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Comment by toolz | Hacker News Reader

The real story (in my opinion) behind Ivermectin are the studies not being conducted. Here you have a ton of studies claiming to have found benefit with a worldwide, massively available drug that has practically zero risks for most people (and it's an extremely well understood drug) and we don't have first world countries conducting RCTs to understand it better.

So you have to ask yourself - when do we get high quality RCTs, who funds them and why? This to me is a clear cut indicator that we have very maligned incentives for health science. How can we be this far into a global pandemic, with all of this funding and not have multiple high quality RCTs on this drug? It's sad to say the least. Even if Ivermectin ends up being fairly weak or completely ineffective - surely there's something to learn here...

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> The real story (in my opinion) behind Ivermectin are the studies not being conducted. Here you have a ton of studies claiming to have found benefit with a worldwide, massively available drug that has practically zero risks for most people (and it's an extremely well understood drug) and we don't have first world countries conducting RCTs to understand it better.

First world countries are in the process of conducting RCTs testing Ivermectin, for example the activ-6 and covid-out studies in the US.

> So you have to ask yourself - when do we get high quality RCTs, who funds them and why? This to me is a clear cut indicator that we have very maligned incentives for health science. How can we be this far into a global pandemic, with all of this funding and not have multiple high quality RCTs on this drug? It's sad to say the least. Even if Ivermectin ends up being fairly weak or completely ineffective - surely there's something to learn here...

The thing to learn here is that there's no conspiracy, trials are underway, and science is already working properly.

> First world countries are in the process of conducting RCTs testing Ivermectin, for example the activ-6 and covid-out studies in the US.

... "in the process of"?

How long has ivermectin existed? How long has the pandemic been around for? How long has ivermectin been claimed to have huge benefits for, regardless of the source?

Isn't it possible that there are some other reasons why RCT's haven't been conducted yet by "trustworthy" sources in the view of these meta-analyses?

Is it really such a huge conspiracy theory that researchers simply don't want to bite the hand that feeds them? Is it not a fact that literally billions that have flowed into the coffers of Big Pharma for the vaccines and their $700/pill protease inhibitor drug, and the fact that almost all research studies are performed with funding dollars that originate from them or from HHS/CDC/NIH, which also now see a dramatic, multi-fold increase in power, reach, and funding?

>How long has the pandemic been around for? How long has ivermectin been claimed to have huge benefits for, regardless of the source?

Science takes time, the pandemic has been around for less than 2 years. Ivermectin has been a suggested for what, a year at most?

>Is it really such a huge conspiracy theory that researchers simply don't want to bite the hand that feeds them?

If a scientist could definitively prove ivermectin was effective they would be world famous. The reason so many shitty papers got published so quickly on ivermectin is because people were trying (and failing) to grab that fame and fortune. The incentives are obvious.

Consider that maybe your need to see conspiracy in the world comes from within, rather than external forces.

Who makes ivermectin, if not Big Pharma?

Wouldn't it have been way easier to just sell pills they already manufacture than investing all the time and energy into new stuff?

ivermectin is a generic drug now, the profits are squeezed down to nearly nothing due to competition and it's being mass produced in many places.

It'd be super easy to patent a covid-specific derivative of ivermectin. But of course that mean you'd have to prove it works for covid.

Well this is nonsensical for a myriad of reasons, including that a derivative that was patented and proven to work would just encourage people to take the cheap generic that also works but is more widely available and has better understood risk profile, but it does show potential motive as to why it's taken this long to get real RCTs spun up to study ivermectin.

What is the point in this, everyone will just use ivermectin cuz its cheaper

Big Pharma isn't a singular entity.

In this case, if Ivermectin was so effective against Covid, then Merck would be commercially incentivised to prove that.

When you combine that fact with the facts that complex problems rarely have simple solutions, that such high levels of collaboration are rare, & that the same people promoting Ivermectin are also promoting theories of 2020 election fraud, it's pretty easy to doubt that this conspiracy theory is realistic.

Well the patent expired and then Merck created Molnupiravir, so I don't see any incentive there.

How long does it take to conduct a proper RCT?

When everyone goes and beats the ‘we already have ivermectin’ drum, it’s clearly a pharmaceutical conspiracy’ why doesn’t anyone bring up the massive and significant lifesaving properties of adding steroids to the mix.

This came out of UK research at the start of the pandemic and has easily saved hundreds of thousands of lives.

The ivermectin notes that spurred this on was an Australian in-vitro study that noted that ivermectin had activity against sars-cov-2 in high dose, in-vitro.

It was promptly lost in the noise because basically everything, even high dose H20, can be shown to have in-vitro effectiveness against viral replication, and there were more promising avenues of research.

Then it pops out again after the anti-fact brigade lost the evidence pile-on with both hydroxychloroquine and azithromycin and along comes a study that immediately gets trumpeted as revolutionising the treatment of covid but it turns out has horrific methodological and statistical problems, and the scientific world gets to work trying to establish the facts, and so far things don’t look good for ivermectin as a treatment.

Yet there’s still a global conspiracy of top level research scientists and doctors trying to suppress these easy wins and maximise worldwide misery.

You seem like you like to do your own research, how do you process those facts?

> The thing to learn here is that there's no conspiracy, trials are underway, and science is already working properly.

Thank God! I was worried it may be a nuanced situation full of brazen conflicts of interest.

Yes because there's no conflict of interest as to why ivermectin of all drugs is being pushed so hard.

Ivermectin is cheap and out of patent. Cui bono?

Sorry, but no. "Ivermectin works" is the standard, not who benefits financially from some other medication.

I don't understand how that's relevant to a discussion about conflicts of interest.

If someone is promoting Ivermectin, how do they benefit from that given that anyone else can jump in and take away any increase in sales?

We do have first world countries conducting RCTs to understand it better. For example, see ACTIV-6 coming out of Duke University: https://clinicaltrials.gov/ct2/show/NCT04885530

ACTIV-6's tagline is "Outpatient Repurposed Drugs" which matches up with your description. There are other ACTIV trials with other focuses: https://www.nih.gov/research-training/medical-research-initi...

> Here you have a ton of studies claiming to have found benefit

Maybe the real reason we aren't seeing more trials being funded is that scientists are looking at these early studies and what we already know of the drug and concluding that it's not an avenue worth pursuing? (Especially when we already have several proven vaccines in place).

By way of analogy are you going to invest your time to build a web framework for Cobol running on mainframes? I'm sure it's been done, but it's probably not worth your time to build one as we already have many high quality web frameworks available.

There are two large high quality studies mentioned in the article.

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