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As I See It... (27 June, 2006)

28 June, 2006

Drugs, Money and LifeThere are some ophthalmic diseases which can be cured, others which cannot. It depends upon the fortune or misfortune of the sufferer. Well, if it comes to that, everything depends on chance. “He chanced to be in the building when it suddenly collapsed. One can only feel remorse!”

One always feels sorry for the disabled. The promising singer who has become dumb, can still enjoy the warbling of others. He who gradually becomes deaf, and the various appliances for hearing are no longer of any use to him, walks through a door and into a world of silence. He who becomes blind can use his faculties for hearing and speech to the utmost.

There are many institutions, social and welfare groups, and hospitals, where the blind are evaluated and cared for. And there are many dedicated individuals who try to evolve new methods for assisting the blind. The audio book, which is really an audio cassette, or compact disc, are wonderful tools to provide the enjoyment of reading or studying. I am perhaps on the threshold of blindness myself, having run the gamut of cataract removals, detached retinas, and one unnecessary and bad operation on my left eye. This led to non-alignment of the two eyes, and for the past 20 years my vision has become blurred and out of focus. But I could somehow manage read a page containing bold print, or sit quite close to a TV screen, or quizzically peer at a computer monitor, as I am doing now. Age brings its own handicaps and difficulties. One becomes resigned to whatever lies ahead.

I happened to find an article the other day in The Guardian, which made me sit up and read transfixed. I shall quote some of the text and incorporate my own observations, here and there, in parentheses.

Drugs firm blocks cheap blindness cure

Company will only seek licence for medicine that costs 100 times more A major drug company is blocking access to a medicine that is cheaply and effectively saving thousands of people from going blind because it wants to launch a more expensive version of the product on the market.

Ophthalmologists around the world, on their own initiative, are injecting tiny quantities of a colon cancer drug called Avastin into the eyes of patients with wet macular degeneration. This degeneration is an expected phenomenon of old age that can lead to severely impaired eyesight and even blindness. They report remarkable success at very low cost because one phial can be split and used for dozens of patients.

But Genentech, the company that invented and manufactures Avastin, does not want it used in this way. Instead it is applying to license a fragment of Avastin, called Lucentis, which is packaged in the tiny quantities suitable for treating afflicted eyes, but at a higher cost. Speculation in the US suggests it could cost £1,000 per dose instead of less than £10! The company says Lucentis is specifically designed for eyes, with modifications over Avastin, and has been through 10 years of testing to prove it is safe. All this sounds satisfactory and reasonable. (But the objection still nags : Why should the company not compromise at an affordable price?)

Unless Avastin is approved in the UK by the National Institute for Clinical Excellence (Nice) it will not be universally available within the NHS. But because Genentech declines to apply for a licence for this use of Avastin, Nice cannot consider it. In spite of the growing drugs bill of the NHS, it will appraise, and probably approve, Lucentis next year. (Must prices be fixed for the NHS in the UK ignoring the rest of the world?)

Although Nice's role is to look at cost-effectiveness, it says it cannot appraise a drug and pass it for use in the NHS unless the drug is referred to it by the Department of Health. The department says its hands are tied. (It is probable that endless red tape and excuses will follow, and cause endless delay, out of both callousness or lack of control. In the United States a problem currently agitating the concerned authorities is the reluctance of pharma companies to reveal to the public results of ongoing tests of drugs under production, so that safety aspects may be known to doctors and patients. A short while ago a leading US pharma company put a pain killer on the market without warning of possible side effects. As a result 38,000 patients suffered heart attacks, and all of them died of heart attacks!)

New drugs for the condition are badly needed : those we have now only slow the progression to blindness. With Avastin, many patients get their sight back with just one or two injections. Is this not truly a wonder drug?”

Pharmaceutical firms say they need to launch drugs at high prices because of the hundreds of millions of pounds spent on developing them. This is a fatuous statement. Naturally a lot of research has to be done in such cases, but I am reluctant to believe that costs cannot be effected in this sphere of drug production. One pictures all those labs and manicured lawns, with perpetual sprinklers. The latest models of automobiles neatly parked on the roadside. White-coated men and women swarming all over the place, gripping test tubes, and almost on the verge of ejaculating in ecstasy : “Eureka!” Rest of the time is spent enjoying very comfortable lives. Is it possible to calculate how much “research” has resulted from all this fuss and bother, and wine and roses, to lead to the discovery of treatment and “cure” for, say, cancer? I could go on and on, citing examples of diseases, “research”, and medicines - real or imaginary! I suppose I am sounding like a spoil-sport, and kill-joy!

Hurdy Gurdy Pot-Pourri
Scientists + Politicians + Capitalists + the Media + the Army

Evidence suggests that matter is drifting into cyber space, and it may well be that soon humankind will have to live by new rules.

Since Religion cannot prevail over Nature, and Science cannot prevail over Nature, there is bound to be an Explosion, marking zero on the Richter Scale!

Now good eyesight is essential for Information Technology, blindness is its mortal enemy. Apart from this, and largely based on “humanitarian grounds”, surely Bill Gates, while he is tossing his billions around to finance various Good Works, should take note of all this? How about setting up a few pharmaceutical firms to produce and sell life saving medicines at No Profit prices? And clinics dotted all over the world dispensing Genentech drugs to prevent or combat blindness? Even if it means inventing Microsoft 2 in order to do so, it would be more than worthwhile. It is gratifying to find that Bill Gates and his fellow billionaires desire to show that albeit they were clever enough to make all that money, they are not stupid enough to want to keep all of it!

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