a) We do test on terminally ill people, but after testing in other models. b) Thalidomide was all roses compared to the horrors you can inflict. c) Profit-driven industry makes extremely perverse incentives.
Still I do come down more on your side of the argument, and we have historically made massive leaps doing some horrific things.
I wonder if we can get better models based off of human cell-lines / tissues? Like CRISPR did?
[–] arcticbull 11 hours ago
People frequently don't realize that thalidomide is a very good chemotherapy drug that's back on the market with the appropriate category X designation.
It treats multiple myeloma, graft-vs-host disease, various HIV associated disease and Kaposi's sarcoma, Leprosy and potentially TB.
[–] ch4s3 1 day ago
People who are specialists in something other than economics often make this argument but it's often a very weak argument, IMO. Liability means that you are incentivized to be quite cautious in pushing a potentially dangerous product. Particularly with pharmaceuticals a class action can be easily and successfully argued in court. Moreover, a relatively small number of dangerous flops will tank your reputation with consumers. I would also add that you can't make any more money selling drugs to people you have killed.
The worst money incentive for drug manufacturers is that market forces push them towards recurring treatments for diseases that effect a large number of people. However that seems less than perverse to me.
[–] jmcqk6 1 day ago
That assumes that people are playing a long game. If you're looking for your payday and exit, and there are many people out there who are only looking for the next payday, this argument falls apart.
> Moreover, a relatively small number of dangerous flops will tank your reputation with consumers.
One success the anti-vax people have achieved is to muddy the waters around this. Your public reputation is no longer correlated to actual performance.
> Liability means that you are incentivized to be quite cautious in pushing a potentially dangerous product
There's a long list of people throughout history who do not have this caution at all.
You seem to be taking a theoretical economics approach. Reality is different. People are not perfectly rational actors, and consequences are not consistent.
Look at what actually happens in reality.
[–] estearum 1 day ago
Payday and exit is pretty hard in biotech as you need to conjure up billions of dollars in capital, which doesn't often flow to people who payday-and-exit.
What happens in reality is that people try really hard to make safe and effective drugs, they mostly fail, and the ones that are approved are generally safe and effective.
[–] ch4s3 16 hours ago
What are you talking about? Shareholders are looking for sustainable projections of growth. Killing a bunch of people will tank your stock which is how executives get paid. You really need to think beyond their first thought o nstuff like this.
> There's a long list of people throughout history who do not have this caution at all.
None of them run pharmaceutical companies.
>You seem to be taking a theoretical economics approach. Reality is different
No I'm describing reality and you're arguing from populism.
[–] fc417fc802 15 hours ago
Then why are there so many examples of PE destroying things to make a (relatively) quick buck?
[–] ch4s3 11 hours ago
PE is short for PRIVATE equity, there are no public shareholders in PE, no share price. When I critique that people here often don't understand basic things about the economy this is what I mean.
[–] anthuswilliams 1 day ago
d) elderly and infirm people are in a weakened state and so are less likely to recover from accidental complications your drug might introduce
e) sickness is itself a confounder for the toxicology effect of a drug. Suppose you take a drug and your liver shuts down - did the drug cause it or was it your underlying illness? This can lead to programs being prematurely shut down and actually prevent the development of treatments that might have gone on to succeed.
Just to expand on this for the audience. Even a perfectly reasonable synthesis of MPPP, a synthetic opioid, can produce MPTP[1], which will destroy all of your dopaminergic neurons and give you permanent brain damage. This was discovered entirely by accident. Or, Karen Wetterhahn, who got a single drop of organic mercury on her gloved hand and spent the next year suffering from her brain rotting from the inside out.
This only barely scratches the surface from what I can remember, but there's absolutely, unambiguously a lot of good reasons why these barriers are there. These are rules that have been put down through blood and tears.
[1]: https://en.wikipedia.org/wiki/MPTP