AIDS export says what I've been saying for ages

[yesthattom]

http://www.cnn.com/2005/HEALTH/conditions/12/25/aids.vaccine.ap/index.html I hate the way the world works.

Comments

[kimuchi.livejournal.com]

But there is vaccine testing going on now in SF...

[rainbear.livejournal.com]

Just curious..

Do you know anyone who's actually signed up for the testing?

They're doing the same thing in NYC, but I don't know anyone who's a part of it--mostly because they do things like advertise on Craigslist for volunteers.

[kimuchi.livejournal.com]

No, I don't, but I'm pretty much completely antisocial.

I did think of signing up myself (the advertisements in the MUNI lightrail stations caught my eye), but due to my antisocial lifestyle I don't think I meet the criteria.

[lilbjorn.livejournal.com]

In fact, they have a strong disincentive to create a vaccine. Right now they have the best of all possible worlds. Expensive medications that people have to use for the rest of their miserable lives. Why would anyone want to piss of the wealthy and powerful stockholders by destroying that gravy train?

[stitchinthyme.livejournal.com]

I was just going to say something very much like this. Once a vaccine is created, the disease will slowly be eradicated, and eventually neither treatment nor vaccine will be necessary, and the drug companies won't make money off it anymore. This is one reason why having private companies solely responsible for such research is terminally stupid -- they act in their own best interests, not the public's.

[barking-iguana.livejournal.com]

Well, that is mitigated some by having multiple companies compete with each other. They've each got to trust that the others aren't about to develop a vaccine. Unfortunately, that trust is a lot easier to achieve than the libertarian fundamentalists would have us believe.

[gulfie.livejournal.com]

It's not mitigated at all by other companies. It would be mitigated some by a non profit, medical institution, but not much.

The basic facts are economic.

Think about it like cigarettes. Back when a pack of cigarettes cost a dollar.

A reoccurring cost of $1 /day is worth ~ 365 /year, or about as much as a $7300 in the bank at 5% interest.

Every customer of a cigarette company was basicly worth, $7300 to that company. Like chattel, or human capital. Why would a cigarette company stop selling cigarettes?


Now an AIDS patient on antiretrovirals spends about $30/day, or is an asset of about $220,000 to whichever drug company has the patient. You can argue that the patent runs out after 20 years, that will change the math down to an asset value of $100,000 or so, minus overhead.


Unless the potential profit, is at least $100,000 per cured person... as a for profit corporation, operated for the benefit of its investors, it is almost illegal to for the company officers to make the cure.

Illegal? Yes, illegal. The officers of the company have a financial responsibility to maximize profits for the share holders. Curring people, and destroying the corporations revenue stream is not in line with
this responsibility. So it is not going to happen, and if it did happen, the shareholders would be well within there rights to file legal claims against the officers.

So the corporations that own the patents are not going to poop in there own koy pond, but what about other companies with cheaper antiretrovirals, or even a cure?

Examine the ROI choice between developing another maintenance therapy, vs a cure. A therapy, gets maybe $100,000 through the life of a patient. A cure might get what? $5000? $10,000? Surely not $100,000. The medical insurance company executives would be rioting in the streets if they had to fork over $100,000 per person.

A very simple ROI analysis concludes that when the cost of developing a cure or a therapy... develop a therapy. For profit corporations are legally bound to do 'the right thing'.


A notes about AIDS funding:
$700 million sounds like a lot.
But...

it's about $2 / american.
it's equivalent to a 23 day supply of antiretrovirals for the 1 million Americans with AIDS.

But it is $700 / american with aids.
But it could be $2 / american who would never get aids.


Sometimes the invisible hand of the market, is all to visible, and probably not doing what is best for us.

[barking-iguana.livejournal.com]

First of all, we were discussing a vaccine, not a cure. A vaccine will probably be administered to orders of magnitude more people than therapies are administered to.

Secondly, you're simply not taking into account that one company can change the market for all the others. Even considering cures: if Pfizer develops a cure, Merck loses most of its market for therapies. (I don't actually know who's in the market, I'm just picking Big Pharma names at random.) If Merck thinks that Pfizer might develop a cure, than Merck would likely do so itself, not to get totally boxed out of the market. The real-world problem is that Merck bosses probably hang out with Pfizer bosses and they all let each other know just how well they're dragging their feet.

Also, though it's a relatively minor point, you need to take into account the discounted value of future money.

[gulfie.livejournal.com]

For all intents and purposes a vaccine is a cure, well not for the .6 % currently positive but for the other 99.4 %. But yes it does change the math , but only superficially. Full vaccination costs less than 1 - current % * population * cost.

For the hypothetical $100,000 aid maintenance case. There are 300 or so not infected. $100,000 / 300 = $330 $330 at best in america. The cost per person goes up as vaccination rates go down. 100% vaccination isn't needed to stem an outbreak. But even at $330, as a prophylactic measure, is going to he a very hard sell to patients who can rationalize away that they are not ever going to need it.


I'm not saying that a company could not 'take' revenue from another company, I'm asking 'why would they'? Economics and business tactics agree. Fighting, or competition in the market, does not serve the interests of the shareholders. Even without collusion, players in the market can come to the same conclusion that economic combat only wares down the economic machine and lowers profits. In market that is open ended there is little reason to fight, not much profit in it.


As to the discounted value of future money, sure. It's an actuarial problem balancing any decrease in production cost vs inflation for the 20 + year life cycle of the patented therapy vs the spread of the epidemic. Insurance companies run this sort of problem all the time. Medical companies have the understanding of it. Currently they are on the winning side. The time value of an epidemic is that it will grow.


My hope for an AIDS cure/vaccine is based in Asia. eventually a large and funded government will step in and attempt to solve the problem.

[tim1965.livejournal.com]

Non-profit, non-schmofit. Non-profits act just like any for-profit. They have "excess income" rather than profit. And they distribute this profit to officers and the company in the form of mega-high salaries, perks, kick-back contracts to Board members, conflict-of-interest contracts with Board members, etc. -- rather than to shareholders.

Almost every study of non-profits shows that they are as inefficient and corrupt as for-profits.

[inflectionpoint.livejournal.com]

I would wager that what the article says is true.

When I was looking for work and made inquiries at A Company That Makes Vaccines, one thing that struck me as odd was that the company in question not only had money from in house, they also got a lot of money from federal grants, similar to those that we used to apply for back in Academic Hell.

Upon more discussion with other folks, what I learned was that it's hard to get companies to fund vaccine research for two reasons... the first being that it's not a very profitable product, unlike a maintainence medication that needs to be taken for a person's whole life, a vaccine is often a -pardon the pun- one shot deal. The second reason is a bit strange.

There is a perception that vaccines are products with a very high potential for liability to the company. The adjuvants and other ingredients in a vaccine can be dangerous to small sections of the population, and that can have effects that can lead to suits that companies don't want to get near.
Personally, IMHO one way to deal with that problem would be to make a safer product.

The presence of thiomersal, a mercury derivitave, in many vaccines came about as a cost saving measure to allow packaging in vials that contain more than a single dose. This particular cost saving measure had some consequences that people are still recovering from.

I don't know how to make decisions about safety versus cost of product. I really don't. But I do know that the perception that these are high potential liability products might be a tool that could be used to get the industry to look at better testing of adjuvants, preservatives, and so called inert ingredients before anyone else does get hurt.

And please note - I am pro vaccination for just about everything and am counting the days till the HIV vaccine is here. I just want it to not hurt anyone inadvertently. I want this to be over.

[tim1965.livejournal.com]

Why does this surprise anyone?

For years, political scientists and sociologists have known that it's government spending that drives technological innovation -- NOT the marketplace. Government investment drove the development of radar, the microwave, the laser, most medicines, physical infrastructure (who built your highway, Bechtel or the Federal Highway Development Trust?).

The first AIDS drugs all came from NIH. AZT (a shitty, useless medicine if there ever was one) was developed by NIH and the patent licensed to a private company. Once the profits from AZT were known within the pharmaceutical industry, only then did other drug companies (in the U.S. and overseas) begin searching for more AIDS drugs.

Of course, with the incentive being drugs to combat the symptoms rather than the cause of the disease, what incentive exists in the marketplace for drug companies to develop a vaccine that will make their investments useless? None.

This is one reason why government exists, to combat flaws in the marketplace.

The incentive structure confronting people with HIV and AIDS has been well-known for nearly two decades.

What we should be more outraged at is that the mainstream, corporate-owned media is only just now getting the message to the public. Of course, they won't push this story much at all. Why? Because the same incentive structure confronts the corporatized mass media, and corrupts the news in the same way that it corrupts medicine. And the choke-chain around the media's neck will get yanked on pretty hard once the corporate masters understand that stories like this will cause people to question the value and wisdom of corporate media ownership as well.

[gulfie.livejournal.com]

To be fair. Government is a lot older than 'the marketplace'. Not to mention the lots of other things government does (or should) do, that have no relation to 'the market'.


The creeping idea that everything must service 'the (hallowed) market' is rather off putting I think. It is of course what 'the market' would want. The market, what there is if it, is here to serve us, not the other way around.

[tim1965.livejournal.com]

Advocates of the free market would argue that trade came long before any government (it's their claim to ethical superiority, which is based on a state-of-nature claim).

But I agree that government has lots of reasons for existing. That's why overcoming market failure is just one of them.