Lipitor was formulated in 1985, went through an expensive and exhaustive trials process which concluded in 1994, and hit the market in 1996. Today it is one of the best selling drugs in the world, has revolutionized heart health, and saves tens of thousands of lives in the US annually.
So was Lipitor’s development and approval process a failure? If you ask some patients and their families who were stuck in the early 90s with hope but no access to the drug, they would probably say so. And I understand the emotions involved, but the truth is that if human civilization has existed without a lifesaving treatment for hundreds of thousands of years, delaying it for a couple more to better under its effectiveness is the right decision for the public good.
>dthe truth is that if human civilization has existed without a lifesaving treatment for hundreds of thousands of years, delaying it for a couple more to better under its effectiveness is the right decision for the public good.
I don't understand how that's the counterfactual though. Let's say the patents we're talking about are ones that in the early 90s had a 90%+ chance of dying without Lipitor. Not giving them the drug simply to have a control group is just as morally fraught as giving people completely untested drugs that kills them. To suggest otherwise is just status quo bias.
It's clearly a complex issue where you draw the line, but we should be able to have an intelligent conversation as a society about probabilities and tradeoffs.
People who don’t get a drug while it is under development aren’t in a control group. People in a clinical trial who don’t get the drug are in the control group. Yes it is a morally tricky situation, but the people who signed up are aware of it. Everyone else simply doesn’t get the drug because the drug hasn’t been approved yet.
The point that people are making is that it's the trolley problem. Yes you actively kill one person by making a drug available prematurely but you kill 5 people through inaction otherwise.
You claim a specific belief here about the odds ratios, but hypothetically if the odds ratio were more similar to what I claimed than what you claimed, would you change your opinion?
Yes, that's a great example of a success story. However, other drugs have gone through the same process and were eventually found to not be as effective as during the trial; or worse, they were found to be dangerous.
Aside from the threat to the patients, there's the opportunity cost of such "misfires."
In the US, we can upon death donate our organs to others in need. We can also, again upon death, donate our bodies to science. Yet while alive, we can't decide to help ourselves, and ideally others as well? That doesn't make sense.
So was Lipitor’s development and approval process a failure? If you ask some patients and their families who were stuck in the early 90s with hope but no access to the drug, they would probably say so. And I understand the emotions involved, but the truth is that if human civilization has existed without a lifesaving treatment for hundreds of thousands of years, delaying it for a couple more to better under its effectiveness is the right decision for the public good.