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Originally posted by S600MBUSA:

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Originally posted by RAMIUS:

"Doc, if you're on that witness stand because your patient died from a GI bleed, what will you tell the judge when it comes out that you could have given them our combo product, instead of cheaper option that you prescribed?"

An expert witness/defense counsel could tear apart this line of reasoning pretty easily.

Is there any evidence from a randomized controlled trial that shows the combo product (Duexis in your example, I presume) is more effective at preventing GI-toxicity than than the "cheaper option" of separate pills that contain the exact same ingredients?

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Originally posted by a1abdj:

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I thought we were a bunch of right-wing, laissez-faire, free-market, personal liberty, leave me alone to conduct business as I see fit types.

I've been noticing some of the same hypocrisy I usually see on the left creeping in on the right as well.

Some have two sets of standards. One for when it suits their views, and another when it does not.

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Originally posted by leavemebe:
I have been working in drug development for 25+ years. I also have a lot of physician type friends, both practicing and in the industry.

From my perspective the problem lies primarily in having various "cartels" involved in health care with lots of middle men and women who add no value to actual patient care. Primarily these folks "push paper" and add costs/skim money. The cartels include the AMA and the various state licensing boards, the insurance industry, the various state legislatures, lobbyist and state government agencies, the big drug companies via organizations like RPharma and of course the massive federal cartel and lobbist that intends to control and take a cut of all buying and selling in the health care space. Think ObamaCare, Medicare, Medicaid, etc. Companies like the one RAMIUS refers to also play in that mix and take a cut. All of these cartels interweave to eliminate true price discovery and restrict individual access to care. For example, when I tried to get the actual charge in advance for a CT scan for myself as an experiment a few years ago, I was told "We can't do that sir, our contracts with the insurance companies will not allow us to share our prices". And of course the AMA has been keen for a long time to keep controls on the #'s of physicians. As it is structured and operates now, the system is far from "free enterprise" but very close to monopolistic on a grand scale.

Drug development is expensive and most of those costs are driven directly by regulatory requirements. Congress has demanded that drugs be shown to be safe and effective for the intended use before they are marketed. That bar has gotten ever higher as medical science and regulatory requirements have advanced. It is easy to spend $100+ million or even a billion $ getting a single drug tested, approved and commercialized today. That is up substantially from when I first started working at FDA.

If I was king for a year, I would take government out of health care entirely and go into the cartel busting business. I don't see that happening so we all get to watch as the system gets more and more expensive and parasitic in nature. The best course for the individual is to take care of yourself, eat and exercise responsibly, and avoid the U.S. system as much as possible.