Slashdot Mirror
The Peculiar Economics of Developing New Antibiotics
HughPickens.com writes Every year at least two million people are infected with bacteria that can't be wiped out with antibiotics but the number of F.D.A.-approved antibiotics has decreased steadily in the past two decades. Now.Ezekiel J. Emanuel writes at the NYT that the problem with the development of new antibiotics is profitability. "There's no profit in it, and therefore the research has dried up, but meanwhile bacterial resistance has increased inexorably and there's still a lot of inappropriate use of antibiotics out there," says Ken Harvey. Unlike drugs for cholesterol or high blood pressure, or insulin for diabetes, which are taken every day for life, antibiotics tend to be given for a short time so profits have to be made on brief usage. "Even though antibiotics are lifesaving, they do not command a premium price in the marketplace," says Emanuel. "As a society we seem willing to pay $100,000 or more for cancer drugs that cure no one and at best add weeks or a few months to life. We are willing to pay tens of thousands of dollars for knee surgery that, at best, improves function but is not lifesaving. So why won't we pay $10,000 for a lifesaving antibiotic?"
Emanuel says that we need to use prize money as an incentive. "What if the United States government — maybe in cooperation with the European Union and Japan — offered a $2 billion prize to the first five companies or academic centers that develop and get regulatory approval for a new class of antibiotics?" Because it costs at least $1 billion to develop a new drug, the prize money could provide a 100 percent return — even before sales. "From the government perspective, such a prize would be highly efficient: no payment for research that fizzles. Researchers win only with an approved product. Even if they generated just one new antibiotic class per year, the $2-billion-per-year payment would be a reasonable investment for a problem that costs the health care system $20 billion per year." Unless payers and governments are willing to provide favorable pricing for such a drug, the big companies are going to focus their R&D investments in areas like cancer, depression, and heart disease where the return-on-investments are much higher.
Emanuel says that we need to use prize money as an incentive. "What if the United States government — maybe in cooperation with the European Union and Japan — offered a $2 billion prize to the first five companies or academic centers that develop and get regulatory approval for a new class of antibiotics?" Because it costs at least $1 billion to develop a new drug, the prize money could provide a 100 percent return — even before sales. "From the government perspective, such a prize would be highly efficient: no payment for research that fizzles. Researchers win only with an approved product. Even if they generated just one new antibiotic class per year, the $2-billion-per-year payment would be a reasonable investment for a problem that costs the health care system $20 billion per year." Unless payers and governments are willing to provide favorable pricing for such a drug, the big companies are going to focus their R&D investments in areas like cancer, depression, and heart disease where the return-on-investments are much higher.
The main point where multiresistencies are created is animals. When we give them antibiotics in order to enable "storing" them even denser, we enlarge the contact between patogen and antibiotics by a huge factor.
Our greed for cheap meat has brought us to the point where we destroy our own hardly-won victories against illnesses. And, the current system unfortunately even rewards you if you apply your antibiotics for animals -- by giving you money.
I have HIV, more funding goes into 1 years worth of funding for my university sports team than has gone into HIV cure R&D funding over the past 5 years COMBINED.
Big pharma don't want to make you better, they want your money.
Why cure something when you can keep it under "control" and earn 100x more?
Why help more people more often and improve quality of life, when you can help less people and earn more?
You are wrong.
Research averages 2.7 billion dollars a year of the $25 - $30 billion yearly total funding for AIDS in the USA.
Over the last five years? R&D = $13.5 billion; total spending over $130 billion.
Here's the actual numbers:
http://kff.org/global-health-p...
Or are you comparing the sports funding at your University to the HIV research funding at your University?
That would be a pointless comparison. We already know that University of Phoenix doesn't have much of a research program in anything.
We can't make any decision until we see past the government/Medical bureaucracy and get complete audit of those "costs".
The Medical Industry is completely opaque when it comes to costs. They are shifted from one area of the business to another, they are obfuscated by accounting gimmicks, government regulations, and insurance practices. Of course that's all par for the course. But before you make policy decisions, you have to know the truth...what's driving the costs. there is no reason all thee issues can't be pushed back in an audit and reveal the truth. Changing the practices can only come after the causes are revealed.
I bet many would be surprised at the answers.
When Fascism comes to America, it will call itself Anti-Fascism, and tell you to give up your guns.
Ha ha ha ha! In the USSR we invented 4 or 5 antibiotics over the life of the country (a country that lasted for 69 or 74 years, depends on how you count) and it was complete and total socialism and of-course it was complete and total failure. How many antibiotics did they invent in Cuba exactly? North Korea?
American capitalism in 19th century American Free Market is actually what created cheap accessible and effective medical and pharma systems as for profit businesses and for the last 100 years American socialism/fascism have been destroying everything that was done.
You can't handle the truth.
In the 19th century, people were still taking blue mass (mercury) to treat miasms (bad vapors thought to cause sickness).
It wasn't until the 20th century that actual useful medicine got started, but the big blockbusters, sulfa drugs and penicillin came from Germany and France respectively. Meanwhile, the "American Free Market" gave us radium water and the deadly Elixir sulfanilamide.
So go ahead and wash your anti-freeze down with radioactive waste while the rest of us look for an actual solution.
You should check what you're swimming in first. You'd be surprised how many expensive treatments you can get in America that are denied in Canada because they've been shown to make things worse or to have no effect at all.
Not only are there orphan drugs, there are orphan diseases, one of which is MS. One of the major drugs used to control this is Avonex. Check out the cost of a monthly supply, and note that a monthly supply consists of exactly four doses. About the only way anybody but the 1% can afford it is the fact that if you're using it you're automatically eligible for Medicare, SSI and whatever assistance your state offers. And, I suspect that if that weren't the case, the price would drop dramatically because without the subsidies there wouldn't be any market for it.
Good, inexpensive web hosting
First, the 19th century is the years between 1800 and 1899. In the 19th century, they had no effective medicine. They were still bloodletting. They could amputate limbs, although the patients often died of infection. I think you mean the 20th century, which is the years between 1900 and 1999. We are now in the 21st century.
Second, America never had a cheap, accessible free market capitalist system. I don't know where you get your ideas from. I live here, I work in the health care system, and I know the history and problems with the American health care system.
At the beginning of the 20th century, doctors couldn't do much. If you were shot in the leg, and the leg was infected, they could cut it off, and your chance of survival would go up from zero to maybe 50%. If you had heart disease, they couldn't do much to extend your life. If you had cancer they could give you morphine.
Things were going along like that without much progress until WWII, where the U.S. government (not free market capitalism) systematically studied the problems and came up with innovative new ways of handling surgery. Penicillin (from Alexander Flemming in England, an academic researcher) was a big breakthrough. Adriamycin, the first cancer drug, was discovered on -- guess where -- the Adriatic sea, by Italians.
The U.S. was a center of tremendous innovation after WWII, not because of free market capitalism, but because the U.S. government funded academic researchers, who provided a lot of the basic research that the private drug companies took and made money out of. The area with the most dramatic progress was heart disease, and much of the important research was done by the U.S. government's Veterans Affairs hospitals.
After WWII, there were private doctors, but people who couldn't afford their prices went to government hospitals, which were scattered around the country. What reason would capitalist doctors have to treat people who can't afford to pay a lot of money? By the 1980s, when doctors could finally do something useful, they got very expensive. People who can't afford health care are left to die http://www.wsj.com/articles/SB...