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An anarchist takes on Big Pharma by teaching patients to make their own meds

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Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#211

Wow. Cool. I wonder how hard are the synthesises of the useful antidepressants like mirtazapine. Also, I found ASX-05 (Phase III) uses a DM metabolite that is retained much more by the addition of brupropion. DM is the stuff in some cough syrups.

Well, mirtazapine isn't scheduled in the US so you can probably get some precursors with relative ease. You can find the synthesis info online [1] and at least some of the chemicals used in the synthesis are available online [2], though for the price it seems like it might be more economically feasible to just buy a pill from a pharma company.

[1] http://www.arkat-usa.org/get-file/22868/ [2] http://www.sigmaaldrich.com/catalog/product/aldrich/648434?l...

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#212

That seems both super dangerous, and super awesome. It's not something that we should have to consider. But this is the world we live in, now; legitimate supply lines of life-saving medicine have collapsed for a fair number of people. I understand why people might be troubled by someone actively going out and advocating this as opposed to simply making the information available, but if you're offered medicine with 95…

> super awesome. This is not super-awesome. Humans have made incredible progress by specializing and optimizing, and this process improves productivity, efficiently, and (most importantly when it comes to medicine) safety. The idea that we will have people taking the risk of getting sick or dying because they are not able to manufacture drugs with the same purity and potency as pharmaceutical companies shows there is…

Yes, that also seems pretty clear. But we are here, and this is now. Complaining is easy and feels good, but let's talk practical solutions.

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#213

Earlier quoted context omitted.

Enbrel? They just received another patent extension, too. This is what government granted monopolies look like.

EMSAM Unfortunately, no other class of drug class has worked, and the traditional delivery methods (ie - pill form) caused measurable hearing damage, just from the trial periods.

If you take the oral version (as opposed to the patch version) you can get it from India (where the patents have expired). A site I've used in the past that's reliable is AllDayChemist. Search for Selegiline and you can get it for as cheap as 18 cents per 5mg tablet.

Good luck!

Edit: Sorry, read below that you need the trans-dermal version.

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#214

Earlier quoted context omitted.

You want pharma companies to keep doing drug discovery why not ban outright any kind of marketing or advertising for their products? R&D spend across the industry is a fraction of the marketing spend. Think of all the good research that money would fund once pharma companies were freed from spending it on advertising.

Whenever I visit the US I find it insane how much advertising for drugs is shown on TV, with the usual "ask your doctor about..." disclaimer at the end. Why aren't more American's up in arms about this?

doctors told them they were being rebellious & put them on medications

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#215

Earlier quoted context omitted.

If the drug is out of patent and it is very profitable, why doesn't anyone set up a company to manufacture and sell it cheaper in the US? Same question with epipen.

The drug was repatented with the delivery mechanism, as soon as the original patent expired. It's the usual practice to keep novel delivery system/drug combinations off the market until the original drug patent expires, thereby extending the profitability of the patent, at the cost of users suffering medicine that is consequently decades out of date.

I think a similar issue applies with Epipen. There is an alternative, Adrenaclick (still expensive but not quite as bad), but because the delivery mechanism is different the prescription needs to be written differently.

Transdermal delivery unfortunately seems to be underexplored and very expensive in general. Transdermal estradiol is another one that is much more expensive than the pill form but is better in terms of safety. Generic patches available outside the US are less expensive (than patches in the US, still quite a lot more expensive than pill form). I'm not sure if generic patches are completely unavailable in the US or if they are just also quite expensive.

Melatonin is another case where transdermal delivery can be helpful, but it is difficult to find and fairly expensive (not quite as bad, though).

Beyond delivery mechanisms, drug companies also create modified forms of a drug (prodrug or metabolite or slightly different but similar substance) that have small advantages over the previous version. Again, these can't be substituted and doctors need to know to write the prescription for the form available as a generic. Best for the drug companies is when the origional form is pulled from the market by the FDA right after the patent expires, as happened with the antihistamine Seldane/terfenadine (replaced by Allegra/fexofenadine, a metabolite).

In other cases where out of patent drugs are not available as generics it is because the market is small and the current manufacturer can instantly drop their price to match if a generic appears, making it likely that anyone who attempts to make a generic will loose money.

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#216
post #177

Earlier quoted context omitted.

So I don't think one can generically fault "regulation" for a poorly performing health market in the US. You're absolutely right, however, I do think the worst parts of our medical system exist as consequences of regulation. The mandate that emergency rooms treat anyone who enters is onerous and there's no free lunch, paying customers are stuck with the bill. The licencing system isn't optimal for cost effective care…

> The mandate that emergency rooms treat anyone who enters is onerous and there's no free lunch, paying customers are stuck with the bill. I don't think that's onerous, I think that is a minimal, and admittedly imperfect, expression of our societal intent that people shouldn't die unnecessarily in emergency rooms - either from lack of being able to pay; nor from a practical standpoint, lack or delay of on-hand proof…

I don't defend the status quo. I think this is the right way to resolve healthcare.

I agree with about 95% of this: https://market-ticker.org/akcs-www?post=231949

We just need smarter regulations:

> every medical facility needs to have a price for each billing code

> every healthcare facility has to publish their prices

> heatlh care facilities must honor their published prices for everyone

> if someone needs car and they can't pay, the government will pay for the care but the government holds a debt and can garnish wages / use tax refunds / credit welfare to cover the debt

If people could shop on price for routine care, medical companies would become more efficient and extend those prices to people in an emergency

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#217
post #198

Earlier quoted context omitted.

> Find stuff that's off-patent and build generics Indian pharma industry is mostly doing these. We export a lot of generics to other continents as well.

Indian pharma is not just manufacturing generics; the government also uses compulsory licensing to ignore patents.

Those constitute only a minsicule amount total manufacturing. It is used only for few serious diseases, e.g. leukemia.

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#218
post #177

Earlier quoted context omitted.

> The mandate that emergency rooms treat anyone who enters is onerous and there's no free lunch, paying customers are stuck with the bill. I don't think that's onerous, I think that is a minimal, and admittedly imperfect, expression of our societal intent that people shouldn't die unnecessarily in emergency rooms - either from lack of being able to pay; nor from a practical standpoint, lack or delay of on-hand proof…

> Someone arrives in an ambulance near-death, if I lack morals then one level of maximized extraction price is to have those patients commit to pay a value that represents the earning potential for that person for the rest of their life. They have to agree before getting admitted. Actual markets don't work that way. If you could actually make that much money then someone would open a competing emergency room right ac…

> Actual markets don't work that way.

Isn't that exactly what's happening in slower motion with the incredible price hikes in many drugs such as insulin? And you assume that the neighborhood can sustain two emergency rooms - a second competitor isn't going to arise if the setup costs are high and the competitor can't undercut and survive the competition phase. This is exactly why there aren't multiple competitors to residential ISPs, because after the risk and costs are factored in setting up overcapacity for a market isn't a good investment.

Further if you look at the drug markets, sufficient cost and time barriers exist and allow even makers of generic drugs (with no patent monopolies) to charge inhuman rates for drugs. And generally investors are not going to back efforts to fund a head-to-head competitive slugfest when the market of users for a given drug is basically of fixed size. Again building overcapacity is generally avoided in these markets because of the high entry barriers.

https://www.nytimes.com/2017/04/14/business/lannett-drug-pri...

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#219
post #177

Earlier quoted context omitted.

> The mandate that emergency rooms treat anyone who enters is onerous and there's no free lunch, paying customers are stuck with the bill. I don't think that's onerous, I think that is a minimal, and admittedly imperfect, expression of our societal intent that people shouldn't die unnecessarily in emergency rooms - either from lack of being able to pay; nor from a practical standpoint, lack or delay of on-hand proof…

I don't defend the status quo. I think this is the right way to resolve healthcare. I agree with about 95% of this: https://market-ticker.org/akcs-www?post=231949 We just need smarter regulations: > every medical facility needs to have a price for each billing code > every healthcare facility has to publish their prices > heatlh care facilities must honor their published prices for everyone > if someone needs car and…

Healthcare often isn't billable in consistent units. Someone goes in for surgery, and they get opened up, despite pre-imaging, there are complex things that can go wrong and instead of a 1 hr 10k effort, you need to put in a 6 hours 100k effort? how is that billed? are you going to require statistics of probabily of going wrong too? By the time you get all these 'consistent billing units' figured out for all the multitude of ever changing procedures wouldnt have been cheaper just to have covered reasonable costs instead of maintaining a multi-way cost/trust verification excercise?

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#220

Earlier quoted context omitted.

I sometimes feel like "free-market" types are actually incapable of understanding this point. The idea that markets and property exist as some sort of independent, empirical objects is baked so deeply into their ideology that it's almost as if they lack the symbolic vocabulary to even conceptualize the idea that property itself is created by regulations.

You seem very strongly invested in this point, which is strange considering how easily refuted it is: Property existed long before third-party regulation. Rather than ownership being enforced by a third party with monopoly on violence, it was enforced by the threat of escalating violence from the property owners themselves. Eg. You take one goat from my herd and refuse to give it back, and we are now at war. Result:…

And with those conditions economic growth and stability of society seems much lower than the more civilized alternatives...
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