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Comment by hga | Hacker News Reader

Echoing the comment that w1ntermute's made after your's, Lipitor/atorvastatin wouldn't freaking exist as a drug without the system where it costs so much in the US during the period of patent protection. According to Wikipedia, it was first synthesized in 1985 and approved by the FDA in 1996; that period is well into the "you won't recover your drug development money without the US market" phase.

But don't worry, if the usual suspects are successful, we'll all be paying peanuts for drugs in due course. Pity there will be no effective antibiotics against many resistant drug bacteria strains....

(The thing that really gets me is how many of these advocates for an end of medical innovation as an inevitable outcome of their nostrums will find their own lives cut short in due course due to it. Ideology trumps self-preservation.)

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You're parroting industry propaganda with no basis in fact whatsoever. I pity you for being so deeply invested in an ideology that trumps self-preservation.

Are you implying that pharmaceutical companies would happily invest billions into a drug without patent protection?

No, I'm implying that the insane price markups seen in the USA mainly fund insane profit margins and marketing budgets, not research.

As for patent protection: something needs to change there as well, because too damn much of the research budget goes into drugs that are no improvement over existing ones, purely to take market share from a competitor or replace drugs whose patent protection is running out.

source (look at the 10th and 11th paragraph): http://www.nybooks.com/articles/archives/2004/jul/15/the-tru...

Seems like we need a nationalized method for finding drugs, a DARPA for pharma that spends some of the trillions from defense weaponry on defense of national health.

Making the process even more political is going to improve it???

Radical American conservative propaganda aside ("The government can't do anything right!"), actually, creating a nationalized pharma research and development program is an interesting idea definitely worth considering. The public sector has shown itself to be very capable of scientific innovation (see NASA, NIH, NOAA, the Internet, the Manhattan project), and even if several tens of billions were invested in the program, it would probably even become a net positive for the government if discoveries are licensed and sold at highly reasonable prices, both giving the program direct income and reducing national healthcare spending. And, of course, the agency would be able to focus on drugs which aren't the "Take 10 pills for the rest of your life while we bill you" kind.

At the very least, there needs to be better regulation of big pharma practices and prices in the US. Unfortunately, due to the lobbying power of the industry, I doubt we'd see any real solution anytime soon.

Why regulate? If the pill doesn't do what you want for a price you find a reasonable, don't buy it.

Lipitor is a single terrible drug from a pointless class of drugs that actually increase average mortality in people who take them.

High cholesterol is associated with higher risk of heart attacks, but lowering cholesterol isn't associated with a lowering of heart attack risk. In addition, the side effects are vile and costs are high.

The most depressing thing about the modern pharmaceutical industry is that its two biggest cash cows, statins and the modern new-school psychotropics, have very little evidence that they actually help anyone, and involve lobbying budgets the size of small nation's GDPs to keep the gravy train going.

You could be right about statins, although I gather for some they appear to be a good idea. My doctors are pushing them on me, I'm firing the doctors sequentially hoping to get one who will listen (e.g. absolutely no cardiovascular disease in a long lived family) ... the major argument for their being first line treatment is that nothing less works in practice (e.g. "get more exercise). However that doesn't change the principle WRT to drug development today.

What "modern new-school psychotropics" are you referring to? That's a field I know a fair amount about, and I don't see the problem you're citing at all (which is not to say some aren't over-prescribed, but I believe that is a different problem). I would probably be very ill or dead without one (low dose, off label Seroquel to treat anxiety which I have a family disposition towards; it's the difference between 4 and 7 hours of sleep a night, bright light treatment gets me the final extra hour I need).

It and the other atypical anti-psychotics seem to be a lot better than the older "typical" ones, and those were miracle drugs, something witnessed by my mother when she was a nurse. Similarly, the current Prozac and beyond anti-depressants are maybe not quite as effective as the previous tricyclics but their side effect profiles are a whole lot better, e.g. making it more likely a patient will wait those out long enough for the therapeutic effect to begin, and I personally benefit from a laser specific SSRI (doesn't touch anything else), since "wrong" anti-depressants can make me manic.

If you're taking seroquel that is probably a good reason to be on a statin given the current medical evidence as you have an increased risk of metabolic syndrome due to being on an antipsychotic.

Low dose, though, this is an off-label use, it's not for schizophrenia or bipolar disorder where a bare minimum of 4? times that is needed (and as I remember its dosing is non-linear).

I haven't followed the current info on atypical anti-psychotics possibly inducing metabolic syndrome or worse, but I do watch for signs of it. And that's not why my PCPs are pushing statins, it's because of my lipid levels. Which, strangely enough, are exactly where they were in 1999, they got a bit better for a while, and are now back to a level that wasn't considered worthy of dangerous medical intervention back then.

No doubt there are those who suspect previously not so bad lipid levels are actually bad; me, having watched the drama of lipids and health since around when it first became a big thing, and all the revisions in the conventional wisdom, I'm ... a bit more conservative with all that.

Well sounds like you have a good handle on your health inputs! Good on you.

Statins are among the most scientifically supported class of drugs ever created. Your assessment is both wrong and potentially harmful if somehow treated as credible.

I have zero financial bias in making this statement.

No they are not, and my assessment is not wrong. I also have zero financial bias in making this statement. Does it add to the discussion?

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