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(Project-Syndicate)   Eroom's Law. that's Moore's Law backwards. And it may just kill you   (project-syndicate.org) divider line 54
    More: Fail, Eroom, Food and Drug Administration  
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5603 clicks; posted to Politics » on 23 May 2014 at 11:45 AM (13 weeks ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2014-05-23 10:04:12 AM
The article focuses on the decline in spending on medical research for new drugs, but I think we are probably running out of drugs as well.

The solution to our health will will come with real breakthroughs in nanotech. We will end up with a couch or tube that you lay down on and stick a couple IVs in your arm. Spend a night there once a week or so and let the machines clean out disease and other bad things for you.
 
2014-05-23 11:29:33 AM
I hope so. But I don't think nanotech will be quite that great of a panacea... (What role would nanotech have in, say, gene therapy?)

Anyway, I hope it happens before some percentage of the population is wiped out by some antibiotic resistant bacteria... All because we don't have enough research looking into newer, more effective antibiotics...
 
2014-05-23 11:49:23 AM
Don't worry. We'll just sp3nd less and raise the cost to create new drugs. Problem solved.
 
2014-05-23 11:55:15 AM

Slives: The article focuses on the decline in spending on medical research for new drugs, but I think we are probably running out of drugs as well.

The solution to our health will will come with real breakthroughs in nanotech. We will end up with a couch or tube that you lay down on and stick a couple IVs in your arm. Spend a night there once a week or so and let the machines clean out disease and other bad things for you.


Yep. There's more to biomedicine than drugs. Genetics, for instance. Genetics is moving at quite a clip.
 
2014-05-23 11:57:39 AM
We have plenty of pedophiles in prison.  Let's cut costs and go directly to human tests early on.
 
2014-05-23 11:58:23 AM

Mrbogey: Don't worry. We'll just sp3nd less and raise the cost to create new drugs. Problem solved.


Ahh. I remember this now...  Bend the "cost curve"... down? Was that the direction we were shooting for?  :-)
 
2014-05-23 11:58:48 AM
Jesus why would anyone want to live forever?
 
2014-05-23 11:59:31 AM

Smeggy Smurf: We have plenty of pedophiles in prison.  Let's cut costs and go directly to human tests early on.


You just say that because they let you out.
 
2014-05-23 12:03:46 PM

Mrbogey: Don't worry. We'll just sp3nd less and raise the cost to create new drugs. Problem solved.


The problem with free market fundamentalism is that it works brilliantly in the short term and gives us wonderful boner pills and baldness remedies, but (I suspect) doesn't necessarily fund a whole lot of basic research.

If someone can find me a link showing that big pharm or some other privately-run healthcare business is spending lots of money on basic research, I'll be pleased as punch to be proven wrong.

/...and please note that I emphasized the word "basic"
 
2014-05-23 12:03:55 PM

Thank You Black Jesus!: Jesus why would anyone want to live forever?


sp3.fotolog.com
 
2014-05-23 12:04:02 PM
There's already a law about that.

It's called the Law of Diminishing Returns.
 
2014-05-23 12:04:53 PM
There should be some sort of Law that charts the regress of trust in sciences (like biology) in relation to the number of republicans in office.  Maybe Derper's Law, I don't know.
 
2014-05-23 12:05:08 PM

Smeggy Smurf: We have plenty of pedophiles in prison.  Let's cut costs and go directly to human tests early on.


Let's add white collar criminals to the list too, and I'll sign on to your idea.
 
2014-05-23 12:05:35 PM
Shouldn't that be waL s'erooM?
 
2014-05-23 12:14:30 PM

Ishkur: There's already a law about that.

It's called the Law of Diminishing Returns.


At some point the creation of new more specific/nuanced laws itself becomes subject to the law of diminishing returns in terms of usefulness.  This in itself is a new law which I will call Steve.
 
2014-05-23 12:19:32 PM

Thank You Black Jesus!: Jesus why would anyone want to live forever?


Can you imagine how lonely it will be after the sun novas and collapse into a white dwarf?  And you'd still have a trillion years to go.
 
2014-05-23 12:20:59 PM

Smeggy Smurf: We have plenty of pedophiles in prison.  Let's cut costs and go directly to human tests early on.


And since no one has ever been falsely convicted I can totally get behind this.
 
2014-05-23 12:21:12 PM

Ishkur: There's already a law about that.

It's called the Law of Diminishing Returns.


It is also called the Law of avoiding Thalidomide (etc.) happening again.
 
2014-05-23 12:25:34 PM
Not having a new drug to save you does not mean the lack of it is what kills you. I believe it is the disease or malady you have does that. On the other hand, if you get hit by a bus on the way to pick up your meds does imply that your days were numbered anyway.
 
2014-05-23 12:28:01 PM

xria: It is also called the Law of avoiding Thalidomide (etc.) happening again.


That's a good example for a variety of reasons.

As a matter of degree, morning sickness ranks pretty low when compared to looking at a new drug treatment against a high-mortality cancer, for example.

Around the time that Thalidomide (1957) and other drugs (MAOI, spring to mind, around 1952) were developed, the rules were too lax. But we've swung way far the other way. Drug trials in the US are extremely expensive and restrictive.
 
2014-05-23 12:37:13 PM
And Vioxx still managed to slip through.
http://en.wikipedia.org/wiki/Rofecoxib

Merck withdrew the drug (2004) after disclosures that it withheld information about rofecoxib's risks from doctors and patients for over five years, resulting in between 88,000 and 140,000 cases of serious heart disease.
 
2014-05-23 12:40:50 PM

phaseolus: The problem with free market fundamentalism is that it works brilliantly in the short term and gives us wonderful boner pills and baldness remedies, but (I suspect) doesn't necessarily fund a whole lot of basic research.


please prove this assertion.
 
2014-05-23 12:48:15 PM
I assumed eroom's law would be that your computer techies get twice as big and half as smart every year.
 
2014-05-23 12:55:19 PM
It is far more profitable to tweak existing drugs.

http://www.bmj.com/content/345/bmj.e4348
http://www.plosbiology.org/article/info%3Adoi%2F10.1371%2Fjournal.pb io .1001716


"the share of spending by pharmaceutical and device industry on preclinical research has decreased from about half (55%) in 1998 to a quarter (25%) in 2010"
 
2014-05-23 12:57:54 PM

phaseolus: Smeggy Smurf: We have plenty of pedophiles in prison.  Let's cut costs and go directly to human tests early on.

Let's add white collar criminals to the list too, and I'll sign on to your idea.


Lawyers, bankers, con artists.  I'm ok with that
 
2014-05-23 12:59:14 PM
upload.wikimedia.org
 
2014-05-23 01:00:53 PM

Mrbogey: phaseolus: The problem with free market fundamentalism is that it works brilliantly in the short term and gives us wonderful boner pills and baldness remedies, but (I suspect) doesn't necessarily fund a whole lot of basic research.

please prove this assertion.


There is very little basic research done in industry. The industry is great for taking basic research and turning it into marketable products quickly, but the default position of those profit-making institutions is to spend the absolute minimum on R&D, and to only change their products when absolutely necessary.

This is pretty widely accepted by people who do research in academics and industry. They both see themselves as having separate but important roles to play.Where the industry does to research, it's typically invested in ways to make more money, such as making production cheaper. When people talk about basic research, they mean things like producing an understanding of how cancer cells work.

Basic research leads to new understanding of the world. Industrial research allows companies to exploit basic research efficiently.
 
2014-05-23 01:02:37 PM

Mrbogey: phaseolus: The problem with free market fundamentalism is that it works brilliantly in the short term and gives us wonderful boner pills and baldness remedies, but (I suspect) doesn't necessarily fund a whole lot of basic research.

please prove this assertion.


I'm tired of seeing these examples used.

Viagra was developed as a treatment for angina and hypertension. It didn't work well for these, but the "boner" side effect was noted and it ended up being approved and marketed for this. It's also been approved to treat pulmonary hypertension, a devastating disease for which there are few effective treatments. For you outdoors types, it also works to treat altitude sickness, though it has no official approval for this indication,

Propecia was developed as a treatment for benign prostatic hypertrophy, for which it has been used for a long time. The effects on male pattern baldness were secondary. It was also hoped that it could help prevent prostate cancer, but that didn't pan out.
 
2014-05-23 01:15:14 PM

Mrbogey: phaseolus: The problem with free market fundamentalism is that it works brilliantly in the short term and gives us wonderful boner pills and baldness remedies, but (I suspect) doesn't necessarily fund a whole lot of basic research.

please prove this assertion.


When the history books are written covering the late 20th and early 21st Century, assuming there's anyone around to read them, the subject of antibiotics will be the cautionary tale about the failure the free market.

It's a classic Tragedy of the Commons - it's too easy for farmers to feed antibiotics to their chickens and cows, without needing to take into account the long-term creation of drug-resistant pathogens.  It's too easy to prescribe an antibiotic to the patient with a virus just to get them out of the doctor's office.

As we've run out of working antibiotics, the cost of developing them has increased, so the pharmas are simply getting out of that business altogether, concentrating instead on developing the drugs that patients will have to take for the rest of their lives - anti-cholesterol meds, etc - or novelty drugs like Viagra.  That's where the money is - and it's an indefinitely recurring revenue stream, the Holy Grail of capitalism.  Antibiotics, in order to be effective, need to be cheap and are only used for a short period, which conflicts with the short term profit motives of these companies.

As a result, the development pipeline for antibiotics has ground nearly to a halt, the industry and university research centers that have done the basic research are being closed, the knowledge is being lost as the researchers move on or retire.  It will take decades to restore them.

Never mind that we now have pathogens spreading through the ecosystem for which we have absolutely no drugs to combat.  We're increasingly at risk of a resistant pathogen spreading through our food animals and wiping them all out. Our hospitals are already seeing the spread of resistant bacteria, and can't get rid of it - it is becoming increasingly likely that a hospital stay will kill you through an infection you acquired there.

From the pharma company standpoint, there's decreasing market incentive to make them.  From a societal standpoint, it's increasingly essential that we have them.

From a classic "free market" standpoint, the wisdom is that when the demand grows enough, the value will increase enough that market will respond with a solution - the problem is that you can't just decide one day to come up with a new antibiotic, and they only have value if they're cheap and universally available.  A $1000 per dose antibiotic is worthless.
 
2014-05-23 01:41:04 PM

Cubicle Jockey: And Vioxx still managed to slip through.
http://en.wikipedia.org/wiki/Rofecoxib

Merck withdrew the drug (2004) after disclosures that it withheld information about rofecoxib's risks from doctors and patients for over five years, resulting in between 88,000 and 140,000 cases of serious heart disease.


Everyone knew those were side effects of Vioxx even when it was in its testing phase. It says right in the literature in the bottle and all the literature they gave to doctors that those were side effects. Just because people said it worked and thought, "oh it must work better if I take even more!" doesn't mean the drug itself is bad. Doctors wanted to keep prescribing it incorrectly and patients wanted to keep taking it incorrectly because at the time it was the only drug of its kind that did what it did. Celebrex has the exact same side effects and to a degree suffers the same misuse issues.

People have to realize they are old and they can only get so much relief. Drugs like Vioxx and Celebrex aren't intended to be daily maintenance medications but that's how they are prescribed and used. If you are stupid and your doctor is stupid why is it the drug company's fault?
 
2014-05-23 01:41:47 PM
Slightly off topic, but I wonder if there is a law about diminishing quality of software? With all the new hardware software doesn't have to be as perfect.
 
2014-05-23 02:19:25 PM

Thank You Black Jesus!: Jesus why would anyone want to live forever?


Because they don't have an angry sergeant yelling at them?

http://en.wikipedia.org/wiki/Battle_of_Belleau_Wood#Marines_attack_B el leau_Wood
 
2014-05-23 02:27:58 PM

MindStalker: Slightly off topic, but I wonder if there is a law about diminishing quality of software? With all the new hardware software doesn't have to be as perfect.


Not quality (at least directly) but efficiency, absolutely.

Software and data grow to fill all available processing and storage ability. When processor time was precious, every bit of it was used to try and run as fast as possible. Now that cycles and bytes are cheap, hardware is used to cover up our laziness. Instead of running faster, your spiffy new desktop's oomph is used to make Joe Coder's life easier.

There are plenty lightweight Linux desktops out there (xfce, lxde, icewm to name a few) if you want to see what genuinely fast desktop software looks like: On a modern machine, it's basically instant. They're ready before the screen draws the next frame. You'll know that Windows, Mac and normal Linux are all molasses by comparison... But you won't really care (I'll be honest - I don't either), because you gain very little from a desktop that's faster than you are. However, programmers gain hugely from having abstracted frameworks rather than having to reinvent the wheel every time, so we're happy to use the cycles you don't notice to our own advantage.
 
2014-05-23 02:32:49 PM

Morpher59: When the history books are written covering the late 20th and early 21st Century, assuming there's anyone around to read them, the subject of antibiotics will be the cautionary tale about the failure the free market.

success of microevolution

FTFY :-)

The low hanging fruit has been plucked. Developing new drugs is way more expensive. It's not that drug companies are developing new viagra knockoffs (viagra happened by accident, incidentally, as mentioned in a previous post). It's that all production is slowing down. It's several factors more expensive now.

Incentivize business into development, and you get more development.
 
2014-05-23 02:46:19 PM

Mrbogey: phaseolus: The problem with free market fundamentalism is that it works brilliantly in the short term and gives us wonderful boner pills and baldness remedies, but (I suspect) doesn't necessarily fund a whole lot of basic research.

please prove this assertion.


It's pretty well-known since it was on fark, I bet one of your alts was in that thread.
 
2014-05-23 02:59:56 PM
I think basic medical research is one of those things that the government needs to be doing most of the work in, anyway. We should be paying university research departments FAR more than we are now for stuff like new antibiotics, and let the private companies focus on coming up with the next Viagra.

Eventually we may face an outbreak of some new disease (or a mutation of an old disease with resistance to current antibiotics) where tens or hundreds of millions die needlessly just because coming up with a cure was simply not profitable enough.

The "invisible hand" can only reach so far- hell, Adam Smith would be first to acknowledge that.

The sooner the "all government bad" and "all taxes are theft" idiots are disposed of the better for us all.
 
2014-05-23 03:05:40 PM
I also question the validity of the article's numbers.  It's been proven time and again that Pharmacos spend %1900+ percent more on advertising and promotion than research and development.  And they spend lots on patent trolling and tricks designed to keep making billions off of drugs that only they are allowed to make.
 
2014-05-23 03:32:29 PM

Destructor: Morpher59: When the history books are written covering the late 20th and early 21st Century, assuming there's anyone around to read them, the subject of antibiotics will be the cautionary tale about the failure the free market.success of microevolution

FTFY :-)

The low hanging fruit has been plucked. Developing new drugs is way more expensive. It's not that drug companies are developing new viagra knockoffs (viagra happened by accident, incidentally, as mentioned in a previous post). It's that all production is slowing down. It's several factors more expensive now.

Incentivize business into development, and you get more development.


Agreed, but in this case that won't happen without non-"free market" forces.  I'm not saying pharma companies are bad, or that the failure of the market is exclusively by them.  This is a case where all of the actors seem to be behaving rationally (pharmas make money, farmers increase their animal yield, doctors successfully treat a disease, patients stop taking drugs when they feel better), but the combined result of all of those rational actions is bad because the externality (evolution of resistant pathogens) doesn't affect any of the actors directly and in the short term enough to change their behavior.
 
2014-05-23 03:36:59 PM

Morpher59: Agreed, but in this case that won't happen without non-"free market" forces.


Riche: I think basic medical research is one of those things that the government needs to be doing most of the work in, anyway.


I think the key to victory here is corporations do what they do best (making money by providing a desired product), and government spearheading some leadership. Both by incentives and by funding/farming research to universities (or other competent parties or even bidders). The Human Genome Project is the sort of thing a company wouldn't undertake by itself, but its already proved to be very useful.

Stuff like that.
 
2014-05-23 03:44:26 PM
Will the "century of biology" turn out to be little more than a fantasy?


I guess this guy is ignoring that innovation is almost exponential at this point in society.

Does he really think we're not going to have serious breakthroughs in the next 5 years alone?

Didn't really feel like reading tfa after this sentence.
 
2014-05-23 04:07:34 PM
Fubini:

There is very little basic research done in industry. The industry is great for taking basic research and turning it into marketable products quickly, but the default position of those profit-making institutions is to spend the absolute minimum on R&D, and to only change their products when absolutely necessary.

Bingo. Pharma companies don't do much basic research, they troll through papers created by university or NIH researchers for interesting stuff, then develop therapies based on that publicly funded research. They then again use public funds and resources to do the trials and get the drugs approved.

It's a hell of a lot more profitable to change the dosage schedule of a drug and get the patent renewed for another decade or two than it is to actually develop a drug. See also Prilosec being rebranded as Nexium.
 
2014-05-23 04:15:02 PM

maxheck: Bingo. Pharma companies don't do much basic research, they troll through papers created by university or NIH researchers for interesting stuff, then develop therapies based on that publicly funded research. They then again use public funds and resources to do the trials and get the drugs approved.


Isn't only a bad thing because they're not paying for it? That can be corrected either directly or indirectly (taxes on them). Circle of life... er, pharmaceuticals...

Seems like the system is essentially good, but out of whack. It needs an overhaul.
 
2014-05-23 04:22:26 PM
Destructor:


maxheck: Bingo. Pharma companies don't do much basic research, they troll through papers created by university or NIH researchers for interesting stuff, then develop therapies based on that publicly funded research. They then again use public funds and resources to do the trials and get the drugs approved.

Isn't only a bad thing because they're not paying for it? That can be corrected either directly or indirectly (taxes on them). Circle of life... er, pharmaceuticals...

Seems like the system is essentially good, but out of whack. It needs an overhaul.


Oh, certainly. Developing a drug from an interesting effect noticed in a petri dish is a long, arduous, complex process, and that's what the pharma companies excel at. It just drives me nuts when people claim that pharma companies (and their quarterly profits) are what's driving innovation. They're not. They're Henry Fords, not Albert Einsteins.
 
2014-05-23 04:39:06 PM

Morpher59: Destructor: Morpher59: When the history books are written covering the late 20th and early 21st Century, assuming there's anyone around to read them, the subject of antibiotics will be the cautionary tale about the failure the free market.success of microevolution

FTFY :-)

The low hanging fruit has been plucked. Developing new drugs is way more expensive. It's not that drug companies are developing new viagra knockoffs (viagra happened by accident, incidentally, as mentioned in a previous post). It's that all production is slowing down. It's several factors more expensive now.

Incentivize business into development, and you get more development.

Agreed, but in this case that won't happen without non-"free market" forces.  I'm not saying pharma companies are bad, or that the failure of the market is exclusively by them.  This is a case where all of the actors seem to be behaving rationally (pharmas make money, farmers increase their animal yield, doctors successfully treat a disease, patients stop taking drugs when they feel better), but the combined result of all of those rational actions is bad because the externality (evolution of resistant pathogens) doesn't affect any of the actors directly and in the short term enough to change their behavior.


Nice job leaving out the massive failure that is the FDA your example

They're the stupid ones still green lighting the animal antibiotics and the ones who aren't paying to stockpile new antibiotics like they do w/ vaccines
 
2014-05-23 05:14:37 PM

Thank You Black Jesus!: Jesus why would anyone want to live forever?


Maybe not forever, but 100 years seems awfully short to have a life with all that's out there to see and do. And if I could live most of those centuries as healthy as I was at 39? That would be excellent.

*Chose 39 because, while sex is still fun, it's not has huge a driving force. Over 40, I started to go grey.
 
2014-05-23 05:17:29 PM

Morpher59: When the history books are written covering the late 20th and early 21st Century, assuming there's anyone around to read them, the subject of antibiotics will be the cautionary tale about the failure the free market.

It's a classic Tragedy of the Commons


I agree about the commons but it's not the market. The idea that in a free market there would never be innovation stands in stark contrast to literally a century of progress that saw humanity develop new technology amazingly quick. Most of it due to private entities innovating. Hell, Bell Labs was a division of a corporation tasked with making things for the sole reason of patenting them for future use. And we all benefited hugely from it.

To say that private entities won't innovate unless forced to is simply wrong.

TheBigJerk: It's pretty well-known since it was on fark, I bet one of your alts was in that thread.


I don't have any alts. I'm actually an honest guy who reads a lot and is quite logical. And no, what you know very well isn't instantly true.
 
2014-05-23 05:52:12 PM

ShadowKamui: Nice job leaving out the massive failure that is the FDA your example

They're the stupid ones still green lighting the animal antibiotics and the ones who aren't paying to stockpile new antibiotics like they do w/ vaccines


So you're saying the government should be doing a better job controlling the irresponsible behavior of the free market?

I think that was my point.
 
2014-05-23 06:06:06 PM

Mrbogey: The idea that in a free market there would never be innovation stands in stark contrast to literally a century of progress that saw humanity develop new technology amazingly quick. Most of it due to private entities innovating.


This is not true.

Historically speaking, scientific and technological progress is almost a completely arbitrary result of blind ambition mixed with luck, timing, and happenstance. And it is almost completely divorced from any sort of economic or profit incentive. Sure, affluent societies will spearhead more technological development because they can afford to support a larger portion of their leisure classes to pursue these matters, but by and large, the free market does not drive technological progress. Never has. Capitalism is never the inventor -- it is the exploiter of the invention.

For evidence, just watch any video essay by James Burke
 
2014-05-23 06:06:17 PM

Mrbogey: I agree about the commons but it's not the market. The idea that in a free market there would never be innovation stands in stark contrast to literally a century of progress that saw humanity develop new technology amazingly quick. Most of it due to private entities innovating. Hell, Bell Labs was a division of a corporation tasked with making things for the sole reason of patenting them for future use. And we all benefited hugely from it.

To say that private entities won't innovate unless forced to is simply wrong.


I'm not saying that at all - I'm saying that in the current market environment, innovation *specifically* in the development of antibiotics has all but stopped, and that's a shame because all of the antibiotics we have are quickly becoming worthless due to a short-sighted and irresponsible use of them.
 
2014-05-23 07:51:15 PM

Morpher59: ShadowKamui: Nice job leaving out the massive failure that is the FDA your example

They're the stupid ones still green lighting the animal antibiotics and the ones who aren't paying to stockpile new antibiotics like they do w/ vaccines

So you're saying the government should be doing a better job controlling the irresponsible behavior of the free market?

I think that was my point.


No your point was that you have no idea what the actual problem is nor offer a sane solution

Its the exact same crap that's wrong at the FCC, the government simply isn't doing its job.
 
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