> Indeed, Laufer and his collaborators can’t stop pissing off powerful people because Four Thieves is living proof that effective medicines can be developed on a budget outside of institutional channels.
Synthesized. Not developed. Synthesizing medicines is easy. Developing them is extremely difficult.
Eh, it's not as simple. From what it looks like, they're not just copying syntheses from the patent application. With this Chematica data, it seems like they were pursuing novel syntheses for a variety of drugs in order to minimize side product formation or make the synthesis easier, which is an impressive feat.
That being said, they aren't running clinical trials or evaluating drug efficacy, which is another difficult part of drug development.
I hate to be negative. But I have seen enough of these sort of initiative over the years to be skeptical. In reality it seldom makes sense to do it yourself. Few things in general needs to be built or invented. If they do chances are they aren't the ones to do it. It almost always makes more sense acquire the capability to do what you want somewhere else. But as soon as you do that all the edgy rhetoric and potential goes out the window in favor of liability and reality. So reality eventually becomes the enemy of the escapist fantasy. And the powerful remain powerful while the real problems go unsolved. I would very much like to be wrong though.
> At the pharmacy, a pair of single use Mylan epipens can cost over $600 and the company’s generic version costs $300 per pair, but an ongoing shortage means you probably can’t find them, even if you can afford them.
This was true years ago but not anymore. CVS sells a generic epipen two-pack for $109 [1]. Still not cheap, but let’s not pretend that these cost $300 and are not even available. I wanted to like this article but when I read this it made me think either reading journalist didn’t check his facts or is more invested in the narrative than reality.
Edit: I posted this even though I figured it would attract downvotes. I’m curious if downvoters think my claims are untrue or don’t like the way I’ve phrased my comment.
To me, an article I can’t trust is basically worthless, which is why I pointed these inaccurate facts out.
As a former pharmaceutical chemist I’m calling bullshit.
Could they have made a few grams of nalaxone? Sure it’s pretty simple. Did they make enough to make a difference? No. Did they make sufficiently pure drug so that people don’t get poisoned? Probably not.
And did they make the AIDS drug? He’ll no. That synthesis is way more complicated than their mini lab can handle.
It makes for good VICE articles, but these guys are amateurs who are likely going to get someone killed.
Is there some route to naloxone that I am not aware of that doesn't start from some opiate or opium alkaloid? The morphine total syntheses I've read were rather involved and low-yield. Perhaps progress made on the biosynthetic step through reticuline? That would be exciting.
I wish there was an equivalent of CI and peer-reviewed pull-requested contribution to their system, to ease collaborative improvement to the methods. You'd really want many sets of eyes able to look at all aspects of the drugs to vastly reduce risk.
I saw one of Michael's talks. They do share the data about their hardware and processes openly (though I don't know where/how, since it's not the kind of info I understand). But one of the things he mentioned needing more open information about is the chemistry. There are databases of chemical reactions that can be used to train AIs to find new, easier and cheaper ways to synthesize medications, but those databases are controlled by large for-profit corporations who refuse to release the data. Presumably for "safety" reasons, but it's not hard to imagine that "safety" isn't the whole story.
He went due to securities fraud but one could argue that, if it weren't due to the drug price thing, he could have flown under the radar, since the investors didn't lose any money.
> These precursors are controlled by the federal government ... they’d make medicine from poison [by using the street drugs to get back to the precursors]
cf: “A Simple and Convenient Synthesis of Pseudophedrine from N-Methylamphetamine”
I don’t know if YC proactively seeks organizations to fund but these folks look like a pretty small potential investment with a huge social win. If ever there was a time to “do good” with that enormous pile of capital and connections y’all have— this might be it.
>“...the price of Daraprim hasn’t changed,” he said. He reached into his pocket and produced a handful of white pills. “I guess I better hand out some more,” Laufer said as he tossed the Daraprim into the audience.
I found it hard to keep reading after that. What's it called when people get so emotional about a cause they just start acting irrationally and doing more harm than good?
It's definitely a stunt, but I don't see it as being particularly irresponsible. Daraprim's use is quite narrow and its side effects are pretty unpleasant; nobody's going to abuse it. It's not like he's throwing handfuls of homemade Ritalin.
...Chematica’s database is currently posted on a password protected website on the dark web. During his talk at HOPE this year, Laufer implored the audience to help with cracking the password and releasing the data into the world.
They're talking about an encrypted file, right? If Merck just had this posted on "the dark web", constantly hammering them with bad passwords would probably clue them in. Incidentally, which did Merck value more, the database or the opportunity to keep it away from this group?
I was at his 2018 talk and the Vice article did an excellent job of summing it up. Usually the HOPE videos come online a few weeks after the conference (it was last weekend).
This sort of reminds me of the ability to 3D print guns. Technology gets cheaper and more efficient and ultimately democratizes access to "things"... Physical printed items, transportation, drugs... I think we're only scratching the surface here with this.
An interesting approach to the criminal lack of healthcare to vulnerable populations in the US (and potentially other places with third world health systems)
The essential problem here seems to be that the FDA approval process for medicine laboratories is impractically severe and probably represents an instance of regulatory capture.
While this is cool, it doesn't seem to generate attention in a way that could fix the underlying problem, except by dint of people who already know about it. Legislators are infamously subject to undue influence from medical companies that want to protect their oligopolies. A better hacking initiative might work to expose and excoriate those pharmaceutical and medical device companies which have abused the right to lobby in order to generate profits.
I met Michael at free software conference in Havana, Cuba in November. Didn't know who he was at first, after one of the talks he approached me and asked me if I wanted to get a beer. Unfortunately, I wasn't feeling well and turned him down. Later I saw him give a talk and realized he was the EpiPencil guy. He gave a great talk and I had the opportunity to have a few more conversations with him. He's obviously very intelligent. But he's also a deeply empathetic and passionate person who's giving his best effort to make the world a better place. Super inspiring!
Such "patient assistance programs" are common, and they're designed to further maximize profits at the expense of heightened insurance premiums over time.
> “The rhetoric that is espoused by people who defend intellectual property law is that this is theft,” Laufer told me. “If you accept that axiomatically, then by the same logic when you withhold access to lifesaving medication that's murder. From a moral standpoint it's an imperative to enact theft to prevent murder.”
Exactly what I would also say as pro capitalist but anti patent.
The article is not about anarchism. It is about not staying idle while people can't afford drugs. The methods may be questionable, like the partnership with dealers. But at least they try to do something.
I just hope there is a way for them to make money without legal risks
I don't see how that's a pro capitalist argument. Your not getting rid of a monopoly on the IP, you are compelling people to give up there property to prevent a worse evil
> “The rhetoric that is espoused by people who defend intellectual property law is that this is theft,” Laufer told me. “If you accept that axiomatically, then by the same logic when you withhold access to lifesaving medication that's murder. From a moral standpoint it's an imperative to enact theft to prevent murder.”
If it's murder to apply intellectual property law and withhold drugs...what do we call the untold number of deaths that will result in the absence of a profit motive for developing new medicines? Is that murder?
The views of these people are childish and dangerous. I love their spirit, but their actual message here is just stupid and illiterate of basic economics.
I see your point but I think that there is a middle ground to be struck here. I don't think medical care and drug research can be ethically applied upon the basis of economic motivation alone. Through this lens Laufer makes some sense. You raise a strong and valid counterpoint however. There is currently a huge profit motive to develop new medical treatments (so long as they are indeed profitable). What will the effects be if we reduce that profit motive? This is a complex question that I think requires a nuanced answer that takes into account both our moral responsibility to take care of the sick but also recognizes the incentives innate to human nature
>Although the initial clinical results with cabotegravir were extremely promising, Four Thieves grew impatient with waiting for it to become commercially available. (The drug is currently undergoing Phase III FDA trials, which means it’s being clinically tested on a large cohort of human subjects.)
>After Four Thieves synthesized cabotegravir, it was just a matter of convincing at-risk populations to use it. According to Laufer, some Four Thieves affiliates began partnering with heroin dealers to cut their product with the cabotegravir.
I know nothing about chemistry/medicine, but this seems stupidly dangerous. There are good reasons to be patient and wait for drugs to go through the phase trials.
It also seems stupidly dangerous to allow uneducated/untrained people to make their own drugs at home by following directions. What if they unknowingly miss a step? For instance, the article is stating that opioids are needed to create Naloxone. That would be a costly mistake to make. They should never release this particular recipe.
These are truly brilliant people who probably have not spent a lot of time hanging around the average person. One reason governments and systems are in place is to prevent the non-well-rounded geniuses from giving an untrained mind an opportunity to make a devastating mistake.
It's ironic to me that some anti-control people that buck against the system don't seem to have a problem when it's them making decisions for others.
Making the drug and trying it on yourself is one thing. Sharing it with someone else who understands you and how you made it is somewhat similar. Convincing random people who don't know you to take it is crossing some sort of line, and setting up a situation where people are taking your homemade version of a non approved medication without even knowing it is just plain wrong. I know they are already taking heroin, but these are still people and not your lab rats. You shouldn't be making their decisions for them about what goes in their body.
In their do it yourself lab, what are they doing to remove stereoisomers?
This owns. It's important to realize that a lot of at-risk populations that would most benefit from medication are often the most economically disadvantaged, and that our current healthcare system often excludes them from the help they need. Obviously, lab-grade medication is less risky than stuff that's been produced in a mason jar, but when the choice is between having access to life-saving medical equipment or not, the choice is pretty clear. If you have concerns with how this could hurt people, then the best solution would be to make sure that everyone has access to the care they need, rather then allocating care on the basis of how much they can afford.
darawk|7 years ago
Synthesized. Not developed. Synthesizing medicines is easy. Developing them is extremely difficult.
Hasz|7 years ago
That being said, they aren't running clinical trials or evaluating drug efficacy, which is another difficult part of drug development.
klipt|7 years ago
34k5uoi5ui|7 years ago
If you want to help, they need someone to crack a rar file containing the Chematica data (which was acquired by Merck pharmaceuticals)
https://twitter.com/MichaelSLaufer/status/102263726560276889...
unknown|7 years ago
[deleted]
imbruglia|7 years ago
gnicholas|7 years ago
This was true years ago but not anymore. CVS sells a generic epipen two-pack for $109 [1]. Still not cheap, but let’s not pretend that these cost $300 and are not even available. I wanted to like this article but when I read this it made me think either reading journalist didn’t check his facts or is more invested in the narrative than reality.
1: https://www.cvs.com/content/epipen-alternative
Edit: I posted this even though I figured it would attract downvotes. I’m curious if downvoters think my claims are untrue or don’t like the way I’ve phrased my comment.
To me, an article I can’t trust is basically worthless, which is why I pointed these inaccurate facts out.
thatcat|7 years ago
https://www.collective-evolution.com/2016/10/01/hackers-prov...
refurb|7 years ago
Could they have made a few grams of nalaxone? Sure it’s pretty simple. Did they make enough to make a difference? No. Did they make sufficiently pure drug so that people don’t get poisoned? Probably not.
And did they make the AIDS drug? He’ll no. That synthesis is way more complicated than their mini lab can handle.
It makes for good VICE articles, but these guys are amateurs who are likely going to get someone killed.
vzcx|7 years ago
jgtrosh|7 years ago
yosito|7 years ago
femiagbabiaka|7 years ago
monochromatic|7 years ago
Except that’s totally unrelated to why he’s in prison.
mertd|7 years ago
JshWright|7 years ago
j88439h84|7 years ago
tomcooks|7 years ago
AnabeeKnox|7 years ago
pauljaworski|7 years ago
andrepd|7 years ago
peteretep|7 years ago
cf: “A Simple and Convenient Synthesis of Pseudophedrine from N-Methylamphetamine”
https://heterodoxy.cc/meowdocs/pseudo/pseudosynth.pdf
thx11389793|7 years ago
rubyn00bie|7 years ago
spaceflunky|7 years ago
I found it hard to keep reading after that. What's it called when people get so emotional about a cause they just start acting irrationally and doing more harm than good?
TheSpiceIsLife|7 years ago
PhasmaFelis|7 years ago
jessaustin|7 years ago
They're talking about an encrypted file, right? If Merck just had this posted on "the dark web", constantly hammering them with bad passwords would probably clue them in. Incidentally, which did Merck value more, the database or the opportunity to keep it away from this group?
r3dk1ng|7 years ago
zxcmx|7 years ago
agotterer|7 years ago
I was at his 2018 talk and the Vice article did an excellent job of summing it up. Usually the HOPE videos come online a few weeks after the conference (it was last weekend).
Something1234|7 years ago
dsr_|7 years ago
anonu|7 years ago
robbiep|7 years ago
briandear|7 years ago
scythe|7 years ago
While this is cool, it doesn't seem to generate attention in a way that could fix the underlying problem, except by dint of people who already know about it. Legislators are infamously subject to undue influence from medical companies that want to protect their oligopolies. A better hacking initiative might work to expose and excoriate those pharmaceutical and medical device companies which have abused the right to lobby in order to generate profits.
yosito|7 years ago
shoo|7 years ago
tfolbrecht|7 years ago
horsecaptin|7 years ago
ceejayoz|7 years ago
1996|7 years ago
Exactly what I would also say as pro capitalist but anti patent.
The article is not about anarchism. It is about not staying idle while people can't afford drugs. The methods may be questionable, like the partnership with dealers. But at least they try to do something.
I just hope there is a way for them to make money without legal risks
lovich|7 years ago
blhack|7 years ago
darawk|7 years ago
If it's murder to apply intellectual property law and withhold drugs...what do we call the untold number of deaths that will result in the absence of a profit motive for developing new medicines? Is that murder?
The views of these people are childish and dangerous. I love their spirit, but their actual message here is just stupid and illiterate of basic economics.
skadamou|7 years ago
_emacsomancer_|7 years ago
blhack|7 years ago
/s
eezurr|7 years ago
>After Four Thieves synthesized cabotegravir, it was just a matter of convincing at-risk populations to use it. According to Laufer, some Four Thieves affiliates began partnering with heroin dealers to cut their product with the cabotegravir.
I know nothing about chemistry/medicine, but this seems stupidly dangerous. There are good reasons to be patient and wait for drugs to go through the phase trials.
It also seems stupidly dangerous to allow uneducated/untrained people to make their own drugs at home by following directions. What if they unknowingly miss a step? For instance, the article is stating that opioids are needed to create Naloxone. That would be a costly mistake to make. They should never release this particular recipe.
These are truly brilliant people who probably have not spent a lot of time hanging around the average person. One reason governments and systems are in place is to prevent the non-well-rounded geniuses from giving an untrained mind an opportunity to make a devastating mistake.
EDIT: This reminds me of the guy who attempted to develop a nuclear reactor in his parents shed. https://en.wikipedia.org/wiki/David_Hahn
phyller|7 years ago
Making the drug and trying it on yourself is one thing. Sharing it with someone else who understands you and how you made it is somewhat similar. Convincing random people who don't know you to take it is crossing some sort of line, and setting up a situation where people are taking your homemade version of a non approved medication without even knowing it is just plain wrong. I know they are already taking heroin, but these are still people and not your lab rats. You shouldn't be making their decisions for them about what goes in their body.
In their do it yourself lab, what are they doing to remove stereoisomers?
waluigi|7 years ago