--- Log opened Sun Dec 22 00:00:25 2024
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09:46 < hprmbridge> Eli> Semaglutide is off patent in 2026. I would think he would get his wish soon.
09:47 < fenn> that was quick
09:47 < fenn> don't they have some special FDA-only exclusive right that's totally not a patent, in exchange for doing the billion dollar clinical trials
09:49 < fenn> wow it's been approved since 2017
09:49 < fenn> the obesity trial was 2021
09:52 < hprmbridge> Eli> It looks like the OG patent expires in 2026 but their are a bunch of secondary patents that last into the 2030s
09:55 < hprmbridge> Eli> I was reading a book about it and the original formula came from gila monster venom. I guess some yo-yo decided to swab a Gila monsters mouth and put it in a molecule db and it became one of the most successful drugs of all time
09:56 < fenn> makes sense
10:00 < hprmbridge> Eli> Capitalism made food so prevalent and tasty that capitalism had to create a medication to prevent us from eating so much of it.
10:00 < hprmbridge> Eli>
10:00 < hprmbridge> Eli> Semaglutide will have pervasive effects on society. Companies like nestle and Coca Cola will have top line numbers adjusted due to demand changes
10:10 < hprmbridge> Eli> Also, I spoke to a woman who was putting health care data on the blockchain. I told her about my idea of collecting volunteers healthcare data. A 1% volunteer rate would result in a 3 million person retrospective epidemiology trial of ~80 years (avg age of death for a white woman). I think this would be the most transformative immediate thing that could be done for public health.
10:10 < hprmbridge> Eli>
10:10 < hprmbridge> Eli> She brought up the fact that the government cannot be trusted with healthcare data, data cannot be truly deanonymized, and also, ethically, humans don’t necessary understand the implications of centralized data and therefore cannot be trusted to give informed consent.
10:10 < hprmbridge> Eli>
10:10 < hprmbridge> Eli> I was thinking about it, and I’m wondering if humans can have a death contract where they have the option to contribute their entire medical history to the collective good upon death. Genetic data can be scrubbed to prevent possible misuse against their relatives. Even though it’s not legal for insurance yo discriminate against people based on genetic data, you wouldn’t really want your trust the
10:10 < hprmbridge> Eli> government with it, just in case.
10:13 < hprmbridge> kanzure> why would you want health data to use a blockchain?
10:13 < hprmbridge> Eli> Eventually the US will have a death with dignity law where people in pain can perform medically assisted suicide. I should be allowed to get my affairs in order during this time and be allowed to review my medical history before volunteering it.
10:13 < jrayhawk> donating data for the greater good is less risky than donating a kidney
10:14 < hprmbridge> kanzure> what is you just used a file server instead
10:14 < hprmbridge> kanzure> if
10:14 < hprmbridge> Eli> I forget what her business case was. But they were already successfully selling a product from what I recall.
10:15 < jrayhawk> "blockchain" is usually a political package for an high-availability API
10:19 < hprmbridge> Eli> I had spoken to another biologist in the past and their business model was to allow patients to make money selling their health data to big pharma. Payment would take place on the blockchain. This can’t be done because of HIPPA. And also due to  other ethical issues. Only the government could get doctors yo do something like that. Anyway, I think my idea would solve some potential issues.
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16:01 < hprmbridge> Eli> The other thing I was thinking was that there should be an award given by the government to companies that get non-patentable therapies through clinical trials. For example, if I can show clinical improvement of stroke victims using an OTC supplement, the government should give me a large amount of money. There are almost certainly a large number non-patentable substances that can improve patient
16:01 < hprmbridge> Eli> outcomes for the top killers. I suspect this would result in an enormous number of new treatments, often with better side effect profiles than current treatment. There has to be an incentive to get things that are effective, but not commercially viable through the fda approval process.
16:03 < hprmbridge> Eli> The award would have to be low at first, because the number of things that are non-patentable but likely work might overwhelm the bureaucracy and cost a lot of reward money.
16:05 < L29Ah> how about making it a charity foundation instead of relying on some government bureaucracy exclusively?
16:08 < L29Ah> if you are able to funnel government monies to some good cause, at least put some checks in place to avoid them redirecting the monies to their friends' pockets instead of your case after a few iterations
16:10 < hprmbridge> Eli> I like that idea. And it’s something I would do if I was a multibillionaire. The problem is that the average new drug costs 2 billion to get through fda approval. You would need to exceed that for reward money. And, you probably want market mechanisms in place. So, the reward money would be correlated with medical savings. Stroke doesn’t really have good treatments, so if you can reduce days in
16:10 < hprmbridge> Eli> hospital you’re saving tens of thousands of dollars in cost for the medical system for each patient.
16:11 < L29Ah> or remove FDA
16:12 < L29Ah> does removing FDA cost more or less than 2G$?
16:12 < L29Ah> or at least decriminalizing non-FDA-approved drugs
16:14 < L29Ah> also if patients profit from your drug, they could chip in to your foundation
16:15 < hprmbridge> Eli> Im also sympathetic to that. I understand the idea of removing the efficacy requirement and just having a safety requirement. Economists have been talking about the cost/benefit of the fda for a long time. For socialized medicine to pay for it, you still need somehow to show efficacy so the tax payer isn’t paying for snake oil.
16:15 < L29Ah> somehow i think correcting perverted stimuli is cheaper than band-aiding them with astronomical rewards you gotta obtain somewhere
16:18 < L29Ah> socialized medicine won't pay for expensive treatments even if they are cost-effective for a productive member of society (meaning that the cost of treatment is lower than the expected income due to saved/restored/acquired capability), since socialized medicine is focused on minimizing cost/benefit; also it's very slow to take approaches in due to bureaucratic complexity and the lack of incentives for 
16:18 < L29Ah> the people involved
16:24 < hprmbridge> Eli> OTC supplements would be very cheap. Even reducing hospital stay for stroke patients for only a couple days would result in huge savings. Socialized medicine currently pays for hospital stays.
16:28 < hprmbridge> kanzure> L29 is your idea that the patients owe a debt to the company?
16:36 < L29Ah> not really, since i don't believe in "intellectual property" and similar things
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18:46 < hprmbridge> kanzure> "A  team pioneered a freeze-drying method to send mouse sperm to the ISS, where it was stored for six years. Upon its return, the sperm produced healthy baby mice. The findings revealed that freeze-dried sperm could remain viable for up to 200 years in space."
18:51 < superkuh> Impressive.
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23:14 < fenn> "Genetic data can be scrubbed" woah woah woah woah. don't throw the baby out with the bathwater
23:14 < fenn> the link between genetics and health outcomes is the whole point of collecting large scale health data
23:16 < fenn> "there should be an award given by the government to companies that get non-patentable therapies through clinical trials" i thought there already was a FDA exclusive authorization for exactly this purpose, a sort of fake patent
23:17 < fenn> https://www.fda.gov/drugs/development-approval-process-drugs/frequently-asked-questions-patents-and-exclusivity#What_is_the_difference_between_patents_a
23:20 < fenn> New Clinical Investigation Exclusivity"
23:20 < fenn> hatch waxman amendment 1984
23:25 < fenn> that's 3 years exclusivity, and antibiotics get an additional 5 years
23:26 < fenn> "orphan drugs" get 7 years exclusivity; i'm not sure if that stacks
23:29 < fenn> since the real problem is the $2 billion cost of a new drug clinical trial, the reward money should go to the FDA bureaucrats instead, to give them an incentive to increase the number of new drugs making it to market
23:29 < fenn> this is a comparatively small amount of money
23:30 < hprmbridge> Eli> I understand, and I would love this. However, with many of the socialized healthcare systems collapsing, there will be immense pressure to ration healthcare based on genetic data and perceived ROI of the treated patient to society. So I can understand people who are hesitant to give up their data that could impact their and their children’s benefits. Scrubbing genetic data is for political, not
23:30 < hprmbridge> Eli> scientific, reasons.
23:31 < fenn> why is there no "flat tax" health insurance advocacy
23:31 < fenn> everyone who is alive needs health insurance, right? it's not your fault if you have X Y Z disorder (unless it is)
23:32 < fenn> i'm pretty sure genetic discrimination for health insurance is already illegal
23:33 < fenn> da gubbmint is already taking mandatory blood samples from newborns (taken for health reasons) and using this for "law enforcement"
23:33 < fenn> at least we could get some good out of this
23:37 < hprmbridge> Eli> Yes it’s illegal. But the person I spoke to I’m pretty sure her family was from China and she had a very different perspective on trusting the government. And, I can’t say I would completely dismiss it based on some people f the things I see the US government do. Doctors probably already discriminate on how long to work on patients at the individual level based on personal bias. A elderly homeless
23:37 < hprmbridge> Eli> criminal probably gets less treatment than a child, ceterus paribus. It wouldn’t take much to entrench that bias via legal means. Especially when money gets tight.
23:39 < NewtonTreendy> what do you guys think of "if reproduction was controlled in all countries, we could have perfect fair healthcare."
23:40 < fenn> https://apnews.com/article/michigan-newborn-blood-spots-constitution-d3db6a3d09ae65d7c7054a0f483c6833
23:44 < fenn> Eli, yes we should prepare for unintended consequences, but we should plan for success
23:44 < fenn> don't plan for failure, that's a sure way to fail
23:45 < fenn> without gobs of health-genetics data the US will continue to fall behind in healthcare quality and cost effectiveness
23:46 < fenn> not unrelated to your previous point, there are many new drugs that work fine in 99% of the populace but have horrible side effects in that last 1% due to genetic differences
23:46 < fenn> we have to identify and understand what went wrong
23:46 < fenn> as it is, they just ban the new drug, and everybody loses
23:48 < fenn> also, the government doesn't (yet) provide health insurance. it's important to keep the distinction between private companies with (secret) data and governments with (secret) data
23:49 < fenn> your example of discriminating against an elderly homeless criminal is actually standard practice and it's called "triage"
23:50 < fenn> "Triage is usually relied upon when there are more injured individuals than available care providers"
23:50 < fenn> normally this is only supposed to happen during disasters (an earthquake? in california?! who could have planned for this!)
23:51 < fenn> a national collapse in healthcare funding due to shifting demographics and falling tax income would have the same "ethically justifiable" result
23:52 < fenn> psst nobody tell kanzure he's contributing to the common good by trying to make more children
23:54 < hprmbridge> Eli> I agree. Any rational economist would understand this would save a lot of lives/money. But tax payers are not rational. That’s where the problem lies.
23:55 < fenn> i would like to see a relaxation of the current "zero tolerance" policy of no human experimentation. currently it's very difficult both to get and provide unproven treatments, and as a result many people die needlessly
23:55 < hprmbridge> Eli> A guy just shot an insurance CEO. And I’m not 100% convinced the shooter will be found guilty by a jury of his peers. That’s how much emotion there is around this topic.
23:56 < fenn> i'm going to consciously refrain from commenting on this topic
23:56 < fenn> health insurance is too expensive and unreliable because healthcare costs too much. everybody is looking at the wrong end of the problem
23:57 < fenn> i just bout a $4 tourniquet on ebay. i'm surprised this is legal. if it were like any other piece of lifesaving medical equipment it would cost thousands of dollars
23:58 < fenn> and i wouldn't be allowed to own it
23:59 < fenn> fortunately china is sequencing the crap out of everything and everyone
23:59 < fenn> will they share the data?
--- Log closed Mon Dec 23 00:00:07 2024