Goldman Sachs report: "Is curing patients a sustainable business model?"


#101

Step 1; force pharma to stop advertising and marketing. No such activity allowed, ever. Put the savings into defraying costs.

Step 2: For every 2 years that a pharma company has a treatment for a disease but not a cure, they must pay into a pool to fund a cure, some percentage of their profits from the treatment. If they do have a cure, but it’s less than 85% effective, they must continue to pay until they get an acceptable cure.

Step 3: Informed consent is exactly that. It’s spelled out in detail, even if jargon must be used. Consent forms must be provided a week in advance of treatment so that people have time to search on line or ask their MD for help. If that’s not possible, then the MD doing the procedure must spend a minimum of 25 minutes taking questions on it.

Step 4: No more speed dating office visits. Minimum 25 minutes per visit.

Step 5: If a person is taking more than 3 drugs for any reason, the reason is updated every 3 months with an explanation in their record, and if it’s going to continue, why that isn’t “treatment failure.”

Step 6: Obesity centers open, that specialize in fatigue syndrome, thyroid issues (including reverse T3 correction), SIBO and repeated gut infection, screening for IBD and Celiac, sleep diagnostics and treatment that really works including circadian reversal, PCOS and other specifically female illness. There is a payment plan where they pay you and your workplace to go there, instead of the reverse. They pay you from “lack of cure” penalty money they get from the pharmacos. Some percentage is worked out so you can keep your home and pay your bills while there, and your workplace doesn’t have to pay you as much for your time off.

Step 7: Clinical Practice Guidelines and Pharmacy Practice Managers are abolished so that your doctor can plan your health for you as they always should’ve been able to, and the merry go round of generic brands can stop.

This would make a start on a healthier society.


#102

It’s so Catbert… I love it. Yeah, it’s possible.


#103

I would put it even more simple terms: if your business depends upon making profits off of finding and/or making cures, then you are in the wrong business. The prime motivation for a pharmaceutical company should not be making money.

Alas, post-Reagan economics only sees dollars (or euros, or yen) as a valid measurement of success. Too many believe the lie that the only things stakeholders should care about is increasing monetary value.


#104

“If money is all you love, then that’s what you’ll receive.” - Leia Organa, Star Wars (1977)


#105

after 25 years in acute care social services I found the terms “caring & helping” are quite relative to one’s status.


#106

That’s interesting - I stand corrected. But, in my defense, is it fair to say that you were using already approved drugs, not doing drug development?

PS - $20M - wow! Too bad they don’t give residuals :>D


#107

Mostly, but not entirely.

My work was based around 4-methylmethcathinone, which is not approved by anyone. It’s a nasty party drug, not medicine.

One of the other guys in the lab was working on developing oxytocin as an addiction therapy for methamphetamine users. That was a pre-existing drug (actually a hormone/neurotransmitter, but in nasal spray form), but without any proven medical use at the time.


#108

It tickles my memory that someone already wrote a book with tjis as the premise. Michael Crichton maybe?


#109

I know, some of them haven’t had a bath in weeks!

But Ebenezer, who then would provide the desperate young starlets, illegal nannies and groundskeepers, and other exploitable meatpuppets that serve the Bright Elect?

Oh, ha ha, Governor Moonbeam! He’s almost as laughable as a Green Party candidate! Everyone knows only the anti-human parties can win an election!

Melinda, of course.


#110

Until the basis for medical education changes, carrying $200k or more in debt before earning a dime does tend to focus one’s mind on finances. I don’t look at it as “love of money” but more love of living indoors and eating regularly. Add to that the innate feeling that one’s value in society should somewhat reflect one’s value to society and you understand my issue here.


#111

An easy point to prove. Those who care for children are consistently valued less than equivalent positions caring for adults. Pediatricians are the lowest paid medical specialty, elementary school teachers are paid less than high school teachers are paid less than college professors. Daycare providers are generally minimum wage. Where is the biggest societal impact? Those who actually produce goods and services are valued far less than those who move the money thus produced. F***ed up society.


#112

I was helping to answer your daughter’s question, in that unlike doctors, lawyers and anyone else offering a service that is otherwise highly valued, the finance types only think about money. There really is nothing else in their world.


#113

Social democracy is a mixed economic theory, which is both socialist and capitalist in close to equal amounts, usually leaning slightly towards socialism. The big problem with third way liberalism which has dominated for the last 30 years is that it consistently favoured capitalism over socialism, creating the precarious working class we have today.

Social democracy isn’t communism though, which is deliberately confused with socialism by the right.


#114

The coded message of publicly funded healthcare is: “It’s nice to have you around.”


#115

I know - poison Americans via industrial food production, then rent them the antidotes. That’s what I call a sustainable business model!


#116

Why we must smash capitalism, exhibit Z.


#117

I think we mostly agree about the premise. The targets are primarily discovered by academia and government-funded research. Pharma companies take it from discovery to development and commercialization. The latter part is expensive, as there is a lot of dropout. But I haven’t noticed pharma companies lacking profit.

~60% of drug discovery-type instruments (protein purification, NGS, chromatography/mass spec) are sold into academia or publicly-funded research. That’s where the innovative work is being done here. The (expensive, time-consuming) part of the work that is done by pharma companies is really just factory work.


#118

Apologies. My bad. This is an argument I hear frequently, that goes “your job is so valuable, you save lives and ease pain. How could you cheapen it by asking for money?” I thought that was where you were going. Struck a nerve a bit.


#119

Not sure why “lobbyist” has become such a dirty word. The Human Rights Campaign are lobbyists. The Sierra Club are lobbyists, labor unions are lobbyists. We have a representative system here in the USA – you wanna get something done in congress? Probably good to gang together with a bunch of like-minded folks and… lobby!

I do understand you are talking about “not good lobbyists” like the NRA, of which there are many. The not-so-great politicians who are swayed by them? Very much the responsibility of the citizenry, who vote them into power again and again, often against their own interests. I would rather we get the citizenry doing good things, versus privatizing the tax system via massive tax-deductible contributions given to the .01% (one percent of the one percent).


#120

Ah, but these are not purely lobbyists. The archetypical lobbyist is more of a mercenary: not fighting for a cause but for the money. It is a common trope for the lobbyist to not have any beliefs but only wants to win for the sake of getting a reputation as a winner, and doesn’t care who his clients are. Many a John Grisham novel, many a film has been made showing the lobbyist not blinking an eye at corruption until the client does something really, really scuzzy.

Which circles back to medicine as a business where the profits are more important than the patients, in a way.