I was recently hit up for a fundraiser for cancer research. Which started me thinking (bad idea).
Is there any incentive to actually cure any terminal disease? Unless it’s a pandemic (like the much-publicized bird flu), I just don’t see it.
See AIDS. No cure, but boy they can sure keep you alive on drugs. See Magic Johnson. Now, I don’t know what his quality of life is, (or what his drug bill is), but he’s had the virus for what, 15 years now?
The pharma industry seems to me to be motivated to keep you a customer. But not to cure. To cure, you’d lose a customer. So, for profitability (and shareholders), why would you sink money into a cure rather than a band-aid?
It sounds terrible, but it just makes sense, money-wise.
If cancer were to be cured, a lot of money, jobs, etc., go down the tubes. Same for MS, MD, or any of a number of illnesses that have active charities collecting for “research”. How long has Jerry Lewis been spending his Labor Day raising money for MD? I have no problem with the concept of giving, and certainly it feels good to feel like you are helping. But when was the last time any major disease was wiped out? I’m not speaking about advances, I’m talking about actual cures.
I know about polio. What else in the last 30-40 years or so has been terminated?
Is this a product of the almighty dollar (the pharmas improving your life, and extending your life to keep you buying their products), a product of the diseases themselves (i.e. they aren’t curable, no cure to be found), or a combination of both?
There may indeed be more money in the revenue stream from maintenance drugs than from preventive or curative treatments. But there may be more money in preventative drugs, since everybody at risk would take the drug: think prophylactic vaccines.
Having said that, a number of diseases are multifactoral and chronic: they don’t have simple causes, and they unfold in stages over a long time: cancer, dementia, hepatitis, AIDS, …These things rarely have a simple “cure”, and it is more likely that any effective strategy is either of a preventative or of a management mode.
For example, consider Gardasil and Cervical Cancer: Knock down variants of HPV that are associated with something like 70% of cervical cancer incidence and ~90% of chronic genital warts. Per patient, less of a revenue factor than from cancer therapy, but a much larger client base.
The current therapies for AIDS involve interfering the ability of HIV to reproduce and to function. This is a chronic problem, with a good revenue stream per patient. A prophylactic vaccine would have a similar economic model to that of Gardasil.
Profit. I can’t find a cite, but I recall a news story about some pharma company official commenting that as far as he knew, nobody had any intention of finding a vaccine for AIDs.
If you cure a disease, you can patent your cure, and name your price for it.
Then you move on to the next disease, or inconvenient condition (like ED), and make your money off of that.
And they’ll always be a next disease.
Add to that glory-hungry scientists desperate to be known as the next Salk or Pasteur (not to mention the Nobel prize money, which is nothing to sneeze at, as well as the incredible ease that you’d get other grants) and you’ve got huge incentives to cure diseases once and for all.
There’s also disincentives to not try and find a cure. You don’t want another company to beat you to the punch, getting the money for itself and wiping out your revenue stream with one fell swoop (and I find it really hard to believe that companies are colluding with each other when they could make money and generate enormous good will by releasing a cure). Plus, if they were willfully repressing a cure, someone would squeal. Scientists can be an idealistic lot, and there’s too many involved in cancer and AIDS research to believe that they’ve all been bought off or intimidated into silence.
The reason they haven’t found a cure is because… They haven’t found a cure. For cancer and to a lesser extent AIDS, they may never find a one-size-fits-all, one treatment and you’re helthy forever type of cure.
Unless the Pharma People (and their extended famlies and loved ones) are all immune to AIDS, cancer, Alzheimer’s, heart disease, diabetes, etc. - I think the idea that they don’t want a cure is pretty far fetched.
Well, it is possible that some unnamed person who may have worked for the pharma industry in some capacitity might have said something that was vaguely along those lines. It’s not really possible to derive anything more specific from Der Trihs’ statement.
I find it extremely unlikely that it’s a common attitude in the industry, though I can imagine some companies giving up or scaling down their AIDS research and shifting to other ailments. It’s not, after all, the only disease around.
Ok. I’m a scientist at a pharma compnay, so I think I’m qualified to answer. I can say, unequivocably, that we would love to cure cancer and AIDS at my company tomorrow for both cure and profit.
If there were some vast conspiracy, I can tell you that I, personally, would have to be in on it. Obviously, me saying this could be part of the conspiracy, so I can only tell you that for myself, the answer to the OP is obvious.
Why do you act like these are mutually exclusive? If we cured both cancer and AIDS at my company, we would save untold lives. We would also make buttloads of cash. Remember, my company (company X) is not in some sort of agreement with company Y to only make therapeutics rather than cures. If my company only made therapeutics for, say, lung cancer, when there was an obvious cure available, you can be damn sure that company Y would produce the cure. That would put the profits of company X’s product down the toilet and send millions of people a year to their doctors to pay for company Y’s cure. People are going to keep smoking, therefore customers, to use a bad term in the context of this OP, will always be created. Same with AIDS or virtually any other disease.
Have you ever stopped to consider that curing a disease is freaking hard?! Antibiotics and vaccines cured diseases because those were the lowest fruits on the vine. Antibiotics target bacterial processes which are vastly different than mammalian processes; vaccines are simply killed or attenuated versions of the actual virus. In neither case was a molecular understanding of the treatments necessary. Now, think of AIDS, with its amazing mutation rate. Or cancer, which are YOUR OWN CELLS, that we’re trying to treat! These are impossibly complex to cure!
We need to understand, on a molecular level, what is going on with these diseases before we can home to cure them.
Also, consider the current climate where companies are terrified of having a drug turn out to be harmful after it gets FDA approval (which is no small feat). Now, I’ve done dozens of tumor studies in mice. These are, for all intents, genetically identical mice. I treat them in exatly the same way. They are fed exactly the same diet and kept in the same cage. Meanwhile, I have therapeutics that will work in 3 out of 10 of them in a given study. Try extrapolating that to humans, where genetic differences and lifestyle differences come into play.
No drug is going to work in everybody. Furthermore, there are going to be unpredictable results, and harmful side effects in some people.
As an aside, if you want to see drugs get produced at a higher rate, and with better quality, then protect the pharma companies from litigation. If a company gets FDA approval for a drug, and later it is found, through no fraud or mistake of the company, that there are harmful side effects, then no one can sue the company. You take the drug, and there are some chances involved in it. If a company puts forth a drug that it truly believes to be effective and safe, and the FDA agrees, then litigation should be disallowed. I’m not talking about Vioxx where there is evidence of wrong doing. My 2 cents, anywho.
I have to agree with some of the statements Fiveyearlurker made. A drug company has to jump through an enormous number of hoops - both political and research, clinical trial, etc., in order to get a drug on the market. It costs an incredible amount of money to develop a drug. The you have the idiots that wanted to block approval of Gardasil “because it might encourage young girls to have sex.”
Not every drug is going to work for everyone. I am allergic to non-steriodial anti-inflamatories (Motrin, Advil, Aleve, etc.) with effects that can range from hives to breathing difficulties. Should those drugs be taken off the market because I can’t take them? Of course not - millions of people are helped by them every day. If a drug company has done their job ethically (not like the Vioxx deal) and the drug was approved, they shouldn’t be subjected to lawsuits from people whose body chemistry doesn’t happen to agree with the drug. I think it hurts the development of new drugs in the long run.
Fiveyearlurker, thanks for your post. As someone in the industry, I think your opinion holds a lot of weight. I appreciate the time you took to write.
I don’t know if I buy “vast conspiracy”. But perhaps you can shed some light on this. As a scientist, are you told what to work on? Are you given priorities? Or are you on your own? As a business, I find it hard to believe that your company allows you to run without some sort of direction.
I also understand that many diseases can change on the fly, and morph into different strains. Difficult to hit a moving target.
But I do struggle with the FDA excuses. They seem to make decisions to fast track certain drugs. This blood substitute fiasco that I read about recently was one of these things. Has it saved lives? Probably. Has it ended lives? Probably. But who pulls who’s chain at the FDA? With all the cross-pollenization between Pharma execs, the FDA, and lobbist groups, who really knows how it all works?
I know how it’s supposed to work (more or less). But even with all the checks and balances, things like Vioxx happen.
Money talks a lot more than we’d all like to think.
To follow up on Lurker’s points, capitalism is at minimum the reason why regardless of a anything, trying to cure AIDS will always be on the path.
To offer a parallel case, previous to roughly the eighties, all car manufacturers in the US had essentially decided that maintaining a status quo on automobile technology was the most profitable course. Now, do you think there is any way that eventually this wouldn’t have been broken? No, because even if the Japanese hadn’t come to do it, eventually someone would simply because there’s a buck there to be made and doing something that isn’t in the status quo is the only way to accomplish winning out.
And you will note that even though the technology level did not change as it should have, car styling did change every year. Looking at communist countries, if they had a working car that did it’s job, why waste the time to change the look? In a capitalist country though there is a reward for if you can win over more customers with slicker lines, more speed, and bucket seats.
As time goes on and more and better medicines for prolonging AIDS will be created. Medicines which prolong it better will be more profitable. Making medicines which can further and further prolong the disease will be the only way to win over customers from the competitors. And to do that you have to get to know the disease better and better, and all the different ways that it can be fought. And so, even though you weren’t looking for a cure, eventually the shear amount of knowledge and work towards prolonging the disease is going to reveal a cure. And once that happens, it’s just a matter of time before Toyota sweeps in to grab the pie.
I was given a disease to work on, and a particular type of cell to target, but little more than that.
Personally, I’m in a position where I’m VERY early research and discovery. So, I work on discovering which molecules to target in the first place. My research can be quite basic science oriented. I rarely do therapeutic studies, and frankly, none of my research is expected to lead to any discoveries. I’m the guy they hire to play around with mouse models, and hopefully he comes up with something that sheds some light on potential therapeutics. I have two target molecules now that I’m playing with, but one of them I’m relatively certain has no human therapeutic value (I’m persuing it as an interesting mouse phenomenon, that could *possibly *extend to humans). I’m at a large and very profitable company, so they can afford to have a bunch of people like me on the payroll who in all likelihood are just a waste of money; we’re kind of like a lottery ticket.
For others, yes, of course there is direction (not that there isn’t for me, I’m still subject to oversight, but when you aren’t being asked to produce therapeutics, no one can complain that you aren’t.). But, the direction is given, almost exclusively, by other scientists. Not the business people. And the decision that your project is given a “no go” is based on science; it only happens when a group of scientists gets together and says that they don’t believe that your research is headed somewhere. The business people get involved relatively late in the game. The science, at least the preclinical modeling, is already done by then.
I can say that my research is overseen by patent attorneys pretty frequently, in order to make sure that the company has my work covered. But, no one on the business end cares that I exist.
I can’t imagine that someone would have the cure for cancer in their lab, and the scientific committees would say, “Nope. That’s too good a drug. We’re pulling the plug on you.” There are just so many reasons that couldn’t happen, that it’s silly to consider.
As far as diseases that have been for practical purposes eliminated, think of smallpox. AFAIK the only existing smallpox is isolated in a few labs; debate continues as to whether the best course would be to destroy those or to keep them in cold storage in case somebody else doesn’t destroy theirs.
There are also lots of diseases that, in developed countries, have been minimized to the point where a local outbreak makes headlines. Back in the day, virtually every child got measles, mumps, German measles, chicken pox. Relatively few do now. Most doctors (in developed countries) have never seen a case of diptheria, whooping cough or typhoid fever, and are quite pleased for that fact to continue. The pharmacological industries are prospering nonetheless.
It will be a long time, if ever, before we can prevent all cancer. Meanwhile there is a vast amount of money to be made if you can develop any treatment that prolongs the useful life of a cancer victim. Profit motive is good.
IMHO, the only diseases that the industry is ignoring are those that affect very few people and/or can be treated at least in part by existing non-patentable remedies. An example from my personal experience: Few years ago I was found to have lymphocytic colitis. Its main symptom is chronic diarrhea. Its principal treatment is lots of Pepto-Bismol for a significant period of time. It’s relatively rare, and the P-B treatment apparently works most of the time for most people. Nobody is ever going to spend money finding a better treatment unless every other malady affecting humanity is eliminated. And rightly so.
Ditto for any disorder, even a fatal one, that strikes only one in a gazillion people. While this is incredibly sad for that one, it’s probably a reasonable and ethical approach. Why spend money researching for one person when that some money could be used to help thousands?
If indeed, there was one giant “Pharma” company in the entire world, you could have a point. But each individual company is fiercely competitive with the others. Thus, although it is possible that DrugCo (who has an expensive treatment for AIDS) might have a economic reason for not designing a cure for AIDS, PharmaInc isn’t getting any of that cash, and thus if they find a cure they make PharmaInc huge sacks of cash, and the only Company hurt is DrugCo. Thus, PharmaInc would dearly love to find a cure for AIDs. (Not only get filthy stinking rich, but the Nobel prize, acclaim, honors, and so forth)
Thus, not only does this paranoid idea need a conspiracy amoung the top levels of Management of one drug company (and we all know how hard it is to keep a secret- someone is going to get fired or a turn of consience and fink out), we have to assume that every large drug company all over the world is engaged in a HUGE International conspiracy. If i used enough :rolleyes: :rolleyes: :rolleyes: and :dubious: :dubious: :dubious: emoticons to show what I thought of it, the hampsters would die on the spot from overwork.
In other words- not only “no”, but **NO FUCKING WAY!
**
You might be surprised. There is a big push from a bunch of companies to treat Crohn’s disease and ulcerative colitis from an immunological perspective (by targeting molecules that are involved in the inappropriate immune responses elicited in colitis).
While perhaps not directly affecting lymphocytic colitis, I would be surprised if an appropriate immunological target would work in Crohn’s and not in lymphocytic colitis.
This is different from what my gastroenterologist and internet searches told me. From those two sources, LC is not caused by the same thing as Crohn’s and UC. In fact, there is no particular effort that I’ve been able to find that is actively trying to find out what does cause LC. It’s not nearly as serious as either of the other two diseases. As I said previously, a whole lot of appropriately taken Pepto Bismol often puts a complete end to LC, but AFAIK would not have much positive effect on either of the two other diseases. Since P-B has been thought to have a mild antibiotic effect, LC *may * have some sort of bacteria involved. Or maybe not. Maybe the P-B just relieves the symptom long enough for the body to address whatever caused it in the first place. Nobody seems to know, or care.
We don’t really understand what causes UC or Crohn’s either. All we know is that they tend to be caused by the immune system, for unknown reasons, beginning to start attacking either the normal intestinal bacteria which should ordinarilly be ignored, or your own intestinal cells.
While they all manifest differently, my personal opininon is that a successful immune target for Crohn’s would be applicable to other types of colitis as well. And there is a lot of cash going into Crohn’s research.
