Are The FDA & The Patent System Getting In The Way Of Saving Lives Again?
from the that-market-ain't-free dept
There was a somewhat horrifying article in the NY Times recently about some serious drug shortages in the US, especially for certain forms of cancer. There are a few efforts underway to deal with the shortages, but as the article notes, it's pretty ridiculous that there are any shortages at all, since "the number of cancers diagnosed in a year was easy to predict." Of course, the real problem is that in a claimed effort to "protect" people, the FDA has made it almost impossible for competition to exist:A crucial problem is disconnection between the free market and required government regulation. Prices for many older medicines are low until the drugs are in short supply; then prices soar. But these higher prices do little to encourage more supply, because it can be difficult and expensive to overcome the technical and regulatory hurdles. And if supplies return to normal, prices plunge.Left out of this paragraph, but equally important, are patents, which clearly hinder such competition as well. We've discussed in the past how the FDA can often get in the way of medical innovation. Even if it means well (and I'm sure it does), putting in place systems that make it too costly to create real competition does the exact opposite of its intended purpose.
Thank you for reading this Techdirt post. With so many things competing for everyone’s attention these days, we really appreciate you giving us your time. We work hard every day to put quality content out there for our community.
Techdirt is one of the few remaining truly independent media outlets. We do not have a giant corporation behind us, and we rely heavily on our community to support us, in an age when advertisers are increasingly uninterested in sponsoring small, independent sites — especially a site like ours that is unwilling to pull punches in its reporting and analysis.
While other websites have resorted to paywalls, registration requirements, and increasingly annoying/intrusive advertising, we have always kept Techdirt open and available to anyone. But in order to continue doing so, we need your support. We offer a variety of ways for our readers to support us, from direct donations to special subscriptions and cool merchandise — and every little bit helps. Thank you.
–The Techdirt Team
Filed Under: competition, drugs, free markets, patents, pharmaceuticals, pricing, regulations
Reader Comments
Subscribe: RSS
View by: Time | Thread
When people are getting sicker and dying so a corporation can make more profit the system is screwed.
Do we need to travel to DC and start stacking up body bags to get their attention? This is another step down a horrible path and while they seem to pay lip service to having the FDA look into these things, that have made the FDA as impotent to do anything as they possibly can.
Maybe it is time to tie patents to orphaned drugs. Yep you get an exclusive patent on your new super drug, BUT you are required to keep producing X drug that people need at a regulated price. If you create an artificial scarcity for either drug to get more money your patent is rescinded or we auction it off to one of your competitors who will have the same restrictions.
They like to forget that "the people" are stakeholders in these things as well. That we agreed to let them have the exclusive rights to profit from what they made, but when you screw with the market to inflate your profits at the expense of the health of the people you have gone to far.
It is time to stop worrying about corporations well being. They have had everything they wanted given to them and it has benefited society as little as possible in exchange. It is time to rebalance the scales, and have oversight that keeps it balanced.
[ link to this | view in chronology ]
Re:
[ link to this | view in chronology ]
Many problems with US health care
As long as lobbyists and politicians convince voters that we have the best health care system in the world and that any changes will hurt citizens, not much is going to happen.
Anyone care to mount an effective campaign to get things turned around?
[ link to this | view in chronology ]
While they might just want lower costs for a nice yard, people dropping dead tend to make the place look a little drab.
[ link to this | view in chronology ]
Re:
I have pondered this a lot. Do the masses have any leverage? Do we reach a tipping point where things get so bad for so many people that the very wealthy are moved to act?
But my conclusion is that the masses don't have that leverage. The very wealthy can get by with far fewer people. In fact, it's probably better for the planet if we continue to have a worldwide recession. Consumption goes down, which reduces degradation of the planet.
And if people die off, it's a crude form of population control.
When companies made money from people borrowing and consuming, then having lots of consumers was a good thing for those corporate owners. But if consumers stop borrowing to pay off debt and buy less as a result, they don't contribute to the wealthy and therefore, other than for humanitarian reasons, the wealthy have no incentive to save them.
If you look at politics in this country and around the world, you realize there are a lot people ready to eliminate funding on those programs that help the poor and the middle class.
[ link to this | view in chronology ]
[ link to this | view in chronology ]
Re:
They seem out of touch with reality, it would be nice for them to be told no sometimes. No we have nothing left that can treat you. We had some but we sold the last does on eBay to the highest bidder... and it wasn't you. Enjoy your fever.
[ link to this | view in chronology ]
US Chamber of Commerce Secret is revealed!
She couldn't get her drugs the legal way.
Perhaps drug companies manufacture a pill that gives people a clue.
[ link to this | view in chronology ]
The FDA
[ link to this | view in chronology ]
It's pretty clear that the real purpose of the FDA is to protect the pharmaceutical gatekeepers.
[ link to this | view in chronology ]
Yup, I want the FDA out of the way of the drug business, so that I can be sure that the standards in the US catches up with Mexico.
[ link to this | view in chronology ]
Re:
I know, I know, you would never do something like that. It's all the other stupid people out there that need your wise council on what is and isn't good for them.
Good thing educated folks like you and the FDA are here to tell us what's what, or the unwashed masses would be stabbing themselves in the eyes with their forks and eating mud out of the gutter.
[ link to this | view in chronology ]
Re: Re:
[ link to this | view in chronology ]
Re: Re: Re:
There is an important role for third-party evaluations and certifications in the market, but it doesn't have to be done by a massive government bureaucracy with the sole power to decide who can and can't sell their products, enforced by armed men who will kidnap you and throw you in cage for years at a time if you don't comply.
The only support that can be mustered in favor of the FDA existing is disgusting mixture of "I'm smarter than the unwashed masses" elitism combined with "if the government doesn't do with guns, it will never be done" stupidity.
[ link to this | view in chronology ]
Re: Re: Re: Re:
Have you considered what someone on a fixed income might do to save money? Dang, I can get my meds for half price from this place. I need the money to eat, so yeah, let's do it.
People spend tens of millions of dollars on fake medication already with the FDA involved, can you imagine the free for all without them?
[ link to this | view in chronology ]
Re: Re: Re: Re: Re:
History, mainly. Walgreens isn't going to sell a knock-off that kills their customers, if they can help it. In a market without the FDA, third-party certs would be invaluable.
"Oh, Drug Underwriters Inc. signed off on their facilities. I know that no facility they've ever signed off on has released any contaminated pills, so that's a good endorsement."
Dang, I can get my meds for half price from this place. I need the money to eat, so yeah, let's do it.
So the answer is to make them so expensive through regulation, that those same people have to choose between eating and getting their meds? How does that help anyone?
People spend tens of millions of dollars on fake medication already with the FDA involved
And here we see that the failure of the system is used as evidence for why the system is needed. (Reminds me of arguments for the war on illegal drugs too, now that you mention it.) Maybe if people didn't believe that a benevolent dictator in a government office building would do their thinking for them, they'd start to do some themselves.
[ link to this | view in chronology ]
Re: Re: Re: Re: Re: Re:
Like I said, I think the system needs some fixing, but that doesn't mean to blow it up entirely.
[ link to this | view in chronology ]
Re: Re: Re: Re: Re: Re: Re:
This is just a case study, in my opinion, of what an entire market with "rational actors" would act like.
As opposed to having the wise, learned elitists at the top to make decisions for us, you mean? Airborne is useless. I don't buy it, and I tell everyone I know that asks about it that it's useless. The thing is, I don't grab a gun, walk into a Walgreens, and threaten to hurt the clerk for selling it. (People forget that this is the entire purpose of the government; to threaten with violence. If you wouldn't do it yourself, why does it suddenly become acceptable and moral to pay someone else to do it for you?)
Like I said, I think the system needs some fixing, but that doesn't mean to blow it up entirely.
The FDA is not the system. The FDA is one particular leech on the system. Dynamiting the FDA is not blowing up the system entirely.
[ link to this | view in chronology ]
Re: Re: Re: Re: Re: Re: Re: Re:
Do the studies show what the manufacturer is claiming
Are there ill effects
Are the drugs not contaminated
That's it. And last I checked, the only time the FDA has done any type of physical incarceration is when people knowingly commit fraud, and it's usually top level execs who make the decision. Most of it is punitive damages, so I'm not really sure where your gun example comes into play, unless the supreme court has ruled that money = firearms, and I missed it.
Clearly you have issues with government, and I don't think I can change your (or anyone elses) mind about trusting government. I'm sorry you feel that way. Personally, knowing the people who do the work and their motives, I trust most of the underlings in what they do. Does it mean that there isn't corruption, of course not, but as I think I've pointed out, there's no such thing as a corruption free system.
It also looks like you have issues with trusting other people(learned elitists, which personally, I trust people who have spent their entire career studying something). I understand the sentiment(I don't trust profit maximizers), but in a world of specialization I can't know everything, so I have to put faith in something. To me, that something isn't that the uninhibited free market is the best mechanism to regulate company actions. I see the trade off as losing some freedom of choice in favor of the overall safety of the system, which I prefer. Just my opinion, so take it for what it's worth.
The system I'm talking about is a safe and effective drug market. Most of the things that create that system stem from FDA regs and oversight, IMO, so I think getting rid of the FDA would be like getting rid of Ghaddafi(although I'm not saying they are Ghaddafi, just that this is a very recent parallel to draw). Nobody knows what Libya will be like, there's been no entities that have existed without his oversight for 30 years. Does the vacuum create a more robust system, or does it devolve into chaos? Can the robust system fill in quick enough so that the chaos wouldn't ensue? These are questions that I'm not smart enough to answer, and I realize this, so I'll toss it over to you to fill me in.
[ link to this | view in chronology ]
Re: Re: Re: Re: Re: Re: Re: Re: Re:
Tell, me, what does the government do if you don't pay them? That's like saying a mugger isn't really committing a violent act if he asks for your money at gunpoint first, because he hasn't actually shot you yet to take it.
It also looks like you have issues with trusting other people
Not at all. What I have "issues" with is people telling me what I can and can't do with my own body. This man wants to sell me a pill; I want to buy the pill. Who are you or anyone else to threaten me with financial or bodily harm for doing it? And to make matters worse, you then tell me that you have to hurt me for my own good. I'd much prefer if it you and your ilk just stayed the hell out of my life, actually. I know you won't, though.
Violence is all anyone knows anymore, apparently.
[ link to this | view in chronology ]
Re: Re: Re: Re: Re: Re: Re: Re: Re: Re:
[ link to this | view in chronology ]
Re: Re: Re: Re: Re: Re: Re: Re: Re: Re: Re:
Which apparently doesn't count as force, according to you?
consider contract law as use of force
Because contracts are voluntarily entered into,and if you don't hold up your end of the bargain, you've essentially stolen from the other party. Theft is force. I haven't signed any contract with the FDA, but will that prevent them from trying to hurt me if I don't follow their "recommendations"?
If a man wants to sell me a pill, and I want to buy it, the person who threatens to steal our property and throw us in jail are using unjust force to do it. There is no "equity" here. Just a bully with a lot of guns at his command.
The fact that the bully is a government bureaucrat that will no-doubt be later appointed to a big pharma executive position for his role in pushing people towards that company's expensive products over the cheaper alternatives while he was in office is immaterial to the analogy, but icing on the cake nonetheless.
[ link to this | view in chronology ]
Re: Re: Re: Re: Re: Re: Re: Re: Re: Re: Re: Re:
Just like with contracts, you decide that you want to enter the stream of commerce to solve a problem. You abide by all the rules of that stream of commerce. The contract example was one where 2 people were harmed, both felt that they had the right to something, and unfortunately someone was going to be forced to do something they didn't want. Sure, they assented to the original deal, but drug manufacturers and consumers assent through the democratic process.
[ link to this | view in chronology ]
Re: Re: Re: Re: Re: Re: Re: Re: Re: Re: Re: Re: Re:
Voting is force. It's always been force. We vote because we hope that the decisions to use force that come out of a democratic process will be better than the decisions to use force by a dictator, but that doesn't change the nature of the action. Actions do not lose their essential nature or become moral simply because a majority of voters command them into law.
A contract you don't agree to is not a contract.
[ link to this | view in chronology ]
Re: Re: Re: Re: Re: Re: Re:
• Are you saying that Vitamin C has no positive effect on the immune system? (NIH: "people who take vitamin C supplements regularly might have slightly shorter colds or somewhat milder symptoms.")
• Are you saying that Echinacea has no health benefits whatsoever? (NIH: "studies have shown that echinacea may be beneficial in treating upper respiratory infections.")
• Are you saying that taking more Zinc isn't a good thing? (The NIH says: "Zinc deficiency is characterized by growth retardation, loss of appetite, and impaired immune function.")
• So, Ginger has no cold-fighting effects? (NIH: "Other uses include treating upper respiratory tract infections, cough, and bronchitis.")
So, pretty much the FDA disagrees with the NIH on the effectiveness of Airborne.
Wake up. The FDA raids, fines and persecutes companies that sell vitamins and herbs because their drug company buddies don't want the competition from things with no side effects that can't be classified as drugs, even though they are effective.
[ link to this | view in chronology ]
Re: Re: Re: Re: Re: Re: Re: Re:
(And if you don't like it, prepare to get the shit kicked out of you by the government. It's not really violence, though, because the law says it's okay! Aren't we all so enlightened these days?)
[ link to this | view in chronology ]
Re: Re: Re: Re: Re: Re: Re: Re:
Zinc does have effects, see Zycam. It shortens the length of colds through chemical means, and should be classified as a pharmaceutical. It also causes anosmia(loss of smell), but since Zycam was classified homeopathic(even though it wasn't).
As for the other 2, I don't have time to do the research(and doubt that there is any significant effect in large trials), but the post shows your lack of knowledge of the scientific process, and random trials. Just because a single study shows that something might occur, does not mean it's true. The reason the FDA didn't approve Airborne wasn't conspiracy, it was the fact that when they compared taking Airborne to taking a placebo, there was no measurable difference between the 2. This leads to the conclusion that if you take nothing and take Airborne and both have the same effect, then Airborne has no effect and should not market itself as having an effect.
[ link to this | view in chronology ]
Re: Re: Re: Re: Re: Re: Re: Re: Re:
I've always understood that you're supposed to take Airborne (which has a "massive" dose of Vitamin C in it) before going into a situation where you're likely to be exposed to sick people. That's why they call it Airborne (hint: you're supposed to take it before getting on a plane).
I tend to think it's a waste of money, but then, I don't think I should threaten people to stop them from buying and selling it either. I guess that's where we differ.
[ link to this | view in chronology ]
Re: Re: Re: Re: Re: Re: Re: Re:
"boosting the immune system" is a largely meaningless phrase, on par with "encourages good health". "Boosting" is not defined, nor is "immune system" ("immune system" is a colloquial term, not a medical one. You have no "immune system", you have many different and distinct biological activities that are collectively needed to keep you alive.
In scientific papers, "might" means "neither proven nor disproved". In other words, when you read "might" you can safely ignore the rest of what "might" be, as the it adds nothing to your knowledge or understanding.
"May be" is just another was to say "might".
(The NIH says: "Zinc deficiency is characterized by growth retardation, loss of appetite, and impaired immune function.")
Taking more zinc can be very beneficial if you have a zinc deficiency. If you don't, then this statement in no way asserts that taking zinc has any benefit. Odds are that you don't have a zinc deficiency.
This is only a statement of what people use use ginger for, not of whether or not it's effective for these uses.
So, all in all, these quotes do not support the idea that the FDA and the NIH disagree about the effectiveness of Airborne.
Where Airborne got into trouble was in making health claims that were not supported by the evidence. None of these quotes counter that conclusion.
[ link to this | view in chronology ]
Re: Re: Re: Re:
As for 3rd party evaluators, doesn't this put us in the same exact situation? Why does anyone think that there would be less corruption in a third party system? For example, look at Standard and Poor's rating of the high risk bonds from a few years ago. They were essentially being paid off to give good scores to the bonds(and causing a collapse), and their opinion is still high enough that when they downgrade the US's credit rating everyone takes it seriously. Why would drugs be any different?
Do I agree that there are inefficiencies in the system? Absolutely. Do I think that doing away with the system is a better solution? No way. If you think I'm making a fatal flaw in reasoning, please let me know, but I think the FDA is one of the few governmental entities that is actually necessary.
[ link to this | view in chronology ]
Re: Re: Re: Re: Re:
You don't necessarily have to, as long as you make the choice to buy goods with a reputable third-party cert. I wouldn't buy a copy of every car I'm interested in just to crash test it myself, for example.
As for 3rd party evaluators, doesn't this put us in the same exact situation? Why does anyone think that there would be less corruption in a third party system?
There would undoubtedly still be corruption, but the key point is that no third-party cert company would have the power to outright ban products that they didn't certify. With the FDA, you have a huge problem with regulatory capture, whereby the incestuous relationship between corporate profits and government force scheme to keep out competitors so that they can extract monopoly rents from citizens.
In a free system, I can choose to patronize an ethical company over an unethical one. Tell me, who can I choose to give my business to if the FDA is the corrupt one?
[ link to this | view in chronology ]
Re: Re: Re: Re: Re: Re:
As for the current situation, we're in it because big pharma is subcontracting the work overseas where there is not the oversight and the FDA is catching the contaminants in the drugs. Sans the FDA, there would probably be deaths. In my opinion, since the drugs are off patent(see my post below), this is a manufacturing and capacity issue which the FDA has kind of exacerbated because it doesn't want medicine to kill the patients (although with chemo you're just adjusting the rate of killing the patient). This seems to be more analogous to what the system would be like without patents or FDA regs, a single company would manufacture in the cheapest place possible and would have the capacity to sell everything, essentially at cost. If they increased the price others would enter the market, but not quick enough to fix any drop in production rates. This isn't like the C. Allen Black case, which I think the FDA/NIH should have opened the patent up so others could manufacture it, this is a case where free market principles have made it so there is little to no incentive to enter the market.
[ link to this | view in chronology ]
Re: Re: Re: Re: Re: Re: Re:
You can still take those companies to court. If you sell me aspirin laced with botulism, you can bet there'd be a lawsuit coming your way. You don't need the FDA for that.
[ link to this | view in chronology ]
Re: Re: Re: Re: Re: Re: Re: Re:
[ link to this | view in chronology ]
Re: Re: Re: Re: Re: Re: Re: Re: Re:
"Ha-HA! I was offering a product that everyone thought was great and I could have kept doing it year after year and raked in shitloads of money, but instead I grabbed whatever I could physically wheel-barrow out of my factory and went on the run! Sure showed them! Damn glad their wasn't an FDA to stop me!"
(Say, do you know where I can get a monocle and a tophat? Apparently, after my dastardly plan to eliminate the FDA comes to fruition, there will be some poor, uneducated people that I will want to crush under my evil, capitalist boots, just because I can!)
[ link to this | view in chronology ]
Let me tell you something: patents have nothing to do with a current drug shortage, as most of the stuff that's in short supply is off the patent. As such, anybody can make it. But. The big "But". To make the simplest easiest to synthesize drug, you have to go through the FDA scrutiny. And that is insanely time and money consuming. In a nutshell, to make a simple drug (hardware aside), you have to hire 5-10 chemical engineers, and a small army (hundred or so) of "compliance people", the only function of which will be to ensure that the facility is following the FDA regulations to letter. Guess what that will do to the price of the drug.
You might ask - why does FDA has all this regulations? Simple answer - people want quality drugs. The only way to ensure the quality, is to create all these regulations. So, if something happens (hey, we are living in a real world, stuff happens) and lawyer-happy Americans will (for sure - there a whole firms out there for drug companies) start suing, FDA can say that they did everything humanly possible. And as long as manufacturing adhered to the FDA rules, they will use it as their defense.
So, let me ask you, under these circumstances, whom should we blame? FDA? Nasty drug companies, who don't want to operate at risk and at loss? Cash hungry lawyers? Or a mass of American populus, who wants everything, at best quality, but without paying for that.
So please, before you accuse anybody, do your homework!
BTW, for those upset about the cost of new therapies, saying that they are based on government-sponsored public domain research, if you'll do the math, you'll see, that actual discovery cost is no more than 5% of the final tab. Even marketing (however controversial it is) is still cheap, when compared to the expense of complying to the FDA regulations.
[ link to this | view in chronology ]
Re:
Doxil - off patent in 2009, but still 3 more years of exclusivity
And I agree, I prefer to know that the drugs I'm using are safe and have been shown to be effective.
[ link to this | view in chronology ]
Re: Re:
[ link to this | view in chronology ]
[ link to this | view in chronology ]
Here are a few paragraphs that I found interesting that you seemed to gloss over:
"More than half the recent shortages have resulted because government or company inspectors found problems like microbial contamination that can be lethal on injection. Others have occurred because of capacity problems at drug plants or lack of interest because of low profits, according to the F.D.A."
“The race to the bottom has led to an increase of products coming from plants in China and India that may have uncertain supply and may have never been inspected,” Ms. Bresch said. “If the F.D.A. was required to inspect foreign drug plants at the same rate it does domestic ones, we might not have so many of these shortages.”
[ link to this | view in chronology ]
gene patents can lock the public into outdated and costly health solutions
[ link to this | view in chronology ]
Patents aren't the big problem with health care
However, a lot of drugs are no longer patented and health care delivery is still too expensive. When our system can't afford to deliver even the basics of health care because it costs too much, eliminating patents isn't likely to change that.
[ link to this | view in chronology ]
bias
Once again you have proven yourself as biased and misleading.
In Federalist No. 43, James Madison wrote regarding constitutional rights of inventors, "The utility of the clause will scarcely be questioned. The copyright of authors has been solemnly adjudged, in Great Britain, to be a right of common law. The right to useful inventions seems with equal reason to belong to the inventors. The public good fully coincides in both cases with the claims of the individuals."
Figure it out already!
[ link to this | view in chronology ]
[ link to this | view in chronology ]
For those of you who would do away with the FDA,
[ link to this | view in chronology ]
Patents are cited by mamy pharmaceutical firms as a key motivator in the funding of research leading to new drugs that save millions of lives.The hope of having the next blockbuster drug under patent is vital to justifying the huge investment top bring a key new drug to market. We know this because most new blockbuster drugs are originated in countries with strong patents-US, FR, DE JP, UK.
The alternative is either no new drug R&D or Gov funded pharma R&D.
[ link to this | view in chronology ]
The other side of the argument
Here's a look at how an unregulated system can result in some questionable products. If we are going to explore the subject, we need to look at all issues.
Drugs Posing as Supplementals May Contain Dangerous Ingredients - NYTimes.com
[ link to this | view in chronology ]
writer royalties unpaid and given the runaround big time
[ link to this | view in chronology ]