[FoRK] Accidental theorist lost, wanted back

Stephen Williams sdw at lig.net
Thu Jul 16 20:05:58 PDT 2009

J. Andrew Rogers wrote:
> On Jul 16, 2009, at 4:41 PM, Stephen Williams wrote:
>> I would go for a system where specialty, very expensive drugs have a 
>> reasonable base price and a monthly payment if they are successful 
>> (anti-cancer, etc.).  If and when it doesn't work, the drug companies 
>> do not profit (as much).
> Eh?  Have you thought through the economics of this?  The profits on 
> pharmaceuticals as a class are far from being so spectacular that the 
> cost of something like this could be buried.
> Suppose you do have an anti-cancer drug, which like most anti-cancer 
> drugs only has a modest success rate, let's say 20% for the sake of 
> argument.  You have just cut the pool of people amortizing the very 
> high development costs by a factor of *five*, correspondingly 
> increasing the drug cost to the survivors by a factor of five.  Maybe 
> with your "reasonable" base price it only costs the survivors four 
> times as much as it would have cost if the costs had been evenly 
> distributed over cancer patients.
> And what about those cases where the anti-cancer drug may or may not 
> work well but the person survives due to an alternative therapy?  What 
> constitutes a failure such that the pharmaceutical company doesn't get 
> paid.
> Most drugs, particularly the specialty expensive ones, rarely have 
> anything even approaching a 100% success rate.  All you've done is 
> greatly increase the cost that must be absorbed by the people for whom 
> it works.
> This just looks like a way to increase the risk for pharma companies 
> even more.
> J. Andrew Rogers
I realize that it is problematic.  Only in certain cases would the 
evidence be clear.  Still, the incentivation would be nice.  Even if you 
just gave the drug companies 50% of the income tax revenue for 5 years 
for people saved, it might be a net tax and out of pocket savings and a 
boon for drug research funding.

A different tactic might be to fund drug success in some award-based way 
that doesn't have the inhibitory effect that high pricing does.  Maximum 
possible use should result once success is found, not using it sparingly 
and restricting the pool of payers by trying to recover costs + profit.  
Put aside some billions every year toward "buying" rock star drugs into 
generic status or some halfway measure.

As it is, expensive drugs are dispensed with little or no feedback, 
after trials, of whether they are effective in particular cases.  For 
the small number of cases where I know that an over the counter solution 
works better than the current commercial RX, I make it a point to 
mention them to any MD I come in contact with.  On the other hand, I've 
told 2 people just in the last 3 weeks to go get a prescription for a 
certain wonder drug that, from my experience, is likely to cure problems 
they've had for years (exzema / psoriasis) or weeks (fungal skin 
infections).  These were people who had been prescribed various other 
things that never worked and had given up.  All of this anecdotal stuff 
is no replacement for clinical trials, however it would be useful for 
people to have more actual and relevant evidence that things work.

This stuff is pretty cool: Imiquimod  http://en.wikipedia.org/wiki/Imiquimod
Just get rid of your pre-cancer / cancer at home, a la Compound-W.

This is a very mild version of the first step in Mohs surgery 
(chemosurgery) using an escharotic.  (Beware of mustard seed oil in 
India!)  Interesting that Mohs surgery 
http://en.wikipedia.org/wiki/Mohs_surgery is a real, legitimate version 
of Hoxsey Therapy http://en.wikipedia.org/wiki/Hoxsey_Therapy that was 
thoroughly debunked.


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