Thread: Measles

Originally Posted by tintin

I don't know anything about the doctor or the claims against him(i have to admit that they make him sound like a crook). I have heard several testimonies from scientists/whistleblowers who's careers were ruined and work discredited by the big Pharma because there research would destroy them. I am a firm believer in the potential evil of people especially when big money is involved. Big pharma doesn't have a perfect track record either (think the opioid crisis).

I work in big pharma. There is a lot of BS always going round about us burying miraculuous cures, suppressing research etc.
It is true that we are in it for the money. And that is exactly why you can know those claims to be silly.
If ANY company would find a cure for cancer, or aids, or something else, they would fight each other to get to the patent office first, and rake in trillions.

The idea that some person's research would destroy a pharma company is a fairy tale.
The biggest thing wrong with pharma is that assholes like Skrelli can buy single providers and jack up the price by 600%

The 'cheap' stuff is where the abuse is. Not the expensive stuff. One of the products we make is a very complex thing to make. It needs to be babysat through up to 2 months in bioreactors needing constant attention. It requires a half billion dollar plant, several hundred employees, tens of millions of $ in upkeep, ... for not even 2500 patients worldwide. It took also close to a decade from breaking ground to regulatory approval. It should be obvious why a treatment is around 100K per person per year.

Companies like where I work for make a sport out of buying promising startups and getting their product to market. They LOVE small startups who make promising new products. Rather than stomping them out, they rush to be first to buy them out.

I should add: we are also often accused that we are more interested in treatments than in cures. That is true in a way. the reason is that there are many diseases where someone dies because their body does not manufacture a certain enzyme that is key to the immune system, of the disposal of toxins at the cellular level.

What we do at my company is to grow genetically modified cells in bioreactors. We feed them oxygen, nutrients, etc. And they excrete as waste that particular enzyme, which can then be injected in the patients who don't produce it. This process is extremely costly for various reasons. It is complex, needs complex infrastructure to make, and is very tightly regulated. The costs involved are atrocious. The only reason anyone can make these things is that patients die if they don't get it. And it's usually not a nice death either.

Anyway, we can manufacture the enzymes that are missing, and doctors can inject them in their patients. Those diseases are literally genetic defects. Think of it like a coffeemachine like you have at work, except it is not making coffee because a distracted plumber forgot to hook it up to running water when it was installed. But we are able to splice in a funnel in the machine, and someone needs to top it up with water from a tap.

But the defect is still there. It's coded in your genes. Now this is where it gets interesting. Up until now, we've been in a situation where we can treat, but not cure. This is NOT because of greed or laziness. It's because rewriting DNA in a living person has not been feasible until now.

However, techniques have been developed to do just that. The layman's explanation (which is really all I know tbh) is that we tie a good copy of the missing or defective DNA to a tailormade virus. The virus is keyed to the DNA of the patient, and when the patient is infected, the virus will somehow edit the new part in. This is literally a cure. At present, the technique is still far from perfect, but it works.

Recently there was a high profile case in Belgium that angered me a lot. Basically, a baby was born with an extremely rare disease that would kill it. There is a treatment, but it is horribly expensive, and comes with side effects. There was also a new experimental cure. The cost is 2 million USD for a single treatment. The company who made it got terrible press and was accused of greed etc because they would not lower the price or give it for free. And people's reactions made me made, because they don't want to understand the reality.

The treatment was 150K per year or so. It should be obvious that the cure was more cost effective. But even aside from that: working with genetically modified treatments is very tightly regulated. They need clinical trials, and time to market is generally 10 or more years. But at least, this regulatory approval covers a single molecule which can be used on all patients. With this new generation of cures, you need to do a large part of all this very expensive work over and over, for every single patient. On top of that, the number of patients were we can do this is even smaller.

So that 2 million $ cure: it doesn't cost 2 million to make. The company needs a profit too. Especially considering that investors need to put in hundreds of millions of dollars, for a potential profit many years down the line, when it is very uncertain that it will be be a success. So yeah, that 2 million is part profit. But having knowledge of the industry, my colleagues and I discussed it and we are fairly certain that the actual cost in making this single-dose cure is over a million per patient.

Maybe 10 or 20 years down the line, we get good enough at it as an industry that we can make tailor made cures at a competitive price. But at present many diseases cost 6 figures per year to treat, or 7 figures to cure. Not because we are greedy, but because we are still so limited in what we can do at the genetic engineering level.

Just few observations.
Gilead created a med to treat HepC. Was it cheap? Nope. Was it cheaper than having people get liver cirrhosis and what ever follows that? Countless hospitalizations, visits to docs, labs and eventually a liver transplant? Yeah much much cheaper. Just a little thought on how to look at prices of meds.

Second, opioid crisis. I love how the government comes hard on Pharma and docs etc because of it. Well somehow they forget that it was them who said that pain is a vital sign and nobody in the hospital should have any pain. Zero, nada. They started showing patients a smiley to sad face chart with questions to grade their pain form 0-10. If you said anything above 6 or so - boom opiates. So what did they expect, Tylenol would take care of that? Of course everybody was loaded with opiates to keep the patients and the government happy. Why you may ask. Well few years back they spine surgeons were told if their patients report post op pain, medicare wouldn't reimburse for the hospitalization.

Additionally, when it comes to complex drugs, the cost is not only in the molecule itself. This stuff that we make, can be made by a couple of PhD students in a university lab, with minimal cost. In this case, minimal cost is still a university grade lab and high tech equipment. Still, recently there was a news article where this was mentioned. They could make it for a fraction of the price.

But that literally doesn't mean squat.

The challenge is not in making this thing. the challenge is in making the EXACT same molecule that was in the FDA filing, in EXACTLY the same process that was in the FDA filing, using ONLY equipment that was fully documented in the FDA filing, following all practices that are required by FDA regulation.

We have a number of identical bioreactors in our plants. Every single one needed separate FDA approval. Every component we use, every piece of equipment, material, and even the water that we use, ... literally everything that ever comes in contact with the product needs to go through a lengthy FDA filing process.

Every single change that touches the product causes a re-filing. Every single change that is simply a non impact change needs to go through cumbersome change control processes. Every company that makes drugs needs specific processes to deal with changes, deviations, training, audit trails, etc. That is why we needed over 500 employees to make something for only 2500 patients.

the challenge is not just in making the molecule. It is in making the molecule, and ONLY that molecule, into an absolutely pure drug. And on top of that we have to implement the 1000s of pages of processes, tests, manufacturing guidelines etc that are mandated by regulation.

It's like when you made aspirin in science class. Making aspirin is simple, as long as you only care that it is 'mostly aspirin' instead of '100% aspirin'. If you need to guarantee that every batch is 100% pure aspirin and nothing else and implement the entire body of FDA regulation, things get exponentially more difficult in a hurry. On top of that, aspirin is simple because it's a simple molecule that can be made in a trivial process. What we do is feed nutrients to genetically modified cells in a bioreactor to get them to excrete enzymes that we use as a cure.

That type of manufacturing is even more tightly controlled and difficult to control.

Originally Posted by alex1921

Second, opioid crisis. I love how the government comes hard on Pharma and docs etc because of it. Well somehow they forget that it was them who said that pain is a vital sign and nobody in the hospital should have any pain. Zero, nada. They started showing patients a smiley to sad face chart with questions to grade their pain form 0-10. If you said anything above 6 or so - boom opiates. So what did they expect, Tylenol would take care of that? Of course everybody was loaded with opiates to keep the patients and the government happy. Why you may ask. Well few years back they spine surgeons were told if their patients report post op pain, medicare wouldn't reimburse for the hospitalization.

Recently I was in a car accident.

My leg was shattered and I had to have a plate and screws etc.

The surgeon told me that he wanted to put a needle in my back and make me numb from the waist down (like an epidural).

I told him that I was in too much pain for silly jokes, forget the needle and that he could wake me up when he was finished.

I am a real coward and I am not quiet about it, there is no way I was going to be conscious and listen to the hammering and sawing etc.

Anyway, my point is that I was on morphine after the surgery for a few days. I guess morphine is an opiate. I felt no pain and I am thankful for that.

I suffered no side effects and I am not addicted.

I did have several nightmares and got pushed to the nurses station to sleep but I imagine that had more to do with the accident than the Morphine.

I will say that while I was on the morphine I was given a cognitive test and the result was that i was fantastically stupid. To be honest, I was on the morphine so I didn't really care

Steve

Pain meds are necessary for operations and many procedures and for many folks who are in serious chronic pain with no other alternatives.Abusing them or taking them when you don't need to is another story.

I remember seeing a story where a woman said her daughter had a tooth pulled and was on Oxy for 3 days and became addicted. I think that woman doesn't know what her daughter is doing in her life.

Originally Posted by alex1921

Just few observations.
Gilead created a med to treat HepC. Was it cheap? Nope. Was it cheaper than having people get liver cirrhosis and what ever follows that? Countless hospitalizations, visits to docs, labs and eventually a liver transplant? Yeah much much cheaper. Just a little thought on how to look at prices of meds.

Second, opioid crisis. I love how the government comes hard on Pharma and docs etc because of it. Well somehow they forget that it was them who said that pain is a vital sign and nobody in the hospital should have any pain. Zero, nada. They started showing patients a smiley to sad face chart with questions to grade their pain form 0-10. If you said anything above 6 or so - boom opiates. So what did they expect, Tylenol would take care of that? Of course everybody was loaded with opiates to keep the patients and the government happy. Why you may ask. Well few years back they spine surgeons were told if their patients report post op pain, medicare wouldn't reimburse for the hospitalization.

I can't "Like" that but thanks.

Much of the opioid problem isn't so much folks getting addicted trying to treat pain. Its a criminal thing. Drug distributors sending millions of doses to these little town in the middle of nowhere and crooked doctors and pharmacists and folks looking the other way when they knew something wasn't right.

Originally Posted by onimaru55

You make an incorrect assumption. That the flu vaccine gives you 100% immunity & protects everyone, when in fact this year it was only 29% effective according to the U.S. Centers for Disease Control and Prevention.
https://www.webmd.com/cold-and-flu/n...-effective-cdc

You can still make someone sick even if you are vaccinated.

Did not mean to give the impression I believed the flu vaccine is 100%. what it IS, is better than nothing. If everybody has a 40% immunity chance, then that makes it that much less likely that an "at-risk" person contracts the flu. Given I still have one parent (my Mother-in-Law), and she is diabetic. I get the shot, as does the REST of the family.

Originally Posted by Orville

Did not mean to give the impression I believed the flu vaccine is 100%. what it IS, is better than nothing. If everybody has a 40% immunity chance, then that makes it that much less likely that an "at-risk" person contracts the flu. Given I still have one parent (my Mother-in-Law), and she is diabetic. I get the shot, as does the REST of the family.

My father is 91 & has never had a flu shot. Never gets more than a sniffle in winter either. Now he's in a nursing home full of potentially sick people we may need to reconsider. It might even be mandatory for him to reside there. I guess they'll tell me.

As a kid I've had measles 2x, Rubella & chicken pox. Haven't had any kind of shots in about 25 years & I don't get the flu or colds certainly not in the last 20 years or so . Used to get sick a lot as a kid.
I do spend thousands $$$ on supplements & can fall back on my natural therapies training if needed for most things short of setting broken bones.

We all have different life experiences that colour our beliefs.