Why can’t we cure the common cold?
theguardian.com
theguardian.com
Is there a good reason why we shouldn't club together as rich countries and fund a not-for-profit drug research body that does fund this sort of thing?
Recent evidence contradicts this statement. Notably, the pay-off to Gilead for its hepatitis C cure [1].
Besides, TFA outlines non-conspiratorial reasons underlying pharmaceutical companies’ nervousnous around developing vaccines. (TL; DR people are unwilling to pay as much for prevention as they are for a cure; also development is expensive and risky.)
EDIT: [1] https://mobile.nytimes.com/2015/02/04/business/sales-of-sova...
This is a straw man.
Millions of Americans contract a rhinovirus strain every year [1]. The number is closer to 30,000 for HCV [2]. A rhinovirus cure thus has orders of magnitude more potential customers across which to spread fixed costs.
On the demand side one has, on one hand, 7 to 10 days of the sniffles; on the other hand, fatal liver failure.
Nobody would pay, nor should expect a third party to pay, $100,000 to cure their common cold. The article eyeballs the value of the vaccine market. It’s approximately the present value of 8.7 hours per year * your marginal hourly earnings over your remaining working years.
[1] https://www.cdc.gov/features/rhinoviruses/index.html
[2] https://www.hepatitisc.uw.edu/pdf/screening-diagnosis/epidem...
If you're in the top whatever percent of rich people with a net worth over $100 million, would you not pay $100k to be better from the common cold? Call it the Tesla model - don't go for the price conscious mass-market first. Sell to those for whom money is no object first.
Build the Model-S of common cold treatment. When you feel a cold coming on, your private house-call-making doctor comes to your house, you cough on a petri dish with rhinovirus food, the doctor takes it back to the lab, rushes it through whatever testing is required, then comes back the next day, gives Bill Gates a pill or a shot, and the day after, he's right as rain.
Simultaneously, work on getting the cost of the equipment down. Depending on what's being research, a medical lab could easily cost over $10 million - too expensive to scale quickly, but making lab equipment that's orders of magnitude cheaper will pay dividends for itself. The first human genome that was sequenced cost ~$3 billion, now we're just waiting for it to drop below $1000 (currently at $1400). (23&me's $200 kit isn't technically sequencing, but they definitely also benefitted from that work.)
Once the cost is brought down, bring it to a broader market. Charge $1,000 to never get the common cold again, and reap in money selling both the cure and the supporting equipment. There are enough people paying over $1,000 for elective surgery to support many plastic surgery clinics; I'd venture a cure for the common cold would be able to sustain a few, at least until a competitor comes out with a vaccine.
Unfortunately, the NTSB and the FDA regulations, as well as the behavior of patents on things like car transmissions vs drugs, are very different things (for good reason, mind you), so this isn't a likely scenario.
Hell no. I might pay for treatment for someone who were immunocompromised. For me? Nope. It's just a virus. It'll go away.
I'd pay a lower amount, however.
So, I'd not pay that to cure me of the common cold. Not a chance. I don't mind the cold. You sniffle and feel poorly for a few days. Meh... The benefit isn't worth that much to me. I'd probably pay up to a few thousand for it, but not that much.
This seems to be quite an outlier in a discussion on general vaccine economics.
Oh yes. Most of the people that would be involved in this decision are linked near of far to the drug companies.
If we are willing to take more risks and require less paperwork we could have a vaccine for the common cold in a few years.
We need a Big Pharma version of Elon Musk.
Not true - there are plenty of examples of genuine cures developed and marketed by pharma.
What drug companies do require is a return on their investment, which can be in the multiple-billions. This isn't evil-big-pharma stuff... this is just how any sensibly-run company operates, pharma or otherwise.
Achieving an ROI is seen as difficult in this particular case because (as TFA says) people don't value vaccines highly enough because they are taken when they're well, and (as you say) they're only needed once.
(Personally, I think the article over-estimates this challenge; sell 100m doses at $50/dose and [assuming CoG is not a problem] you've got a major blockbuster. Even if the NHS/insurers didn't want to pay, employers and individuals likely would, at this price level. And 100m doses is pretty low-ball, if you consider the likely uptake of a vaccine promising a genuine cure for the commonest cause of the common cold.)
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> Is there a good reason why we shouldn't club together as rich countries and fund a not-for-profit drug research body that does fund this sort of thing?
I've wondered about this in the past. I think a major aspect is risk.
If it was easy to pick a disease to cure and a way to do it, then we'd not be in this situation in the first place - developing drugs is actually incredibly difficult and unpredictable. This is well-demonstrated by an analysis published in Forbes a few years ago. https://www.forbes.com/sites/matthewherper/2013/08/11/the-co...
Rather than taking an individual drug and pricing the work done on it to bring it to market (as with many previous studies) this analysis looks at total R&D spend by individual pharma companies over time, and divided that spend by the number of new drugs brought to market. As such, it takes into account the extraordinarily high rate of attrition in drug development - the time and money spent on countless thousands of drug candidates that are abandoned before the ever make it to market. (Note the analysis does have one major weakness, but now's not the time.)
To quote the article: "For companies that have launched more than three drugs, the median cost per new drug is $4.2 billion; for those that have launched more than four, it is $5.3 billion."
And there's the rub: I'm sure you could find some way of funding a few hundred million if it was guaranteed to result in a cure for a disease - Governments, the Gates Foundation, etc. But do such bodies genuinely have the will to spend countless billions, every year, to chase those few new treatments that might --or might not-- emerge? And having found a new treatment, would they just give it away... or would they want to recoup some of the costs they'd invested?
Name one.
Roche sells MabThera which (together with chemotherapy) cures about 2/3rds of a common type of lymphoma. They also recently failed with a large phase III study in this setting, having hoped to cure even more people with an improved treatment.
Celgene and Abbie/Pharmacyclics both have large phase III trials running in the same disease, aiming to cure more patients through the addition of their drugs to the current standard-of-care treatment.
Novartis has just launched Kymriah, a CAR-T treatment which offers the prospect of long-term remissions in paediatric ALL. (Too early to say whether some of these will effectively represent cures.)
Various pharmaceutical companies are attempting to develop new antibiotics, which would cure infections.
(Just recent examples, and off the top of my head...)
Edit: Oops, also Harvoni, etc.
- you only need one cure, so the work only needs to be done successfully once (competition is in this case potentially wasteful)
- knowledge and good people are pooled (not hoarded by the companies able to offer the best compensation)
- access to larger sources of funding for individual projects
- knowledge from failed projects could be publicly disseminated instead of locked up in the company's archives
- no need to turn a profit
The usual arguments I hear against state- or superstate-run organisations over the private sector is, as others have said here, the perceived wastes of resources when projects don't appear to be on a successful track: a private company would cancel early to avoid more waste, whereas a publicly funded organisation wouldn't necessarily do so as the project managers aren't incentivised by shareholder value. However, it seems to be to be just a case of having the right incentives. If they were instead tasked with improving patient outcomes measured over, I don't know, 10 years, then that could be a valid reason to use to cancel research that doesn't seem to be going anywhere ("it doesn't seem like this drug, even if it passes trials, will make a meaningful improvement in patient outcomes"). Another aspect of public organisations could be that the scientists in charge of the research would have their own reputation to consider, instead of that of the company. It would be in their own interest for costly projects to fail quickly if they go nowhere.
Here's a thought: would it work if such a public organisation could underwrite the research of private drug companies? These companies could then be paid a "non finders fee" for failed drug projects that nevertheless showed significant promise, in return for low-cost access to the successful ones, and of course public sharing of the reasons why the drug failed. Would the economics of such a system work, or would drug companies find ways to game the system?
I don't want to put some chemicals in my body for cold. I would imagine that to be case for many people.
This already happens with major threats, there was Ebola that got solved quickly. Keep in mind that government resources are also limited.
"For his PhD on asthma, Johnston developed a technique called polymerase chain reaction, which magnifies DNA so that viruses can be identified more precisely."
which make me not sure what to believe: Is that bad spelling or has the author not even basic knowledge of modern biology?
Of course this will never be done because the system for developing vaccines is so broken that it is impossible to make money selling a vaccine for the common cold. You could make a magic vaccine that was 100% effect with zero side effects (no vaccine is magic) and it would be impossible to develop and sell under the current regulations.
If pharmaceutical companies thought there was a fortune to be made curing the common cold they would be doing it.
I assume it's hyperbole and you don't mean to say that the studies required by the FDA are comparable to the GDP of the US? Are you sure a price of $100 would not cover it?
It would actually be easier to bribe congress to shut down the FDA than perform the studies required to get a cold vaccine approved - at the very least the bribery approach has a chance of success.
For example, how are 'flu vaccines approved each year? Is it because 'flu can be lethal in rare cases?
This doesn't sound like a debunking of what people think at all. If the chance of getting infected from a kissing for a minute is 6%, and you spend a week around an infected person and you kiss them repeatedly, you will almost certainly get sick with that infection rate.
People's immune systems are so different... before I believe that I'd want to see every sick person kissing every healthy person or something. I don't even know how that would work with incubation times. Lock people away and just allow contact every 2 days for 3 weeks? But then all the sick people would probably be healthy again already.
My head explodes just trying to think about this kind of trial, mixed with statistics :P
Sure, I'm just saying this was not a very strong result in terms of disproving the fact that kissing doesn't spread cold viruses.
> Adults suffer an average of between two and four colds each year, and children up to 10, and we have come to accept this as an inevitable part of life.
I live in Europe and go through one or two flu seasons a year on average. I don't recall catching cold/flu ever since I started using cold water exclusive year-round, as I wrote previously[1]. I was pessimistic about this practice at the beginning, and truth be told this enhanced immune system is the only benefit I'd attribute to cold showers, yet there it is, no cold for quite a few winters despite people around me getting it on schedule.
Mind you, I am probably more mindful about disease vectors than most. Avoid shopping-trolleys and -baskets, keep my fingers clear of mouth, nose, and eyes at all unwashed times.
I didn't do much to avoid it, though, a few times I even had to nurse close ones through their colds fully expecting to catch it from them, yet nothing.
But not sure how useful such anecdotes are. My memories are also not perfect. It depends on many factors, such as age, your immune system condition, stress, general health, etc.
If we'd spend all the money that people spend on OTC cold remedies that almost certainly don't work on developing a vaccine we probably could have one soon.
They will adept. And possibly give you more than a runny nose.
But there are studies that high doses can help a lot with colds.
EDIT:
examples:
http://www.mdpi.com/2072-6643/9/4/339
https://www.eurekalert.org/pub_releases/2017-03/uoh-ldo03301...
https://www.consumeraffairs.com/news/high-doses-of-vitamin-c...
After reading about it i tried this, and confirm that high doses help to cure colds much faster. In 2 of three cases i managed to get over a cold which otherwise lasts 7-10 days for me in just 3-4 days with much lower symptoms. The dose at which this begins to work is 3g (yes 3000mg!) per day - i take 6x1g the first day, then 3g/day a few days more. Pure Vitamin C powder with no other additives(many products nowadays are combinations, in spain where i am right now, the pure powder is hard to get, in Germany it’s in every drugstore). It works even better with herpes i sometimes get on the lips. Here, the success rate of making the illness last 2-3 days instead of 10 is 100% since i started do treat it that way a few years ago, with much less symptoms, just a little itching, no big wounds for many days like many suffer from (and i did) when getting a herpes push.
I can clearly understand why this is not researched and communicated much - a pot of 100g Vitamin C powder, good for about 5 such treatments costs just 3€ ... not much money to be made.
EDIT:
This is my personal experience - for which I don't claim general applicability for everyone. But I find it very interesting that some people see the urgent need to downvote a post where someone reports personal experience, without saying it must be generally applicable.
The thing is as with Vitamin C, most supermarket products just have low doses. So to get an effect i recommend getting pure and high dosed preparates of both, each by itself.
Some OTC products already contain vitC and zinc in proper amounts, e.g. Sambucol (not affiliated).
[1] https://en.m.wikipedia.org/wiki/Zinc_and_the_common_cold
I would not take zinc in the same numbers as Vitamin C - but exactly therefor eI said I would take them apart, because, at least in the German and Spanish Market, you have combination preparates with 80mg Vitramin C and 5mg of Zinc - to achieve the effects I observed in myself you'd need 3x10 of these for the Vitamin C amount, whioch would be a lot of zinc which I would not recommend and have no experience with and no knowledge about the risks.
The articles seem to not agree in doses and helpfulness - one says it must be >= 75mg to actually do something, another that even 90+ mg doesn't do anything. And I believe to remember that already from 25mg/day you can get strange effects in the belly as side effects...
I didn’t see the researcher team coming through my door...
I didn’t say it works for everyone, but only report how it turns out for me.
Interesting that some find a personal report enough reason to downvote...
How do we know the research you point at is not sponsored by those with an interest in selling more expensive stuff?
"It may not work for everyone but it works for me" is a fallacy – if you run a 50/50 blind study on yourself for the next 30 colds you catch, controlling for factors like season, air quality, stress levels, sleep, and nutrition, and you still find that Vitamin C consistently cuts your colds in half, then we'll believe you. Otherwise, stop pushing misinformation.
Unless you can prove what I wrote didn’t happen to me, i can as well insult you of pushing misinformation about what happened to me and what not.
I talk about personal experience and clearly mark it as such.
And then, i didnt know this is a forum of „low-information patients“ - but i start to believe it...
Furthermore it has been said in the article that there is no verified cure for colds. Insofar even if someone would refuse to take other non-verified, more expensive medications because of my report, it wouldn’t do harm. It’s just changing one unverified cure against another.
do i talk about cancer? No. It’s about colds.
Believing only in studies will not help you at all - many studies have been proven to be false for many different reasons and later detected errors. Just happened for cancer studies of multiple decades!
So with your randomly selected criteria there‘s still many things that can be wrong, and the same goes for all studies that prove Vitamin C helps and those that prove it doesn’t. You forgot age, for example... 30 colds is at least 3, at my current rate rather 10-15 years... a lot changes in a body. I can be weaker due age, or fitter due more sports etc...
So i believe only in what works for me, and i report about it personally with clear marking that it’s just that, personal experience.
And i didn‘t recommend anything to anyone else.
Also, i said that success rate is just 2/3. THAT would have been a good point to attack my idea that Vitamin C helps - because it is actually a low rate.
While we discuss this, a lot of money is spend for other cures of cold that equally has no proof of working. But this is accepted... you might be better off trying to stop big pharma for advertising anything as a cure for cold instead of insulting me for telling personal experiences.
Who knows if there was actually Vitamin C contained in what i bought?
But my experience still exists.
I took that stuff that has been sold to me as Vit C and had a lot less to suffer. Didn’t spend a lot of money, and didn’t have a lot of risk involved.
So what?
I tried other remedies before - as well ones that were organical stuff recommended by someone ( ginger tea for example which some believe in is helping a lot - but not myself ) as well as commercial products. I believed or at least hoped they‘d help in each case. But only this did with some - and i say 66% is not great, just some - reproducability.
With Herpes it‘s 100% were in my personal experience it removes a lot if suffering and bad feeling for days.
I'm happy you found something that works for you, but the certainty you ascribe to causes is not justified by the evidence.
yes sure, it can be many things - and a repeatability of 2 in 3 is not very much... just some.
It can also be that as the original article mentions there are many causes for a bad cold, that my system worked only with a part of them.
I just get a bit upset with (some other) people saying my personal experience isn't a properly conducted study - it sure isn't.
At the same time, these studies fail every day, in the end they are all just statistics, which can be forged, lead to wrong assumptions, or just be flawed in a failure criterion not being thought of until now - like, oh, 30,000 cancer studies... http://www.sciencealert.com/more-than-30-000-scientific-stud...
But I'm not even talking about cancer - and I sure would defintely rather try fighting cancer with a "western medicine" approach that has some reasonable success rate and never recommend anyone diagnosed with such trying to treat that thing with a spoon of Vitamin C everyday...
The other talks about 1g daily as prevention. I talk about 3x1g as treatment when symptoms start to appear until they are gone.
Different things.
And again, I don't say my own experience is a scientificly proven thing working generally, just a personal report and maybe a thing worth trying for the curious instead of throwing a lot of bucks in other treatments.
I think theres a lot of (financial) interest in suppressing that the thing I wrote about works for more than just me - and there's not much to be gained for me personally if writing about this will help others too... so, what's your motivation trying to supress me in reporting my experience?
Anyway, I never had common cold since I started following Pauling protocol (more precisely, never longer then a single day of mild discomfort). Its 10 years now. Taking 5-10g daily and when I sense it coming doing bowel tolerance which usually ends up somewhere between 20-50g. Before I started doing this I had it 3-5 times a year lasting usually 2 weeks.
It works equally effective for my daughter.
Keep in mind that you need to be on lowish carb if you want C to be effective due to the fact that one of the transporters (GLUT4) is shared with glucose. Timing is also crucial, taking it to late and it doesn't help much, it must be started on first signs of illness.
I wonder why people love to hate vitamin C vs common cold that much given that C is cheaper then water, you don't have side effects and the worst thing that can happen is that it will not do anything for you. Comparably, nobody hates 8 glasses of water per day even tho there is 0 proof that you should do more then your body asks of you. Because, you know... its just water.
One of the things that people often forget is that even if C does not stop common cold, it sure as hell makes complications less probable. Some of those can turn to chronic disease, such as arthritis.
I grew up before children were vaccinated against chicken pox. When I was about 5-6 years old, I had a case... Mom counted 12 pox, which was enough to assume that I'd be immune for the rest of my life.
Some children are covered with chickenpox... Heard a story of someone who scratched their eye out. The mother of six children told me her oldest had a horrible case, but her subsequent children each had a less-severe case than the previous.
One theory is that winter diseases stem from decreased sunlight... Less ultraviolet light -> less vitamin D. Red light is also important. A few years ago there was an outbreak of chickenpox amongst some baseball players who came from Central America, where chickenpox is not a problem.
On account of my experience with chickenpox, and the institution of mass vaccination of children & adults against the horrible chickenpox virus (99.99% survivable)... Shouldn't we be looking at what makes people vulnerable to colds? Virus exposure might not actually be important. From the article:
> In 1984, researchers at the University of Wisconsin-Madison decided to investigate one of the best-known ways of catching a cold. They infected volunteers with a cold virus and instructed them to kiss healthy test subjects on the mouth for at least one minute. (The instruction for participants was to use whichever technique was “most natural”.) Sixteen healthy volunteers were kissed by people with colds. The result: just one confirmed infection. (emphasis added)
I heard of an investigation in Central America that found providing clean water, outhouses, and basic nutrients was the most important public health intervention that could be done for a village.