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Sugar Pills, now more effective!

Byoliveridley

Well, all sugar is not bad for you. Apparently, when given to you in pill form by someone wearing a white coat with a pleasant demeanour, it can cure all kinds of ills.

It’s not that the old meds are getting weaker, drug developers say. It's as if the placebo effect is somehow getting stronger.The fact that an increasing number of medications are unable to beat sugar pills has thrown the industry into crisis. The stakes could hardly be higher. In today's economy, the fate of a long-established company can hang on the outcome of a handful of tests.

Via Wired

An interesting article that takes the reader through a recent history of placebos, why they seem to work better now than they used to, and tangentially, why the competitive research paradigm of the pharmaceutical industry delayed recognition, and continues to delay possible fixes and therapies.

A few things about the placebo effect:

  1. There appears to be a physiological and neurological basis to the effect, something that can actually be turned off by deactivating the body’s natural production of opioids.
  2. This effect is triggered by various patient stimuli, including exposure to advertising, faith in the medicine, doctor bedside manner, etc. It appears that for minor ailments, these effects could be as strong as the medication prescribed.
  3. It is not short lived, the effects can linger well after consumption of sugar pills.
  4. Despite all this, the article states that we are no closer to finding the most appropriate way to administer placebos (Hmm, or are we? Read on!).

Pharmaceutical companies conduct hundreds of clinical trials every year. They are not required to publish them in most countries, so negative results, failures, etc. which reflect badly on the company’s stock price are routinely hushed up. This means that the mounds of data that show tested drugs as no better than placebo are not accessible for research. This is one of the greatest drawbacks of competitive research paradigms, the lack of cooperation, the inefficiency that comes from duplication of negative results, and the lack of statistical power that comes from inability to use all the data available. In a milieu where knowledge = stock price, this is the logical approach, but something to note next time an Ayn Rand acolyte comes bleating to you about the beauty and perfection of the market. You might ask “What are some options to the current patent exclusivity driven regime”? My favourite economist Dean Baker of the Center for Economics and Policy Research has written extensively about the drug development process and alternatives in his excellent (and free to download) book The Conservative Nanny State, I suggest reading at least the chapter on drug development and patents!

Anyway, back to placebos, what to do? How to administer sugar pills in a quasi-official setting for minor ailments. It’s almost like you need a parallel paradigm of medicine that dispenses sugar pills that did not have to go through double blind randomised clinical trials. it would help if this paradigm uses vaguely scientific terminology while doing very little harm. It would work in conjunction with the conventional approach, not in competition so there is little danger of people taking sugar pills for malaria!

I give you, Homeopathy!!! This blog(ger) is no stranger to this wonderful form of medicine, involving concepts such as the memory of water, similars, dilution, etc. When I wrote about homeopathy last year, it was more in relation to the psychological aspects of my experience with it. I (and I assume you did not click through to read!) wrote about my parents’ great and enduring relationship with their homeopath, and the benefits it brought them. Back in India this time around, it was suggested that I take some homeopathy for a cold I was developing, which I did (yum, sugar!). The cold went away in a few days 🙂 There was some swine flu medicine being passed around as well (I did not partake), which worked too, nobody at home got swine flu 🙂

So, how to make it work? It already works in India because belief in the efficacy of homeopathy is well established. As long as the homeopath is well qualified in basic diagnosis, and crucially, knows when to punt the patient into conventional therapy, the system works to a certain extent. But what about a society with no such foundation? Do you go to a clinic with both an allopath and a homeopath, and if your ailment is one where placebo works about as well, let the homeopath make some well diluted similars for you to consume? How to settle turf wars? Would it be better for the allopath to feign develop an expertise in homeopathy and make that work for her in treating the patient? Would they apply the most important lessons in homeopathic treatment, Listen, Empathise, Soothe?

I don’t know. It is not my nature to believe in sugar pills, faith, or advertising. So it is hard for me to say what would work. But given that sugar pills work well, it is vital for society to find a way.

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  • Abbott Drops AIDS Drug Price in response to Thailand's hardball.

    Byoliveridley

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    The move, facilitated by the World Health Organization, is apparently Abbott’s response to a decision by Thailand earlier this year to resort to compulsory licensing of Kaletra, a practice that reduces health care costs in a way that pharmaceutical companies view as patent infringement (C&EN, Feb. 5, page 11).

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    The price of $1,000 per year per patient, Abbott says, is 55% less than the average price at which the drug is now sold in the 40 countries. The company says it wants to increase drug affordability while “preserving the system that enables the discovery of new medicines.

    Compulsory licensing is a perfectly legal option underlined by TRIPs (Agreement on Trade-Related Aspects of Intellectual Property Rights) in response to national emergencies (AIDs is a national emergency, isn’t it?). More importantly, governments in poorer countries really should invoke this provision as much as they can. Because every time they invoke it, they make big pharma come to the bargaining table.

    $1000 per patient per year is still a lot of money, though, I would encourage Thailand to play even more hardball!

  • NC Smoking bill dead this year

    Byoliveridley

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    This is pushing smoke out of places where only adults are, but into places where children are. A person who’s addicted to tobacco and can’t smoke all day will get in that car and have to light up three or four or go home and do what they didn’t do during the day. That seems common sense to me.”

    Yeah, and if you stop a murderer from killing in public, he will kill at home, so we should just let him shoot people randomly in public.

    North Carolina General Assembly – House Bill 259 Information/History (2007-2008 Session)

    Whatever, it does not matter, smoking in public will be history even in the South in a decade or less, just a few lawsuits away. I think we first need to overturn the laws against local government passing anti smoking legislation.

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    NC House Smoking Bill passes committee

    Byoliveridley

    Updates on the smoking bills I mentioned last week….

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    Dismissing North Carolina’s heritage as a tobacco state, a House committee on Tuesday passed a far-reaching indoor smoking ban.

    The Judiciary Committee passed the ban by a 9-4 vote. The measure would prohibit smoking in all indoor workplaces in North Carolina, including bars and restaurants. The rules also would apply to private clubs, except those with nonprofit or tax-exempt status.

    The measure would be complaint-driven — local health departments would act on complaints from the public — and violators would first receive warnings.

    “This was a significant and important event to advance the public’s health in North Carolina,” said Dr. Leah Devlin, director of the state Division of Public Health.

    But critics of the legislation, House Bill 259, pointed out that it faces an uphill battle on the House and Senate floors.

    “What they really want is a complete prohibition of indoor smoking in North Carolina,” said state Rep. Paul Stam, R-Wake. “We all know smoking is nasty and dangerous. The question is whether, in a free society, you let people do some things that are nasty and dangerous.”

    Some opponents said passing the bill could set the stage for similar bans inside personal vehicles and homes.

    “You want to smoke and you own the building. Is it really that bad for the public?” asked state Rep. Ronnie Sutton, D-Robeson.

    Yes Paul and Ronnie, not only did you construct a straw man, you blew smoke on it, gave it lung cancer, tortured it with cigarette butts and finally set it on fire. Sheesh, what asses.

    Update

    From Laura Leslie, WUNC (our local NPR affiliate) reporter who maintains a reporter’s blog at WUNC

    Under the current version of the bill, which isn’t available on the web just yet, only NON-profit clubs could allow smoking – like the Elks Lodge, for example.

    So for the standard nightclub or bar, smoking would be banned.

    Hope it helps – and thanks very much for reading!!
    Laura

    So, that’s a lot of progress on the house bill, making it very close to the senate bill.

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    Monsanto Ashamed of Selling Bovine Growth Hormone

    Byoliveridley

    Why else do they not want people to know that their product is being used? You would think that Monsanto with its millions in profits and its monopoly in bovine growth hormone, would let the free market decide whether people want their ice cream/milk rBGH free or not. Surely, wouldn’t Monsanto’s commanding market presence, and the simple fact that conventional milk supplied by hormone injected cows tends to be cheaper than rBGH free milk be a sufficient counterweight against a simple rBGH free label?

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    This is a classic strawman’s argument. I don’t know if there is sufficient evidence to show that hormone filled milk is harmful to humans, but there is sufficient evidence that it is harmful to cows. As always, I point to the Meatrix (Note, available on youtube as well, but embedding has been disabled…).

    Here’s a letter from the Oregon Physicians for Social Responsibility summarizing the harmful effects of rBGH.

    1. Increase in IGF-1 levels – possible link to cancer in humans
    2. Mastitis in Cows – Do you want your breasts infected and painfully inflamed? That’s what RBGH does to cows
    3. Antibiotics Resistance – To combat mastitis, the cows are pumped with antibiotics, which end up in the solid waste, and water runoff.
    4. 15 other side effects in cows, bad enough that Canada and the EU do not permit this growth hormone

    All right, the product is still legal here in the US and I absolutely respect Monsanto’s right to sell it, fight for it and conduct a vigorous product defense (including obligatory astroturf group rbstfacts). But stop trying to get the government to do your dirty work for you and “banning” companies from telling consumers that they did not use your product, it’s shameful and unnecessary.

    Consumers have a right to pay premium for a product that they think is superior for one reason or the other. It is anti-free market and protectionist to restrict information that will help these consumers decide.

    What next? We all know that cosmetics tested on animals are not more harmful to people than animal cruelty free cosmetics. Shouldn’t that label be banned as well?

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