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Posts Tagged ‘pharmaceuticals

“You’re mugging old ladies every bit as much if you pinch their pension fund”*…

Who benefits from the commercial biomedical research and development (R&D)? Patients-consumers and investors-shareholders have traditionally been viewed as two distinct groups with conflicting interests: shareholders seek maximum profits, patients – maximum clinical benefit. However, what happens when patients are the shareholders?…

Adding investments by governmentally-mandated retirement schemes, central and promotional banks, and sovereign wealth funds to tax-derived governmental financing shows that the majority of biomedical R&D funding is public in origin. Despite this, even in the high-income countries patients can be denied access to effective treatments due to their high cost. Since these costs are set by the drug development firms that are owned in substantial part by the retirement accounts of said patients, the complex financial architecture of biomedical R&D may be inconsistent with the objectives of the ultimate beneficiaries…

It has been estimated that of the total $265 billion spent annually on biomedical research worldwide, over a third – $103 billion comes from public sources. Nevertheless, as public input capital is allocated predominantly into early stage research, nearly all output – medicines – is ultimately brought to the market by private firms. Importantly, these firms are not independent agents. They have owners-shareholders to report to. Until the end of the previous century the major type of owners-shareholders were individual households. At the turn of the millennium, however, they have been displaced by institutional investors, the largest of which are public retirements schemes or quasi-public funds, such as occupational pensions.

First, government money underwrites the basic R&D that goes into drug discovery and development, then public pension monies fund the private companies that bring those drugs to market. As the private companies are solving for highest profits, as opposed to optimal public health, those drugs are often priced out of the reach of the very people whose pension contributions funded their development. Drugs “priced out of reach” is certainly not a new phenomenon; AIDS drugs (to take one example) were priced by Western pharma companies at prices that rendered them inaccessible to most citizens of low-income countries in Africa and Asia. The pensioners in wealthy nations were, effectively, living off of the misery of those in poorer companies.

But the dynamic has continued, deepened– and come home to roost. Now patients in high-income countries are denied access to effective treatments due to their high cost, while these costs are being set by the drug development firms, owned in substantial part by the retirement accounts of those same patients, and benefiting from direct and indirect governmental support.

Investing in one’s own misery– the painful irony of pharma funding: “Pension and state funds dominating biomedical R&D investment: fiduciary duty and public health.”

[Image above: source]

* Ben Elton, Meltdown

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As we untangle unintended consequences, we might send healthy birthday greetings to Charles Value Chapin; he was born on this date in 1856. A physician and epidemiologist, he was a pioneer in American public health. He co-founded in first bacteriological laboratory in the U.S. (in 1888) in Providence, were he was Superintendent of Health– a position he held for 48 years. In 1910, he established Providence City Hospital where infectious disease carriers could be isolated under aseptic nursing conditions; his success inspired similar health control measures throughout the U.S. A professor (at Brown) and prolific writer, his impact on health policy and practice was so broad that he was hailed as “the Dean of City Public Health Officials.”

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“Gain not base gains; base gains are the same as losses”*…

When inventor Frederick Banting discovered insulin in 1923, he refused to put his name on the patent. He felt it was unethical for a doctor to profit from a discovery that would save lives. Banting’s co-inventors, James Collip and Charles Best, sold the insulin patent to the University of Toronto for a mere $1. They wanted everyone who needed their medication to be able to afford it. [see here]

Today, Banting and his colleagues would be spinning in their graves: Their drug, which many of the 30 million Americans with diabetes rely on, has become the poster child for pharmaceutical price gouging.

The cost of the four most popular types of insulin has tripled over the past decade, and the out-of-pocket prescription costs patients now face have doubled. By 2016, the average price per month rose to $450 — and costs continue to rise, so much so that as many as one in four people with diabetes are now skimping on or skipping lifesaving doses

Why Americans ration a drug discovered– and given free to the world– in the 1920s: “The absurdly high cost of insulin, explained.”

* Hesiod (See also Proverbs 28:20: “he that maketh haste to be rich shall not be innocent”)

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As we ponder pleonexia, we might send healing birthday greetings to Edward Lawrie Tatum; he was born on this date in 1909. A geneticist, he shared half of the Nobel Prize in Physiology or Medicine in 1958 with George Beadle for showing that genes control individual steps in metabolism. During World War II, his work was of use in maximizing penicillin production, and it has also made possible the introduction of new methods for assaying vitamins and amino acids in foods and tissues. Tatum and Joshua Lederberg (the winner of the other half of the 1958 Nobel award), discovered genetic recombination in bacteria.

His discoveries were made freely available to the scientific community.

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“If you don’t have a plan, you become part of somebody else’s plan”*…

 

pscil

 

 

In 1955, a bank executive and a New York society photographer found themselves in a thatch-roofed adobe home in a remote village in the Mazateca mountains. Gordon Wasson, then a vice president at J.P. Morgan, had been learning about the use of mushrooms in different cultures, and tracked down a Mazatec healer, or curandera, named María Sabina. Sabina, about 60 at the time, had been taking hallucinogenic mushrooms since she was a young child . She led Wasson and the photographer, Allan Richardson, through a mushroom ceremony called the velada.

“We chewed and swallowed these acrid mushrooms, saw visions, and emerged from the experience awestruck,” Wasson wrote in a Life magazine article, “Seeking the Magic Mushroom.” “We had come from afar to attend a mushroom rite but had expected nothing so staggering as the virtuosity of the performing curanderas and the astonishing effects of the mushrooms.”

Appointing himself as one of the “first white men in recorded history to eat the divine mushrooms,” Wasson inadvertently exposed much of the Western world, and the burgeoning counterculture movement, to psychedelic mushrooms. On the other side of the globe, the Swiss drug company Sandoz received 100 grams of the mushrooms from a botanist who had visited Sabina on one of Wasson’s return trips. They went to the lab of Albert Hofmann (see here) the Swiss chemist who first synthesized LSD. In 1963, Hofmann traveled to Mexico with pills containing synthetic psilocybin, the active compound in magic mushrooms.

“We explained to María Sabina that we had isolated the spirit of the mushrooms and that it was now in these little pills,” Hofmann said during an interview in 1984. “When we left, María Sabina told us that these tablets really contained the spirit of the mushrooms.”

Hofmann’s pills were the first indication that while people can have spiritual and transcendent experiences from eating the mushrooms themselves, they can also have such experiences with a man-made version of just one of the mushroom’s compounds: psilocybin.

This development is particularly relevant today, as scientists study psychedelic mushrooms as potential treatment options for those who suffer from severe depression, addiction, and more. In clinical trials, such as those ongoing at Johns Hopkins University and Imperial College London, participants don’t eat caps or stems. They consume synthetic psilocybin, made in a lab by chemists in a way similar to how Hofmann first made his psilocybin.

It’s a necessary hurdle: Psilocybin mushrooms can be grown relatively easily, and aren’t expensive to produce. But researchers have to source their psilocybin from highly regulated labs because natural products vary, and researchers need consistency in chemical composition and dosage in order to do controlled studies. Clinicians need to know how much of a drug they’re giving to a patient, how long it takes to kick in, and how long it lasts; they also need to be sure their drug isn’t tainted with other chemicals. It also helps to be able to mass-produce large amounts and not be threatened by variables, like weather, that affect agricultural products.

As psilocybin moves closer to becoming a legal medicine meeting all the regulatory requirements, doctors won’t be writing prescriptions for mushroom caps or stems—and this will come at a certain cost. Johns Hopkins researchers have claimed they’ve paid labs $7,000 to $10,000 per gram of psilocybin, whereas the street price of magic mushrooms is around $10 per gram. Besides the cost of chemical materials, the steep sticker price comes from the labor required to adhere to the U.S. Food and Drug Administration’s strict drug-making standards, known as Current Good Manufacturing Practice.

It’s an unprecedented moment, and psychedelic culture must reckon with what it means for a magic mushroom to become a synthetic pill, to be picked up at your local pharmacy or from a doctor. There’s some wariness in the psychedelic community about what synthetic psilocybin represents: big business, questionable investors, and patents on experiences they think shouldn’t have a price tag or a profit margin. Since it’s a known natural compound, psilocybin itself cannot be patented, but the way it’s made and used can be. Already there are organizations applying for patents for their synthesis process, and innovators coming up with new ways to make large amounts of synthetic psilocybin, all seeking protection for their intellectual property…

The truth is, there is money to be made in psychedelics, and investors are flocking to back startups in the psychedelic and mental health spaces. The current antidepressant medication market was valued at $14 billion in 2018 and is estimated to grow to $16 billion in the next three to five years. Any drug company that can compete stands to become very wealthy…

As magic mushrooms make the shift from recreational drug to mental health treatment, patients won’t be eating caps and stems, but a synthetic product made in a lab—one that pharma companies can patent and from which they can profit: “Get Ready for Pharmaceutical-Grade Magic Mushroom Pills.”

* Terence McKenna

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As we ponder the profound, we might recall that it was on this date in 1956 that city authorities in the California beach town of Santa Cruz announced a total ban on the public performance or playing of rock and roll music, calling it “detrimental to both the health and morals of our youth and community.”

It may seem obvious now that Santa Cruz’s ban on “Rock-and-roll and other forms of frenzied music” was doomed to fail, but it was hardly the only such attempt. Just two weeks later in its June 18, 1956 issue, Time magazine reported on similar bans recently enacted in Asbury Park, New Jersey, and in San Antonio, Texas, where the city council’s fear of “undesirable elements” echoed the not-so-thinly-veiled concerns of Santa Cruz authorities over the racially integrated nature of the event that prompted the rock-and-roll ban… (source)

rock ban source

 

“Behold, I have given you every herb bearing seed”*…

 

 click here for zoomable version

This map of medicinal plants depicts one or two important species that grew in each state in 1932, identifying the plant as native or cultivated and describing its medical uses. A few species of seaweeds float in the map’s Atlantic Ocean, and the border identifies important medicinal plants from around the world.

The map, printed by the National Wholesale Druggists’ Association for use of pharmacists during a promotional campaign called Pharmacy Week, was intended to boost the image of the profession. At a time when companies were increasingly compounding new pharmaceuticals in labs, pharmacists wanted to emphasize their ability to understand and manipulate the familiar medicinal plants that yielded reliable “vegetable drugs.” “Intense scientific study, expert knowledge, extreme care and accuracy are applied by the pharmacist to medicinal plants and drugs,” the box of text in the map’s lower left-hand corner reads, “from the point of origin through the intricate chemical, botanical, and pharmaceutical processes employed in preparing medicine.”

As historians Arthur Daemmrich and Mary Ellen Bowden write, the early 1930s were a turning point in the pharmaceutical industry. In the previous decades, chemists working for large companies had begun to systematically invent new medicines for the first time, developing synthesized aspirin and vaccines for diseases like tetanus and diphtheria. The 1938 Food, Drug, & Cosmetic Act would bring a heightened level of federal regulation to the production of new medicines. And in the 1930s, 1940s, and 1950s, researchers would go on to invent a flood of new antibiotics, psychotropics, antihistamines, and vaccines, increasingly relying on synthetic chemistry to do so. The pharmacist’s direct relationship to the preparation of medicine would diminish accordingly.

More at “A Depression-Era Medicinal Plant Map of the United States“; visit the map’s page on the David Rumsey Map Collection website.

* Genesis 1:29

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As we take our pick, we might recall that it was on this date in 1727 that Dr. James Lind, a Royal Navy surgeon, began an experiment designed to determine a remedy for the scurvy that was afflicting many British sailors.  Suspecting that diet was involved, Lind divided a dozen crewmen on the HMS Salisbury who were stricken with scurvy into six groups of two and administered specific dietetic supplements to each group.  The two lucky sailors who were fed lemon and oranges for six days recovered, and one was even declared fit for duty before the Salisbury reached port– thus demonstrating (before Vitamin C had been identified) that regular intake of citrus could prevent (or cure) scurvy.

 source

 

Written by LW

May 20, 2015 at 1:01 am

“You take the blue pill – the story ends, you wake up in your bed and believe whatever you want to believe. You take the red pill – you stay in Wonderland, and I show you how deep the rabbit hole goes”*…

 

The Top Pharmaceutical Products by US Retail Sales in 2011

Compiled and Produced by the Njardarson Group (The University of Arizona): Edon Vitaku, Elizabeth A. Ilardi, Jon T. Njardarson

See the rest here along with many other Disease-Focused Pharmaceuticals.

 click the image above or here, and again,  to enlarge

via Medical School and Science Llama; top-most image, here.

* Morpheus to Neo, in The Matrix.

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As we swallow, we might spare a thought for Donald J. Cram; he died on this date in 2001.  An organic chemist who specialized in the creation of molecules that mimic the chemical behaviour of molecules found in living systems, Cram shared a Nobel Prize for work that effectively founded the field of host-guest chemistry… and that led to advances in drug-delivery systems that enabled many of the products pictured above.

source

 

Written by LW

June 17, 2013 at 1:01 am

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