New treatments give an example of how treating one patient can benefit others | Hacker News Reader

New treatments give an example of how treating one patient can benefit others

randomactsofmedicine.substack.com

31 pointsjseliger14 comments

One of the great successes of modern medicine. When I first started treating Hepatitis C patients in 1995 our Hepatitis C treatments had terrible side effects and rarely worked after 48 weeks of treatment. Now the treatments are 98% effective in 8-12 weeks and have minimal side effects. People need to stop saying that big pharma doesn't find cures.

One caveat to "big pharma finds cures" is that, to my understanding, a lot of the research is done via public institutions, big pharma just handles the manufacturing and distribution.

I know adalimumab's discovery was funded (at least in part) by government grants, but Humira still made AbbVie richer than god.

Big Pharma also often handles the clinical trials and approvals. I don't know if there is a mechanism for a public lab to get approval for a medicine? Probably if we found a way to drive down the cost of clinical trials, we'd be able to structure the system in a way to eliminate the middle-men here, but that's much easier said than done.

Ah, good point... are clinical trials expensive to run?

A couple of billion per drug.

They are a bit more than half of the total drug R&D costs, so they cost more than all the research, experimental synthesis and pre-clinical experiments combined. If you've discovered a drug which works in vitro and on animals, and want to start clinical trials, you're not even halfway done.

This is a good article. One of the sad things is that the rates of NAFLD (non-alcoholic fatty liver disease) are increasing in proportion to the increase we see in morbid obesity, diabetes, etc... and this can also lead to cirrhosis and the need for liver transplantation.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle...

However, with the newer GLP-1 agonists (like Ozempic/semaglutide), we might be seeing an ability to better treat NAFLD and its downstream cirrhosis.

I've been listening to "The glucose revolution" and I believe getting glucose monitors into the hands of the general public might prevent a lot of this.

Right now continuous glucose monitoring requires an expensive patch, lasts for a finite time and is available to few people.

The holy grail would be a non-invasive monitor such as a watch.

It seems avoiding glucose spikes might be the key to preventing much nafld, diabetes, obesity, heart disease, etc.

What is the most convenient and cost-effective spike-flattening food that you could take with your high-glycemic meal?

Haven't gotten through the whole thing, but it is enlightening in lots of ways, not just "eat this".

For example, I like what it said about eating your food in a different order. With no change but the order - eating fiber first, then proteins and fats, and carbs last - your glucose spike will be minimized, by quite a lot.

It also said we get cravings when our blood sugar drops. And it always drops after a spike.

also, walking for 10 minutes after a meal helps lessen spike.

EDIT: good summary someone prepared:

https://www.believebig.org/wp-content/uploads/2022/12/Glucos...

A restaurant should do this, rather than bringing out the bread first. And show how helpful/healthful it is.

If a physician randomly hands these blood glucose monitors out to some motivated but non-health-nut people, has them try it for a week, do they develop long-term better eating patterns?

I believe that's basically what happened in the author's case.

There's a lot of literature in medicine of how often one small subset of patients consumes a disproportionate level of healthcare resources, i.e. the Pareto principle. It's fantastic seeing just how much providing effective treatment for that small subset offers drastic benefits to everyone else. For liver transplants, it's a very 1-to-1 situation, but for other resources such as hospital beds, the ripples probably go much farther.

Reply on news.ycombinator.com