Comment Re:The important bits (Score 2) 81
For a games-theory argument, consider that the regulatory agencies are free to require any safety requirements at no cost to themselves, but if something goes wrong they are held responsible. As a result we have a system where it costs 2.5 billion dollars to bring a drug to market, so that it's economically infeasable to implement existing cures for rare diseases. It's also impossible for individuals to manage their own risk with informed consent.
(1) If you read a little further down that Google search, you find out that maybe it doesn't cost $2.5 billion after all.
http://www.nytimes.com/2014/11...
$2.6 Billion to Develop a Drug? New Estimate Makes Questionable Assumptions
Aaron E. Carroll
NOV. 18, 2014
The bottom line is that the report contains a lot of assumptions that tend to favor the pharmaceutical industry. While the Tufts Center reports that $2.6 billion is the cost to develop “a new prescription medicine that gains marketing approval,” it might be more accurate to say that it’s the cost to develop certain new molecular entities for which pharmaceutical companies did all of the research. That’s very few drugs, in the scheme of things.
(2) Another game theory argument is that drug companies and doctors will sell drugs to make as much money as they can, even if they give people drugs that they don't need and it harms them. The Nobel-prize winning economist Kenneth Arrow wrote that a free market in health care is impossible, because the consumers (patients) don't have enough information to evaluate what the doctor is telling them.
(3) Most scientists agree that theory should be confirmed with empirical fact. In fact, there are countries that until recently had almost no government regulation, and they bring new drugs to market all the time. Unfortunately, most of those new don't live up to their claims when western doctors try to use them. So their drugs aren't any good. Those facts disconfirm your theory.
(4) In fact, without regulation, drug companies and doctors sell drugs with unfounded claims, and give patients drugs that are inappropriate and harmful, following their financial motivation rather than the interests of their patients. This confirms Arrow's theory.
For example, China has relatively few government regulations.
JAMA Intern Med. 2014 Dec;174(12):1914-20. doi: 10.1001/jamainternmed.2014.5214.
Use and prescription of antibiotics in primary health care settings in China.
Wang J, Wang P, Wang X, Zheng Y, Xiao Y.
RESULTS: Most staff in the primary health care facilities had less than a college degree, and the medical staff consisted primarily of physician assistants, assistant pharmacists, nurses, and nursing assistants. The median (range) governmental contribution to each facility was 34.0% (3.6%-92.5%) of total revenue. The facilities prescribed a median (range) of 28 (8-111) types of antibiotics, including 34 (10-115) individual agents. Antibiotics were included in 52.9% of the outpatient visit prescription records: of these, only 39.4% were prescribed properly. Of the inpatients, 77.5% received antibiotic therapy: of these, only 24.6% were prescribed properly. Antibiotics were prescribed for 78.0% of colds and 93.5% of cases of acute bronchitis. Of the antibiotic prescriptions, 28.0% contained cephalosporins and 15.7% fluoroquinolones. A total of 55.0% of the antibiotic prescriptions were for antibiotic combination therapy with 2 or more agents. In nonsurgical inpatients in cities, the mean (SD) duration of antibiotic therapy was 10.1 (7.8) days. Of the surgical patients, 98.0% received antibiotics, with 63.8% of these prescriptions for prophylaxis.
CONCLUSIONS AND RELEVANCE: Antibiotics are frequently prescribed in Chinese primary health care facilities, and a large proportion of these prescriptions are inappropriate. Frequent and inappropriate use of antibiotics in primary health care settings in China is a serious problem that likely contributes to antimicrobial resistance worldwide.
