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With no prospects for profits, big pharma neglects new infectious diseases

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Re: With no prospects for profits, big pharma neglects new infectious diseases

#91

Post by j_m_b »

cjfd wrote: post #63
hnzix wrote: post #57

Earlier quoted context omitted.

Please put the invisible hands of the market over your ears and wait for the drugs to trickle down. Jokes aside - while people are justifiably pointing out the community healthcare angle, arguably this problem is exacerbated by the American FDA drug approval model, ie no corporation will fund clinical trials unless they're guaranteed a profit monopoly.

Actually, there is a market solution to this problem. I cannot claim to have thought this up, it was discussed in an episode of econtalk. Don't remember the person that was interviewed. The idea is that big pharma companies have to publicly post a price for each of their patents. If anyone is prepared to pay that price they get the patent for that price. Next there needs to be a tax that is a percentage of the price…

>The money that comes from this tax needs to be funneled back into healthcare or even better go straight to the ones who are paying for the particular medicine that the patent protects.

Tax money is allocated for one thing is often used for other things. There is nothing preventing lawmakers from doing this, they after all, make the laws.

Re: With no prospects for profits, big pharma neglects new infectious diseases

#92

Post by Infinitesimus »

cactus2093 wrote: post #88
foogazi wrote: post #41

Are there national laboratories with the capabilities to find a cure? Is there a NASA equivalent for infectious diseases to launch a covid-19 moonshot?

The WHO is saying a vaccine is 18 months out, and I’m very curious what that means. I haven’t seen any detail as to why it takes that long. It’s short enough that clearly they expect it won’t be very hard, like no one would say a general cure for cancer is 18 months out. So what is preventing us from speeding it up more? Why can’t it be made in 6 months, or 3 months? Is the majority of that 18 months a basic r&d phas…

> People have been saying a vaccine is 12-18 months out, and I’m very curious what that means. I haven’t seen any detail as to why it takes that long.

All the things you said are factors. Clinical trials are one of the biggest because you have multiple phases to observe to guarantee safety.

It's no use shipping a vaccine in 3 months after a small test and have everyone die in a year because of a side effect no one waited long enough to see.

Drug development and safety is a very complex space from what I've learned

Re: With no prospects for profits, big pharma neglects new infectious diseases

#93

Post by Aunche »

empath75 wrote: post #78
nostromo wrote: post #2

Perhaps they’re behaving entirely rationally. Infectious diseases do not kill that many people compared to cancer in America. We may have a bad “flu” year this year, with a spike of elderly deaths, but we have a bad cancer year every year.

This bad flu is going to kill tens of millions of people and wipe out health systems around the world and wreck the world economy. I wish people would stop downplaying it.

If it is really going to kill tens of millions of people, you can bet that pharmaceutical companies are already working on cures.

Re: With no prospects for profits, big pharma neglects new infectious diseases

#94

Post by bo1024 »

cjfd wrote: post #63
hnzix wrote: post #57

Earlier quoted context omitted.

Please put the invisible hands of the market over your ears and wait for the drugs to trickle down. Jokes aside - while people are justifiably pointing out the community healthcare angle, arguably this problem is exacerbated by the American FDA drug approval model, ie no corporation will fund clinical trials unless they're guaranteed a profit monopoly.

Actually, there is a market solution to this problem. I cannot claim to have thought this up, it was discussed in an episode of econtalk. Don't remember the person that was interviewed. The idea is that big pharma companies have to publicly post a price for each of their patents. If anyone is prepared to pay that price they get the patent for that price. Next there needs to be a tax that is a percentage of the price…

This is the COST (common-ownership self-assessed tax) from the recent book Radical Markets by Weyl and Posner.

Re: With no prospects for profits, big pharma neglects new infectious diseases

#95

Post by Aunche »

refurb wrote: post #4

What's needed is a new payment model for anti-infectives. This already happens at a small scale with grants from institutions like BARDA. The DOD of also does this for vaccines for biological weapons like anthrax where there is a high likelihood the drug will never be used, but a vaccine is needed because if there is an outbreak, the consequences are severe. Basically, rather than paying for drugs on a per unit basis…

> Discover a new drug for a anti-biotic resistant infection? Great, here is $500M as long as you agree to produce as much drug as needed for free or some nominal cost.

Most AR bacteria can be killed by trying different antibiotics. Sure they can mutate to something more dangerous, but it doesn't make sense to make drugs for bacteria that don't even exist yet. There are too many variables to account for.

Re: With no prospects for profits, big pharma neglects new infectious diseases

#96

Post by HarryHirsch »

barry-cotter wrote: post #64
refurb wrote: post #9

Earlier quoted context omitted.

Sure, but as a result we don't have problems like thalidomide popping up every decade or so. There are benefits (and drawbacks) to having a much more stringent approval process. And probably worth adding that in public health emergencies, the FDA is more than willing to pull back on regulations in the interest of the public good.

You can have a stringent safety process without having any efficacy process. The FDA has no incentive to approve drugs but plenty to deny them so delay is the order of the day. Delay in approving new effective drugs costs lives. The FDA has not shown any willingness to pull back on regulations during the current COVID crisis, nor have they historically shown any such willingness. Politicians have forced them to. They…

[flagged]

Re: With no prospects for profits, big pharma neglects new infectious diseases

#98

Post by vikramkr »

tus88 wrote: post #43
refurb wrote: post #4

What's needed is a new payment model for anti-infectives. This already happens at a small scale with grants from institutions like BARDA. The DOD of also does this for vaccines for biological weapons like anthrax where there is a high likelihood the drug will never be used, but a vaccine is needed because if there is an outbreak, the consequences are severe. Basically, rather than paying for drugs on a per unit basis…

> Discover a new drug for a anti-biotic resistant infection? Great, here is $500M as long as you agree to produce as much drug as needed for free or some nominal cost. If you were going to develop the drug at your own cost with no subsidy for failure, why settle for 500M? Why not do it on your kwn merit and reap billions instead? And keep all the IP.

In other disease areas that makes sense, but for anti-biotics that 500 million is more than you'd be able to make on the market. Especially if the antibiotic is really good - the better it is the less it will be used since we want to prevent resistance developing to our best drugs. That 500 million might be necessary to make the development be worth it.

Re: With no prospects for profits, big pharma neglects new infectious diseases

#99

Post by vikramkr »

Infinitesimus wrote: post #92
cactus2093 wrote: post #88

Earlier quoted context omitted.

The WHO is saying a vaccine is 18 months out, and I’m very curious what that means. I haven’t seen any detail as to why it takes that long. It’s short enough that clearly they expect it won’t be very hard, like no one would say a general cure for cancer is 18 months out. So what is preventing us from speeding it up more? Why can’t it be made in 6 months, or 3 months? Is the majority of that 18 months a basic r&d phas…

> People have been saying a vaccine is 12-18 months out, and I’m very curious what that means. I haven’t seen any detail as to why it takes that long. All the things you said are factors. Clinical trials are one of the biggest because you have multiple phases to observe to guarantee safety. It's no use shipping a vaccine in 3 months after a small test and have everyone die in a year because of a side effect no one wa…

Guaranteeing safety is absolutely a crucial part of it. And if you pull something out that doesn't work, giving people a false sense of immunity would also make things worse.

And safety shouldn't be underestimated. The story of dengue vaccine development is a cautionary tale. The first time you get dengue is usually not too bad, but it can be deadly if you get it again. Part of that is hypothesized to be driven by your own immune system, which, once immunized against one strain, produces antibodies against it in the next infection. However, if it's a slightly different strain of dengue the second time around, the antibodies meant to neutralize the disease are believed to make the disease more virulent instead (antibody-dependent enhancement). The immune system makes it worse. So when a dengue vaccine that didn't fully immunize against all strains was developed (not deliberately, people tried to immunize against all strains but this is a case where less efficacy than expected made things worse), it didn't make things better. It ended up priming people to get dengue.

Biology is super weird - even something as "simple" as vaccine development has a lot of unknown unknowns. And as dengue showed us, it's not just a case of "it might not work," because it could make things worse. That's why we have to run these clinical trials and take time to do things right, especially for something that would be as widely deployed as a coronavirus vaccine.

Re: With no prospects for profits, big pharma neglects new infectious diseases

#100

Post by vikramkr »

foogazi wrote: post #41

Are there national laboratories with the capabilities to find a cure? Is there a NASA equivalent for infectious diseases to launch a covid-19 moonshot?

Looks like there are a lot of companies deploying clinical trials to test existing antivirals already.

The NIH and all are likely already researching this strain, and importantly they're also funding labs in universities nationwide (since there's no reason to expect that a team of scientists who come up with the insights needed to find a cure would happen to already work for the government).

The government tends to be really good at getting things with clearly defined goals done, and they're good at rapidly scaling any work that needs massive funding an institutional support. But finding a cure for a viral infection is more of a creative task (and not a task that is important enough to be worth it likely - vaccination and preventative measures are probably more important and more feasible to implement since they don't necessarily require a scientific breakthrough).

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