[extropy-chat] RE: [futuretag] QALY pharmacoeconomics

[Rafal Smigrodzki]

Can't this kind of stuff stay on wta?

Rafal

On 12/18/05, Hughes, James J. <james.hughes at trincoll.edu> wrote:
> Interesting question, albeit not very coherently stated.
>
> Some observations:
>
> QALYs are a tool for assessing the social utility that can be generated
> by alternative investments of public monies. It can certainly be
> extended to include the social utility produced by both public
> expenditures and regulatory efforts, which are also an investment of
> sorts. However your posts seems to assume that public regulation is only
> to be judged in terms of how many benefits they deny the public access
> to. I'm willing to concede some of that, but I think there is a much
> stronger case on the other side: in general, food and drug regulations
> keep the public from wasting money on unproven, ineffective and
> dangerous drugs, "natural" and otherwise.
>
> For instance, millions of women took estrogen replacement therapy and
> then found out that it increased their risks of cancer and heart
> disease. In retrospect, it would have been nice to have required a large
> scale double-blind clinical trial of HRT before it was prescribed rather
> than after.
>
> As for "natural" therapies, a major study of milk thistle just found it
> ineffective in reducing liver disease, and St. Johns wort has been shown
> to be ineffective in treating depression.
>
> The reason that QALY calculations have not included "natural" treatments
> hitherto is because once we know, through clinical trials, what efficacy
> a treatment actually provides then its not "natural" anymore - its just
> medicine. As we've seen with Vioxx and many other drugs, however, even
> the process of clinical trsting is very problematic.
>
> Although the process and science of clinical trials can be much
> improved, if anything, public health and QALY maximization would be
> improved by more aggressive food and drug regulation, not less.
>
> What keeps the FDA from acting in the public interest is the influence
> of the pharmaceutical and health supplements industries, pursuing their
> various forms of lobbying and influence, increasingly naked and
> unashamed under the Bush administration.
>
> So if your real concern is QALY maximization, let's start with policy
> questions such as:
>
> - what QALYs are being produced by investing in the administrative
> overhead of 1500 private insurance firms (and the administrative
> externaltiies they impose on hospitals and doctors' offices) versus
> investment in something like universal health insurance in the US?
>
> ------------------------
> James Hughes Ph.D.
> Executive Director
> Institute for Ethics and Emerging Technologies
> http://ieet.org
> Williams 229B, Trinity College
> 300 Summit St., Hartford CT 06106
> (office) 860-297-2376
> director at ieet.org
> _______________________________________________
> extropy-chat mailing list
> extropy-chat at lists.extropy.org
> http://lists.extropy.org/mailman/listinfo/extropy-chat
>


--
Rafal Smigrodzki, MD-PhD
Chief Clinical Officer,
Gencia Corporation
706 B Forest St.

Charlottesville, VA 22903

tel: (434) 295-4800

fax: (434) 295-4951



This electronic message transmission contains information from the
biotechnology firm of Gencia Corporation which may be confidential or
privileged. The information is intended to be for the use of the
individual or entity named above. If you are not the intended
recipient, be aware that any disclosure, copying, distribution or use
of the contents of this information is prohibited. If you have
received this electronic transmission in error, please notify us by
telephone (434-295-4800) or by electronic mail
(fportell at genciabiotech.com) immediately.