From: Anders Sandberg (asa@nada.kth.se)
Date: Wed Jul 18 2001 - 06:19:09 MDT
On Wed, Jul 18, 2001 at 01:28:02PM +1000, Miriam English wrote:
> At 02:26 PM 17/07/2001 +0200, Anders Sandberg wrote:
> >Ever heard of Losec?
>
> Hmmm... nope. Maybe it is marketed under a different brand name in Oz.
Does any of Antra, Gastroloc, Mopral, Omepral or Prilosec sound familiar?
The generic name is Omeprazole.
(Maybe one reason you have not heard about it is that you are not a swede -
since Astra was swedish, the ups and downs of Losec were mentioned quite
heavily in the media)
> > Exactly why was that a huge commercial success for Astra, if they could
> > have gone on selling palliatives for ulcers instead?
> >Now the market for ulcer treatments is much smaller.
>
> I don't know of any ulcer cures marketed here in Oz. It has been known for
> maybe a decade, maybe two, that the pylori(sp?) bacteria are the cause of
> stomach ulcers, but I haven't seen anything other than quackery about them
> at chemists (acid-neutralising alkalis, clay drinks, etc.) and quack
> palliatives are advertised heavily on TV and in the print media.
Odd. Here in Europe ulcers are commonly treated with Losec to get the acid
concentration down, combined with an antibiotic to get rid of the
Heliobacter. OK, it won't cure *all* ulcers, but it has moved most gastric
ulcers into the minor problem category. BTW, diet and lifestyle seems to be
less relevant to the illness than previously believed.
In any case, Losec was Astra's best seller for many years, making the
company a tidy profit. Of course, now the patent has ended and proton pump
inhibitor drugs are becoming generic. It still means that ulcers will
likely never become a serious problem again. A nice example of how
capitalism can solve some problems.
> >You are likely thinking of why so little is spent on malaria vaccines and
> >cures for other tropical diseases. That is a real problem, but the issue
> >isn't that cures are unprofitable (they aren't) but that it is hard to make
> >any profit commensurable with the investment in the current regulatory
> >climate. The base costs of pharmaceutical development are high, and if you
> >try to get FDA approval or something like it they will be even greater.
> >That will make the potential market in the developing countries small, and
> >given the latest anti-patent moves on pharmaceuticals you might end up
> >funding competitors instead. If you just sell something less well tested
> >cheaply or do the tests in the developing nations you will be crucified in
> >the media as a ruthless profiteer exploiting the poor. It is a lose-lose
> >situation which any sensible corporation will try to stay out from, leaving
> >it to far less well funded organisations. Too bad.
>
> Yes. This is part of my point. Capitalism fails here.
>
> It is not really the fault of regulations either. The regulations are there
> for a very good reason: to try to eliminate unethical business practices
> and honest mistakes (think thalidomide). And those costs would come about
> one way or another eventually, perhaps by total distrust of all medical
> companies and associated loss of sales, or by insurance costs after mopping
> up disasters, or by general damage to the drug-buying public.
I think others have given more detailled answers to these arguments. On a
more general level I think it is more important to think in terms of
how well different systems work in different situations, and which can be
implemented ethically. Saying that capitalism is not an universal solution
to every problem is a truism; it is more interesting to look at questions
about what alternatives exist and when they might be applicable, and
whether one can propose systems of allocation that are better.
> What it comes down to is that the phamaceutical companies are motivated by
> money. That is neither a good nor a bad thing. But it does mean that
> humanity can't depend upon capitalism alone.
>
> This is where non-profit organisations shine. They help humanity where the
> money won't lure capitalism.
You can get capitalism to solve your problems if you find a way of
converting your wish into money. If people show that they are willing to
pay for a solution, then a market exist. It might require some lateral
thinking of finding a way of making money from selling drugs to the very
poor, but I think it can be done. As a first approximation, what about
something similar to that publishing scheme where for every book sold a
copy goes to the third world? If for every second (or tenth) aspirin sold
in the west an antimalaria pill was given to (say) WHO. "Ethical drugs"
might be a great marketing trick (which incidentally might force a
reconsideration of the heavy bottom-line thinking in publicly funded health
care).
> I feel the need to repeat that I am not against capitalism -- I think it is
> very cool. I just don't think it is the answer to everything. And
> capitalism as religion scares the willies out of me, just as all religions do.
Well, money is a measure of value, and isn't value exactly what all
religions strive to achieve? :-)
-- ----------------------------------------------------------------------- Anders Sandberg Towards Ascension! asa@nada.kth.se http://www.nada.kth.se/~asa/ GCS/M/S/O d++ -p+ c++++ !l u+ e++ m++ s+/+ n--- h+/* f+ g+ w++ t+ r+ !y
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