Selling Snake Oil
Posted: Tue Jan 10, 2023 3:27 pm
Seán Moran hunts the hype around hypertension.
https://philosophynow.org/issues/152/Selling_Snake_Oil
https://philosophynow.org/issues/152/Selling_Snake_Oil
For the discussion of all things philosophical.
https://canzookia.com/
Well, I will take a m oment to enjoy our common ground.Sculptor wrote: ↑Tue Jan 10, 2023 4:59 pm What is and what is not "snake oil" might surprise you.
STATINS.
THe multi billion £££ industry selling statins is based on very dubious evidence, and fake statistics.
ANd it does not do what it claims.
THe claim is it reduces LDL cholesterol with the aim of reducing atherosclerosis. But you have to ask how. WHere is that LDL going? Statins in fact increase the LDL receptors in the liver in and can in fact reduce serum cholesterol. But by adding to the congestion of the liver and this has side effects.
But is LDL the problem in the first place?
LDL plays a completely vital role in a number of metabolic processes such as the immune system, and many important tissues are made of cholesterol including brain tissue.
It should be no surprise that it is only a particular type of LDL that is problematic. That is small dense LDL damaged with Glycation caused by oxidation and inflammation of the arteries does the rest.
Statins do not reduced small dense glycated LDL because the liver will not touch it.
How does LDL get glycated?? The clue is in the word. YES - it is sugar. High blood glucose not only destroys the glycocalyx (the layer of saccharides which protects the lining of the arteries), it also damages LDL. Because our consumption of sugar has rocketed in modern times from rarely available to our ancestors to an additive in very fucking thing you can buy. and rather than being around mostly in the autumn it is on the shelves of supermarkets all year round.
It has been made worse by government advice pushing low fat, aided and abetting by the corn factors peddling subsidised high fructose corn syrup, and corporations pushing fruits juices, breakfast cereals, and Starbucks type coffees over-loaded with the white powder.
But he is the naive person, buying into Pharma's pr - which has an unbelievable budget.“There seems to me to be no limit to the inanity and credulity of the human race. Homo sapiens! Homo idioticus !”
The danger would be to run away with a completely negative attitude to pharmacology. There is no doubt that the money motive is the most dangerous impediment to science. But that does not detract from the many benefits that pharmacological science has given us.Iwannaplato wrote: ↑Tue Jan 10, 2023 8:51 pmWell, I will take a m oment to enjoy our common ground.Sculptor wrote: ↑Tue Jan 10, 2023 4:59 pm What is and what is not "snake oil" might surprise you.
STATINS.
THe multi billion £££ industry selling statins is based on very dubious evidence, and fake statistics.
ANd it does not do what it claims.
THe claim is it reduces LDL cholesterol with the aim of reducing atherosclerosis. But you have to ask how. WHere is that LDL going? Statins in fact increase the LDL receptors in the liver in and can in fact reduce serum cholesterol. But by adding to the congestion of the liver and this has side effects.
But is LDL the problem in the first place?
LDL plays a completely vital role in a number of metabolic processes such as the immune system, and many important tissues are made of cholesterol including brain tissue.
It should be no surprise that it is only a particular type of LDL that is problematic. That is small dense LDL damaged with Glycation caused by oxidation and inflammation of the arteries does the rest.
Statins do not reduced small dense glycated LDL because the liver will not touch it.
How does LDL get glycated?? The clue is in the word. YES - it is sugar. High blood glucose not only destroys the glycocalyx (the layer of saccharides which protects the lining of the arteries), it also damages LDL. Because our consumption of sugar has rocketed in modern times from rarely available to our ancestors to an additive in very fucking thing you can buy. and rather than being around mostly in the autumn it is on the shelves of supermarkets all year round.
It has been made worse by government advice pushing low fat, aided and abetting by the corn factors peddling subsidised high fructose corn syrup, and corporations pushing fruits juices, breakfast cereals, and Starbucks type coffees over-loaded with the white powder.
There are so many implicit and explicit poor assumptions and conclusions in that Philosophy Now essay.
First it assumes that phrama is run like honorable empirical science. It isn't. It's run by corporations whose goal is money. I am not saying that is the only goal of the people working there. Many I assume do want to do good. But the power there is seeking money and of course good products can earn money, but they are happy to twist and manipulate, research, data, doctors, and end-clients if it makes them money. And this happens with great regularity. Bad products, getting doctors to prescribe for off label uses, hiding data on dangers of drugs, suppressing information and even access to alternatives that work, and more. If a bad product makes money or will make money, they can and do work out the costs of later lawsuits. If they end up making money, fine.
The second faulty assumption is that there are no paradigmatic blind spots in pharma. That they will not rule out something on the wrong grounds. But they do. One can look at Japan's pharma to see paradigmatic differences. In Japan the use of medicinal mushrooms and other fungi. These have gone through empirical research and are effective against all sorts of things including cancers. But they are rarely used by regular doctors in the US. Why? Because of money issues and also because pharma companies generally want products that are single chemical based.
Let alone the lack of money in, as you say, diet, exercise and more.
Another faulty assumption is that if a plant based alternative treatment, for example, worked, then some company would go through the whole FDA process and market it. Nope. You can't patent that stuff. It costs a huge amount of money to get FDA approval. They are not going to waste time and money on something anyone can immediately put on shelves.
In his essay he quotes Sir Arthur Conan DoyleBut he is the naive person, buying into Pharma's pr - which has an unbelievable budget.“There seems to me to be no limit to the inanity and credulity of the human race. Homo sapiens! Homo idioticus !”
That's certainly one danger. I have and most likely will again use medicines produced by pharma.
This is merely a guess in two parts. 1) I would think the problem has always been there, since there has always been money involved which will be some kind of distorting factor, but 2) that changes in what a corporation is legally and then also changes in corporate habits has increased the problem. That corporate charters were no longer revoked. That corporations were viewed as persons. Changes in lobbying practices. Changes in marketing practices - so, changes in media, but also that pharmacalogical companies can now market their products directly to end users AND the use of the best cognitive and other psychology in the marketing of medicines. The changes in corporate goals to emphasize short term shareholder gains. The way corporations have engaged non-medical professionals like teachers into the medication model for nearly all behavioral and emotional challenges. That pharma is training the public to view what may well be normal reactions or reactions with societal or social causes as chemical imbalances, for example, has led to third parties demanding, for example, that parents medicate their children. All the manipulative practices related to off-label use of medicines. Drug company mergers are also not helping. For the same reasons that the consolidation of power in media and other industries is causing problems.When did it all go wrong?
Now the pure capitalist can say...that's how the market works. But...pharma is not pure capitalist...Insulin facts
Access to insulin for patients with Type 1 diabetes is a matter of life or death.9
While insulin has existed since the1920s10, the price since then has skyrocketed, especially in recent years. Prices for insulin increased by 197 percent between 2002 and 2013, from $4.34 per milliliter to $12.92 per milliliter.11
There are three insulin manufacturers serving the United States: Eli Lilly and Co., Novo Nordisk A/S, and Sanofi SA.
Eli Lillyannounced12 in March 2019 that it would begin selling a generic version of its Humalog insulin at half the price. The medication, known as lispro, will cost $137.35 per vial. To compare pricing, a 2018 study13 estimated that the cost of making a year’s worth of insulin for one patient ranges from $78 to $133.
Ahead of its hearing on drug pricing in February 2019, the U.S. Senate Committee on Finance sent aletter14 to Eli Lilly asking why insulin is priced so astonishingly high. A vial of NovoLog, one type of insulin, costs15 anywhere from $14 to $300 in the United States but only $48 in Singapore, $14 in India, $6 in Austria, and $0 in Italy.
and the following - notice that they get tax credits for their marketing (there's a lot of irony in that. Encouraging them to focus more on sales than service....American taxpayers fund basic research
Billions of taxpayer dollars go into the creation and marketing16 of new drugs. The Los Angeles Times reports that, “Since the 1930s, the National Institutes of Health has invested close to $90017 billion in the basic and applied research that formed both the pharmaceutical and biotechnology sectors.” Despite taxpayers’ crucial investment, U.S. consumers are increasingly paying more for their prescription drugs.
Federal perks for Big Pharma add up
Pharmaceutical companies also benefit from research and development tax credits. The federal R&D tax credit was first introduced in 1981 to encourage private sector investment in pioneering research.21 This tax credit is available to businesses that attempt to develop new, improved, or technologically advanced products or trade processes.22 In 2015, former President Barack Obama signed into law the Protecting Americans from Tax Hikes Act23, which made these tax credits permanent and extended them to small businesses and startup companies.
Pharmaceutical industries also receive a tax deduction for their marketing and advertising expenses. According to a report in the Journal of the American Medical Association, “From 1997 through 2016, medical marketing expanded substantially, and spending increased from $17.7 to $29.9 billion,24 with direct-to-consumer advertising for prescription drugs and health services accounting for the most rapid growth, and pharmaceutical marketing to health professionals accounting for most promotional spending.” The report also found that from 1997 through 2016, “the number of advertisements … increased from 79,000 (including 72,000 television commercials) in 1997 to 4.6 million (663,000 television25 commercials) in 2016.”
Pharma bosses in smoke filled rooms deciding to not compete with one another on drugs seems to com into my imagination, and talking with their pals in government who have the purse strings to fund research, but magically do not insist on keeping the copyrights on such research seems likely to me.Iwannaplato wrote: ↑Sat Jan 14, 2023 7:05 amThat's certainly one danger. I have and most likely will again use medicines produced by pharma.
This is merely a guess in two parts. 1) I would think the problem has always been there, since there has always been money involved which will be some kind of distorting factor, but 2) that changes in what a corporation is legally and then also changes in corporate habits has increased the problem. That corporate charters were no longer revoked. That corporations were viewed as persons. Changes in lobbying practices. Changes in marketing practices - so, changes in media, but also that pharmacalogical companies can now market their products directly to end users AND the use of the best cognitive and other psychology in the marketing of medicines. The changes in corporate goals to emphasize short term shareholder gains. The way corporations have engaged non-medical professionals like teachers into the medication model for nearly all behavioral and emotional challenges. That pharma is training the public to view what may well be normal reactions or reactions with societal or social causes as chemical imbalances, for example, has led to third parties demanding, for example, that parents medicate their children. All the manipulative practices related to off-label use of medicines. Drug company mergers are also not helping. For the same reasons that the consolidation of power in media and other industries is causing problems.When did it all go wrong?
That's off the top of my head.
and speaking of Insulin...Now the pure capitalist can say...that's how the market works. But...pharma is not pure capitalist...Insulin facts
Access to insulin for patients with Type 1 diabetes is a matter of life or death.9
While insulin has existed since the1920s10, the price since then has skyrocketed, especially in recent years. Prices for insulin increased by 197 percent between 2002 and 2013, from $4.34 per milliliter to $12.92 per milliliter.11
There are three insulin manufacturers serving the United States: Eli Lilly and Co., Novo Nordisk A/S, and Sanofi SA.
Eli Lillyannounced12 in March 2019 that it would begin selling a generic version of its Humalog insulin at half the price. The medication, known as lispro, will cost $137.35 per vial. To compare pricing, a 2018 study13 estimated that the cost of making a year’s worth of insulin for one patient ranges from $78 to $133.
Ahead of its hearing on drug pricing in February 2019, the U.S. Senate Committee on Finance sent aletter14 to Eli Lilly asking why insulin is priced so astonishingly high. A vial of NovoLog, one type of insulin, costs15 anywhere from $14 to $300 in the United States but only $48 in Singapore, $14 in India, $6 in Austria, and $0 in Italy.and the following - notice that they get tax credits for their marketing (there's a lot of irony in that. Encouraging them to focus more on sales than service....American taxpayers fund basic research
Billions of taxpayer dollars go into the creation and marketing16 of new drugs. The Los Angeles Times reports that, “Since the 1930s, the National Institutes of Health has invested close to $90017 billion in the basic and applied research that formed both the pharmaceutical and biotechnology sectors.” Despite taxpayers’ crucial investment, U.S. consumers are increasingly paying more for their prescription drugs.Federal perks for Big Pharma add up
Pharmaceutical companies also benefit from research and development tax credits. The federal R&D tax credit was first introduced in 1981 to encourage private sector investment in pioneering research.21 This tax credit is available to businesses that attempt to develop new, improved, or technologically advanced products or trade processes.22 In 2015, former President Barack Obama signed into law the Protecting Americans from Tax Hikes Act23, which made these tax credits permanent and extended them to small businesses and startup companies.
Pharmaceutical industries also receive a tax deduction for their marketing and advertising expenses. According to a report in the Journal of the American Medical Association, “From 1997 through 2016, medical marketing expanded substantially, and spending increased from $17.7 to $29.9 billion,24 with direct-to-consumer advertising for prescription drugs and health services accounting for the most rapid growth, and pharmaceutical marketing to health professionals accounting for most promotional spending.” The report also found that from 1997 through 2016, “the number of advertisements … increased from 79,000 (including 72,000 television commercials) in 1997 to 4.6 million (663,000 television25 commercials) in 2016.”
Once I did a long research project into the development, research and marketing/use/effects of a drug one of my parents was long-term prescribed. One of the many things that stunned me was the way the drug was marketed to doctors. It was marketed in many of the same ways products like twin-razor shaving blades and Coke are marketed. Manipulative non-scientific marketing. The ads I am talking about here. Then the way reps get doctors to prescribe these drugs. What was clear was 1) the pharmacological companies viewed doctors pretty much the same way marketers view car buyers and soft drink buyers: that these people are gullibly, manipulable, and need not be approached rationally. Engage myth and image and doctor self-interest.
Medical training is not a liberal education because there is so much on their curriculum medics could spend half their lives in tertiary education if they also studied humanities and social sciences.We expect too much learning of medical doctors. Not very long ago the doctor and the vicar were about the only literate people in a rural community. In my experience of doctors they are generally liberal-minded with some exceptions that would not be acceptable in 2023Iwannaplato wrote: ↑Sat Jan 14, 2023 1:57 pmOnce I did a long research project into the development, research and marketing/use/effects of a drug one of my parents was long-term prescribed. One of the many things that stunned me was the way the drug was marketed to doctors. It was marketed in many of the same ways products like twin-razor shaving blades and Coke are marketed. Manipulative non-scientific marketing. The ads I am talking about here. Then the way reps get doctors to prescribe these drugs. What was clear was 1) the pharmacological companies viewed doctors pretty much the same way marketers view car buyers and soft drink buyers: that these people are gullibly, manipulable, and need not be approached rationally. Engage myth and image and doctor self-interest.
We think of doctors as highly educated people, which in a certain sense they are. And given this we expect them not to be had so easily. But the truth is they are technicians and in a sense cloistered by a grueling education, which includes no or little politics of medicine, social and economic issues related to pharma companies or health care and so on. There is no reason to believe that the last 8 years of that education gave them a healthier skepticism than anyone in a working class job. In fact it might be a bit damning on that front.
A billion dollar company may invest some bad money in foolish for their profits ad campaign or sales rep practice or lobbyists. But they've been getting better at and using more and more the kinds of practices that assume they can manipulative scientists to use their products using methods that have nothing to do with science.
Yes, and it's not a problem easily remedied. We could reduce some of it, but in the end, they have to learn as many words as they already know for example.Belinda wrote: ↑Sat Jan 14, 2023 2:31 pm Medical training is not a liberal education because there is so much on their curriculum medics could spend half their lives in tertiary education if they also studied humanities and social sciences.We expect too much learning of medical doctors. Not very long ago the doctor and the vicar were about the only literate people in a rural community. In my experience of doctors they are generally liberal-minded with some exceptions that would not be acceptable in 2023
The sadly irony is that despite all this negative information, NICE in their wisdom has decided to extend the recommendation to take statins to millions more Britons. (how many have shares in pharma?)
Before industrialisation most people lived under the hierarchical rule of the local gentry who believed the social order was ordained by God. Industrial development changed the labour force from compliant labourers(with a few honourable exceptions such as the Tolpuddle martyrs) to victims of Durkheimian anomie who , if they had not had to work so hard, would have become dissenters or outright heathens sooner than they did.Sculptor wrote: ↑Tue Jan 10, 2023 10:18 pmThe danger would be to run away with a completely negative attitude to pharmacology. There is no doubt that the money motive is the most dangerous impediment to science. But that does not detract from the many benefits that pharmacological science has given us.Iwannaplato wrote: ↑Tue Jan 10, 2023 8:51 pmWell, I will take a m oment to enjoy our common ground.Sculptor wrote: ↑Tue Jan 10, 2023 4:59 pm What is and what is not "snake oil" might surprise you.
STATINS.
THe multi billion £££ industry selling statins is based on very dubious evidence, and fake statistics.
ANd it does not do what it claims.
THe claim is it reduces LDL cholesterol with the aim of reducing atherosclerosis. But you have to ask how. WHere is that LDL going? Statins in fact increase the LDL receptors in the liver in and can in fact reduce serum cholesterol. But by adding to the congestion of the liver and this has side effects.
But is LDL the problem in the first place?
LDL plays a completely vital role in a number of metabolic processes such as the immune system, and many important tissues are made of cholesterol including brain tissue.
It should be no surprise that it is only a particular type of LDL that is problematic. That is small dense LDL damaged with Glycation caused by oxidation and inflammation of the arteries does the rest.
Statins do not reduced small dense glycated LDL because the liver will not touch it.
How does LDL get glycated?? The clue is in the word. YES - it is sugar. High blood glucose not only destroys the glycocalyx (the layer of saccharides which protects the lining of the arteries), it also damages LDL. Because our consumption of sugar has rocketed in modern times from rarely available to our ancestors to an additive in very fucking thing you can buy. and rather than being around mostly in the autumn it is on the shelves of supermarkets all year round.
It has been made worse by government advice pushing low fat, aided and abetting by the corn factors peddling subsidised high fructose corn syrup, and corporations pushing fruits juices, breakfast cereals, and Starbucks type coffees over-loaded with the white powder.
There are so many implicit and explicit poor assumptions and conclusions in that Philosophy Now essay.
First it assumes that phrama is run like honorable empirical science. It isn't. It's run by corporations whose goal is money. I am not saying that is the only goal of the people working there. Many I assume do want to do good. But the power there is seeking money and of course good products can earn money, but they are happy to twist and manipulate, research, data, doctors, and end-clients if it makes them money. And this happens with great regularity. Bad products, getting doctors to prescribe for off label uses, hiding data on dangers of drugs, suppressing information and even access to alternatives that work, and more. If a bad product makes money or will make money, they can and do work out the costs of later lawsuits. If they end up making money, fine.
The second faulty assumption is that there are no paradigmatic blind spots in pharma. That they will not rule out something on the wrong grounds. But they do. One can look at Japan's pharma to see paradigmatic differences. In Japan the use of medicinal mushrooms and other fungi. These have gone through empirical research and are effective against all sorts of things including cancers. But they are rarely used by regular doctors in the US. Why? Because of money issues and also because pharma companies generally want products that are single chemical based.
Let alone the lack of money in, as you say, diet, exercise and more.
Another faulty assumption is that if a plant based alternative treatment, for example, worked, then some company would go through the whole FDA process and market it. Nope. You can't patent that stuff. It costs a huge amount of money to get FDA approval. They are not going to waste time and money on something anyone can immediately put on shelves.
In his essay he quotes Sir Arthur Conan DoyleBut he is the naive person, buying into Pharma's pr - which has an unbelievable budget.“There seems to me to be no limit to the inanity and credulity of the human race. Homo sapiens! Homo idioticus !”
Type 1 diabetics would have had to look forwards to very short lives were it not for the isolation and distribution of insulin; were it not for Frederick Banting and others such as Langerhans who worked hard to uncover the workings of the pancreas.
It's a shame that Banting's knowledge about the effect of sugar on metabolism were not well understood by Ancel Keys who gave us the absurd fat/diet heart hypothesis that has led to bad advice and an epidemic of obesity T2D and insulin resistance.
Then there is the pioneering works of the likes of Pasteur, Koch and Ehrlich who built upon germ theory and gave their vaccination knowledge to the world for free. Flemming gave us penicillin.
I depend on daily doses of Allopurinol.
When did it all go wrong?