A couple of weeks ago, STAT covered Michael Laufer, a mathematics lecturer, who was claiming that he could make Sovaldi from a homebrew method with the reactor pictured above. (You may enjoy friend of the blog Josh Bloom's post on Dr. Laufer's claims.)
Through random clickings, I found this video of Dr. Laufer talking about democratizing pharmaceutical compound synthesis. It's an... interesting talk, but when you're talking about making API and considering TLC as sufficient proof of purity.... maybe you have some more thinking to do.
(I have a bunch of jumbled thoughts about people like him (and also Dr. Vinay Prasad's comments in the STAT article.) But if I were King of Pharma (and it's a good thing I am not), it seems to me that I would be making sure that the whole world knew that there are myriad different ways to get hold of the prescription drugs you need (patient assistance plans, etc..), and that I would be setting the price of drugs somewhere the threshold where politicians broadly begin using you as a political football, and interested amateurs like Dr. Laufer begin to get involved. But hey - maybe the problem is that, no matter how low the prices are set, we're always gonna be someone's target. Hard to say. Readers?)
One more modest proposal: In addition to not pricing drugs high enough to become a political football, treat employees well enough that they'll want to defend the industry. My mom was a passionate defender of the pharma industry as a Merck employee in the good old days (70s, 80s, and 90s). I doubt someone who got Pfizered will be willing to speak up when some politician trashes Big Pharma today.
ReplyDeleteAs for TLC, I was surprised to find it still in use during my time at a generic drug company several years ago. I was under the impression that it was an undergrad teaching lab tool that "real" chemists didn't use.
Pharma is always going to be a target. People believe they have a right to any and all health treatments that exist, and cost shouldn't be an issue (I make no implications in that statement). Although healthcare costs are rising across the board, pharmaceutical companies are "corrupt Big Business", doctors and hospitals are benevolent caretakers.
ReplyDeleteI'm currently going through my first true experience deep into the healthcare system in my life (wife is pregnant). I've seen how much treatment from the hospitals/doctors is just wringing as much cash as possible from patients/insurance companies and not medically necessary. Yesterday I went to the dentist. They tried to force me to get my yearly X-rays, not because anything has changed or they were necessary, but because they know that is what my insurance company allows. I politely declined.
It's about feelings, it's not about costs. All are trying to make a profit. One group is perceived very differently than the other. Not that I can say Pharma has done itself any favors in that regard.
If I were king of pharma, there would be legions of people working to make the public understand how much the costs of those non-prescription-drug parts of healthcare are increasing.
DeleteAlthough his goal in pharma industry is completely opposite to Martin Shkreli's, at least in that STAT article he comes off as just as unlikeable person.
ReplyDeleteLife is tough - if you don't have it nothing else matters, and if it feels like hell on earth, nothing else matters, either, so people are not going to be entirely rational about health care (whose job is to preserve it or at least to make it better or longer). Even if it were transparent (which might be one of things to do to make it more efficient - sunlight, disinfectant, and all that - but isn't done because there's lots of money in it for someone to make it opaque), there probably won't be enough money for people to get what they want (maybe even not need) and so people will argue and feel angry about what is and is not paid for.
ReplyDeleteSince health (on our terms, though) is so important, and the amount of knowledge needed to fix it so high (and thus the price tags for it high as well), it's always going to be a football, particularly with our desire for control (health care would be cheaper if we didn't do unhealthy things, but life would be less worthwhile for some and people don't like being told what to do). The only thing to hope for is that you don't do things that make you look to yourself as bad as you look to other people - conscience is a good idea. Conscience doesn't make you money now, though, and if that's all the people holding your stock and your money think, then you're stuck. Hence, pharma's problems, in part.
I imagine getting rid of the people here has the cost that people in the federal government no longer care so much about defending pharma - if it doesn't provide jobs and thus voters, they don't feel the need to publicly defend it (unless they get lots of money).
I have a few thoughts. First of all, I hate this 'hacking the Matrix' tech bro crap. You don't need a computer to do a recrystallization: get real. And that's all I saw him even pretend to do. Sure I believe he ran the reaction, or had somebody else do it for him, maybe even his fancy computer toy did it, but where did his reagants come from? Did he go dumpster diving with some freegans and find the bottle of tetrakistriphenylphosphinopalladium(0) next to the only-slightly-expired lettuce? I'm surprised nobody has said it yet, but I think this guy is full of it. His computer toys are at best a distraction to the fact that the world is full of chemists and most of us could make all the life-saving drugs anybody would ever need, but it's not trivial: it's a lot of lot of lot of steps between things you can find, like, on or in the ground, and the reagants he is using to make Daraprim. The problem is that The Man will not only refuse to employ us to do that, but will also gladly prosecute us should we do it on our own.
ReplyDeleteOf course Dr. Anarchy here knows that, but he thinks his computer will let him download away the problem. Hacking the Matrix, sure your code runs on the mainframe of reality itself, so some people believe. They ought to turn off the computer and go outside sometime. The jerks building ever-more-elaborate 'apps' that consist of a button to summon a servant from the plentiful pool of highly-skilled unemployed people and they get a cut and their bank balance starts zooming upwards: they aren't hacking reality, they're buying shares of an oppressive system on margin. Reality cares not for such antics. Here's 2 beakers and a funnel and a hotplate and some coffee filters, if you can't recrystallize something you probably failed chemistry class. Or at least, should have failed chemistry class.
Compare NurdRage's epic Daraprim videos. Dude was demonstrating that you really can make it from common over-the-counter substances, if you work really hard and think really hard to do it. And he has skills. Does he have a nice six-figure job somewhere? Of course not, that's kind of The Problem isn't it? He needed sodium methoxide for his last step but it's not like Sigma Aldrich sells to 'some guys basement lab'. So he made it out of sodium metal and automotive methanol. Whence the sodium metal? Cooked up magnesium and lye in a soup can, separated the slag by refluxing in dioxane, and viola. Whence the dioxane? Dehydration of antifreeze. And that's the easy part there. The whole synthesis is like that, it's entirely epic. I mean, chemist vs. computer guy, no contest here. One guy really does it. The other guy farts around with a fancy computer setup to hint that he could demonstrate something that a real chemist can do in a bucket. One guy did it and told everybody how he did it, in enough detail that someone skilled in the art could easily reproduce it. The other guy waves his hands and solicits investors to fill in all those petty details which are actually all the work. He's an anarchist, helping the common man? I can't believe that, because he acts so much like a tech'bro.
I do think this relates to the central issue of Chemjobber though: there are lots of us ready and willing to do work which obviously really does need to be done and is in great demand. But many of us don't manage to land in a situation where we can do just that. The reason is that chemists can't just, like, chem, the PTB do not allow it. This takes away power from us and our profession and gives it to someone else. Meanwhile, well, go look at the Amazon reviews for aquarium tetracyline. "My fish had pneumonia, but no health insurance. This helped my fish get over it!" Forget the fancy computer toys. Go start a pet store.
This. I hear so many tech bros talk about doing organic synthesis at home, but they aren't interested in talking to real chemists. I tried to express my interest in working for one of them since I have years of experience working with the FDA, they never replied.
DeleteOf course drug discovery is it's own thing, but generics like Daraprim really are monopolized and if nothing ever really goes generic, I sympathize with the guys who want to churn them out. But these fantasies of chemist-free chemistry are just dumb. And yes, I know homemade meds probably should not be ingested, especially without actual analysis: but people do it every day anyway don't they? Sometimes with fatal results.
ReplyDeleteI used to work for a company with a peptide in trials for ED. One day, I looked through some discussion boards where people described sending the sequence and a credit card number to a contract synthesis shop, and then doing home trials. More than a decade later, I still wonder how these people decided it would be a good idea to take not-for-human-use material and dose themselves.
DeleteIf this is about bremelanotide, the urge is understandable, but it is definitely an example of short-term thinking outweighing long-term consequences.
DeleteWell, you learn something every day: I had no idea people were taking illicit boner drugs. I was thinking more about idiots overdosing on experimental elephant tranquilizers, that's leaving a trail of bodies for sure.
Delete