Irish Medical Council banning certain medicinal herbs/alternative remedies

Pet

What are people's opinions on this? I've read a couple of reports over the past few days about certain herbs being banned from the Irish market (St John's Wort, Gingko Biloba, Yohimbe, etc) by certain councils on the grounds that they can cause "side effects" or "liver damage".

This seems completely and utterly ridiculous to me. I can buy enough aspirin or paracetamol to cause permanent serious liver damage or death; I can buy cigarettes and alcohol which will give me lung cancer/emphysema and cirrhosis; I can do serious damage to my gastrointestinal tract by taking the antibiotics that are being handed out like sweets these days..but I can't buy herbal remedies in case I get a photosensitive reaction? (one of the reasons for banning St John's Wort)
This screams of pharmaceutical companies trying to strengthen their monopoly and take the first line of treatment away from the consumer to make them reliant upon prescriptions for, you guessed it, pharmaceuticals.

Opinions anyone?

DrIndy

Its the Irish Medicines Board ....

secret_squirrel

Its probably because of the new EU proposals banning the sale of a lot of untested (as in a clinical trial) alternative medicines.

I would vent your spleen their way. Seems ridiculous nanny-state-ism to me.

Kernel

I agree with Pet. The greed of pharmaceutical companies nowadays is astounding. The WTO recently forced India to change it's patent laws (it previously patented the method of manufacture rather than the chemical compound/drug) so that they could no longer produce cheaper alternatives.

They'd rather see millions die of AIDs than cut into their profit margins!
:mad: :mad: :mad: :mad:

ArthurDent

Kernel wrote:

I agree with Pet. The greed of pharmaceutical companies nowadays is astounding. The WTO recently forced India to change it's patent laws (it previously patented the method of manufacture rather than the chemical compound/drug) so that they could no longer produce cheaper alternatives.

They'd rather see millions die of AIDs than cut into their profit margins!
:mad: :mad: :mad: :mad:

It's not just a question of greed - it takes upwards of 10 years and at a cost of €100 million to bring a drug from idea through to product on the shelf
(source http://csdd.tufts.edu/NewsEvents/RecentNews.asp?newsid=6 , http://papers.ssrn.com/sol3/papers.cfm?abstract_id=640563, http://pubs.acs.org/cen/topstory/8150/8150notw5.html ). No-one is going to invest this type of money without some chance of profit for an appreciable number of years - this is one of the main reasons that patent exclusivity and protection is fought for by pharmaceutical companies.
If WTO, UN etc was serious about malaria, HIV/AIDs (even diahhrea/measles) treatment - the companies that spent their time and money developing these drugs could be adaquatley compensated - but this does not happen.

When a drug goes off patent and becomes generic (ie anyone can make it) the original company doesn't just see a "drop in their profits" - generally their sales drop to less than 10% of peak - if this was to happen where is the incentive for any company to dvelop new treatments?

ArthurDent

Pet wrote:

What are people's opinions on this? I've read a couple of reports over the past few days about certain herbs being banned from the Irish market (St John's Wort, Gingko Biloba, Yohimbe, etc) by certain councils on the grounds that they can cause "side effects" or "liver damage".

This seems completely and utterly ridiculous to me. I can buy enough aspirin or paracetamol to cause permanent serious liver damage or death; I can buy cigarettes and alcohol which will give me lung cancer/emphysema and cirrhosis; I can do serious damage to my gastrointestinal tract by taking the antibiotics that are being handed out like sweets these days..but I can't buy herbal remedies in case I get a photosensitive reaction? (one of the reasons for banning St John's Wort)
This screams of pharmaceutical companies trying to strengthen their monopoly and take the first line of treatment away from the consumer to make them reliant upon prescriptions for, you guessed it, pharmaceuticals.

Opinions anyone?

Although I think you may have some validtiy in your argument, I still think regulations need to be enforced when something is being sold with claims of medicinal benefit - without some level of testing and certification how do you know that the strenght of St John's wort in one shop is the same as in another, that the one you are taking is pure, free from dangerous substances, made in a safe environment? Without some level of testing how do you know what possible side effects there are in taking this herbal product in combination with some other substance. How do you know if it is safe to take while pregnant, breastfeeding, driving, with alcohol etc. Just because something is "natural" doesn't mean that it doesn't contain active ingredients that can interact with other drugs. And you're right otc medication such as paracetamol can be lethal -but such products are tested and you know by looking at the literature provided with the the estimated safe doses etc.

Kernel

ArthurDent wrote:

It's not just a question of greed - it takes upwards of 10 years and at a cost of €100 million to bring a drug from idea through to product on the shelf
(source http://csdd.tufts.edu/NewsEvents/RecentNews.asp?newsid=6 , http://papers.ssrn.com/sol3/papers.cfm?abstract_id=640563, http://pubs.acs.org/cen/topstory/8150/8150notw5.html ). No-one is going to invest this type of money without some chance of profit for an appreciable number of years - this is one of the main reasons that patent exclusivity and protection is fought for by pharmaceutical companies.
If WTO, UN etc was serious about malaria, HIV/AIDs (even diahhrea/measles) treatment - the companies that spent their time and money developing these drugs could be adaquatley compensated - but this does not happen.

When a drug goes off patent and becomes generic (ie anyone can make it) the original company doesn't just see a "drop in their profits" - generally their sales drop to less than 10% of peak - if this was to happen where is the incentive for any company to dvelop new treatments?

While I understand, and to a degree sympathise with, the need for investment and profit / return on investment, I also think that it is wrong that pharmaceutical companies (and most corporations) should exist solely to make money. It raises ethical questions, such as, if it is more profitable to sell drugs that treat the AIDS virus and cancer, then a pharmaeutical should a pharmaceutical company bother to invest in R&D for a cure?

Medicine and drugs should be developed to cure people, but it's abhorrent to see drug companies (who are already making vast profits) decide to take on third world generics (remember that these generics could not be sold in the first world anyway, because of trade laws) to increase their market share / profit margin, with the resulting deaths of millions of people who can no longer afford the medicine.

Just another evil of capitalism.

ArthurDent

Kernel wrote:

While I understand, and to a degree sympathise with, the need for investment and profit / return on investment, I also think that it is wrong that pharmaceutical companies (and most corporations) should exist solely to make money. It raises ethical questions, such as, if it is more profitable to sell drugs that treat the AIDS virus and cancer, then a pharmaeutical should a pharmaceutical company bother to invest in R&D for a cure?

Medicine and drugs should be developed to cure people, but it's abhorrent to see drug companies (who are already making vast profits) decide to take on third world generics (remember that these generics could not be sold in the first world anyway, because of trade laws) to increase their market share / profit margin, with the resulting deaths of millions of people who can no longer afford the medicine.

Just another evil of capitalism.

So who should pay the costs for developing these drugs? Governments / UN, and who is going to pay the scientists that work on developing these drugs?
We live in a captalist world, research goes on all the time to try and cure all types of diseases, much of it, at least initially in 3rd level institutions, but this all costs phenomenal amounts of money. The generics you are talking about are only possible by piggybacking on technology and synthetic pathways already developed by these "pharmaceutical companies that exist solely to make money".
If the scientists working in these companies and in 3rd level institutions didn't invent (and test these drugs) there wouldn't be any way of making them generically. Most scientist I know whether they work for one of the evil capitalist companies or in a university spend their time trying to find cures for all sorts of diseases - I'm not sure (in my 14 years of working in this area) that I've ever come across anyone that deliberately avoided finding a cure rather than treating a disease, but who knows maybe I've just been lucky.

Kernel

ArthurDent wrote:

So who should pay the costs for developing these drugs? Governments / UN, and who is going to pay the scientists that work on developing these drugs?

If you read my post again, you'll realise that I'm not saying that pharmaceuticals should not make profit, I understand it must happen to fund further research, it's blatant profiteering which has polluted the field of medical research that I object to. The drug companies were making enough profits without the witch hunt against Indian pharmaceutical manufacturers.

ArthurDent wrote:

- I'm not sure (in my 14 years of working in this area) that I've ever come across anyone that deliberately avoided finding a cure rather than treating a disease, but who knows maybe I've just been lucky.

Well, you fail to see the bigger picture. The money being invested in research towards these ailments is what will determine whether people you know will be able to effectively research cures. More money is made by treating rather than curing many diseases (such as AIDS), so my point about blatant profiteering of drugs companies and the implications of such a mindset (in regards to less funding for a cure) is an obvious and logical conclusion, no? I'm not saying somebody will hide a cure for AIDS (although it is feasible), what I'm saying is that they wont get the resources to effectively research a cure in the first place.

Drug companies don't swear a hippocratic oath, instead they swear an oath to increase profits to the shareholders.

ArthurDent

Kernel wrote:

Well, you fail to see the bigger picture. The money being invested in research towards these ailments is what will determine whether people you know will be able to effectively research cures. More money is made by treating rather than curing many diseases (such as AIDS), so my point about blatant profiteering of drugs companies and the implications of such a mindset (in regards to less funding for a cure) is an obvious and logical conclusion, no? I'm not saying somebody will hide a cure for AIDS (although it is feasible), what I'm saying is that they wont get the resources to effectively research a cure in the first place.

Drug companies don't swear a hippocratic oath, instead they swear an oath to increase profits to the shareholders.

Like to present any links to support any of this?
I've supported my position but you seem to be quite happy to present your opinion without anything to back it up.

What about all the money being pumped in stem cell treatment which aims to cure everything from cystic fybrosis to asthma?

I don't buy this "it's all the fault of the evil pharmaceutical companies and their profits" - sure pharmaceutical companies are out to make a profit from their work - what BUSINESS isn't?. Of course companies are going to try and maximise profits - that's their job.

If governments or the UN or god knows who was truly serious they could pay the researchers a good wage to work for them to try and cure any or all diseases. But don't be blaming business for the lack of joined up policy by governments re treatable diseases. Certainly a huge amount of good work has been carried out (ironically enough by American Govt/Army of many diseases since 9/11 - http://www.nih.gov/about/) - but there is room for an awful lot more, hell even immunising against measles (something totally achievable) would save at least half a million lives a year http://www.measlesinitiative.org/index3.asp


Just to point you in the right direction - check out the following:
Both Charitable orgaisation trying to ERADICATE diseases, both founded by some more of those nasty capitalists


The Welcome Trust
http://www.wellcome.ac.uk/

The Gates Foundation:
http://www.gatesfoundation.org/default.htm


And even closer home - check out what SFI /HEA are funding
http://www.sfi.ie/uploads/documents/upload/SFI_FUNDED_SCIENTISTS.pdf

http://www.hea.ie/uploads/pdf/PRTLI%20Participants.pdf

Kernel

I think you're taking this a little away from the original post, which is that the decision to enforce drug patent legislation on Indian pharmaceutical companies is going to cost lives. Do you not agree, with that point?

The companies responsible for enforcing this legislation are going to cause more suffering and deaths in third world countries, just so they can maximise their profits to appease their shareholders for another year?

Also, with regard to charitable research organisations, they have little to do with global pharmaceutical corporations, since they are, by definition, funded by charity.

Read this: http://revolutionarydemocracy.org/rdv5n1/pharmacy.htm

Kernel

A couple more links:

http://www.haiap.org/unipaper.htm

Some good links on the following site:

http://www.africafocus.org/docs05/ind0503.php

ArthurDent

Kernel wrote:

I think you're taking this a little away from the original post, which is that the decision to enforce drug patent legislation on Indian pharmaceutical companies is going to cost lives. Do you not agree, with that point?

The companies responsible for enforcing this legislation are going to cause more suffering and deaths in third world countries, just so they can maximise their profits to appease their shareholders for another year?

Also, with regard to charitable research organisations, they have little to do with global pharmaceutical corporations, since they are, by definition, funded by charity.

I'm only going away from the original post to answer things you brought up.

Re the Charitable Research Organisations - my point here was the both of these were set up by the type of people you claim are only in business for the money - Wellcome trust - set up by one of the biggest pharmaceutical conglomerates in the world and Gates foundation by Bill Gates (Microsoft)

I read your links and still can't see how this gets away from the fact that I have stated before that if we want new treatments and cures for diseases we need to get scientists to work on them. Currently this is done, in the main by companies - the cost is of the order of $100 million dollars to get a new drug through to product, no company is going to do this without being properly recompensed - this is currently done by allowing the exclusivity on the manufacturing process for a period of typically 20 years (a patent) and allowing them to charge anyone else that wants to use their process to make such a drug. If we are to allow the system to change and allow other companies to manufacture the drug at fraction of the cost charged by the original company ( who need to recoup this $100 million cost) grand, lets do this, lets find a way either to fund all research through government agencies or a way for governments to compensate the companies for these costs. But if there is a situation whereby countries use knowledge developed elsewhere, at a huge expense, to manufacture cheap drugs, then in the long run this will not benefit people because there will be no financial incentive to carry out the vastly expensive research in the first place. So where will the next new therapies come from?

Pet

Drug companies don't swear a hippocratic oath, instead they swear an oath to increase profits to the shareholders.

And that's the bottom line. The pharmaceutical companies would much rather see you suffering and in pain every day than to cure you, because if they cured you they wouldn't make any money off you. And ArthurDent, if you try and argue otherwise then you're either blind or really naive.

The reason herbal medicine is considered "alternative" is because of the great discrediting work done by these same companies. If someone wanted to carry out a study of a certain herb's efficiency in treating cancer, where would the money to fund the study come from? And do you think that the vast quantity of doctors who are in the pockets of these companies would just line up and verify the study? They wouldn't, they'd tear it to shreds, even if it meant that an effective treatment or cure was just being thrown away. Some of the best treatments for diseases are natural, but pharmacy can't profit from them because they can't patent something found "as is" in nature, so instead they obfuscate, inveigle and deny.

Pharmacy is one of the biggest industries in the world, after oil of course. There's a lot of money and power behind it; moreso than even the tobacco industry. And Ireland's economy depends greatly on the presence of pharmaceutical giants basing their headquarters here (hence the great drive to push people into science at second and third level). The idea that pharmaceutical companies are these benign figures who only want to cure us is laughable. And the fact that they've managed to brainwash people into thinking that their products are the only treatment is pretty stupid. But when they use their aforementioned power, money and influence to bring about laws like this - well, that's just scary.

Victor

Pet wrote:

I can buy enough aspirin or paracetamol to cause permanent serious liver damage or death

Yes, you can, but (a) it will have warnings (b) there are limits to the amount you can buy in one go.

Pet

Victor wrote:

Yes, you can, but (a) it will have warnings (b) there are limits to the amount you can buy in one go.

(a) Why can't the same be done for these herbal remedies? Most of them will say "Do not take if breastfeeding, pregnant etc" anyways.
(b)I don't know of any herbal (ie, non-extract, non-mineral) compounds that would cause death or liver injury, unless you deliberately wanted to poison yourself and hence took massive doses.

Victor

Aspirin was (originally?) herbal.

Coca, the base for cocaine is herbal.

ArthurDent

Pet wrote:

(a) Why can't the same be done for these herbal remedies? Most of them will say "Do not take if breastfeeding, pregnant etc" anyways.

Of course the same can be done - but this requires testing to find out these limits, and that means that you carry out scientifically acceptable clinical trials (first on cells, then animal models, then humans - at a representative sample size that allows you to draw conclusions for the general population. Care to take a guess at how much these trials cost? Drugs to get to the safety levels that you see them when they get to your shelf (and imo that's not a high enough standard, require Phase I-Phase IV trials costing millions, invloving trials on hundreds and sometimes thousands of people). Who is going to pay for that for herbal remedies?

Pet wrote:

(b)I don't know of any herbal (ie, non-extract, non-mineral) compounds that would cause death or liver injury, unless you deliberately wanted to poison yourself and hence took massive doses.

Black cohosh
Traditionally black cohosh has been used to treat a variety of conditions including rheumatism, rheumatoid arthritis, intercostal myalgia, sciatica, chorea, tinnitus, dysmenorrhoea, and uterine colic. Currently black cohosh is mainly used to treat menopausal symptoms. However, the efficacy and long term safety of black cohosh is not clear.

In October 2004, healthcare professionals were informed, via ‘Current Problems in Pharmacovigilance’ (Vol 30:10), that there have been reports of hepatotoxicity (liver disease) suspected to be associated with black cohosh.

As of 31 March 2005, the Agency had received 20 reports of suspected liver reactions. The cases have ranged in severity from abnormal liver function to various forms of hepatitis. Generally patients recovered or were recovering after stopping black cohosh.
http://medicines.mhra.gov.uk/ourwork/licensingmeds/herbalmeds/herbalsafety.htm#black

Following cases of liver damage, suspected to be associated with the consumption of Kava-kava, Kava-kava was prohibited in unlicensed herbal medicines on 13 January 2003
http://medicines.mhra.gov.uk/ourwork/licensingmeds/herbalmeds/furtherissues.htm#kava



Med J Aust. 2003 May 5;178(9):421-2.

Kava: herbal panacea or liver poison?

Moulds RF, Malani J.

The Fiji School of Medicine, Private Mail Bag, Suva, Fiji. r.moulds@fsm.ac.fj

Following reports of liver toxicity, including liver failure, associated with extracts from the Pacific islands plant kava (Piper methysticum), these have been banned from sale as a herbal anxiolytic in many Western countries, to the detriment of Pacific island economies. Pacific Islanders have used kava extensively for centuries, without recognised liver toxicity. However, the population is small, and there has been no systematic evaluation of possible liver damage. For both economic and public health reasons, it is important to determine if kava is inherently hepatotoxic, and what the mechanisms of toxicity are. Such research could lead to safer kava extracts for sale in Western countries, or identification of a subpopulation who should not consume kava.


"Natural" "Herbal" Eczema Creams Found to Contain Potent Steroids
>15 December 2003

Source: Archives of Disease in Childhood (88, 12:1056-7, 2003).






A recent British study reported that 20 of 24 creams used to treat eczema in children were found to illegally contain unlabeled amounts of corticosteroids.
All children were patients at the pediatric dermatology clinic at Birmingham Children’s Hospital; the creams were submitted for analyzation by parents after reporting they helped improve eczema symptoms in their children. Researchers discovered seven creams contained the synthetic corticosteroid clobetasol propionate (5 labeled “Wau Wa Cream--herbal cream for the treatment of eczema,” and 2 labeled “Muijiza cream--contains extract of Wau Wa root); 13 of the 17 unlabeled or unnamed herbal creams contained corticosteroids. All parents believed the creams were herbal, free from steroids, and safe to use on their children, according to the researchers.
“Topical corticosteroids are important in the management of childhood eczema and when used appropriately, are safe,” the researchers wrote. However, improper use of topical steroids can cause harmful damage, including irreversible skin atrophy (especially on the face), and the spread of eczema, causing the condition to worsen upon withdrawal and stunting children’s growth, according to researchers.
The creams were obtained from different sources, including Indian and Pakistani herbalists in surrounding areas, mail order and family or friends overseas (Pakistan and Tanzania).
http://www.sona.ie/newsd.asp?id=12600



Just some examples - and no I'm not sayiing that all herbal remedies are dangerous, many do contain active ingredients that will help treat diseases, alleviate symptoms. But I believe that they need to be regulated so that when you buy them, you know you are getting somethig that doesn't contain dangerous impurities, that was made, purified, packaged in a safe manner and is the same "strength" as the last time you bought it, ie likely to have the same effect. I would also like to see clinical trials on these products to see if they are safe and efficacious (ie actually do what the claim to do).

ArthurDent

Pet wrote:

And that's the bottom line. The pharmaceutical companies would much rather see you suffering and in pain every day than to cure you, because if they cured you they wouldn't make any money off you. And ArthurDent, if you try and argue otherwise then you're either blind or really naive.

That's a pretty strong statement - care to back it up with facts - 'cos I'm pretty sure you've libelled a huge number of people, including many, many scientists that spend their lives trying to cure and treat diseases. And no I'm neither blind nor naive thanks very much. I have worked in science for 14 years. I spent 9 of them on the bench working trying to make drugs to cure /treat diseases from alzheimers to diabetes and now work mainly trying to help Third Level Researchers get funding for their projects and helping small Irish Companies in the botech area get off the ground. And most of the scientists I come across are people genuinely commited to their area of research .

Pet wrote:

The reason herbal medicine is considered "alternative" is because of the great discrediting work done by these same companies. If someone wanted to carry out a study of a certain herb's efficiency in treating cancer, where would the money to fund the study come from? And do you think that the vast quantity of doctors who are in the pockets of these companies would just line up and verify the study? They wouldn't, they'd tear it to shreds, even if it meant that an effective treatment or cure was just being thrown away. Some of the best treatments for diseases are natural, but pharmacy can't profit from them because they can't patent something found "as is" in nature, so instead they obfuscate, inveigle and deny.

Pharmacy is one of the biggest industries in the world, after oil of course. There's a lot of money and power behind it; moreso than even the tobacco industry. And Ireland's economy depends greatly on the presence of pharmaceutical giants basing their headquarters here (hence the great drive to push people into science at second and third level). The idea that pharmaceutical companies are these benign figures who only want to cure us is laughable. And the fact that they've managed to brainwash people into thinking that their products are the only treatment is pretty stupid. But when they use their aforementioned power, money and influence to bring about laws like this - well, that's just scary.

Nobody claims Pharmaceutical companies are benign figures that only want to cure people - for the last time they are BUSINESSES - they are trying to make a profit, what business isn't? but to claim that they want to keep people ill is both ludicrous and frankly libellous.

I agree with you that many "life-style" drugs are just that, and the need for them has, to a major extent been created, but to suggest that there are legitimate non-pharmaceutical products on the market to treat ALL diseases is not only wrong but irresponsible - care to name a herbal medications that will allow a diabetic to function, an "anti-rejection" type herbal substitute that keep heart, lung transplant patients alive?

Kernel

ArthurDent wrote:

I read your links and still can't see how this gets away from the fact that I have stated before that if we want new treatments and cures for diseases we need to get scientists to work on them. Currently this is done, in the main by companies - the cost is of the order of $100 million dollars to get a new drug through to product, no company is going to do this without being properly recompensed - this is currently done by allowing the exclusivity on the manufacturing process for a period of typically 20 years (a patent) and allowing them to charge anyone else that wants to use their process to make such a drug. If we are to allow the system to change and allow other companies to manufacture the drug at fraction of the cost charged by the original company ( who need to recoup this $100 million cost) grand, lets do this, lets find a way either to fund all research through government agencies or a way for governments to compensate the companies for these costs. But if there is a situation whereby countries use knowledge developed elsewhere, at a huge expense, to manufacture cheap drugs, then in the long run this will not benefit people because there will be no financial incentive to carry out the vastly expensive research in the first place. So where will the next new therapies come from?

I understand (as stated before) the need for some profit for the pharmaceuticals in order to continue research and development - I just don't agree with the blatant profiteering and greed of these companies, as demonstrated in India. You haven't answered my question: Do you agree that the decision to enforce WTO patent laws on Indian pharmaceutical manufacturing is going to cost lives and suffering in the third world? I would follow this up with another question: Do you agree that the pharmaceutical industry was already making huge profits (certainly much more than was spent in R&D) before enforcing this legislation?

I would love to see government bodies such as the UN or EU funding large scale research, I believe they will get around to this in the end (but I would imagine China will make some progress here too). What we need to concentrate on, IMO, is the here and now. The existing system of corporate greed which has afflicted the pharmaceutical industry as a whole. If a cap on profit margins for drugs was enforced, or even legislation whereby a certain percentage of profits had to be reinvested in R&D *and* providing cheap medicines for third world countries, then that may ease the sting a little. And indeed, if such medicines were provided cheaply to the third world, there would have been no market for the generics anyway.

Instead the industry forced the hand of the WTO to stamp out the generics, to ensure their own profit margins increased at the expense of the MILLIONS of people who would have benefitted from generic cheaper drugs, but who now find themselves in a position whereby they face a painful and porolonged death because they cannot (or their governments cannot) afford the overpriced version of a chemical compound which is patented by a rich first world corporation.

In Malawi, for example, there are thousands dying each year because the govenment cannot afford anti-retroviral drugs for people suffering from AIDS. There are some supplies of the drug there, but they can only treat a small number of patients. In the Congo, it has been estimated that over 2 million have died in the last 3 years from preventable illness. Is that worth it, so a drugs company can post and extra 20cents per share divident to their investors?!

Kernel

ArthurDent wrote:

Nobody claims Pharmaceutical companies are benign figures that only want to cure people - for the last time they are BUSINESSES - they are trying to make a profit, what business isn't? but to claim that they want to keep people ill is both ludicrous and frankly libellous.

It's not a leap at all to assume what Pet has. It makes more business sense to sell many drugs which treat a disease rather than sell 1 drug that cures it. Bottom line Arthur, that's all a corporation cares about. You've said yourself that they are businesses who operate to make profit, therefore their only responsibility is to their shareholders, who want to see a bigger and bigger profit posted each quarter/year.

Curing people isn't as good business as treating people.

ArthurDent

Kernel wrote:

I understand (as stated before) the need for some profit for the pharmaceuticals in order to continue research and development - I just don't agree with the blatant profiteering and greed of these companies, as demonstrated in India. You haven't answered my question: Do you agree that the decision to enforce WTO patent laws on Indian pharmaceutical manufacturing is going to cost lives and suffering in the third world? I would follow this up with another question: Do you agree that the pharmaceutical industry was already making huge profits (certainly much more than was spent in R&D) before enforcing this legislation?

We're just going around in circles here, I've told you why pharmaceutical companies fight hard to protect their patent rights, even in contries such as India - I'm not saying its right, I'm saying that in the current situation where the majority of research and the majority of costs associated with bringing new drugs to market companies will try and recoup costs (and profits) against the 100million dollars it takes to bring a drug to market. Of course cheap generics would save lives - but as I have said before - when Governments/UN/EU/WHO fund this and pay the companies that spent their time and money developing the drugs to allow these to be produced then the situation will be sorted out. In the short term the use of generics produced by by-passing the PCT patents will save lives, but in the longterm - who will fund R&D for new drugs, new treatments if there is no profit incentive - not pharceutical companies, Governments - nice idea, but can't see this level of socialism taking off.

Kernel wrote:

I would love to see government bodies such as the UN or EU funding large scale research, I believe they will get around to this in the end (but I would imagine China will make some progress here too). What we need to concentrate on, IMO, is the here and now. The existing system of corporate greed which has afflicted the pharmaceutical industry as a whole. If a cap on profit margins for drugs was enforced, or even legislation whereby a certain percentage of profits had to be reinvested in R&D *and* providing cheap medicines for third world countries, then that may ease the sting a little. ?

I agree with you - can't see it happening , but it would be good. By the way the Government here have actually made some progression in this area - espeically with low taxation on profits from Intellectual property. Way aboe the EU average for R&D

Kernel wrote:

And indeed, if such medicines were provided cheaply to the third world, there would have been no market for the generics anyway./QUOTE]
The market for generics (and supergenerics) is huge world-wide an expected to grow at an annual rate of over 25% as more and more drugs come off patent - this will not change even if the above steps are taken.

ArthurDent

Kernel wrote:

It's not a leap at all to assume what Pet has. It makes more business sense to sell many drugs which treat a disease rather than sell 1 drug that cures it. Bottom line Arthur, that's all a corporation cares about. You've said yourself that they are businesses who operate to make profit, therefore their only responsibility is to their shareholders, who want to see a bigger and bigger profit posted each quarter/year.

Curing people isn't as good business as treating people.

I've already gone into areas that billions are being invested in to cure illnesses, stem cell therapy, gene therapy etc. So how does this fit into your model of businesses only existing to produce drugs to treat things that they can just as easily cure but don't bother. Thousands of scientists are working worldwide to try and cure diseases not just treat their symptoms, most of these therapies are many years off however so there is still a need to work on new, more efficacious and safer drugs. The two can run in parallel.

Kernel

ArthurDent wrote:

We're just going around in circles here, I've told you why pharmaceutical companies fight hard to protect their patent rights, even in contries such as India - I'm not saying its right, I'm saying that in the current situation where the majority of research and the majority of costs associated with bringing new drugs to market companies will try and recoup costs (and profits) against the 100million dollars it takes to bring a drug to market. Of course cheap generics would save lives - but as I have said before - when Governments/UN/EU/WHO fund this and pay the companies that spent their time and money developing the drugs to allow these to be produced then the situation will be sorted out. In the short term the use of generics produced by by-passing the PCT patents will save lives, but in the longterm - who will fund R&D for new drugs, new treatments if there is no profit incentive - not pharceutical companies, Governments - nice idea, but can't see this level of socialism taking off.

But you fail to address my point that the drugs companies are already recouping their R&D costs and much much more profit from the current market (and even the market situation before the Indian embargo). So where does the profiteering stop and the responsibility to provide the drugs to save lives start? I think you view corporate capitalism with rose tinted glasses, or believe that such advances could not be made without such huge profits - which is untrue.

ArthurDent wrote:

The market for generics (and supergenerics) is huge world-wide an expected to grow at an annual rate of over 25% as more and more drugs come off patent - this will not change even if the above steps are taken.

Do you think the pharmaceutical industry is or was in danger from generics? No, they still make huge amounts of money.

Kernel

ArthurDent wrote:

I've already gone into areas that billions are being invested in to cure illnesses, stem cell therapy, gene therapy etc. So how does this fit into your model of businesses only existing to produce drugs to treat things that they can just as easily cure but don't bother. Thousands of scientists are working worldwide to try and cure diseases not just treat their symptoms, most of these therapies are many years off however so there is still a need to work on new, more efficacious and safer drugs. The two can run in parallel.

It fits into my model easily. You must understand that what I am saying is that if I own a huge pharmaceutical company, and I make 90% of my profits selling a drug to treat AIDS, do you think it would show good business acumen for me to seriously invest and research a cure for AIDS? 80% of my business would be lost, and even taking into account selling the cure, it would still be nowhere near as lucrative as selling weekly/monthly treatment drugs for the same illness.

I accept that there is research being done to find a cure, I never questioned this, what I'm saying is that when you get into bed with a corporate monster of profit making above all else, there are serious ethical questions to be raised. The people researching the cures are probably from companies which do not have an investment in treating them..

The companies treating them probably make more money, and would have more to spend on R&D if they were so inclined.

Eventually, with corporate take overs and mergers, the number of smaller drugs companies researching will decrease exponentially, as they are swallowed up by the bigger corporations, resulting in an almost monopoly situation, where all the power and resources are controlled by a major drug corporation, and they will decide (based on what is more profitable) what to research and what not to research.

ArthurDent

Kernel wrote:

But you fail to address my point that the drugs companies are already recouping their R&D costs and much much more profit from the current market (and even the market situation before the Indian embargo). So where does the profiteering stop and the responsibility to provide the drugs to save lives start? I think you view corporate capitalism with rose tinted glasses, or believe that such advances could not be made without such huge profits - which is untrue.

Don't think I view corporate captalism with rose tinted glasses - just as the reality, haven't seen too much evidence of corporate socialism. So you want to put a ceiling on the profits to be made from pharmaceuticals - no moral objections to this, but can't see how it would be achieved, has this happned in any other industry?

Kernel wrote:

Do you think the pharmaceutical industry is or was in danger from generics? No, they still make huge amounts of money.

For the last time I'll explain my postion on this - if companies are allowed to ignore patent treaties and agreements and manufacture and sell drugs much cheaper - the current business model used in pharmaceutical industry world wide will cease to function - profit is obtained because companies that invent (or license) drugs get to prevent other companies from manufacturing it. Will anyone spend the money needed to bring new drugs to the market if they cannot get the returns they currently do - I don't think so(at least not commercial groups, maybe ngo's etc). I'm not saying its right, I'm saying its the business model that applies worldwide. I actually think your idea of legislation around a certain percentage of drugs being donated to countries that cannot afford them is a good idea, or allowing them to make them for themselves, but who is going to make this happen?

Kernel

ArthurDent wrote:

Don't think I view corporate captalism with rose tinted glasses - just as the reality, haven't seen too much evidence of corporate socialism. So you want to put a ceiling on the profits to be made from pharmaceuticals - no moral objections to this, but can't see how it would be achieved, has this happned in any other industry?

Corporate socialism? The closest thing that exists to such a concept would be NGO's like charity organisations, who exist privately, but are non-profit making.

The only way putting a ceiling on profits could be achieved would be through taking percentages of gross profit and dividing up a certain slice for R&D, another for providing cheaper (perhaps even cheaper than cost) drugs to third world / crisis nations based on a proportional representation of the percentage profit to be reinvested in providing cheap drugs, and the necessity of providing the drugs to third world countries, balanced against what the country could afford if below cost. To put an absolute ceiling on profits would probably not be feasible, as I have thought about this in the past. My belief is that percentages of profit margins can be more easily manipulated and provide a fairer system of capitalism. I also, for example, believe that a certain percentage of those profits should be reinvested in the workforce of the corporation.

I like to call it Kernelism.

ArthurDent wrote:

For the last time I'll explain my postion on this - if companies are allowed to ignore patent treaties and agreements and manufacture and sell drugs much cheaper - the current business model used in pharmaceutical industry world wide will cease to function - profit is obtained because companies that invent (or license) drugs get to prevent other companies from manufacturing it. Will anyone spend the money needed to bring new drugs to the market if they cannot get the returns they currently do - I don't think so(at least not commercial groups, maybe ngo's etc). I'm not saying its right, I'm saying its the business model that applies worldwide. I actually think your idea of legislation around a certain percentage of drugs being donated to countries that cannot afford them is a good idea, or allowing them to make them for themselves, but who is going to make this happen?

I understand the business model, but what I was trying to emphasise was that the generic drugs produced in India were not available to countries in the First world which had all signed up to the WTO patent laws, and which provided the companies with more than enough revenue anyway. Going after India / Africa in this way was like a bank manager mugging a homeless person for more money.

murphaph

There are precedents available whereby large corporations have decided to allow people to die because it was more profitable. From the 'Ford Pinto Story';

The financial analysis that Ford conducted on the Pinto concluded that it was not cost-efficient to add an $11 per car cost in order to correct a flaw. Benefits derived from spending this amount of money were estimated to be $49.5 million. This estimate assumed that each death, which could be avoided, would be worth $200,000, that each major burn injury that could be avoided would be worth $67,000 and that an average repair cost of $700 per car involved in a rear end accident would be avoided. It further assumed that there would be 2,100 burned vehicles, 180 serious burn injuries, and 180 burn deaths in making this calculation. When the unit cost was spread out over the number of cars and light trucks which would be affected by the design change, at a cost of $11 per vehicle, the cost was calculated to be $137 million, much greater then the $49.5 million benefit. These figures, which describe the fatalities and injuries, are false. All independent experts estimate that for each person who dies by an auto fire, many more are left with charred hands, faces and limbs. This means that Ford’s 1:1 death to injury ratio is inaccurate and the costs for Ford’s settlements would have been much closer to the cost of implementing a solution to the problem. However, Ford’s "cost-benefit analysis," which places a dollar value on human life, said it wasn't profitable to make any changes to the car.

All in all I'd tend to be quite cynical when it comes to the motives of large corporations.

Wibbs

Kernel wrote:

Curing people isn't as good business as treating people.

Treatment for stomach ulcers would be a case in point. Many possible causes and treatments were put forward over the years, but histamine receptor antagonists like tagemet/zantac were found to be among the best long term treatments available. Thus tagemet/zantac became among the biggest selling prescription drugs in the world(if not the biggest). The long term part is the important bit here. Constant cash flow.

Now along comes an Aussie doctor(Barry Marshall), who up and discovers that 90% of ulcers(peptic and duodenal) are caused by the bacterium Helicobacter Pylori. A simple treatment is also discovered and lo and behold bye bye goes the ulcer. A simple once off drug regimen that's relatively cheap and required no new drugs to work. This all happened in 1982. Funny that his discovery didn't really see common usage 'til the 90's. In fact he was ignored so much that he even infected himself with the bacterium to prove his case(and then promptly cured himself of the resulting ulcer).

I'm not for one moment suggesting that the drug companies alone held this back because of the huge losses they might have incurred, but it does bear pondering. The general medical profession also ignored this particular idea. Than again doctors largely just prescribe the drugs they're given and advertised. The links between the medical profession and drug companies are well known(paid for conferences in exotic locations, etc.) and have some dubious overtones.

It does make one wonder how many other "cures" are around, but ignorance and commercial interests hinder their road to the marketplace.

Myksyk

This seems completely and utterly ridiculous to me. I can buy enough aspirin or paracetamol to cause permanent serious liver damage or death; I can buy cigarettes and alcohol which will give me lung cancer/emphysema and cirrhosis; I can do serious damage to my gastrointestinal tract by taking the antibiotics that are being handed out like sweets these days..but I can't buy herbal remedies in case I get a photosensitive reaction? (one of the reasons for banning St John's Wort)
This screams of pharmaceutical companies trying to strengthen their monopoly and take the first line of treatment away from the consumer to make them reliant upon prescriptions for, you guessed it, pharmaceuticals.

Opinions anyone?

Coming to this a little late so forgive any repititions. I think your comparisons are ill-chosen Pet. The point is that yes, you can purchase enough paracetamol to cause yuorself serious injury but this presupposes that you want to cause yourself serious injury and there isn't much anyone can do about that (unless we wish to ban the open sale of everything from steak knives to alcohol). Paracetamol carries with it advice on usage and dosage and is perfectly safe for those wishing to treat themselves for the ailments for which paracetamol may be useful. Unregulated herbal remedies can be dangerous because they are unregulated. A recent study (I'll try and get the reference) found that there were substantial differences between the quality of st. John's wort being sold publicly. If my memory serves me, this included samples which had no active ingredient in them to samples which had traces of cement and others which had far too much active ingredient in them.

Wibbs wrote:

Now along comes an Aussie doctor(Barry Marshall), who up and discovers that 90% of ulcers(peptic and duodenal) are caused by the bacterium Helicobacter Pylori. A simple treatment is also discovered and lo and behold bye bye goes the ulcer. A simple once off drug regimen that's relatively cheap and required no new drugs to work. This all happened in 1982. Funny that his discovery didn't really see common usage 'til the 90's. In fact he was ignored so much that he even infected himself with the bacterium to prove his case(and then promptly cured himself of the resulting ulcer).

The h pylori story is a great example of how science in the real world works and how it should work. People who are shocked by the time it takes to get from initial hypotheses to relaible, safe and effective medicines in pharmacies are not aware of the nature of this process. The fact is that the h pylori hypothesis was accepted by the scientific community once enough repeatable and reliable research was presented and quickly (yes relatively quickly) got on to the production of appropriate medicine.

And as food for thought ... you may be interested to know that h pylori lives in about 50% of the world's population (in part of the developing world the figure is as high as 90%) yet only a fraction of these people ever get sick so there are still important questions relating to causative mechanism. Interesting too that the possibility exists that recently the bacteria is being implicated in the prevention of oesophageal cancer so the question of whether it is wise to eradicate h pylori is still open.

Myksyk

Even NCCAM points up the limits, dangers and quality issues of St. John's Wort.

Wibbs

Myksyk wrote:

The h pylori story is a great example of how science in the real world works and how it should work.

If that's a great example of how science works I would suggest we're in trouble. According to this piece as late as 1997, only ten percent of ulcer patients were being treated with this very effective treatment. http://www.metamath.com/math124/statis/Marhelio.htm

There was a very good Horizon programme about Dr. Marshall and the amount of resistance he faced from the general medical community was substantial. In this particular case I think science was a a lot slower than it could have been.

Obviously the higher rates of asymptomatic infection among the developing world bear further scrutiny. It's possible that those populations have a greater resistance to the bacterium because of longer historical exposure to it.

BTW I agree completely with your point about unregulated dosage in supplements. St john's wort being a particularly good example.

Myksyk

Hi Wibbs. I'm off on hols for a week and will give my tuppence happeny worth when i return, if this is still going. I have interesting data on the development of this idea and stats relating to the amount of research per year relating to Marshall's claim as well as his own admission late on in the process that further research was needed. The fact that it turned out that he was right in part can make it look like the process was slow but the same process stops scarce funding being wasted on endless amounts of junk science - the bad ideas we don't see because they went throught the same process and were appropriately dumped. The fact is that the scientiofic community embraced his idea but as with all ideas of such import there are onerous demands (rightly in my opinion) put on those who make these claims. If they are in fact good ideas they will get through and we can be all the more confident in them for having gone through the process.

Pighead

People who bitch about modern medicine and preach in favor of alternative remedies as though it's of some ridiculous religious significance to them. Let's put it into a very basic perspective: Results. Most of these natural remedies center around plants and have been used for their medicinal value for hundreds of years, and while many have merit, most pale in comparison to modern medicine. In the last two hundred years, the life expectancy in Ireland has gone from the mid-forties to the mid-seventies. Hmmm. Life Expectancy almost doubling... I'm willing to bet that Ginseng and Ginkgo Biloba had very little to do with that increase. Kernel saw me taking some Panadol for a headache and bitched at me saying, "Do you know what you're putting in your body? That will just COVER UP the pain!" and I replied, "YES! IT WILL! Maybe I don't feel like sitting here ENJOYING my headache." This same Kernel would bitch at me for taking cough syrup when I had a cold, saying it was POISON. When I had a cold it would last about 4 or 5 days. When HE had a cold it would last for TWO WEEKS and he'd end up missing at least four or five days of work and come back STILL all ****ed up and having to leave early for a few days. Sure... Use your healing crystals and magnets. Sprinkle fairy dust into every thing you eat. I prefer Physical Health to Spiritual Harmony. After my quadruple bypass surgery I'll try not to let my Triple Whopper with Cheese drip delicious fat on your grave.

Kernel

Pighead wrote:

Kernel saw me taking some Panadol for a headache and bitched at me saying, "Do you know what you're putting in your body? That will just COVER UP the pain!" and I replied, "YES! IT WILL! Maybe I don't feel like sitting here ENJOYING my headache." This same Kernel would bitch at me for taking cough syrup when I had a cold, saying it was POISON. When I had a cold it would last about 4 or 5 days. When HE had a cold it would last for TWO WEEKS and he'd end up missing at least four or five days of work and come back STILL all ****ed up and having to leave early for a few days.

hahah.. lies, all lies! Pain killers do cover up pain, if it is an ongoing problem you are better off checking out the root cause. Prevention is better than cure Pig! Plus, it's all lies about me being out of work, I have very few sick days (unlike Pig '3 day week' Head) because I don't gobble down anti-biotics for every ailment I get!

The cough syrup was ok, but I noticed you only drank it before you went to the pub, which is different!

DrIndy

Its the old debate of modern medicine versus alternative medicine. Modern medicine is based on laborious clinical trials that prove, that the therapies DO work. Alternative medicine is based on very little hard data and hence is not mainstream medicine. This does not mean that they are ineffective, in fact they are not proven and to doctors, if it isn't proven - then you cannot advocate it to your patients.

Regarding H. pylori, this was so groundbreaking that many people refused to believe it initially. Now everybody is aware and even if there is no signs of the effects of this, any carrier automatically receives eradication therapy to remove it. Of note, the most effective form of treatment was discovered in Ireland that kills 99% of H. pylori infections. the treatment originally used in Australia was only 70% effective.

Kernel

DrIndy wrote:

Of note, the most effective form of treatment was discovered in Ireland that kills 99% of H. pylori infections.

Guinness and Jameson whiskey.. ah yeah, what a cure. I self medicate myself with loads of it whenever I get a stomach ulcer!

Wibbs

Pighead wrote:

In the last two hundred years, the life expectancy in Ireland has gone from the mid-forties to the mid-seventies. Hmmm. Life Expectancy almost doubling... I'm willing to bet that Ginseng and Ginkgo Biloba had very little to do with that increase.

Most of that increase would be down to changes in hygiene, better living conditions, diet and lower infant mortality. Antibiotics and vaccinations would be the two main medical interventions that had the most effect.

DrIndy wrote:

Modern medicine is based on laborious clinical trials that prove, that the therapies DO work.

I would suggest this is partly true. In some instances placebos can be nearly(and sometimes more) effective than conventional clinical therapies. This is probaly why alternative therapies can seem to work. Though some seem to show some promise beyond the placebo effect(eg. acupuncture)

Alternative medicine is based on very little hard data and hence is not mainstream medicine. This does not mean that they are ineffective, in fact they are not proven and to doctors, if it isn't proven - then you cannot advocate it to your patients.

Very good point.

Now everybody is aware and even if there is no signs of the effects of this, any carrier automatically receives eradication therapy to remove it.

Personally that would worry me a little. I know there are some studies that show a link with heart disease, but we don't know if there's another hidden protective effect associated with this bacterium. Just a thought.

PS DrIndy, I'm on the "Kernel" diet as well. Can you up the dosage......

Honor3

St.Johns Wort is only banned in Ireland.

- It is legal in every other country.

I have NOTHING against pharmaceutical drugs, in fact you could say I love them, BUT BANNING St.Johns Wort is PLAIN STUPID.

Firstly, if you go into any Pharmacy in any other European country or any country around the world, they sell pharmaceutical grade of St.Johns Wort.

The IMB's actions wanted of course to take away the health food market, but that is stupid.

Firstly, the IMB are the biggest load of ****. Go into any Pharmacy in Ireland and the products are just junk, they don't import any products (they do, but very little), they ban most of it.

THEY EVEN BANNED 5-HTP, melatonin and much more, they are very stupid. (LEGAL EVERYWHERE ELSE)
I hope someone does something about it.


At least it would be fine, but then getting medications is a huge struggle, and yet they ban these because they think they will take away % of the health food market, BULL CRAP. Whoever made these choices in IMB should cop the **** on.

RobFowl

Wow, this is a new record for me. There are rules against raising zombie threads (ie ones over a year old) but I've never seen one opened again after 9 years !

Thread closed, but feel free to open a new on on the merits or otherwise of St Johns wort just have a look through the forum and boards.ie charters.