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A Doctor Trying to Stop Heart Attacks

50 points| helloworld | 9 years ago |npr.org | reply

23 comments

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[+] darkerside|9 years ago|reply
This is another example of a recurring theme where the profit motive is failing to incentivize pharma companies to create products that can have an immediate impact on saving lives or improving health outcomes. I'm no socialist, but this seems to be a real (albeit very specific) failure of capitalism. Does anyone know of a government agency that is chartered to solve these kinds of problems?
[+] nickff|9 years ago|reply
The United States Department of Health and Human Services, whose motto is "Improving the health, safety, and well-being of America", which has a budget of just over 1.1 trillion dollars, and about eighty thousand employees.[1][2]

For comparison, the largest pharmaceutical company in the world is Novartis, with annual revenues of approximately forty-seven billion dollars.[3]

The pharmaceutical industry is one of the most, if not the most heavily regulated industry in the United States. This industry is also affected by various government interventions into research and development, both in funding and restricting options. If you believe there is a problem (and I think there is), it seems difficult to believe that it is due to a lack of government involvement.

[1] https://en.wikipedia.org/wiki/United_States_Department_of_He...

[2] http://www.hhs.gov/sites/default/files/fy2017-budget-in-brie...

[3] http://www.pmlive.com/top_pharma_list/global_revenues

[+] WalterBright|9 years ago|reply
Doing the safe-and-effective testing the FDA requires is incredibly expensive. But the cocktail is formed from off the shelf cheap components. So why should a company pay half a billion for testing when anyone could then make the drug? (The article didn't say it was under patent, and the tone of it suggests it wouldn't be patentable.)

This is the flip side of the good intentions of FDA's mandate.

[+] legulere|9 years ago|reply
Military can sometimes be interested in solving this kind of problems. Artemisinins which are used against malaria were discovered within the frame of a military project: https://en.wikipedia.org/wiki/Project_523

I don't think that this can be the solution though.

[+] reasonattlm|9 years ago|reply
Heart attacks are a downstream consequence of the molecular damage of aging.

Everything that isn't repairing the root cause damage of aging is going to be a much less effective way of going about things if the goal is to avoid cardiovascular events of that nature. Keeping a machine from a specific failure mode without actually repairing the damage that raises the odds of that failure mode is a much harder thing to do than to enact repair.

This is largely why medicine for age-related conditions has been an incremental process over recent decades: advanced enough to do sensible things with downstream consequences of damage, and so produce marginal effects at sizable investment of time and resources but for various reasons unwilling or unable to address the damage itself. The reduction in heart disease over the past 30 years has been an enormous achievement when considered within these bounds: really going above and beyond, finding ways to keep the accumulation of damage from having the same level of consequences and juggling biochemistry to keep running at a lower failure rate for longer.

But still incremental, and to really solve the problem you have to repair the damage. Nothing else is going to do the job.

[+] coldtea|9 years ago|reply
>Everything that isn't repairing the root cause damage of aging is going to be a much less effective way of going about things if the goal is to avoid cardiovascular events of that nature.

Tons of heart attacks before the age of 60 can be avoided simply by better diet and more exercise.

Given that, it doesn't matter if not ALL are.

Especially if the alternative is hoping for some unicorn anti-aging discovery.

>But still incremental, and to really solve the problem you have to repair the damage. Nothing else is going to do the job.

Yeah, we're still are going to age and die in the end. But the job here is not immortality, is not going down from a heart attack before that...

[+] melling|9 years ago|reply
There are 600,000 heart attack deaths in the US alone every year. And I imagine many millions worldwide.

Incremental progress can save millions of lives a year.

[+] csense|9 years ago|reply
If big pharma's not interested, would the costs of getting this kind of therapy into paramedics' hands be within the reach of private philanthropy (e.g. Gates foundation or YC's recent non-profit efforts)?
[+] Cass|9 years ago|reply
Glucose, insulin and potassium are already readily available on every ambulance, so all you'd need is a clinical trial proving that the mixture is effective and safe to use for heart attack patients. The costs of a clinical trial seem well within the reach of private philanthropy, especially since this isn't an experimental drug where you'd have to start from scratch--all three of those meds have been extensively studied both separately and in combination. (Glucose and insulin is a combination commonly used to treat high potassium levels, for example.)
[+] seatonist|9 years ago|reply
Here's a slide deck with data about the results of the trial (of Glucose Insulin Potassium) mentioned in the article.

http://clinicaltrialresults.org/Slides/ACC2012/Selker_IMMEDI...

From the conclusions slide:

"Composite endpoint of cardiac arrest or acute mortality was significantly reduced, and FFA levels were lower, consistent with the proposed FFA link to arrhythmias"

[+] gist|9 years ago|reply
> And so I started talking to the pharmaceutical companies saying, 'You know, would you make this stuff?' And they basically weren't interested.

How many?

Which ones?

All of them or some or most of them?

So maybe a big name isn't interested.

There are tons of companies who make generics who would probably welcome the opportunity to market a concoction like this or at least entertain the idea.

[+] M_Grey|9 years ago|reply
You seem very ready to assume that the author didn't do his homework, while seeming equally willing to assume that there are some companies who would be game.
[+] mikehotel|9 years ago|reply
A different [edit: diet based] approach to reduce heart disease (also advocated by a physician): https://youtu.be/LXigmGZk5FU

This same approach also appears to address other leading causes of death.

[+] alecco|9 years ago|reply
Yeah, let's get a pill to fix it and keep chugging processed industrial foods and sugar water while sitting browsing social networks.