The Collapse of the FDA
nytimes.com
nytimes.com
Too bad. News broadcasts are full of those ads, and hence TV journalists are loath to investigate the people that pay their salaries.
But they won't. Not until push-comes-to-shove, and the true bosses will reposition to 'the next thing' (smoking, sugary-foods, medicine) and then they will allow the politicians to finally block meds ads. In which case the 'next wave' will begin. Story as old as time...
The problem here is the drugs that are advertised as generally considered "good things". Anybody attempting to regulate the display of these ads would likely need to prove the ads are more harmful than any positive from the ads.
Anyway I have commented many times on the 'legalized bribing' called 'lobbying'. The dishonest ones always week because those with $$$ know very well who can they buy and who can they threaten.
Clearly the pharmaceutical companies think there's a strong reason to directly market these drugs to consumers even if they can't directly purchase these drugs. The ads almost always say "ask your doctor about..." not "think about prescribing x to your patients..." If these ads didn't do much the industry wouldn't be spending billions of dollars on them.
Thats speculative. Companies spend exorbitant amounts of money on things they lose money on all the time. What's not speculative is consumers cant buy the drugs themselves. They might ask doctors about it, but if the doctors are misprescribing that's on them or their training and not the consumer.
What's not speculative is consumers will find a way to buy the things they want to buy, and advertising has some amount of influence on purchasing decisions of most consumers.
Either way, can you draw this back to allowing or disallowing direct to consumer prescription drug advertising? Are you honestly suggesting the billions spent on drug advertising has no impact on drug sales?
It doesn't matter if the adverts have an impact on sales, if it does then doctors are to blame, tv adverts cant prescribe people medication.
If consumers didn't have in your face advertising about how this new magical wonderdrug will solve all your life problems and you'll be happy again just like all these paid actors, you think they'd still be shopping around doctors as hard? You think they'd even know to shop around for that wonderdrug or pressure their doctor to try it?
Do you think people's decisions to shop around for doctors has zero relation to the drug advertisements they see on TV, on billboards, on the side of busses, in magazines, on the radio, on websites, etc?
Do you think people would still buy as much Coca Cola if they stopped advertising?
With your logic we might as well allow marketing of tobacco to minors again. After all, stores aren't legally allowed to sell it to the minors, so it's just a fault of the stores and the kids.
Do you think we as a society are better off or worse off having pharmeceuticals directly advertised to consumers?
https://en.wikipedia.org/wiki/Direct-to-consumer_advertising
> Merck published the first print DTC ad for a pneumonia vaccine targeting those aged 65 years and older, and Boots Pharmaceuticals aired the first DTC television commercial in 1983 for the prescription ibuprofen Rufen.
But that sentence was worded weirdly, so I checked the sources. This is one of the two for that part:
https://web.archive.org/web/20250114005757/https://adage.com...
> While 2006 marks the 10-year anniversary of the Claritin ad, it was actually 24 years ago that the FDA unwittingly opened the door to DTC. Speaking at the American Advertising Federation conference and addressing the Pharmaceutical Advertising Council, then-FDA Commissioner Arthur Hull Hayes Jr. summarized the state of drug advertising, saying it "may be on the brink of the exponential-growth phase of direct-to-consumer promotion of prescription products."
> Drug companies jumped on the phrase "exponential growth" and took it to mean the FDA, however tacitly, supported DTC.
> 'Opening a closed door'
> "It was viewed by the industry as FDA opening a closed door," said Kenneth R. Feather, a former associate FDA commissioner.
> A year later, in 1983, Boots Pharmaceuticals aired the first direct-to-consumer TV ad when it promoted its prescription ibuprofen medication, Rufen. The company also ran newspaper ads at the same time. That was in May; by September, the FDA asked the industry for a voluntary moratorium on drug advertisements. (Ibuprofen actually went over the counter a year later.)
> In 1984, Upjohn sponsored a major conference on DTC advertising in Washington, D.C., where it made no bones about expressing its opposition to the practice. But less than five years later, Upjohn was touting the merits of DTC after its hair-restoration medication, Rogaine, was approved by the FDA and needed to be marketed.
Convincing people to buy things they don’t want or need shouldn’t be protected speech. Convincing people to take medication they don’t need is the pinnacle of idiocratic capitalist absurdity.
https://x.com/RobertKennedyJr/status/1793144103800361050
> We are one of only two countries in the world that allow pharmaceutical companies to advertise directly to consumers on television. Not surprisingly, Americans consume more pharmaceutical products than anyone else on the planet.
> As I told @JoePolish, on my first day in office I will issue an executive order banning pharmaceutical advertising on television
Unfortunately, this is probably illegal. See cases like United States v Caronia.
Since when has something being illegal/unconstitutional stopped the current administration from doing anything?
So its still a choice they are making, just one that further shows that with the current administration (and ultimately SCOTUS with their shadow docket bullshittery) the rights of corporations are protected far more than the rights of individuals.
P.S. I don't subscribe to the above but I believe it's where the owned government officials are at.
Or previous ones.
The point they're making is that $currentAdministration ran specifically on a platform countering this behavior and have failed to keep those promises, whereas others which ignored it simply did not mention it.
I don't understand what you're getting at here
I would wager cardiac and arterial disease would plummet.
If there is a problem with overconsumption or misuse of prescription drugs isn't the blame on the medical professionals that prescribe them? Ads to the general public seems far down on the list of culprits here.
Eventually, doctors that resist the pressure loose in the market, because they end up less liked and more criticized. And that is about it.
Sounds like the incentives for doctors are misaligned. They shouldnt be subject to market demand for improper prescribing, for example that should be offset by fines or license revocation for misprescribing. Consumers cant be expected to know if a treatment is appropriate, so they consult doctors and if doctors are swayed by financial incentives to prescribe thats on the doctors.
The real challenge lies in the expectations the FDA has set for manufacturing. Over time, the regulatory space has been heavily influenced by academic-driven theoretical scenarios for microbiological contamination. While well-intentioned, these theoretical risks often drive overly stringent requirements that don’t always reflect real-world manufacturing risks.
As a result, it’s becoming prohibitively expensive to manufacture drugs for the U.S., especially sterile injectables.
And truly it gets worse every year…
> Digging through company records and test results, they found more evidence of quality problems, including how managers hadn’t properly investigated a series of complaints about foreign material, specks, spots and stains in tablets.
> Those unknowns have done little to slow the exemptions. In 2022, FDA inspectors described a “cascade of failure” at one of the Intas plants, finding workers had destroyed testing records, in one case pouring acid on some that had been stuffed in a trash bag. At the second Intas factory, inspectors said in their report that records were “routinely manipulated” to cover up the presence of particulate matter — which could include glass, fiber or other contaminants — in the company’s drugs.
> Sun Pharma’s transgressions were so egregious that the Food and Drug Administration imposed one of the government’s harshest penalties: banning the factory from exporting drugs to the United States.
> A secretive group inside the FDA gave the global manufacturer a special pass to continue shipping more than a dozen drugs to the United States even though they were made at the same substandard factory that the agency had officially sanctioned. [...] And the agency kept the exemptions largely hidden from the public and from Congress. Even others inside the FDA were unaware of the details.
FDA inspectors found actual, live contamination in drugs produced by a manufacturer, and the agency secretly (otherwise, it would have caused "some kind of frenzy" in the public") gave it an exemption anyway, to make sure supply wasn't impacted. This isn't a "funding" issue, and it's not a "regulations are too strict" issue. This is an issue with the people running the agency behaving completely inappropriately.
If the government had said the imports from India are not allowed due to insufficient quality controls, then the market price for the generics would increase in the US, maintaining the necessary profit margins for the manufacturers to provide higher quality medicine produced at higher cost.
https://www.npr.org/sections/health-shots/2019/05/12/7222165...
>Internal divisions and pressure from Congress also limited the FDA's response to overseas violations,
whistles
>delays in launching a generic version of Lipitor could cost Americans up to $18 million a day, according to a 2011 letter from a group of U.S. senators to the FDA commissioner.
The FDA chose a practical middle ground. Ban what isn't critical, and for those that are, they put additional mitigations in place:
> Exempted drugs were sent to the United States in a “phased manner,” the company said, with third-party oversight and safety testing.
>“The odds of these drugs actually not being safe or effective is tiny because of the safeguards,” said one former FDA official involved in the exemptions who declined to be named because he still works in the industry and fears professional retribution. “Even though the facility sucks, it’s getting tested more often and it’s having independent eyes on it.”
the article states "And the agency kept the exemptions largely hidden from the public and from Congress."
How so, are the examples?
The FDA maintains a public red list of companies with import bans, and a green list companies operating under exemptions.
What transparency are we talking about?
*He and his colleagues had also been engaged in a decades-long debate with a sprawling community of watchdogs — mostly doctors, lawyers and scientists from outside the agency — who were often broadly supportive of the agency’s mission but who fought with officials like Califf, sometimes bitterly, over the specifics: How should the F.D.A. be financed? What kind of evidence should new drugs and medical devices require? How should regulators weigh the concerns of industry against the needs of doctors, patients and consumers?*The existence of problems does not imply there cannot be more plentiful, more diverse, and more severe problems in the near future.
Or, conversely, important things may have been relying on access via the latch-free fence gate: fixing the latch without providing a more appropriate solution to those issues could cause more harm than the benefit you get from "now the fence actually functions as a barrier". (Sure, the latch keeps the wolves out, and stops them picking off the sheep – but it also keeps the sheep away from their only freshwater source, without which most of the sheep are going to die.)
So uhhh, maybe we think in reality instead of offloading to metaphor.
we also know for a fact that the FDA lets unsafe and ineffective drugs into the market, especially from overseas, slapped with a label that its safe according to the FDA. if its a crapshoot, what's the point really?
99.99999% of drugs ever created are unsafe or ineffective.
99%+ of the drugs you will ever encounter in your life are both safe and effective.
That is not a crapshoot. Obviously.
https://www.propublica.org/article/fda-drug-loophole-sun-pha...
Despite its failures (however many you want to point out), our regulatory regime converts a pipeline of almost universally ineffective and/or dangerous compounds into a marketplace of almost universally safe and/or effective compounds. This is a fact.
Unless you think no one is trying to, would try to, or would deceive themselves into accidentally releasing a dangerous or ineffective compound to consumers?
> politically unpopular drug shortages ...
Ask your ADHD friends about how they get their meds.
One side wants to keep it, the other side wants to get rid of it. No one wants to fix the problem.
That’s not what wedge issues are for. They’re not meant to be solved, because then they’re used up, and there’s airtime to fill in the meantime.
Insufficient regulation both on approval _and_ inspection of medical devices (thinking surgical applications and implantables for example) is as impactful on patient safety as drugs.
Half of that stuff didn't work as advertised, the other was actually dangerous, because it e.g. didn't control dosage.
It’s not some temporary thing where we can just raise awareness and then people will vote them out of office next time. The changes that have been made affect the ability for those opposing to win the next election, and even if they were to, the checks and balances have gone.
At this point, unless you plan to work to undo it long-term, you could accept that our society will be quickly devolving maybe 100-150 years or more.
In the past, opportunity abounded in fake science, magical thinking, weird products, dirty industry, manual labor, inequity, and brutish behavior.
If they want to outlaw processed foods and we all start eating flavorless thick hard biscuits of grain and beans and less-than-stellar-looking fruits and vegetables, it’ll probably be better for my mental and physical health.
However, that may be offset by my teeth rotting from lack of fluoride and getting cancer and intestinal problems from lack of regulation. And the death, disease, and disablement will overshadow the fear and excitement from street fights, arcing electrical devices, dangerous bubbling chemicals, planes falling from the sky, things exploding, medicine shows, and AI whorehouses.
A recent discovery was a heart rate monitor used in hospitals that sent all data, including full patient details, to Chinese servers, and would accept arbitrary code updates from said servers.
If you wanted to kill a diplomat, muting or spoofing heart rate data while they have a cardiac event in hospital would be a very sneaky way to do it.
And Mitch McConnell, who suffered from polio when he was 2 years old back in 1944, had strong words, but confirmed the anti-vaccine halfwit anyway.
Good job Mitch!
Not happy about that possibility, but it is a possibility. "What's so bad about measles, anyway?"
If people don't think a drug manufacturer is safe they don't have to buy drugs from them.
It may well be that the legitimate drug manufacturers benefit from tight regulation by the FDA. They can give them legitimacy when the public may otherwise overreact.
I'm not sure an anything-goes environment is going to be something they're going to enjoy. Oh well.
It's extremely misleading to argue with confidence that even a significant fraction of those thousands to millions of deaths would be prevented if only we had the good sense to eliminate medical regulations entirely and that doing so would only result in a few hundred deaths.
It's not just about poisoning deaths from toxic medicine -- it's also about additional deaths from people taking snake oil treatments over proven effective treatments. If the US response to COVID shows us anything, it's that this latter group can be quite significant.
A big problem that's led us to where we are is that many in the right wing fringes that brought us the current administration make their fortunes off selling snake oils in the form of supplements. And while I'm sure some will immediately point out that left wing fringes have their own bullshit cures (e.g., essential oils, healing crystals, etc.), the difference is that this group is still treated as the kooks they are.
It didn't use to be like this. I've considered a number of things in our society that I could point a finger at as the cause but often when I dig just a little below the surface the one thing that I always seem to uncover in all cases is fear.
How did we (U.S.) become such a fearful country? The pace of change? A media narrative? Starting with cable television and 24-hour news?
Fear, hate, and other base emotions maximize engagement. A negative story that inspires fear or hate will get often thousands of times more clicks than a neutral or positive one. Media tends to be ad supported and run on attention maximizing KPIs, therefore the media pushes fear and hate.
Social media added a layer of personalized algorithm-driven amplification that dialed this way up, which is why politics has become hyper-polarized and dominated by insane narratives. It drives engagement.
Edit: the reason for this is probably an evolutionary bias toward negativity and paranoia. As the saying goes: If your ancestor mistook a bush for a lion, they lived. If your ancestor mistook a lion for a bush, they are not your ancestor. We are all the descendants of paranoids. Negative media pushes that button.
What medicine, SPECIFICALLY PLEASE, does the FDA not allow you to have?
edit: because I'm pretty sure you can find doctors who will prescribe 3 liters per minute of elephant farts to treat high blood pressure, or compound up some turbofentanyl mixed with vitamin q to grow hair on your gooch if you look hard enough and there's nothing the FDA can do about it so most of the time peoples' problems are with insurance companies or pesky medical ethics and various state boards of medicine.
I despise nothing more than these bureaucrats. If I want to take the risk on a new medication then that's my choice. If someone else doesn't then that's fine too. I'm not the one telling other people what to do, these worthless busybody bureaucrats are.
Are there laws that would indemnify the healthcare provider for unexpected adverse outcomes for voluntary recipients of experimental drugs?
edit: I wrote a bunch of bullshit and then deleted it but the points are:
1. Narcolepsy sucks
2. The FDA can't stop your doctor from giving you TAK-861, the likely culprit is Takeda. It is 100% legal for Takeda to sell Oveporexton so long as they don't claim that it treats narcolepsy until it has been approved, and it is 100% legal for your doctor to give it to you.
3. Have you looked at >>>RIGHT TO TRY<<<? Again, with this the ball's in Takeda's court.
https://www.fda.gov/patients/learn-about-expanded-access-and...
I know nobody believes me.
Here's an ambulance chaser's blog:
>Unapproved drugs exist in a gray area in U.S. law. Although it is not illegal to prescribe non-FDA approved drugs, it is also not viewed as best practice. If a doctor prescribes an unapproved drug, he or she could face civil liability for the patient’s injuries, illnesses, side effects or death upon taking the drug if the physician reasonably should have known of the potential health risks due to the lack of FDA approval.
https://www.liljegrenlaw.com/can-my-doctor-prescribe-non-fda...
I will certainly take a look at those links as they may help me, but this doesn't change my opinion on the state of things. It infuriates me that I have to jump through all these bureaucratic hoops to get what I need. There is a company with a product they want to sell, and a customer who wants to buy it. The fact that they won't just sell it to me is an indication that our system is fundamentally broken.
I put little weight on the fact that the FDA in particular isn't outright banning me access. They are just one arm of the bureaucratic squid that is strangling me. The FDA says "take this at your own risk" which is on the face of it a fair statement. But they know that the civil liability system, which is just the other arm of the squid, will deny me the ability to actually take my own risk. And they know that the arm of the squid that mandates Takeda can't sell me the medicine without the approval of a doctor means that I won't be able to get through that bureaucratic gatekeeper. So the whole system works together against me while ensuring that no part of it can be blamed because it isn't the decision of any one part that prevents me from getting it, but rather the interaction between these parts. This is why "burn it all down" is such a popular position.
Pity the old ways are
> You’ve died of dysentery
So I’m open to the possibility that lot of these types of feeling, in both directions depending on the political era, is more dictated by environment and media consumption choices and their versions of doom and gloom than reality
Do your friends know about the absolute immunity the Supreme Court invented for the president? Do they know about the illegal deportations that are accelerating? Do they know about the presidential order that aims to deport legal citizens of the USA (the end of birthright citizenship)? Do they know about the gutting of virtually all social programs?
If they don't, then they're ill informed, regardless of their feelings on the matter. If they do and still think all is well, then they are just as much a part of the problem as the ones doing this all.
> Afghanistan is often described as a “failed state,” but, in light of the outright thievery on display, Chayes began to reassess the problem. This wasn’t a situation in which the Afghan government was earnestly trying, but failing, to serve its people. The government was actually succeeding, albeit at “another objective altogether”—the enrichment of its own members.
From https://archive.is/CBQFY .
Was it here or in the reviewed book about corruption where it's mentioned, how corruption endangers security, because guess what the civilians who are mad about the blatant corruption will do when they see an insurgent plant a roadside bomb targeting the corrupt government?
As Supreme Court Justice Louis Brandeis said (and Timothy McVeigh quoted):
> In a government of laws, existence of the government will be imperiled if it fails to observe the law scrupulously. Our government is the potent, the omnipresent teacher. For good or for ill, it teaches the whole people by its example. Crime is contagious. If the government becomes a lawbreaker, it breeds contempt for law; it invites every man to become a law unto himself; it invites anarchy. To declare that in the administration of the criminal law the end justifies the means -- to declare that the government may commit crimes in order to secure the conviction of a private criminal -- would bring terrible retribution.
Indeed. And as soon as the flow of foreign money propping the whole thing up was cut off, they vanished like melting snow across the border.
Corruption endangers security in all sorts of ways. This came up at the start of the Russian invasion of Ukraine, when it became apparent that maintenance money (and in some cases entire pieces of equipment) had been diverted, resulting in operational failure. The US Navy had a corruption scandal a while ago too ("Fat Leonard").
> to declare that the government may commit crimes in order to secure the conviction of a private criminal
Not even conviction, just straight up execution. The lesson of the BLM backlash was that, no, really the US public demanded that the police had the right to execute citizens in the street without accountability.
We've already come close to Trump causing a war [0]. However, there is one aspect of the man (that's on display here) that gives me hope. He is a moron who can't take advice, and who appoints other morons (to make him look good?).
If it was Stalin, or Hitler, or Erdoğan or god help us Xi, the USA would be in real trouble. All of them are very competent leaders, who could take their countries in the direction they desired for a decade(s). Trump, well you just have to look at his popularity ratings, or the economy shrinking 0.5% in his first quarter. He could have poured money on the economy and had everyone getting high and merry on debt, while he took in billions in bribes via is cryptocurrencies. But nooooo, no one has a clue why he is perusing his economic policies, probably because there aren't much in the way of clues to be had.
It could have been so much worse. As it is, it looks like most countries have his measure and are working around him. I don't know what made me cringe more: Netanyahu showing Trump his letter of recommendation for the Nobel Peace price, or Trump lapping it up. Before that is was the European leaders showering gifts on him. It was disgusting. And it worked. Such is the art of politics, I guess. If you are dealing with pigs, it must appear to the pig that you enjoy rolling in their shit just as much as they do. All leaders except Putin that is. Putin played him for such a fool that even Trump picked up on it.
[0] https://theconversation.com/trumps-first-term-lies-at-the-he...
Here's an EconTalk podcast with the other co-author, Adam Cifu, talking about the book. https://www.econtalk.org/adam-cifu-on-ending-medical-reversa...
The NYT article presents his COVID vaccine policy changes as yet more crazy MAGA shit, whereas in fact he holds nuanced views, based on up-to-date review of available evidence. He has published in NEJM and elsewhere on the topic:
https://www.nejm.org/doi/full/10.1056/NEJMsb2506929
A short take on the above from Adam Cifu, whom I respect greatly: https://www.sensible-med.com/p/prasad-makary-and-an-evidence...
With all of that, I suspect that the rumours of FDA's death are greatly exaggerated.
And it completely ignores the long covid elephant.
Anyone know what chelating compounds he is talking about?
He mentions clean foods, but the Trump EPA is protecting corporations from regulations more than its protecting citizens from pollution.
Separately from this, substances that meet the criteria of being "natural" can be sold as supplements as long as you don't claim they cure anything. EDTA is naturally-occurring and you can buy it as a supplement in the US, although the FDA has some beef with this, which I think is what the original remark might be alluding to.
EDTA is also a common food additive and a laboratory reagent, so people who want to use it can buy it easily, which makes the whole debate basically performance art.
There are three pertinent points: (1) it's EDTA; (2) it's not that EDTA is safe or not safe, it's that no one applied to have it approved as an OTC medication; (3) you can still (probably) sell EDTA as a supplement in the US, but the FDA grumbled about it, which angered various chelation cranks.
Then again, pretty much every metal is toxic at some relatively low body-mass concentration, even iron (which actually can and does kill people, especially when children eat adult iron supplements).
Even lovely unreactive gold does have compounds that are toxic.
The way idiots kill their children with it is that among other metals, it removes calcium ions, and those are necessary for life, with low enough concentration in blood eventually resulting in cardiac arrest.
So said idiots have an autistic child, read junk online that tells them that "toxins" caused this, find the compound that is legitimately used to remove toxins, and administer enough to end the autism. By stopping their child's heart.
I don't particularly like the FDA, but restricting the availability of EDTA is not something I'd criticize.
I feel like a basic human life value has decreased recently. Be it ongoing brutal wars, news pushing doom and gloom 24/7, covid certainly didnt help or something similar. A bit like reversal to medieval times when cruel public executions were a spectacle for whole town and families and life of individual was truly worthless.
If thats the case, let the dumb die including offsprings, just don't let their bills to be picked up by society. Extremely cruel, but it seems we are heading that way, and we have this little thing called overpopulation. Extreme freedom with extreme consequences.
I think better would be for people to be more personally picky who they share spaces with.
> Even in applications other than toxicity, no widely agreed criterion-based definition of a heavy metal exists. Reviews have recommended that it not be used. Different meanings may be attached to the term, depending on the context.
I want to guess Oliver Wendell Holmes for some reason, but it doesn't read like something he said. Sorry I can't be more helpful.
"Anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means 'my ignorance is just as good as your knowledge'"[0]
[0] https://www.goodreads.com/quotes/84250-anti-intellectualism-...
"The USA is so enormous, and so numerous are its schools, colleges and religious seminaries, many devoted to special religious beliefs ranging from the unorthodox to the dotty, that we can hardly wonder at its yielding a more bounteous harvest of gobbledygook than the rest of the world put together."
[0] https://www.azquotes.com/quote/1064507
[1] As a middle-aged American who's lived their whole life in the US, this quote is spot on.
Yes, because doctors are secretly plotting alongside with big renewables to trap sunshine with solar panels and imprison it in batteries. They don't want patients to compete with them for access to sunshine.
Back about 15 years ago before it became a weird culture war issue, my sister, who had a diagnosed casein allergy (casein is the main protein in milk), found that she could consume raw milk without any adverse effects.
It would seem dismantling the FDA is the opposite of that; what's needed are more regulations on food, or at least policies that result in more healthy food being available and affordable to Americans, not less regulation.
the fda started with a noble mission but they've been getting heavy handed. or better cliched - slow handed with getting things certified.
you can solve this one or two ways: drop regulation or increase staffing.
so many institutions have unnecessary fluff, tremendous red tape (why do i need environmental review to stick a shed in my backyard??), our modern lives have too much regulation.
let's hope for the best.
the old system is holding back drugs.. there should have been more ozempics, more breakthroughs had the fda not been so slow. companies have a strong incentive not release bad drugs now.. lawyers are not cheap and law firms know money can be made.. it's not the 1930s anymore.. (okay it's still the 1930s in certain places of the world, that's a criticism)
typing this out hoping to convince any regulation reduction is good reduction, i thought of a third fda option: the fda let's everyone go hog wild initially but looks at the top consumed products and checks them for safety and efficacy each year.
these studies struggle to find candidates, the testers rarely have serious side effects, so i think on the net this will not cause the harm you worry.
however! i would be worried taking new broad market drugs post any fda collapse.. but there's fewer of those on average. and pharma companies compete on efficacy and side effects and love to show investors results. so mixed bag.
we play it too safe. ozempic will save many many lives. if it had been approved years earlier it would have saved many many more. waiting for perfect is what the current system feels like, and seems like something you also know is foolish.
18 studies. only 6 novel. not a healthy ecosystem imo
Because cowboys make cowboy decisions, which leads to loss of lives.
"We're going to build on a flood plane, don't worry we've put in protection" turns out they didnt and the things they did made the flooding worse.
> companies have a strong incentive not release bad drugs now
Given that fentanyl exists and managed to get through, and was widely prescribed by doctors, and the whole industry setup to encourage prescription, I think thats not really true. Its not even like its that effective as a pain relief (https://www.bjanaesthesia.org/article/S0007-0912(17)37428-7/...)
Without prescribing any solution here, is it that much of a stretch to think that the FDA in practice exhibited dysfunctional characteristics in markets? With the longevity of the players and the deep pockets associated with health care, is it a stretch to see large changes to the institution as constructive in the long-run?
not allowing companies to poison people for profit, ensuring people are qualified to do safety critical jobs. Making sure that companies can't cut OSHA for profit, ensuring that buildings are built to withstand the weather properly, even though it costs more.
A lot of the "nanny state" shit is there because people died. Now, of course some of it is because conservatives/liberals/that class you don't like got their knickers in a twist as well. But that tends to disappear pretty quick.
But that means that big money can use that as a spring board to remove expensive regulation.
You want clean air? but thats expensive! nevermind, soot spewing engines is manly, everything else is what those people you don't like do.
You want social media to stop sending porn to tweens? freedom of speech my friend! thats what makes america better than communism. You want your child to read the great american novels? oh did we say freedom of speech? no we meant don't do our country down.
All of that is theatre, what matters is the food and drugs you eat are safe, effective and well controlled so that the most amount of good is allowed with the least amount of harm
I mentioned none of those things
If you want a debate, you'll need to engage with the subject, rather than get angry and fire off a bunch of logical fallacies.
Especially when you explicitly mentioned the "nanny state"
I'm not sure why you think "let people poison others for profit, their customers will die" is a good argument.
It's deadly *on the street* because of it's tendency to clump, meaning that your average drug dealer is not competent to dilute it properly. That's not a problem when handled by professionals.
Being prescribed opiods to take home, is a sure fire way to get someone addicted https://www.gov.uk/drug-safety-update/opioids-risk-of-depend...
What is even more bad is companies running competitions to encourage family doctors prescribe opiods for long term use.
sure heroin on the streets is bad, don't get me wrong, but giving it to unsuspecting patients, getting them addicted and then effectively forcing them onto the streets is even worse.
Advertising of drugs is fucking stupid, bribing doctors is even more stupid. But as thats where a lot of money comes for politics, its not going to change.
Typical signs of addiction are: ... Expression of a need for more, or reporting additional use of other pain-relief medicines
In other words, if the doctor doesn't prescribe a high enough dose for the situation the patient has an addiction problem.
I get annoyed by web development, but I wouldn't want to see the solution be a federally mandated burning to the ground of the HTML standard.
... is there, like, a change.org petition I can sign in favor of this? ;)