuck modern medicine in favor of "ancient wisdom" and recent bullshit with an "ancient wisdom" flavor to it. That's where blindly demonizing Big Pharma leads some folks. But this mostly isn't that crowd. As an old-school liberal, I'm a fan of stricter regulation of the industry, transparency (such as the work being done at the All Trials] project), more government-funded research in place of industry funding, and laws against fraudulent marketing of quackery. But since Reagan, that ain't gonna happen. Any other ideas?First you have to show exactly what big pharma is doing. Yes, they make big profits, it's true, and they do it, by and large, by creating medcations that have extended and improved lives, relieved pain, made people whole again. Maybe thay are too powerful and make "too much" money but what is too much and what is the alternative? Do we interfere with their ability to create new medicines? It apparently takes a lot of money for the research and development. What do you think the problem is? How would you fix it? Wht are they doing that you would stop? Some imply that big pharma is interfering with "alternative" medicines. Do you? If so, how have they done this? What alternative medicines have they banned or stopped the sale of? Have they required that alternative medicines be tested for efficacy and safety before they are distributed? Have they shut down distributers? They might like to do those things but so far they don't have the authority to do that--yet they still make profits. What has big pharma done that you would stop? They have no control over alternative medicines or vitamin and mineral supplements. Anyone can manufacture, sell and buy supplements and alternative medicines. You have yet to show how big pharma is causing a problem in the alternative medicine and herbal medicine field. If big pharma's research and development were curbed by law, how would that help the alternative medicine/supplement business? Just what are they doing that you object to (except making profits). Just what are you suggesting be changed? It doesn't do any good to beat the drums against "big pharma" when no one says what they are doing wrong or what they think should be done to change what they are doing. Lois .
Nah, Vy, we're NOT good. :lol: Stand up for your beliefs. Occam:zip: Thanks buddy. I used to think this smiley was a smiley chomping on a cigar!! :zip: I'm sorry Lois if my reply seemed snippy. I just don't want to get sucked into the pharma debate. That's fine, Vyazma. You weren't snippy. I must have misunderstood your position. I still love you! ;-) Lois
Big Pharma makes a lot of money, does a lot of unethical stuff, and produces medications that have saved and improved the lives of billions of people. Easy to hate, but life is never that simple. The question isn't whether or not the system is deeply flawed, because we all know it is. The question is what do we do about it? The woo-woo answer, of course, is to chuck modern medicine in favor of "ancient wisdom" and recent bullshit with an "ancient wisdom" flavor to it. That's where blindly demonizing Big Pharma leads some folks. But this mostly isn't that crowd. As an old-school liberal, I'm a fan of stricter regulation of the industry, transparency (such as the work being done at the All Trials] project), more government-funded research in place of industry funding, and laws against fraudulent marketing of quackery. But since Reagan, that ain't gonna happen. Any other ideas?What unethical stuff are they doing? What is the deep flaw in the system? I agree that their advertising practices are crying out for more regulation. What else? Lois
Big Pharma makes a lot of money, does a lot of unethical stuff, and produces medications that have saved and improved the lives of billions of people. Easy to hate, but life is never that simple. The question isn't whether or not the system is deeply flawed, because we all know it is. The question is what do we do about it? The woo-woo answer, of course, is to chuck modern medicine in favor of "ancient wisdom" and recent bullshit with an "ancient wisdom" flavor to it. That's where blindly demonizing Big Pharma leads some folks. But this mostly isn't that crowd. As an old-school liberal, I'm a fan of stricter regulation of the industry, transparency (such as the work being done at the All Trials] project), more government-funded research in place of industry funding, and laws against fraudulent marketing of quackery. But since Reagan, that ain't gonna happen. Any other ideas?I agree with most of this with a few qualifications. 1) Pharma makes a lot of money - Yes its true that pharma is approx a $10 billion dollar a year industry but that is gross income. When you look at things like return on investment the numbers are not so impressive. ROI for the top twelve pharma companies was 7.7% in 2011 and dropped to 7.2% in 2012 ( see here]). It currently costs more than $1 billion to bring a drug to market. Because the risks are so high in this industry, the failure of a single drug can sink a company, there are most certainly times when there is great pressure on executives to make decisions that are not in the publics best interest, especially when the data doesn't lend itself to an obvious decision. If a new $1 billion drug X is associated with a 0.009% chance of a serious side effect but is more effective than similar drugs already on the market that have a 0.0089% chance of causing the same side effect do you cancel the drug? I am not saying that executives in this industry don't make decisions for purely self serving reasons sometimes, but I don't think these decisions are always as simple as the media portrays or the public believes. The public and the media like a good story and its not a good story unless you have a clear cut villain. 2) I agree that government funded research would be a better option in principal and a lot of the basic medical research is already conducted through NIH finding. The issue is do we move from the current model where the government does the high risk low return basic research letting private industry build on that to bring products to market or does the government now get involved in actual development and production of drugs? While it may seem attractive to put big pharma out of business and let "the people" develop and produce important medicines our history shows that the government is not very good at doing this sort of thing. The government is not especially good at innovation. Nothing comes close to stimulating innovation like competition and the promise of a possible big reward. The government is also subject to the political whims of the ruling party which is never good if you want to sustain projects that are going to take more than 4 years to complete. 3) Absolutely agree that pharma should not be allowed to market the way they do. Advertising should be forbidden on TV, Radio, Consumer magazines, and Medical journals. Pharma reps should still be allowed to drop off promotional material at doctors offices so we are aware of new drugs but they should be forbidden from providing anything of monetary value ( and the same rules should apply when they visit our reps in washington.). 4) Completely agree that all studies should be published, not just favorable ones. Studies should be registered with the FDA before they are started and before the results are known and the final results made available through a federally funded web site/archive. This would create a level playing field for all companies and products. Its hard for even a well intentioned company to be completely honest if most of the other companies are hiding important negative information.
Sorry to break in here, but I get a kick out of how words are conscripted. Two are organic and herbal. Chemists used the word "organic" to mean essentially any compound containing carbon (except carbon dioxide derivatives) for many years. Only recently was it stolen by the "natural" food people. "Herbal" is another. Since I was a kid I've had food doused with herbs: oregano, dill, sage, etc. They were certainly curative, but only of my hunger. :lol: OccamI agree. Its all about marketing. Magic words like natural and herbal are big business. I have a patient who owns one of the biggest dairy brands in the northeast. A few years ago he was telling me that the profit margin on organic milk was so good that he was shifting large amounts of his production to organic products. He is able to charge twice as much for the milk even though it only costs him 10-20% more to produce. I mentioned to him that there was no evidence that organic foods were any safer or more nutritious than those produced by other means and he said he agreed 100% but that it would be financially foolish not to take advantage of this opportunity even if it was based on a false premise and public ignorance. Does anyone here think the farmer is acting unethically or immorally? Lois
Sorry to break in here, but I get a kick out of how words are conscripted. Two are organic and herbal. Chemists used the word "organic" to mean essentially any compound containing carbon (except carbon dioxide derivatives) for many years. Only recently was it stolen by the "natural" food people. "Herbal" is another. Since I was a kid I've had food doused with herbs: oregano, dill, sage, etc. They were certainly curative, but only of my hunger. :lol: OccamI agree. Its all about marketing. Magic words like natural and herbal are big business. I have a patient who owns one of the biggest dairy brands in the northeast. A few years ago he was telling me that the profit margin on organic milk was so good that he was shifting large amounts of his production to organic products. He is able to charge twice as much for the milk even though it only costs him 10-20% more to produce. I mentioned to him that there was no evidence that organic foods were any safer or more nutritious than those produced by other means and he said he agreed 100% but that it would be financially foolish not to take advantage of this opportunity even if it was based on a false premise and public ignorance. Does anyone here think the farmer is acting unethically or immorally? Lois It all depends on what they believe. If they believe their products are better then they are just following a belief system that is not based on good science and not doing their due diligence when they promote these products. I think many of these people, farmers, growers, livestock producers and distributors and retailers actually believe or have convinced themselves that this stuff is better. If on the other hand they know the products offer no advantage but they still participate in the industry charging higher prices and promoting unsubstantiated claims then they certainly are behaving unethically regardless of whether their job is in production, retail or somewhere in between.
Sorry to break in here, but I get a kick out of how words are conscripted. Two are organic and herbal. Chemists used the word "organic" to mean essentially any compound containing carbon (except carbon dioxide derivatives) for many years. Only recently was it stolen by the "natural" food people. "Herbal" is another. Since I was a kid I've had food doused with herbs: oregano, dill, sage, etc. They were certainly curative, but only of my hunger. :lol: OccamI agree. Its all about marketing. Magic words like natural and herbal are big business. I have a patient who owns one of the biggest dairy brands in the northeast. A few years ago he was telling me that the profit margin on organic milk was so good that he was shifting large amounts of his production to organic products. He is able to charge twice as much for the milk even though it only costs him 10-20% more to produce. I mentioned to him that there was no evidence that organic foods were any safer or more nutritious than those produced by other means and he said he agreed 100% but that it would be financially foolish not to take advantage of this opportunity even if it was based on a false premise and public ignorance. Does anyone here think the farmer is acting unethically or immorally? Lois It all depends on what they believe. If they believe their products are better then they are just following a belief system that is not based on good science and not doing their due diligence when they promote these products. I think many of these people, farmers, growers, livestock producers and distributors and retailers actually believe or have convinced themselves that this stuff is better. If on the other hand they know the products offer no advantage but they still participate in the industry charging higher prices and promoting unsubstantiated claims then they certainly are behaving unethically regardless of whether their job is in production, retail or somewhere in between. Good point. However, most jobs require some hiding of the absolute truth, either deliberate or inadvertent. In the case of the farmer, he could add a disclaimer to his products that there is no scientific evidence that "organic" offers any advantage. I'll bet he'd sell the same amount of milk and milk products. Lois
MacGyver,
No question these issues are complex and far more nuanced than the media is likely to convey. Re-investment in research is an important subject, and certainly pharmas do a lot of it (more than the herbal and supplement companies, that’s for sure]). I do think that R&D costs can become a bit of an excuse for some things, such as pushing for patent extensions and excessive marketing budgets. But it is a legitimate issue, of course. I was merely making the point that any profitable industry is likely to draw hostility, particularly one that many of us also depend on for health or even survival.
The issue of the role of government is likewise not simple. Private industry can certainly marshal huge resources rapidly in a way that’s harder for government. And policy shifts with election of new leaders do affect the ability to focus on stable, long-term projects. On the other hand, industry is profit driven rather than driven by general societal goals or perceptions of what is needed, for better or worse. The plethora of NSAIDs and anti-depressants (which appear, in many cases, not to be useful for much of the population for whom they are prescribed) is more about responding to market demand than about targeting the greatest medical needs in any sort of public-health-driven or utilitarian sense. And contrary to the Republican mantra that industry is super efficient and government hopelessly wasteful, it is easy enough to find tremendous waste in private medical research f one presumes that efficiency means the greatest reduction in human suffering per dollar spent. And I believe the industry would be far worse if not for the oversight already in place, and I think additional oversight could reduce the problematic behaviors of industry (such as advertising and failure to publish all the data needed for evidence-based evaluation, as you point out).
I think we are in agreement that the issue is complex and the devil is in the details. While Big Pharma has earned much of the criticism it receives, this criticism is cheap and easy and often not focused on how to make things better, which makes it less than useful. And, of course, unless we have a reasonable alternative to offer, it doesn’t accomplish much to go on about the failings of the current system, real and serious as they are.
Quoting Lois:
Does anyone here think the farmer is acting unethically or immorally?Unfortunately, no since financial laws, our citizen protection government departments, and our educational system allow it.
In our economic system the farmer’s goal is to maximize his profit, not allow himself to go broke while other farmers collect more profit.
Occam
Brennan I agree completely and you are correct,
the devil is certainly in the details. It’s a difficult problem to solve and unfortunately most of our leaders have neither the motivation or the necessary understanding of the problem to solve it I’m afraid.
Quoting Lois:It sounds as if you are saying that if there are no financial laws against it and citizen protection government departments and our educational system allow it, that anything goes. Not sure there isn't something dangerous to society in that philosophy. LoisDoes anyone here think the farmer is acting unethically or immorally?Unfortunately, no since financial laws, our citizen protection government departments, and our educational system allow it. In our economic system the farmer's goal is to maximize his profit, not allow himself to go broke while other farmers collect more profit. Occam
I think there are some interesting parallels to some of the points here.
Mainly farmers and pharmaceutical industry.
Both of these industries have one thing in common. They both provide essential living products. Food and medicine.
Food stamps are directly related to the USDA and the Farmer. Medicine is directly related to large profit oriented corporations and the FDA.
Both have their own separate political issues. But both are being beset by Right wing capitalist forces which directly or inadvertently
want to make access to food or medicine more difficult.(especially for the poor)
I bet we can find examples of nations or civilizations that solved the problem of food and medicine for it’s people that go back hundreds if not thousands of years. Let alone in the 20th(21st) Century.
How is it that the US, the wealthiest nation in the world cannot provide smoothly, without harassment, delay, undue obstacles or stress
food and medicine for all of it’s citizens? Food and Medicine!
If the extreme capitalists and right wingers wish to maximize profits for glow in the dark squirt guns or yachts or candy bars- I get it.
But food and medicine?
As an odd coincidence but right on que, here is a development that partly addresses one of the issue Mckenzie brought up above.
Quoting Lois:
It sounds as if you are saying that if there are no financial laws against it and citizen protection government departments and our educational system allow it, that anything goes. Not sure there isn’t something dangerous to society in that philosophy.Not quite.
- We had stong financial laws, but in the last few decades much of their power has been stripped by guess which administrations.
- Our administrations have managed to put the worst people over government citizens protection departments. It’s insane to put a a petroleum lobbyist over environmental protection, to put drug company executives over the FDA, etc. Most of the citizens protection departments have been weakened to the point of paralysis by putting the people who are most against them in charge of them.
- Similarly, our educational system has been emasculated by defunding, and imposing crackpot requirements on them. Most of the kids today are learning less about the functioning of gobernment, and the reasons to be involved than they did in the past.
- Morality isn’t separate from the human group. We, as humanists, believe in helping each other out, and fainess. The Rand Paul and Tea Party types see that is silly. The job is to win, and if that means screwing everyone else, so be it. So, according to us the farmer is immoral, but according to him, his job is to compete and make a profit and it would be immoral for him to let his competitors win.
Occam