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Is curing patients good for business?

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Old 04-14-18, 09:07 PM
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Is curing patients good for business?

Is curing patients good for business?

Wow. Just wow.
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Old 04-14-18, 09:22 PM
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This is Politics & Religion fodder.
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Old 04-14-18, 09:37 PM
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Why wow? It's obvious that there's a mere token effort, at best, to find genuine cures for the last fifty years.

And yes of course, clearly belongs in P&R.
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Old 04-15-18, 01:19 AM
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It sounds to me like a lack of understanding of the therapy.

The current generation of gene therapy will cure existing patients (hopefully), but will do nothing for inheritance. So, there will always be more patients.

Some people choose to abort due to major genetic abnormalities, but so far nobody is tinkering with the inherited genome. So, cure the current generation, and then cure the next generation.
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Old 04-15-18, 01:47 AM
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Thinking about why the statement was made by a banker and why it was released I can't help but believe that its totally a scam aimed at manipulating investment markets.

Its just a ridiculous story otherwise even if it is true.
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Old 04-15-18, 02:16 AM
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It is an article written to advise people looking for sound investments. It isn't an opposition to treating disease as much as an examination of the business of medicine. And in the US it is a business, not a public service.

If it is disturbing that capitalism is based on profit not conscience, you're kind of late to the game. No one should expect drug companies to cure death or rubber companies to invent tires that never wear out.
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Old 04-15-18, 03:59 AM
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Originally Posted by Kontact View Post
It is an article written to advise people looking for sound investments. It isn't an opposition to treating disease as much as an examination of the business of medicine. And in the US it is a business, not a public service.

If it is disturbing that capitalism is based on profit not conscience, you're kind of late to the game. No one should expect drug companies to cure death or rubber companies to invent tires that never wear out.
The problem with the profit verses conscience dichotomy is the Hippocratic oath: "Practice two things in your dealings with disease: either help or do not harm the patient". Just how does that fare with "keep a patient ill enough to ensure profit, above all else;" which seems to be the goal of "capitalism centric medicine" as outlined by "the banker" in the OP link.
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Old 04-15-18, 06:31 AM
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Originally Posted by AnthonyG View Post
This is Politics & Religion fodder.
but....I'm banned from that forum.
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Old 04-15-18, 10:31 AM
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Originally Posted by genec View Post
The problem with the profit verses conscience dichotomy is the Hippocratic oath: "Practice two things in your dealings with disease: either help or do not harm the patient". Just how does that fare with "keep a patient ill enough to ensure profit, above all else;" which seems to be the goal of "capitalism centric medicine" as outlined by "the banker" in the OP link.
Hey, I agree to an extent. But a drug company treating illnesses that are likely to keep it in business rather than cause it to go bankrupt is more "do no harm". There are enough maladies that drug companies don't need to "keep patients ill" to stay in business - we do a great job of making ourselves ill. But there is little business incentive to cure malaria.


Anyway, drug companies aren't subject to any oaths. Doctors and nurses take oaths, not the engineers at an Xray machine company or the chemist who develops viagra.
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Old 04-15-18, 10:36 AM
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Originally Posted by Kontact View Post
Hey, I agree to an extent. But a drug company treating illnesses that are likely to keep it in business rather than cause it to go bankrupt is more "do no harm". There are enough maladies that drug companies don't need to "keep patients ill" to stay in business - we do a great job of making ourselves ill. But there is little business incentive to cure malaria.


Anyway, drug companies aren't subject to any oaths. Doctors and nurses take oaths, not the engineers at an Xray machine company or the chemist who develops viagra.
Yes, but those that prescribe or call for the use of drugs and diagnostic devices DO take that oath. Do they then benefit from kickbacks of say the over use of either... such as "too many tests" or "too many opioids?"
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Old 04-15-18, 10:49 AM
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Originally Posted by Kontact View Post
It is an article written to advise people looking for sound investments. It isn't an opposition to treating disease as much as an examination of the business of medicine. And in the US it is a business, not a public service.

If it is disturbing that capitalism is based on profit not conscience, you're kind of late to the game. No one should expect drug companies to cure death or rubber companies to invent tires that never wear out.
Investments, of course, keep the business world running, especially start-ups.

One also should keep in mind that "conventional treatment" and "gene therapy" may not both be bringing money into the same businesses.

So, say the blindness gene therapy that was in the news a while ago. Treat them (one or two eyes, your choice), and the person is "cured". Don't treat them, and they're blind, and buying canes, using occupational therapy resources, tax benefits, etc.

The gene therapy company makes money by treating them. The gene therapy company makes NOTHING by not treating them. Curing the few hundred people with the disease would mean the end of the business... until the next generation develops the disease, or perhaps expanding from US markets (300 Million) to global markets (7 Billion), or about 25 times the population pool.
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Old 04-15-18, 11:05 AM
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Originally Posted by genec View Post
Yes, but those that prescribe or call for the use of drugs and diagnostic devices DO take that oath. Do they then benefit from kickbacks of say the over use of either... such as "too many tests" or "too many opioids?"
And those oaths don't mean that plastic surgeon doing breast implants is a "bad doctor" because he isn't applying himself to curing cancer.

Doctors don't make kick-backs running tests or writing scripts. You're wandering into tin foil hat territory. Doctors over-prescribed opiods because they work and the drug company lied to doctors about the addictiveness.

Originally Posted by CliffordK View Post
Investments, of course, keep the business world running, especially start-ups.

One also should keep in mind that "conventional treatment" and "gene therapy" may not both be bringing money into the same businesses.

So, say the blindness gene therapy that was in the news a while ago. Treat them (one or two eyes, your choice), and the person is "cured". Don't treat them, and they're blind, and buying canes, using occupational therapy resources, tax benefits, etc.

The gene therapy company makes money by treating them. The gene therapy company makes NOTHING by not treating them. Curing the few hundred people with the disease would mean the end of the business... until the next generation develops the disease, or perhaps expanding from US markets (300 Million) to global markets (7 Billion), or about 25 times the population pool.
But if you look at the article you'll see that the business that developed the Hepatitis cure has its demand going down incredibly fast. Do the shareholders see a product that produces only 1/4 of the sales it originally did as a good investment compared to the company that develops viagra? You're basically suggesting that the first company should work harder for less profit than its competitors. That isn't sustainable.


If capitalism isn't cutting the mustard, tell your congressional representative to create more federal funding for non-profit medical research to serve the gap for-profit creates. Most of what is happening isn't conspiracy, just keeping the lights on. Here's a list of medical companies that no longer exist - many of which just plain went out of business. Pharma is not 'easy money'.

https://biopharmguy.com/links/compan...me-defunct.php
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Old 04-15-18, 12:01 PM
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Pharma is not 'easy money'.

Should it be?

Should striving to take care of the sick be "easy money?"
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Old 04-15-18, 12:15 PM
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Originally Posted by CliffordK View Post
It sounds to me like a lack of understanding of the therapy.

The current generation of gene therapy will cure existing patients (hopefully), but will do nothing for inheritance. So, there will always be more patients.

Some people choose to abort due to major genetic abnormalities, but so far nobody is tinkering with the inherited genome. So, cure the current generation, and then cure the next generation.

There's only a minor problem for those of us in the USA... The only people able to afford gene therapy are those with at least 3 Mansions.




There's no real need to worry about going out of business, when no one can afford your goods/service.


Originally Posted by genec View Post
Pharma is not 'easy money'.

Should it be?

Should striving to take care of the sick be "easy money?"

Depends on what you mean and are looking at. Much of the R&D and studies are CDC or university research IIRC. AKA...public research ends up in private patent/trademark with granted monopoly. Take for example the EpiPen--a massive cashcow where the drug isn't even patented any longer but the best means of delivery is.

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Old 04-15-18, 12:21 PM
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Originally Posted by genec View Post
Pharma is not 'easy money'.

Should it be?

Should striving to take care of the sick be "easy money?"
Nothing is "easy money". But there should be no expectation that employees and investors should choose a business that is likely to fail in the market, destroying their finances in the process of "caring for the sick". Such a system would just result in less medical care as people avoided medicine as employment or investment.

Do you work to make less money and have an uncertain future? Would you expect others to do so?
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Old 04-15-18, 12:28 PM
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Originally Posted by Kontact View Post
But if you look at the article you'll see that the business that developed the Hepatitis cure has its demand going down incredibly fast. Do the shareholders see a product that produces only 1/4 of the sales it originally did as a good investment compared to the company that develops viagra? You're basically suggesting that the first company should work harder for less profit than its competitors. That isn't sustainable.
So, the company should lobby against things like needle exchange programs and availability of condoms.... just to prop up their disease transmission.

I would imagine the smallpox vaccine companies are hurting... although they may encourage the governments to stockpile their vaccines in case of bio-warfare.

Likewise, the OPV/IPV vaccine companies are also reading the writing on the wall, and thinking it is well past the time to diversify.

Since Hep C is not easily transmitted, the companies should look at new ways to expand, at least in the short term, such as starting/joining a global initiative to eradicate the disease.

Don't consider treatments as one-hit-wonders. Bring in some cash, then diversify. There are plenty of diseases that could likely be attacked with similar approaches.

And, of course, since Hep C patients were advised against drinking alcohol... cure the disease, and investments in production and distribution of alcoholic beverages would be a good investment
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Old 04-15-18, 12:40 PM
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Originally Posted by CliffordK View Post
So, the company should lobby against things like needle exchange programs and availability of condoms.... just to prop up their disease transmission.

I would imagine the smallpox vaccine companies are hurting... although they may encourage the governments to stockpile their vaccines in case of bio-warfare.

Likewise, the OPV/IPV vaccine companies are also reading the writing on the wall, and thinking it is well past the time to diversify.

Since Hep C is not easily transmitted, the companies should look at new ways to expand, at least in the short term, such as starting/joining a global initiative to eradicate the disease.

Don't consider treatments as one-hit-wonders. Bring in some cash, then diversify. There are plenty of diseases that could likely be attacked with similar approaches.

And, of course, since Hep C patients were advised against drinking alcohol... cure the disease, and investments in production and distribution of alcoholic beverages would be a good investment
You seem to be confusing failing to do things for free with purposely doing the wrong thing. They aren't even remotely the same thing. Not legally or morally.
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Old 04-15-18, 12:46 PM
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Another thing. The patent protection is about 20 years. Companies like Bayer still make a lot of Aspirin, but competition keeps the prices down.

The company with the half million dollar eye treatment may well see prices fall considerably in two decades (as well as losing any global monopoly they may have had).

So, say new treatments take a couple of decades to make dents in the number of current and new cases, then patents would have expired anyway, and the cash cow would already be waning.

There are about a dozen treatments for Hep C. A few different serotypes, so some work better than others depending on the serotype. But, there is already competition in the market. Will we see new drug resistant serotypes develop, and thus a need for more treatments? Multi-drug treatments?

Drug patents also tend to be fairly narrow, limited to a single chemical formula, I think, not a method of attack. So, for example, the first H+ blocker (PPI) came out (Prilosec), and only a couple of years later the second was available (Prevacid). Apparently there are now a couple more, Protonix, Nexium, Aciphex, and Dexilant.

Oh, hey, the Prilosec patent is set to expire in April 2018. Likely we'll see prices on all the competing drugs crash at about the same time. It isn't a good time to invest in H+/PPI drugs.
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Old 04-15-18, 12:49 PM
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Originally Posted by CliffordK View Post
Another thing. The patent protection is about 20 years. Companies like Bayer still make a lot of Aspirin, but competition keeps the prices down.

The company with the half million dollar eye treatment may well see prices fall considerably in two decades (as well as losing any global monopoly they may have had).

So, say new treatments take a couple of decades to make dents in the number of current and new cases, then patents would have expired anyway, and the cash cow would already be waning.

There are about a dozen treatments for Hep C. A few different serotypes, so some work better than others depending on the serotype. But, there is already competition in the market. Will we see new drug resistant serotypes develop, and thus a need for more treatments? Multi-drug treatments?

Drug patents also tend to be fairly narrow, limited to a single chemical formula, I think, not a method of attack. So, for example, the first H+ blocker (PPI) came out (Prilosec), and only a couple of years later the second was available (Prevacid). Apparently there are now a couple more, Protonix, Nexium, Aciphex, and Dexilant.

Oh, hey, the Prilosec patent is set to expire in April 2018. Likely we'll see prices on all the competing drugs crash at about the same time. It isn't a good time to invest in H+/PPI drugs.
You should let Goldman Sachs know that you disagree with them.
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Old 04-15-18, 12:51 PM
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Originally Posted by Kontact View Post
Nothing is "easy money". But there should be no expectation that employees and investors should choose a business that is likely to fail in the market, destroying their finances in the process of "caring for the sick". Such a system would just result in less medical care as people avoided medicine as employment or investment.

Do you work to make less money and have an uncertain future? Would you expect others to do so?
No, but the work I do is not considered even close to "charitable" in nature... there is no "altruistic" notion in CAD PCB design, nor is there anything close to the Hippocratic Oath.

In Canada there is an "Engineers Oath or ritual..." https://en.wikipedia.org/wiki/Ritual...of_an_Engineer

And certainly any engineer worth their salt strives to make an honest product.

I do have to agree there is no "easy money" per se; but there are ethical standards... However, the real question is how much profit is enough, when weighed against life?
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Old 04-15-18, 12:58 PM
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Originally Posted by genec View Post
No, but the work I do is not considered even close to "charitable" in nature... there is no "altruistic" notion in CAD PCB design, nor is there anything close to the Hippocratic Oath.

In Canada there is an "Engineers Oath or ritual..." https://en.wikipedia.org/wiki/Ritual...of_an_Engineer

And certainly any engineer worth their salt strives to make an honest product.

I do have to agree there is no "easy money" per se; but there are ethical standards... However, the real question is how much profit is enough, when weighed against life?
You could donate your skills and time to make the world better. Go ahead.

The issue is that it isn't "weighed against life". The issue is that people that work in the medical industry have the free will to choose to research whatever they want, and the Hippocratic oath doesn't oblige them to spend their lives doing what you want them to do.


The Hippocratic oath is there to prevent abuse of power, not to make people slaves to their chosen profession.


If we want top notch research into 'unprofitable' avenues of research, then we have to ask for it through avenues that aren't the free market - donations or taxes. It isn't the doctors fault that they don't live in a communist country.
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Old 04-15-18, 12:59 PM
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Originally Posted by Kontact View Post
You seem to be confusing failing to do things for free with purposely doing the wrong thing. They aren't even remotely the same thing. Not legally or morally.
Did I say "free"? The issue with curing a disease (Smallpox, Polio, and now potentially Hep C) is that the pool of disease decreases, unlike curing various genetic diseases which may have a stable number of newly affected patients (unless aborted which a "cure" might discourage the practice).

But, what really is the difference between refusing to invest in disease prevention vs refusing to invest in disease cures?

Needle exchanges aren't exactly free, and are certainly controversial. Do they encourage illegal drug use? Studies apparently indicate that they don't promote illegal drug use, but there still may be an associated stigma.

Likely, as one sees the possibility of eradication, the demand for the drugs will at least initially increase. Perhaps even getting government and large NGO buyers.
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Old 04-15-18, 01:03 PM
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Originally Posted by CliffordK View Post
Did I say "free"? The issue with curing a disease (Smallpox, Polio, and now potentially Hep C) is that the pool of disease decreases, unlike curing various genetic diseases which may have a stable number of newly affected patients (unless aborted which a "cure" might discourage the practice).

But, what really is the difference between refusing to invest in disease prevention vs refusing to invest in disease cures?

Needle exchanges aren't exactly free, and are certainly controversial. Do they encourage illegal drug use?

Likely, as one sees the possibility of eradication, the demand for the drugs will at least initially increase. Perhaps even getting government and large NGO buyers.
There is no difference, and neither is immoral. But that isn't what you were talking about earlier when you suggested that a pharma should "lobby against" public health policies.

Do you see the difference between "failing to invest" and "lobbying against"? It isn't a small difference.
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Old 04-15-18, 01:09 PM
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Originally Posted by genec View Post
In Canada there is an "Engineers Oath or ritual..." https://en.wikipedia.org/wiki/Ritual...of_an_Engineer

And certainly any engineer worth their salt strives to make an honest product.
Yet, there is the question of "planned obsolescence".

Items have, say a 1 year warranty, and break in 13 months... Accident? Planned?

And, of course, spare parts can be very difficult (and expensive) to acquire.

Certainly in the global market, there is a lot of question whether certain imported products are designed to wear out or break quickly, so that new products can be sold.

Is that even happening in the bicycle world?

I have thought that parts like automobile clutches and transmissions have been intentionally made difficult to service to discourage people from driving old vehicles forever. Or, perhaps not intentionally made to be difficult to service, but rather no thought was put into making them easy to service, especially for home mechanics.
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Old 04-15-18, 01:11 PM
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Originally Posted by Kontact View Post
There is no difference, and neither is immoral. But that isn't what you were talking about earlier when you suggested that a pharma should "lobby against" public health policies.

Do you see the difference between "failing to invest" and "lobbying against"? It isn't a small difference.
So curing disease shouldn't be part of public health policies?
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