tedgresham said:
When someone goes to a doctor that doctor is going to prescribe a new, fancy drug when it is not warranted. Generic drugs will often do just fine. Sometimes there are off the shelf drugs that will work.
The use of "fancy" meds and doctors getting cash incentives to prescribe certain medicines pisses me off a little too. The incentives in particular are in a moral grey area that leave me feeling uneasy.
I think it's less of a problem in the UK because the NHS here has it's own bodies that are motivated by government budgets to pick the most efficient and cost-effective drugs for patients, whereas the US system passes profits onto the doctor directly.
On the other note, it's important to recognise that drugs would never progress if they weren't prescribed. A long time ago the painkillers that are now regarded as effective and taken forgranted would have been expensive experimental "fancy" treatments that people would have objected to paying through the nose for. Progress in the drug field is almost universally positive in the long term and it rides on the back of usage like that.
tedgresham said:
Take something like famotadine. What that stuff was prescribed under a name brand it was extremely expensive. Now it's cheap and off the shelf. Maybe it did cost a bit more to produce originally but I can't see how it cost so much to produce that it was worth ten or twenty times what it costs now. Over the years pills that once cost thirty bucks a piece dropped to a few cents a piece. And you can be sure even at that low price there's a profit in producing it or it would not be available. Drug companies inflate prices for profit.
Ten or twenty times deflation what it cost to make that drug in the 80's? Easily. From the outside, it's hard to see where these expenses come from.
I'm not going to deny that drug companies will maximise their profits - that's simple capitalism. However, the costs really are that huge, and really do taper off that much over time.
The University I'm at right now has had
all it's labs fully modernised recently. The Uni paid towards it, but drug companies in all likelihood have put in a hefty chunk of capital to do that, because they often use Uni labs for their studies and they're investing in a potential future workforce.
Similarly, if I get a good degree I have a chance of signing up for a short contract with a major chemical company (they do everything from drugs to toothpaste to clothing materials). One of the conditions on the contract is that they will pay
all of my student fees for me on top of a wage if I serve the time period.
Think about them doing that for all their new recruits, and that's a ridiculously gigantic amount of money even just in that one incentive scheme. But they really need qualified people to stay at the cutting edge of progress, so they do it.
The other expenses you never hear about are the failed drugs. For every drug that's successfully proved to treat a condition effectively, have side-effects considered minimal for what it does and deemed cost-effective to produce there will be hundreds of drugs that money was poured into making that never saw the light of day.
Add on the fact that people are always working to discover new mechanisms by which molecules can be synthesised (thus lowering production costs over the years) and yesterday's highly expensive medicine will easily be tomorrow's cheap-as-chips "basic" building block off which the newest drugs will be produced.
This is good for the consumer in the long run - in future, we may be looking at drugs which effectively treat or even cure cancer at prices everyone can afford, because technology and knowledge will have progressed far enough that the medicines we consider very complicated right now are off-the-shelf level later.
tedgresham said:
The problem with side effects is that these days it does not matter what medication you're prescribed there comes with it such a long list of how it could screw you up you don't really know if any of it is happening. That was kind'of the point of my original post. Every med the VA sends comes with a warning that, boiled down, says something like, "this could make you nuts, rip your guts out, or kill you, but, well, probably not so take it and find out!"
The last thing, and probably the worst, is that Americans tend to see the answer to all their ills in a pill. Feel bad? Take a pill. Have a pain? Take a pill. It's no wonder we have such a drugged up country. And of course I'm a hypocrite because I reach for a pill too. But what can you do?
The more ambitious you want to get with medicine (and science in general), the more issues there are to deal with. A basic, well-crafted painkiller is not going to have long-reaching side effects if prescribed and used correctly. You're effectively plugging a hole in a receptor somewhere, to put it in the most basic terms.
On the other hand, if you're trying to cure something like Alzheimer's, you're dealing most likely with massively intricate protein synthesis and all sorts of chemical equilibria. The risk of side effects will increase until, again, understanding means that we have the knowledge to produce drugs that can target a problem with pin-point accuracy.
If people want humanity to head forward to a state where we can really cure suffering and disease, problems like this must be put up with until they can be overcome.
I see no reason why people should give up on their dreams of eventually living life without fear of crippling illness because right now there are struggles with unwanted effects that need to be fixed.
I agree that "pill culture" is a bad thing. No drug is really an air-tight solution to a problem, and the thought that it is can be dangerous.
One day we'll live in a world where taking a pill won't "drug you up", it'll just fix what's wrong and that'll be it. That's what we're working towards, and that's why it's taking so long.
