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Re:A Doctor Trying to Stop Heart Attacks by darkerside on Wednesday September 28, 2016 @02:20PM (#12599976)
This is another example of a recurring theme where the profit motive is failing to incentivize pharma companies to create products that can have an immediate impact on saving lives or improving health outcomes. I'm no socialist, but this seems to be a real (albeit very specific) failure of capitalism. Does anyone know of a government agency that is chartered to solve these kinds of problems?
Re:A Doctor Trying to Stop Heart Attacks by nickff on Wednesday September 28, 2016 @03:36PM (#12600604)
The United States Department of Health and Human Services, whose motto is "Improving the health, safety, and well-being of America", which has a budget of just over 1.1 trillion dollars, and about eighty thousand employees.[1][2]

For comparison, the largest pharmaceutical company in the world is Novartis, with annual revenues of approximately forty-seven billion dollars.[3]

The pharmaceutical industry is one of the most, if not the most heavily regulated industry in the United States. This industry is also affected by various government interventions into research and development, both in funding and restricting options. If you believe there is a problem (and I think there is), it seems difficult to believe that it is due to a lack of government involvement.

[1] https://en.wikipedia.org/wiki/United_States_Department_of_He...

[2] http://www.hhs.gov/sites/default/files/fy2017-budget-in-brie...

[3] http://www.pmlive.com/top_pharma_list/global_revenues

Re:A Doctor Trying to Stop Heart Attacks by erentz on Wednesday September 28, 2016 @04:43PM (#12601203)
About 90% of this budget is providing Medicare and Medicaid.
Re:A Doctor Trying to Stop Heart Attacks by nickff on Wednesday September 28, 2016 @04:58PM (#12601322)
Yes, and a large portion of that is spent on prescription drugs; the US Government is one of (if not the) largest customers for most drugs.
Re:A Doctor Trying to Stop Heart Attacks by pmoriarty on Wednesday September 28, 2016 @06:41PM (#12601942)
We need to stop thinking of the government and corporations as distinctly separate.

Officials from government own stocks in corporations, serve on their boards, and often get cushy jobs in the very corporations they "regulated" or acquired government contracts for when they retire from "public service".

Corporate executives also demonstrate their selfless commitment to the public good by going to work for the government and regulate their former employers.

Corporations are taxed and that tax money flows from the government back to corporations. Corporations spend millions lobbying, bribing, and electing government officials to enact laws and contracts favorable to them. Often it's the same people who govern both corporations and the government, and profit from both.

They have their hands in each other's pockets and scratch each other's backs.

Re:A Doctor Trying to Stop Heart Attacks by BraveNewCurency on Thursday September 29, 2016 @07:51PM (#12609685)
You didn't respond to his assertion.

The drugs we have are warped by the abilities of people to make money off them. In fact, we can point to many "dead ends" where companies marketed drugs that were more expensive and worse than existing treatments.

I've personally witnessed a company taking an ingestable pill and turning it into a nurse-administered injection, just so they could take advantage of reimbursement. Same drug, but the patient suffers just so they can make more money.

The total budget of the DHHS is irrelevant. Only money that goes to researching unprofitable drugs would counter the assertion of the OP.

Re:A Doctor Trying to Stop Heart Attacks by Retric on Wednesday September 28, 2016 @08:33PM (#12602471)
That's about as relevant as talking about the DoD budget because they spend a lot of money on healthcare.

If you divide 1.1 trillion by 80k you get 13.75 Million per worker because they mostly hand out money to other organizations.

PS: If you campare US spending on heathcare per person you find the real issue is we let way to many other people in on the game. When you see a doctor chances are far more time is spent by other people not in the room mostly deciding who pays what than the doctor spends dealing with you. That's 95% pure waste and has little to do with heathcare. A doctor making 300k per year (~250k excluding benefits) only costs ~75$ per half an hour. Co pay can often more than pay for a doctors time.

Re:A Doctor Trying to Stop Heart Attacks by WalterBright on Wednesday September 28, 2016 @08:08PM (#12602356)
Doing the safe-and-effective testing the FDA requires is incredibly expensive. But the cocktail is formed from off the shelf cheap components. So why should a company pay half a billion for testing when anyone could then make the drug? (The article didn't say it was under patent, and the tone of it suggests it wouldn't be patentable.)

This is the flip side of the good intentions of FDA's mandate.

Re:A Doctor Trying to Stop Heart Attacks by gozur88 on Wednesday September 28, 2016 @09:54PM (#12602805)
This is the key point. The cost of bringing a drug to market is mostly in the clinical trials. If the drug company can't patent the compound it's testing, it will never make back development costs.

This is the big problem with nutritional supplements and herbal medicine. You can't patent a plant, so there are all kinds of herbs people take that have never gone through double-blind testing. Some of them are probably efficacious.

Re:A Doctor Trying to Stop Heart Attacks by hammock on Wednesday September 28, 2016 @10:55PM (#12603010)
>The cost of bringing a drug to market is mostly in the clinical trials.

I would not say mostly, although clinical trials are a large part of the cost. (Roughly speaking) For every drug that makes it through final approval, there are ten that failed in trials. However, for every drug that makes it into trials, there were ten that didn't - and the R&D for those unseen drugs is also a huge cost for pharma companies.

Re:A Doctor Trying to Stop Heart Attacks by legulere on Wednesday September 28, 2016 @04:20PM (#12601001)
Military can sometimes be interested in solving this kind of problems. Artemisinins which are used against malaria were discovered within the frame of a military project: https://en.wikipedia.org/wiki/Project_523

I don't think that this can be the solution though.

Re:A Doctor Trying to Stop Heart Attacks by reasonattlm on Wednesday September 28, 2016 @01:47PM (#12599714)
Heart attacks are a downstream consequence of the molecular damage of aging.

Everything that isn't repairing the root cause damage of aging is going to be a much less effective way of going about things if the goal is to avoid cardiovascular events of that nature. Keeping a machine from a specific failure mode without actually repairing the damage that raises the odds of that failure mode is a much harder thing to do than to enact repair.

This is largely why medicine for age-related conditions has been an incremental process over recent decades: advanced enough to do sensible things with downstream consequences of damage, and so produce marginal effects at sizable investment of time and resources but for various reasons unwilling or unable to address the damage itself. The reduction in heart disease over the past 30 years has been an enormous achievement when considered within these bounds: really going above and beyond, finding ways to keep the accumulation of damage from having the same level of consequences and juggling biochemistry to keep running at a lower failure rate for longer.

But still incremental, and to really solve the problem you have to repair the damage. Nothing else is going to do the job.

Re:A Doctor Trying to Stop Heart Attacks by coldtea on Wednesday September 28, 2016 @02:21PM (#12599982)
>Everything that isn't repairing the root cause damage of aging is going to be a much less effective way of going about things if the goal is to avoid cardiovascular events of that nature.

Tons of heart attacks before the age of 60 can be avoided simply by better diet and more exercise.

Given that, it doesn't matter if not ALL are.

Especially if the alternative is hoping for some unicorn anti-aging discovery.

>But still incremental, and to really solve the problem you have to repair the damage. Nothing else is going to do the job.

Yeah, we're still are going to age and die in the end. But the job here is not immortality, is not going down from a heart attack before that...

Re:A Doctor Trying to Stop Heart Attacks by melling on Wednesday September 28, 2016 @02:08PM (#12599858)
There are 600,000 heart attack deaths in the US alone every year. And I imagine many millions worldwide.

Incremental progress can save millions of lives a year.

Re:A Doctor Trying to Stop Heart Attacks by csense on Wednesday September 28, 2016 @02:32PM (#12600085)
If big pharma's not interested, would the costs of getting this kind of therapy into paramedics' hands be within the reach of private philanthropy (e.g. Gates foundation or YC's recent non-profit efforts)?
Re:A Doctor Trying to Stop Heart Attacks by Cass on Wednesday September 28, 2016 @05:05PM (#12601369)
Glucose, insulin and potassium are already readily available on every ambulance, so all you'd need is a clinical trial proving that the mixture is effective and safe to use for heart attack patients. The costs of a clinical trial seem well within the reach of private philanthropy, especially since this isn't an experimental drug where you'd have to start from scratch--all three of those meds have been extensively studied both separately and in combination. (Glucose and insulin is a combination commonly used to treat high potassium levels, for example.)
Re:A Doctor Trying to Stop Heart Attacks by seatonist on Wednesday September 28, 2016 @09:30PM (#12602709)
Here's a slide deck with data about the results of the trial (of Glucose Insulin Potassium) mentioned in the article.

http://clinicaltrialresults.org/Slides/ACC2012/Selker_IMMEDI...

From the conclusions slide:

"Composite endpoint of cardiac arrest or acute mortality was significantly reduced, and FFA levels were lower, consistent with the proposed FFA link to arrhythmias"

Re:A Doctor Trying to Stop Heart Attacks by gist on Wednesday September 28, 2016 @02:44PM (#12600171)
> And so I started talking to the pharmaceutical companies saying, 'You know, would you make this stuff?' And they basically weren't interested.

How many?

Which ones?

All of them or some or most of them?

So maybe a big name isn't interested.

There are tons of companies who make generics who would probably welcome the opportunity to market a concoction like this or at least entertain the idea.

Re:A Doctor Trying to Stop Heart Attacks by M_Grey on Wednesday September 28, 2016 @05:54PM (#12601658)
You seem very ready to assume that the author didn't do his homework, while seeming equally willing to assume that there are some companies who would be game.
Re:A Doctor Trying to Stop Heart Attacks by mzw_mzw on Wednesday September 28, 2016 @07:12PM (#12602091)
Given their track record, any "advocacy" type article that appears in the news media should be considered written by someone who didn't do his or her homework until proven otherwise.
Re:A Doctor Trying to Stop Heart Attacks by M_Grey on Wednesday September 28, 2016 @07:17PM (#12602113)
That's certainly possible, but then I still prefer something tangible in response, "Here is the homework you failed to do." You know?

It's too easy just to imply that someone didn't do it, and then sneak a claim in on the side.

Re:A Doctor Trying to Stop Heart Attacks by mikehotel on Wednesday September 28, 2016 @02:46PM (#12600189)
A different [edit: diet based] approach to reduce heart disease (also advocated by a physician): https://youtu.be/LXigmGZk5FU

This same approach also appears to address other leading causes of death.

Re:A Doctor Trying to Stop Heart Attacks by alecco on Wednesday September 28, 2016 @10:14PM (#12602886)
Yeah, let's get a pill to fix it and keep chugging processed industrial foods and sugar water while sitting browsing social networks.