Former Intel CEO Andrew S. Grove says the pharmaceutical industry could learn a lot from the computer and chip businesses.
Comment: Learn more about investing by visiting investmentsforme.com
Comment: I suppose this topic has now gone cold. But for any latecomers (and definitely for Andy Grove himself) you can look at the new article by Paul Albert over on Bacteriality.com:
http://bacteriality.com/2007/12/11/opensource/
I think Paul has a very good point. The 'correct' model for the medical research community to use is not the Semiconductor Industry one, although that was a good first take on the subject -- it is the Open Source Software movement method that should be followed. Paul goes on to give an example of an Open Source Clinical trial as well to prove his point. (The point being that the trial is actually finding cures -- and quickly). If other clinical researchers (especially ones with deep pockets) could take the info and run with it for other illnesses (in parallel with the current ones being worked on) who knows how quickly a lot of them could be also put in the 'cure' bin? There is no reason right now that other researchers in say, MS, or ALS or Alzheimers fields could not also jump on this same bandwagon and attempt similar trials using the same protocol -- they just have not and will not give it a try -- it is hard to turn that giant medical establishment tanker in a new direction very quickly. Sad but true.
Comment: sorry:
http://pdpipeline.org
Comment: I'm going to hope the grinding halt and silence of the Andy bashing bloggers is a good sign. Here are a few minutes of clips. See them on left under What's New...
http;//www.pdpipeline .org
Comment: Well here we go again - something pulled because it might work.
Comment: It may take some time, but worth reading Grove's speech transcript. Go to www.pdpipeline.org and click on What's New? in left side menu. (grab a cup of coffee)
Comment: Maybe he would have. What is it?
Comment: deepgroove: Maybe you are right. What is it? Personalized medicine of some type?
Comment: Good point except if Andrew did a bit more reading, he would have found that all drug companies are now beginning to use what is called pharmacogenomics to stratify patients into responders and non-responders to get around this problem with averages. Keep in mind that it takes 10-12 years to develop a drug, so those "new" drugs surfacing now are actually based on a decade long science.
Comment: Where did all of the comments go, Newsweek, Inc.?
Comment: I've worked in the biotech industry for many years, and have always been envious of the pace of change in the IT industry. If every commercially available hardware/software system had to be approved by the FDA and if every hardware/software failure could result in a life-long disability or death, I think that the pace of change in the IT industry would have been much slower. If every new computer system had to be compared to a "gold standard" created in the 1960's (say an IBM 360), I doubt that I'd be having iPhone envy right now. Mr. Grove is absolutely right to challenge the current system for developing drugs, and I hope that he's successful in his push for change. I agree with many of his comments, but the problem is much bigger than the science. It's all of us, and an unwillingness to acknowledge or accept even the lowest levels of risk. Also, molecules aren't discarded, but without patent protection, it's hard to recoup the costs of the clinical trials necessary to get approval of a drug. Thalidomide, the classic teratogen from the 50's and 60's, was approved by the FDA last year for treatment of multiple myeloma, so new life can be given to old molecules.
Comment: Mr. Grove - please read about Liatermin / artificial GDNF. The rights are owned by Amgen, and Amgen refuses to use it and refuses to release it to other researchers for further testing on humans.
Amgen won't say why they refuse to release this lifesaving treatment. If they believe it doesn't work - OK - just release it to researchers who want to continue testing and let us resume clinical trials on humans. There will be plenty of volunteers for new clinical trials using Liatermin, I can guarantee that.
Why does Amgen continue to hold onto those patents (and not use the treatment) when Liatermin could save my life and yours, Mr. Grove?
We need answers now. Maybe you can get them.
Comment: Let's not heap all the blame on the pharma companies--there's plenty left over for the FDA. The FDA's regulations have created a disincentive for the pharmas to bring a new drug to trial unless they are convinced it will be a winner because it's a REALLY expensive process. And the FDA tells doctors and patients what they may or may not do with a given drug. This nanny-state approach results in a lack of innovation from the companies, and removes the consumer from having any involvement in or input to any part of the drug development process. That being said, another issue is that the pharmas are incentivized to develop only drugs that patients have to take long-term to manage conditions--not to cure them, because then they'd stop taking the drugs. Kudos to Andy Grove for questioning the conventional wisdom and shaking things up!
Comment: We people who suffer from Parkinsons are so damn nice. We're plucky and game, charming and self-deprecating; we go on our walks and do our fundraisers. And the biomedical establishment rewards our niceness by smiling and giving us -- what? Another form of L-Dopa? Agonists whose side effects caused Canada to forbid people taking them to drive?
When I was diagnosed at age 47 with Parkinsons, I was told that something new and exciting would most likely be available in 10 years. A few years later, when nothing much had happened, My doctor told me that she was hopeful about something in the works called GDNF.
it's been 10 years and the exciting development is that Amgen has ceased clinical trials of GDNF, refused compassionate use of the drug to patients who put their well being on the line in early studies, and, worst of all, extended its patent on GDNF so that others cannot work with it. Amgen claims to be protecting patients from potentially harmful effects. But the company has yet to provide compelling evidence of these effects. And if GDNF is harmful, and therefore useless, why extend their patent?
Andy Grove is a smart and very tough man. (Read his autobiography!) If he gets mad enough at big pharma, maybe he can take us all with him. We have the numbers. We just need to be willing to get mad, really mad, and not be quite so nice.
Comment: We people who suffer from Parkinsons are so damn nice. We're plucky and game, charming and self-deprecating; we go on our walks and do our fundraisers. And the biomedical establishment rewards our niceness by smiling and giving us -- what? Another form of L-Dopa? Agonists whose side effects caused Canada to forbid people taking them to drive?
When I was diagnosed at age 47 with Parkinsons, I was told that something new and exciting would most likely be available in 10 years. A few years later, when nothing much had happened, My doctor told me that she was hopeful about something in the works called GDNF.
it's been 10 years and the exciting development is that Amgen has ceased clinical trials of GDNF, refused compassionate use of the drug to patients who put their well being on the line in early studies, and, worst of all, extended its patent on GDNF so that others cannot work with it. Amgen claims to be protecting patients from potentially harmful effects. But the company has yet to provide compelling evidence of these effects. And if GDNF is harmful, and therefore useless, why extend their patent?
Andy Grove is a smart and very tough man. (Read his autobiography!) If he gets mad enough at big pharma, maybe he can take us all with him. We have the numbers. We just need to be willing to get mad, really mad, and not be quite so nice.
Comment: It appears that Andy Grove???s comparison of the technology industry to the drug development process has raised quite a stir, as well as confusion as to what I believe he is really trying to say.
The commonality in the technology industry and the pharmaceutical business is that we are dealing with products that can improve the quality of life for people. However, the very distinct difference is that the consumer has a voice in industrial production; we hear only the company???s voice in the pharmaceutical business. An abrupt cessation of a pharmaceutical product can mean a worsening of a patient???s condition and extreme mental anguish from having put one???s faith in an industry where some companies don???t seriously consider the human element.
How many Edisels did it take for the manufacturer to cease production of that product? Yet, L-dopa (levadopa with carbidopa added as an antiemitic) has been the gold standard of treatment for Parkinson???s for 40 years, in spite of the fact that it doesn???t run as smoothly as a Cadillac. In fact the side effects of this mainstay treatment often results in side effects as bad or worse than the disease itself. Where in corporate America would such a product be allowed to continue to hold its rank?
When Andy Grove says the continued production and forerunner of a product as inferior as the mainstay treatment for a disease that has been around since the 1800???s, I believe he is telling you that this would never fly in corporate America. I believe he is also saying that the pharmaceutical business, unlike corporate America, can exempt itself from many of the rules and regs because of their power structure. In Grove???s approach, there???s no room for juggling statistics or dropping a product if it isn???t going to be a blockbuster. If the drug development process took note of the success of Grove by running a tighter ship of accountability with high expectations,I am convinced we would have better treatments for Parkinson???s. In doing so, we would most likely find the gateway to finding better treatments or maybe even a cure for this and other neurological illnesses.
Comment: Considering how many people have Parkinson's, it's incomprehensible that there is no more advance than there has been with finding a cure, or at least new treatments for symptoms. I belong to a website that I hope you would come visit - http://www.patientslikeme.com. You will find me in the Parkinson's section, but there are also communities of ALS, AIDS, and MS patients.
Comment: Grove is absolutely talking nonsense. You can't compare an engineering driven product development process where failure means your product is too slow, hot, big, etc. to a science driven process where
product failure means IT DOESN'T WORK! Or worse, your sick patients get sicker. In the semiconductor
market your can quickly measure your results. In the (necessarily) regulated medical marketplace it can
take years to do the same thing.
Comment: I think we are missing the point. The point being is that bio-medicine is in "a rut". Why is it that we were better at it before? Why is it that a small biotech company came up with a potential mechanism to treat a specific type of genetic mutation, not a specific disease but a re-usable drug that deals with a genetic mutation type (PTC Pharmaceuticals and it's PTC124 drug candidate currently in Phase III clinical trials). Where are the big pharmas? Why aren't they discovering these drugs?
Comment: Mr. Grove, I would believe that in your business, as in many other (Pharma included) companies or industries you did/do studies on the strengths and weaknesses of the processes being implemented to reach the ultimate goals. Why doesn't the Parkinson's world put their monies together and hire a think tank, like the Rand Corporation, to find the strengths and weakness of the research being employed to find a cure? Once done, we weed out the weak sticks, put our money on the strengths, and make major steps to FIND THE CURE. There is SO much money going into research without any real accountability, it astounds me that the really bright people haven???t concluded that WE must resolve this, not the Pharmaceutical or other bodies we have looked to and looked at for all these many years. Including you, there are some very bright people with Parkinson???s who have the talent and wherewithal to take on a project like this. What say you?
Comment: I think Mr. Grove knows this, but the world needs to know that the Parkinson's world has received old drugs with new names each time a patent expires. Even more interesting perhaps is that the new drugs contain Aspartame, a chemical that ,I think most scientists would agree, should NOT be used in a fragile brain of someone with a neurological disease, much less be used in a healthy person's brain.
Comment: Rebecca, e-mail me and I'll see if I can get you in touch with a former MS patient who has successfully used glyconutrients .
bridjta@comcast.net
Comment: Thank you, Mr. Grove! We have been waiting to hear from you. Bravo!
Have you heard of Liatermin? In 1994, Amgen bought Synergen Corporation, and with it the patent rights to its synthetic GDNF. It was tested in Phase I and Phase II trials, and trial participants in both the UK and US got their lives back while receiving this treatment. But in 2004, Amgen abruptly halted its Phase II trial and withdrew treatment from participants in all of the study groups.
Since then many of the US trial participants took Amgen to court twice to compel them to provide Liatermin for compassionate use to them (as OK???d by the FDA). Amgen has steadfastly refused, and continues to refuse to sell its patent to other researchers so they can continue trials on humans.
Here is a potential life-saving treatment for Parkinson???s which is being withheld by a single drug company ??? when there are other researchers who would gladly resume testing. This makes no sense ??? either scientifically or financially.
(reposted to get rid of ??? errors)
Comment: Thank you, Mr. Grove! We have been waiting to hear from you. Bravo!
Have you heard of Liatermin? In 1994, Amgen bought Synergen Corporation, and with it the patent rights to its synthetic GDNF. It was tested in Phase I and Phase II trials, and trial participants in both the UK and US got their lives back while receiving this treatment. But in 2004, Amgen abruptly halted its Phase II trial and withdrew treatment from participants in all of the study groups.
Since then many of the US trial participants took Amgen to court twice to compel them to provide Liatermin for compassionate use to them (as OK???d by the FDA). Amgen has steadfastly refused, and continues to refuse to sell its patent to other researchers so they can continue trials on humans.
Here is a potential life-saving treatment for Parkinson???s which is being withheld by a single drug company ??? when there are other researchers who would gladly resume testing. This makes no sense ??? either scientifically or financially.
Comment: Mr. Grove questions the pace and goals of discovery and development in biotechnology/pharma, not the mechanisms. He is right in asking what are the reasons and the costs that support the current approach to new drug development. The comparison to the semiconductor industry may be somewhat farfetched but his questions are perfectly valid. I have worked in biomedical research for years, both in academia and in industry, and I know that, unfortunately, research managers have their own agendas. "Not Invented Here" is the rule of the thumb for rejecting new ideas coming from researchers who try to make a difference. Even the entry level scientist firmly believes that he is in competition with the guy at the end of the hallway. Companies will sit on patents and undeveloped products unless their predicted market value is more than USD 300m. Cooperation, which may help achieve breakthroughs, is generally not an option as it would entail sharing potential fame and credit for an achievement and that is generally out of the question.
Comment: Mr Grove questions the pace and goals of discovery and development in biotechnology/pharma, not the mechanisms. He is right in asking what are the reasons and the costs that back the current approach to new biomedical therapy development. The comparison to the semiconductor industrry may be somewhat farfetched but his questions are perfectly valid. I have worked in biomedical research for years, both in academia and in industry, and I know that, unfortunatelly, research managers have their own agendas. "Not Invented Here" is the rule of the thumb for rejecting new ideas coming from researchers who try to make a difference. Even the entry level scientist firmly believes that he is in competition with the guy at the end of the corridor. Companies will sit on patents and undeveloped products unless their predicted market value is more than USD 300m. Cooperation, which may help achieve breakthroughs, is generally not an option as it would entail sharing potential fame and credit for an achievement, and _that_ is out of question.
Comment: Government regulations and past experiences with medical disaster (see: thalidimide) would seem to be a more pertinent follow-up question. Yes, it's frustrating to consumers to hear about potential breakthroughs in research that never make it in human trials. But wouldn't it be worse to see side effects cause disasters in yourself, your family, or your friends?
Comment: I applaud the efforts of Mr. Groves, unfortuantely he's facing a industry completely controlled by big pharma and protected by the government. Advances in medicine are underway all of the time by the physics-minded technology sector.....the problem is that any advancements that do NOT involve big pharma are attacked and/or discredited to protect deep pockets. Americans need to wake up soon...or continue suffering!
Comment: I fully appreciate Mr. Grove's position...I only wish more Americans would look into that absolute nonsense that happens to biotechnology companies when attempts are made to advance medicine without the pharmaceutical companies. Nothing short of gestapo tactics are used by the government to control any advancements in medicine that do NOT involve big pharma!. Americans better wake up soon
Comment: Mr. Grove needs to read up on the science of complexity. The human body is many orders of magnitude more complex than a transistor, so he's not comparing apples to oranges, but orangutans to oranges! Medicine is so hard to advance because it's so hard to isolate the variables. On top of that there's the placebo effect, which never arises in semiconductor research. The computer industry has relied upon the advances of two devices: the computer chip and the hard drive, and has a very limited number of side effects to protect these devices from, whereas side effects abound in medicine, even in medicines we *think* we understand, such as aspirin. Mr. Grove certainly knows how to build a computer, and I respect his expertise in that area. But until he learns how to build a human--or even a single-celled organism--I won't consider his opinions any more valuable than the man-on-the-street's.
If he wants to complain about anything, he should talk about the slow progress in battery technology. The energy density of batteries has not seen the orders of magnitude increases we've seen in transistors per square millimeter. Electrochemistry is closer to his area of expertise, so he might have something more valuable to say there.
Comment: Two points:
1. There is no mechanism in the US for translational research in this country beyond big pharma, which is not willing to risk dollars on unproven technology for diseases that won't guarantee astronomical payouts (like heart disease and diabetes). Therefore, the so-called orphan diseases are solely dependent on philanthropy to take academics' research and try to move it into the clinic..
2. I'm sure people are saying, "But what about the NIH?" NIH funding has remained completely flat for the duration that Bush has been in office, and it is now to the point where we are only funding 9% of the grant applicants, and we are renewing grants at 70% of previous levels. We are failing to nurture an entire generation of young scientists in this country, and they are infrastructure surely as road and bridges are.
In the year and a half since my son has been diganosed with Duchenne Muscular Dystrophy (another disease with a pin-pointed cause and no new treatments in over 20 years), I have been amazed to find out that all of the major breakthroughs are coming from Europe and Asia. My son would have a better chance at early treatment if we were Dutch or British, so those of you who consider the US so superior in all ways should look beyond nuclear stockpiles and flag waving.
Comment: "But in pharma, if a clinical trial doesn't work--which means the average of all the patient responses is not better than the average of a placebo treatment--they just throw [the drug] away, when in fact the averages may hide stuff that did work, and something that made patients different [such as genetics]. I've never heard anyone talk about the opportunity costs of a good drug being thrown away. But a good drug wrongfully convicted means the loss of benefits goes on forever."
....yes Mr. Grove, and that is exactly what has happened to a generation of Parkinson patients. Good Drug No Future ......
Comment: Bravo, Andy!! Not one new drug since my wife was diagnosed 10 years ago, only reformulations of the old ones. Big pharma won't change unless they see patent and profit potential which is tempered by the FDA's arcane rules and regulations.
Comment: Mr Grove shows the same misunderstanding of science that Bill Joy did when he suggested that science research into nanotechnology should end until it can be regulated. Comparing pharma with Intel is to compare science with engineering -- the two are truly incomparable.
Science begins with an immeasurably complex black box which must be slowly and carefully dissected before it can be understood. Pharma can't wait to do that, so it has to literally shoot in the dark to try to fix what *might* be broken. The microelectronic industry works with a white box in which *everything* is known about the device. As such, it's easy to make small changes will complete certainty as to the outcome.
Also pharma has to experiment on mice/rats/dogs/monkeys because they lack simulators on which they can test their ideas. Pharma experiments often take months/years vs the minutes/hours that Intel enjoys. And unfortunately, most of the time the drug's target mechanism is different in animals than in man, making the experiments prone to misinterpretation and complication.
Engineering may be hard, but science is nearly impossible.
Comment: No, Grove is right. There can be commonality in the biomedical industry that could be reused. The mechanisms of diseases are quite common, especially genetic disorders. You have X types of mutations. Where they lie determines the disease. The biomedical industry has the ability to piece this together. They have done so with rodents rather well. What is missing and has been missing for years is translational research. Taking the discoveries from mice to men. This was and still is a rather big gap. The NIH is doing what it can to close this gap but big pharmas need to get involved if we want to see any major progress in closing this gap. They are just not willing to risk the money. It is easier to tweak an existing drug and get a new patent.
Comment: "something that made patients different [such as genetics"
Uh, andrew, everyone is exactly the same.
Comment: Grove cannot compare the pharmaceutical industry with the electronics industry - at least not rightly so. The growth in the electronics industry is due to the advances in transistors. Really it is these transistors that underlie the whole industry. Using the learning effect theory, these are going to become easier and easier to produce the more of them that are produced. Think about how many billions of transistors are produced - no wonder they keep getting smaller and allowing such advances in electronics.
Compare this to the pharmaceutical industry. Research is done on an individual basis for each disease. A cure is not a simple transistor, but rather, it is based on a complex problem. It takes time to discover all the interactions between complex drugs and the complex human body.
Maybe there are problems with the pharmaceutical companies, but in a very basic sense, these two industries cannot be compared. This criticism, coming from a CEO of one of the most respected companies, is something that any undergraduate studying Operations Management can tell you is wrong.
Comment: This cannot be discussed with no mention of the legal climate around the medical industry. "The fundamental tenet that drives us all in the semiconductor industry is a deeply felt conviction that what matters is time to market, or time to money." I can just see Dr. Grove being bashed over the head with that comment in a court room or by a grandstanding politician in some ridiculous congressional hearing. Intel has had its share of courtroom battles over the years, but nothing that comes close to what pharmaceutical companies face. He makes very good points, and I tend to agree with him, but the two operating environments are radically different.
Comment: hello Dear Mr. Grove,
If we were machines - I have confidence that your corporation would have fixed us all by now...
I am an advocate for cures -
I was diagnosed in 1994 at age 31,
They have two extremely good alternatives to palliative meds - since L-Dopa Carbi-dopa - are certainly not cures at all...
Amgen had GDNF -they withdrew the drugs from the patient study,
by pulling a monkey out of their (back pockets) -I do know the men were getting out of their wheel chairs -
the study was done by the Morris K. Ufdall -doctors/ scientists at the University of Kentucky.
the similiar study in Bristol England had excellent findings the GDNF protein worked!
Dr. Michael Levesque at Cedar Sinai in LA, had great success with an adult stem cell transplant,and testified before congress - but the good doctor has not been approved for clinical trials - I know you are a man with a good mind for good business,
but bigpharma only thinks good business works with addictive /palliative drugs - Mirapex was not a good drug for many PD patients, but they aren't interested in patients being cured, just the dividends of big money being added to there bank accounts.
peace to your heart,
sincerely,
christena
Comment: Mr. Grove knows what he is talking about. The Parkinson's community is just waking up to the fact that throwing money at research will not find a cure for this debilitating disease. More effort needs to be applied on bringing forth the discoveries made in the labs to treatments for patients.
Brought together by the Internet, patients now can keep track of the progress of research. We can access the journals. We can communicate with researchers across the world. We know what the pharma companies are doing and we know that for many of them -- the bottom line is what really matters.
There was an effective treatment for Parkinson's being developed. It is called GDNF -glial cell line derived neurotrophic factor. Delivered by a pump infusion method directly into the brain it gave many clinical trial participants in the US and the UK their lives back. Three years ago, Amgen, the patent owner and sponsor of the phase II trial pulled the plug on further human testing and denied compassionate use (which was okayed by the FDA) for those who were already receiving treatment in the clinical trials. The results of their phase II trial are considered by many scientists as inconclusive due to differences in dosage and delivery system from the phase I trial. Further research was recommended.
Many patients believe that GDNF works, and it was the most hopeful treatment under development for those in advance stages. There is nothing else comparable available now.
Amgen hasn't continued the development of this treatment and wouldn't sell it to another company or researchers who are very interested in it. What an awful waste!
Comment: There is a small revolution starting in medicine already, and from a contributor who was also part of building the technology industry. Some of those same open-source concepts have been ported into solutions for diseases of aging and chronic inflammatory diseases now also clearly associated with cancers.
Unfortunately, status quo medical industry brick, mortar, and government regulation has stalled progress already revealed by molecular genomics and a ground-breaking pathogenesis. It is not researchers or their industry that should shoulder all the blame, but we ourselves for not demanding congressional acts that remove the barriers and pave the way for results with humans, in silico and in vivo, with full comprehension of the human immune system genomics and metagenomics. We, as an aging population (and we are all aging every day no matter how old we think we are), must demand and expect this new science to come to light now.
It will require legislation to move genomic clarity from sitting idly in regulation files because it is not yet recognized as evidence that surpasses failed but legally-approved murine models. The NIH and FDA might think to move slowly forward into the science of this century but instead strangles and stalls, full of rank and corps who must service the revolving door with personally safe but socially cancerous lack of action that hide blissfully behind a lack of demanding legislation to move them into this century.
We are all so familiar with the death sentence we see about us, we actually believe there is nothing that can be done so we let distractions of war and getting on with our daily lives stop us from the future we should bring. I'm with Andy in thought and purpose. I am recovering from a killer disease. Are you?
Comment: There is a small revolution starting in medicine already, and from a contributor who was also part of building the technology industry. Some of those same open-source concepts have been ported into solutions for diseases of aging and chronic inflammatory diseases now also clearly associated with cancers.
Unfortunately, status quo medical industry brick, mortar, and government regulation has stalled progress already revealed by molecular genomics and a ground-breaking pathogenesis. It is not researchers or their industry that should shoulder all the blame, but we ourselves for not demanding congressional acts that remove the barriers and pave the way for results with humans, in silico and in vivo, with full comprehension of the human immune system genomics and metagenomics. We, as an aging population (and we are all aging every day no matter how old we think we are), must demand and expect this new science to come to light now.
It will require legislation to move genomic clarity from sitting idly in regulation files because it is not yet recognized as evidence that surpasses failed but legally-approved murine models. The NIH and FDA might think to move slowly forward into the science of this century but instead strangles and stalls, full of rank and corps who must service the revolving door with personally safe but socially cancerous lack of action that hide blissfully behind a lack of demanding legislation to move them into this century.
We are all so familiar with the death sentence we see about us, we actually believe there is nothing that can be done so we let distractions of war and getting on with our daily lives stop us from the future we should bring. I'm with Andy in thought and purpose. I am recovering from a killer disease. Are you?
Comment: hello I was diagnosed in 1994 at age 31 and there was a chance of a cure, GDNF owned by Amgen but it worked too well, so they pulled a BS monkey studyout of their back pockets, their is also available Dr. Levesques adult stem cell operation - so far they have given us bad drugs such as the likes of Mirapex, with
horrid side effects -they could cure us, but palliative medicine is their bread and butter ...
if bigpharma had it their way we'd all be on drugs! yet these drugs do not cure -they are only palliative at best.
sincerely,
a young onset pissed off parkie...
Comment: Both Andy Grove's interview and most of the subsequent discussion misses the point. It is that medical community (includes doctors, researchers, drug companies) is a cartel and abides by a strict code of silence. Drug companies pick and choose research that suits them, and doctors only pick and choose the reasearch that suits them, if there is any research done to explore avenues that might not fit fit with pharamas and doctors' business model because who decides what research to fund? The standard conventional medical treatment for sleep apnea is CPAP machine and mask and it costs more than one thousand dollars and has made CPAP equipment manufacturing a billion dollar plus industry. In reality it can be treated by simple exercise of throat muscles like singing aloud for 20 minutes a day. No sleep specialist will tell you this because he can't charge $100 consultation fee for telling something as simple as that and will not get repeat visits from you. Computer revolution happened because the industry was open to new ideas and innovation from any source whereas medical community has a monopoly on healthcare and is not interested in innovation and finding simple solutions to problems.
A lot of research that medical community rejects because it does not fit their business model of treating people with expensive medicines and equipments is picked up by so called 'alternative' practitioners. There are numerous treatment modalities that cost a fraction of conventional treatments and are far more effective and backed by science that are practiced by 'alternative' practitioners and rejected by mainstream medical community. Treatment for Autism is one example that is 100% successful and is practiced by Dr. Bernard Rimland for over 20 years. Treatment for Schizophrenia as practiced by late Dr. Carl Pfeiffer is far more effective than mainstream psychiatric treatment. Alzheimer's disease and dementia is preventable and even curable in some cases by treating oxidative stress. All these treatments are rejected by mainstream medical community because they have a vested interest in not treating illnesses and just treating symptoms. Treatment for ADD (attention deficit disorder) is another example where treatments not supported by mainstream medicine are far more effective and rooted in science than Ritalin.
Comment: While I understand Mr. Grove's example of comparing drug development to the management of his life-changing computer chip development, a different perspective can also be presented when comparing the two. Information at peoples' fingertips, with the help of Intel, has resulted in it becoming almost dynamic. By the time a drug is developed. something else is learned, something better is presented. The treatment or the delivery method is obsolete before it gets to market, just like Ipods, cell phones, or technology in general, are always being 'improved'. This can be good in some cases; not good in others.
I like ducks though.
" People in labs trying to save the world, have barely interacted with a patient who has the disease they are trying to solve. Doctors, I mean specialists, are part of a team. How can we get them to realize this? They think they are superior. And pharmas, biotechs etc. wouldn't save their own family members if it wasn't economically profitable," she quacked.
Research cultural revolution. Do it or die.
Comment: Andy should try his hand at science sometime. It is disingenuous to compare the peer review system to medieval guilds. Maybe its the Parkinson's...
Comment: How quickly would Intel advance if there were hordes of lawyers waiting to pounce with class action suits over the FDIV bug, or if it could be driven into bankruptcy over non-factual claims about their products?
Earth to Mr. Grove: alas, science doesn't work like a corporation. Nature is sadly resistant to executive or Congressional Congressional decree.
Comment: The premise of the article is flawed, as is Mr. Groves understanding of drug development. I also believe Mr. Groves opinion is being colored by his condition; being effected by a greivous illness. If I had parkinsons, I would want to know when I could expect a treatment as much as Mr. Groves does.
The nature of drug discovery is much different than the nature of developing consumer products. Defective Intel processors irritate customers, and can even cost customers money and cause recalls (remember the FPU math fault in the original Pentium processor) . Defective drugs kill people - there is no recall for that. Drugs that fail in trials do not just get shelved. The drugs which fail trials are examined for use in other indications, or the science around the drug is expanded and new compounds are developed that may be more efficacious. Failed drugs are also sold to other companies that may see promise in them or alternative use.
A pharma executive can not tell if a drug will be safe and efficacious, that answer is in the hands of science or God - depending upon your persuasion. Any pharma executive that would step forward saying "by date x, our company will have developed, tested and marketed a drug to treat or cure condition y" would be a charlatan.
Comment: The premise of the article is flawed, as is Mr. Groves understanding of drug development. I also believe Mr. Groves opinion is being colored by his condition; being effected by a greivous illness. If I had parkinsons, I would want to know when I could expect a treatment as much as Mr. Groves does.
The nature of drug discovery is much different than the nature of developing consumer products. Defective Intel processors irritate customers, and can even cost customers money and cause recalls (remember the FPU math fault in the original Pentium processor) . Defective drugs kill people - there is no recall for that. Drugs that fail in trials do not just get shelved. The drugs which fail trials are examined for use in other indications, or the science around the drug is expanded and new compounds are developed that may be more efficacious. Failed drugs are also sold to other companies that may see promise in them or alternative use.
A pharma executive can not tell if a drug will be safe and efficacious, that answer is in the hands of science or God - depending upon your persuasion. Any pharma executive that would step forward saying "by date x, our company will have developed, tested and marketed a drug to treat or cure condition y" would be a charlatan.
Comment: The premise of the article is flawed, as is Mr. Groves understanding of drug development. I also believe Mr. Groves opinion is being colored by his condition; being effected by a greivous illness. If I had parkinsons, I would want to know when I could expect a treatment as much as Mr. Groves does.
The nature of drug discovery is much different than the nature of developing consumer products. Defective Intel processors irritate customers, and can even cost customers money and cause recalls (remember the FPU math fault in the original Pentium processor) . Defective drugs kill people - there is no recall for that. Drugs that fail in trials do not just get shelved. The drugs which fail trials are examined for use in other indications, or the science around the drug is expanded and new compounds are developed that may be more efficacious. Failed drugs are also sold to other companies that may see promise in them or alternative use.
A pharma executive can not tell if a drug will be safe and efficacious, that answer is in the hands of science or God - depending upon your persuasion. Any pharma executive that would step forward saying "by date x, our company will have developed, tested and marketed a drug to treat or cure condition y" would be a charlatan.
Comment: I do not believe timetables can be expected in the pharmaceutical industry, a medical product undergoes several processes which are not even part of the production phase, they are in fact part of the "invention" of the product. Maybe it is in fact important to support research and innovative techniques in order to achieve faster ways of health for the constant issues concerning human/animal wellbeing, and yes it is rather difficult to think how Parkinson disease's meds have not changed at all but perhaps it is due to the fact nothing better has come up yet. I think that it's way better to wait for a proper-engineered product than a fast-new-product which may be displaced in a couple of years by something with a better quality and manufacturing process.
Denisse E.
Comment: Why is the speed of progress so different in semiconductor research and drug development? Simple, drug hunters cant put out drugs that will kill their customers. Atleast they try their best not too. And who are you goint to test drugs that have hidden liabilities if not on rodents and non human primates? That takes time.
For example, how do you treat a disease like Alzheimer's that in a majority of the population takes 50 and more years to manifest itself? Ofcourse companies and scientists want to cure diseases. Its just not as easy or simple as Andrew Grove and others who have never attempted to cure a disease make it sound. Drug discovery is the most frustrating and hardest pursuits out their. ~s
Comment: Thank you Andy Grove - I couldn't agree with you more about the ducks. This research team works on this; that team works on that - but they don't talk or connect the dots enough. Some of the loudest quacking is coming from knowledgeable patients on the internet. Researchers should work on the cutting edge, but when they pass up treatments for shinier new technology., people die.
Paula
Comment: Of course there's something wrong with big pharma! The FDA and the pharmaceutical industry want to make sure nothing that works outside of their realm is ever used. Why? Because it would cut into their profits. This industry is about making money. Period. I personally don't use Western medicine unless there is no other option. Too many people believe "alternative" medicine is risky and ineffective. Truth is, the real risk is in drug therapies and the belief the way to stifle disease is to stop the symptoms, without regard to what is causing the symptoms. A classic example is cholesterol. Doctors want to lower it with drugs and with no regard to why it's elevated. That's as crazy as unplugging the pesky oil light in your car. As a Registered Nurse (for over 35 years, most of it in critical care units), I'm disgusted with what passes for "science". Newtonian physics has been old hat for centuries. It's time to step into Quantum physics and really learn something awesome.
Comment: yes, we do need a revolution in biotech, it needs to be like the rvolution that gave us the personal computer revolution that produced bill gates and steve jobs, they got us away from the "elites" that ran the big mainframe computers of that long-gone era and now we have the internet and cheap, powerful computers in just about every aspect of our lives. Did you know that before the human geneome project, that there were biologists that could not possibly see a reason to decode all the genes in humans and animals? What we need is a massive project, based on the principals of the current open-source computer software revolution (linux operating system) where medical knowledge is not owned by big publishers like Nature magazine and also the big phama companies, we need open source projects like MIT's biobricks where even high-school kids can design and assemble new biological parts like the computer nerds built their computers that launched the personal computer revolution and companies like novel, microsoft, intel, apple etc.
The computerization of biotech (called bioinformatics) is allready changing biology and also tying it to the phemonimal growth of computer tech (moors law), where soon, you could get your genes sequenced at your doctors office to beeter diognose your ills and personalize any medical treatmen needed. In the UK, they are funding the next step in nanotech research where the next generation of nano-engineers will use computers to design small nano-computers attached to small robotic nanoassemblers and be able to eventually do all storts of things like monitor cellular functions, diagnose deseases, fix cellular functions bakc to naormal, eliminate all deseases, make people young again..the sky is the limit, 150 years ago, the car, phone, televistion, computers, the internet, the moon shot were not even possible to properly imagine or even possible to plan for, now we are on the brink of the biotech/computerized nanotech revolution and this is a direct result of the chip revoution, the computer revolution that gave us peaple who could build computer chips with 10 billion (nano-sized transistor) components, program these systems with millions of lines of complex computer code, now we have the nano-tools to address the complexiity of the human body and its 3 billion codes of DNA and will soon ahve the capacity to understand how its components work, how to custom build its parts and replacement DNA parts, how to mod it, how to repair ist DNA parts indefinely etc, we will have come out of our current medical "dark ages" into a more rational age. Did you know that the Mprize is a prize for researchers to slow/stop/reverse aging in mice, then huamans (www.mprize.org), this is an example of the new thinking and how ordinairy people can contribute their ideas, monies etc towwards these goals.
Comment: Andrew Grove is right. There is something fundamentally wrong with the pharmaceutical industry. It is costing most stakeholders dearly. To illustrate, within about the last couple of years the pharmaceutical industry has thrown out Vioxx (Merck, pain), Bextra (Pfizer, pain) and torcetrapib (Pfizer, in late stage development for cholesterol management) because of increased risk for heart attack, stroke and death. These three examples alone cost tens of billions of dollars in lost development costs, lost sales opportunities and legal liability. In all three examples, the increased risk appears to have been mediated at least in part by increased blood pressure. Increased blood pressure is one of the most widely known risk factors for heart attack, stroke and death. Furthermore, blood pressure typically is measured when patients visit doctors ??? perhaps especially when patients participate in randomized clinical trials (RCTs). Given these conditions, how could the FDA and the industry inadequately account for the effects of increased blood pressure?
Part of the reason is that first generation RCT designs that are taught by universities, enforced by the FDA and followed by industry do not measure and test the benefit/harm of treatment with respect to health variables. Benefit/harm can be measured over time and across health variables starting at the level of individual patients. Instead, researchers perform statistical tests on health variables or changes in health variables and assess causality by using group comparisons. It is possible to measure and test benefit/harm when drugs are used to manage and control chronic functional health problems, which generally are recognized to consume over 75% of our health care dollars. This includes Parkinson???s disease ??? a problem apparently of some personal interest to Andrew Grove.
Here is another way to describe the problem with first generation RCT designs. They confound or mix up individuality with measurement error, dose with type of treatment, and treatment effects with how they are valued. Such confounding largely precludes personalized health care and drastically weakens the evidentiary basis for many decisions involving health care.
A software solution to these problems has been publicly available since at least 1992. However, this technology is disruptive. The heavily regulated pharmaceutical industry is highly resistant to disruptive innovation that involves RCT design.
This software is compute intensive. Helping to fix the pharmaceutical industry is a huge market opportunity for Intel and other information technology companies.
Comment: Andrew Grove is right. There is something fundamentally wrong with the pharmaceutical industry. It is costing most stakeholders dearly. To illustrate, within about the last couple of years the pharmaceutical industry has thrown out Vioxx (Merck, pain), Bextra (Pfizer, pain) and torcetrapib (Pfizer, in late stage development for cholesterol management) because of increased risk for heart attack, stroke and death. These three examples alone cost tens of billions of dollars in lost development costs, lost sales opportunities and legal liability. In all three examples, the increased risk appears to have been mediated at least in part by increased blood pressure. Increased blood pressure is one of the most widely known risk factors for heart attack, stroke and death. Furthermore, blood pressure typically is measured when patients visit doctors ??? perhaps especially when patients participate in randomized clinical trials (RCTs). Given these conditions, how could the FDA and the industry inadequately account for the effects of increased blood pressure?
Part of the reason is that first generation RCT designs that are taught by universities, enforced by the FDA and followed by industry do not measure and test the benefit/harm of treatment with respect to health variables. Benefit/harm can be measured over time and across health variables starting at the level of individual patients. Instead, researchers perform statistical tests on health variables or changes in health variables and assess causality by using group comparisons. It is possible to measure and test benefit/harm when drugs are used to manage and control chronic functional health problems, which generally are recognized to consume over 75% of our health care dollars. This includes Parkinson???s disease ??? a problem apparently of some personal interest to Andrew Grove.
Here is another way to describe the problem with first generation RCT designs. They confound or mix up individuality with measurement error, dose with type of treatment, and treatment effects with how they are valued. Such confounding largely precludes personalized health care and drastically weakens the evidentiary basis for many decisions involving health care.
A software solution to these problems has been publicly available since at least 1992. However, this technology is disruptive. The heavily regulated pharmaceutical industry is highly resistant to disruptive innovation that involves RCT design.
This software is compute intensive. Helping to fix the pharmaceutical industry is a huge market opportunity for Intel and other information technology companies.
Comment: You cannot compare the computer industry and the way things get to the market with the pharma industry. Playing with electronics is not the same thing as playing with people's lives. Most of the time it takes more than a decade for a single drug to even get to the clinical stage and then there is no guarantee that the drug will not fail. Fruthermore, research is driven by demand. Right now a lot of focus is being diverted to treating obesity releated illness because of the high demand. Maybe if people would take some of the responsibility then the researchers could focus on more important things. Moreover, if illness A only affects 1 out of 100 people and illness B affect 50 out of 100 people then of course there will be a greater research effort for illness B. Drug development is expensive and we are doing the best that we can with the resources that we have. By the way, academic research is necessary to drive the future because that is where the creativity lies.
Comment: One significant barrier to more rapid progress in pharmaceutical research is the litigious nature of the American healthcare system. Even established drugs, with known side effect profiles, are subject to massive suits and withdrawals if these side effects actually occur. Each and every drug potentially brought to the market needs to be evaluated not only for efficacy and safety but for the likelihood of being the subject of a capricious lawsuit designed not to protect consumers but to encourage settlements which enrich only the attorneys taking the cases.
Comment: Two societal barriers stand in the way of patient-genetics-specific pharma testing:
1. Scientific acknowledgement of the requisite differentiations leads in socially controversial group vs. group directions, i.e. if my forebrain neurochemistry is different from yours, what happens if the stepwise-next scientific conclusion is that my ancestral group is inferior to your ancestral group in intelligence, or superior in physical abilities?
2. Similarly, if anti-Alzheimers pharmaceutical X works on you but not on me, does that make you life-insurable until age 90, and me only until age 50? How about my ability to practice my profession? Suppose it's an anti-heart-attack drug...how about employment, or my driver's license?
It's not sufficient to call for changes without effectively addressing the sensitive barriers...and not by just wishing them away, or dismissing those who regard them as important.
Comment: Two societal barriers stand in the way of patient-genetics-specific pharma testing:
1. Scientific acknowledgement of the requisite differentiations leads in socially controversial group vs. group directions, i.e. if my forebrain neurochemistry is different from yours, what happens if the stepwise-next scientific conclusion is that my ancestral group is inferior to your ancestral group in intelligence, or superior in physical abilities?
2. Similarly, if anti-Alzheimers pharmaceutical X works on you but not on me, does that make you life-insurable until age 90, and me only until age 50? How about my ability to practice my profession? Suppose it's an anti-heart-attack drug...how about employment, or my driver's license?
It's not sufficient to call for changes without effectively addressing the sensitive barriers...and not by just wishing them away, or dismissing those who regard them as important.
Comment: I believe Mr Grove's comments are particularly insightful and need to be taken seriously. I believe his emphasis is on reform of the development process. If a drug fails, no efforts are undertaken to understand why the drug failed and valuable inductive information is lost. He knows what he's talking about -- if the electronics industry used the same processes the pharma industry uses, we'd still be using vacuum tubes.
Comment: I think Mr Grove's comments are particularaly insightful. If you'll read the article, his complaint is about the process, not technique. If the semiconductor industry used the same development process that the pharma industry does, we would still be using vacuum tubes.
Comment: This is a classic managerial attitude coming from someone who, I assume from his comments, has little practical knowledge of how drugs affect a system as complex as the human body. One protein involved in the onset of cancer, may also have a critical role in the growth and replication of cells as well as tens of other interactions in various other molecular pathways. Targeting that one protein may be a solution, but in the non-cancerous cells that surround it and somatic cells in general it may create havoc when necessary functions are shut down as a result. In addition, finding a novel solution can be quickly abrogated by redundancies in the body which resumes the negative function while making the novel solution obsolete. Iressa (Gefitinib) is one drug in particular that was very effective as a breast cancer treatment until people developed a resistance to it by using another pathway to perform the same function. Research is currently underway to understand WHY this happened the way it did. Comments like his may sound great, but in practical application there is little benefit and much to lose. There is something to be said about letting the ???wild ducks quack??? . Looking into the past, great scientific achievements have come from allowing passionate scientists. Frederick Sanger, a scientist working at Cambridge was literally kicked out of his lab after what the university considered years of fruitless research. He moved his lab into a hallway and continued his work. Dr. Sanger was eventually awarded TWO Nobel prizes for his work-- one for sequencing and determining the structure of insulin and the other for helping to invent a way of sequencing DNA. This research jumpstarted the genomic and proteomic research we enjoy today. While cures aren???t fast or easy to come by, it is due to the dedicated work of scientists who devote their lives to improving the plight of man.
Comment: Grove displays an incredibly shallow knowledge of drug discovery and development and the many important differences between biological science and chip engineering. While making a new chip involves building on many incremental advances and solving new ones. Developing a drug is 10% engineering (choosing well a potential drug molecule) and then 90% unveiling how it works in people - an unbelievably complicated biological system. In most cases the drug doesn't work and you lose your investment, often having to start anew. Setting goals like "xyz drug this year" is fantasy.
Comment: Grove displays an incredibly shallow knowledge of drug discovery and development and the many important differences between biological science and chip engineering. While making a new chip is building on many incremental advances and solving new ones. Developing a drug is 10% engineering (choosing well a potential drug molecule) and then 90% unveiling how it works in people - an unbelievably complicated biological system. In most cases the drug doesn't work and you lose your investment, often having to start anew. Setting goals like "xyz drug this year" is fantasy.
Comment: This is a classic managerial attitude coming from someone who, I assume from his comments, has little practical knowledge of how drugs affect a system as complex as the human body. One protein involved in the onset of cancer, may also have a critical role in the growth and replication of cells as well as tens of other interactions in various other molecular pathways. Targeting that one protein may be a solution, but in the non-cancerous cells that surround it and somatic cells in general it may create havoc when necessary functions are shut down as a result. In addition, finding a novel solution can be quickly abrogated by redundancies in the body which resumes the negative function while making the novel solution obsolete. Iressa (Gefitinib) is one drug in particular that was very effective as a breast cancer treatment until people developed a resistance to it by using another pathway to perform the same function. Research is currently underway to understand WHY this happened the way it did. Comments like his may sound great, but in practical application there is little benefit and much to lose. There is something to be said about letting the ???wild ducks quack??? . Looking into the past, great scientific achievements have come from allowing passionate scientists. Frederick Sanger, a scientist working at Cambridge was literally kicked out of his lab after what the university considered years of fruitless research. He moved his lab into a hallway and continued his work. Dr. Sanger was eventually awarded TWO Nobel prizes for his work-- one for sequencing and determining the structure of insulin and the other for helping to invent a way of sequencing DNA. This research jumpstarted the genomic and proteomic research we enjoy today. While cures aren???t fast or easy to come by, it is due to the dedicated work of scientists who devote their lives to improving the plight of man.
Comment: This is a classic managerial attitude coming from someone who, I assume from his comments, has little practical knowledge of how drugs affect a system as complex as the human body. One protein involved in the onset of cancer, may also have a critical role in the growth and replication of cells as well as tens of other interactions in various other molecular pathways. Targeting that one protein may be a solution, but in the non-cancerous cells that surround it and somatic cells in general it may create havoc when necessary functions are shut down as a result. In addition, finding a novel solution can be quickly abrogated by redundancies in the body which resumes the negative function while making the novel solution obsolete. Iressa (Gefitinib) is one drug in particular that was very effective as a breast cancer treatment until people developed a resistance to it by using another pathway to perform the same function. Research is currently underway to understand WHY this happened the way it did. Comments like his may sound great, but in practical application there is little benefit and much to lose. There is something to be said about letting the ???wild ducks quack??? . Looking into the past, great scientific achievements have come from allowing passionate scientists. Frederick Sanger, a scientist working at Cambridge was literally kicked out of his lab after what the university considered years of fruitless research. He moved his lab into a hallway and continued his work. Dr. Sanger was eventually awarded TWO Nobel prizes for his work-- one for sequencing and determining the structure of insulin and the other for helping to invent a way of sequencing DNA. This research jumpstarted the genomic and proteomic research we enjoy today. While cures aren???t fast or easy to come by, it is due to the dedicated work of scientists who devote their lives to improving the plight of man.
Comment: I find Grove's position to be naive and ill informed. There are huge, vast, differences between how a drug is developed and how an electronic device is developed. While there is much known about how to design and fabricate chips and improve them in that way, there is much about biology still to be learned and much to be done to understand how best to treat an illness. Hence the need for these so-called pointless animal experiments that don't lead anywhere. What would Grove prefer -- to test things in humans right away and see how they work? It's not like a piece of electronic equipment - if it fails, you throw it away. If a drug fails in any one of a million ways that drugs could possibly fail, people die. Pharmaceutical science needs to be driven by scientists, not by wannabes who are frustrated by the pace. The cost is much too high.
Comment: As a "patient" with several labels from the medical community AND a member of the medical community, I feel the frustration from both sides. I've been involved in clinical studies as a health care provider and have seen the bureaucratic bologna that happens. There are several phases to clinical trials, and when we get to the point of testing on people, well how many people are raising their hands? Some of us may say, "I would do it!!", but there is a lot of risk for both medical community and pharmaceutical trial participant. What about medications and pregnant women? Doctors don't know what they can given pregnant women b/c the FDA won't approve testing on pregnant women b/c of the theoretical risk to the fetus. That's a no-brainer. Look at all of the press the FDA and medical community is getting over cold medicines... Parents are told to NOT give medicines to infants/toddlers less than 2 yrs, and they do it anyway, and then get upset when there are poor outcomes and now NOBODY can give anything to children less than 6 yrs old. There is way more to this whole dilemma than the FDA and NIH; Intel dealt with computer chips and hopefully didn't put something into someone's body. We're talking apples and oranges...
Comment: The people who rose to the top of the current system got there by playing by the old rules. If you are going to change the system, you have to create separate hybrid systems that can be sheltered and protected -- kept a little longer in the incubator.
Kerry O'Connor
Comment: The health care industry is one of the few where people actually protest it when you come up with new or more cost effective ways to provide care. There is far more money to be made by keeping people ill then in actually curing them. A few years ago there was a Robert Wood Johnson demonstration project in Washington State called the Shared Care Plan, In it there combined personal health records with case managers and cut costs by $3,000 per person. When the funding ran out they dropped the program because it cost the local specialists and hospitals too much money. (E they lost income by keeping the patients health.
Comment: The medical and health care practice fields and the topic of Mr. Groves, research -commercial, academic and other, are two very different systems. However, it has been shown that drug companies are much more interested in finding treatments than cures, i.e. repeat business. The story about the discovery of Heliobacter pylori and its connection to stomach ulcers may shed some light on that.
Comment: It is true that the bias is toward expensive procedures and acute care as opposed to the drudge work of organizing information and care better. Health insurers are forced to pay for more expensive interventions with little marginal treatment gains, because poor use of research capital pays for studies that make it the standard of care. Capital is not being spent as quickly on care organization where it will produce a better ROI. Patients in many instances don't do their part by participating in their care, and they certainly don't demand these improvements. But many short-term demonstration projects give perfect cover for proponents of the status quo, because by enrolling small numbers of sick and recently hospitalized patients, they overstate the cost savings that would accrue to the general population and justify skepticism about the claims. These projects often have substantial indirect costs in the practices in which they are implemented, which are not accounted for and make the lack of long-term sustainability more rational than a first glance would suggest, especially in practices that are not part of integrated health plans. It is actually in large integrated health plans where most of the work of developing better information systems is occuring. Foundations, out really to make a political point with their dollars, often turn out to be every bit the show ponies as the biomedical establishment, choosing to miss a chance at being workhorses in the tough effort of transforming our health system.
Comment: I suffer from Multiple Sclerosis and Fibromyalgia. I believe we are being held back by the focus on "pharma". We need the FDA and medical researchers to give homopathic and herbal type treatments a look. I think the secret lies in the combination of treatments. My doctor aren't able to provide me with information about treatments that may be effective because they don't want to be liable. So the FDA needs to get off its butt and start testing and approving herbal and homopathic type treatments. Who knows the cure maybe where the flower meets the powder.
Rebecca Bergeron
Comment: Alas, homeopathy is pseudoscience. It started with the bizarre notion that the way to cure someone showing a particular symptom is to give him something that would make it worse... but to dilute it so much that he's only actually getting whatever is used to dilute it. Patently absurd... but in a perverse way, suited to today's hyperlitigious environment, because by definition, a homeopathic "treatment" can have no side effects!
Comment: With respect, the reason homeopathy is not studied is that it is complete hokum. The principles of homeopathy, the idea that like cures like, is of the same mistaken hypothesis that lead ancients to believe that parrots and limes are classified together because they are both green (an opinion held by no less a personage than Aristotle). Further, when analyzed, homeopathic preparations are so dilute that there are nodetectable molecules of the supposed curative compound in solution due to the level of dilution. It becomes incredibly expensive distilled water, nothing more than panacea. There's no point to studying pseudoscience, any more than there should be FDA study of faith healers or psychic surgeons.
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