Patents and healthcare thing (2 Viewers)

[katie tully]

it's just that your tangets are unimportant and dull

breasts are unimportant and dull?

homo.

 

[Nebuchanezzar]

breasts are unimportant and dull?

homo.

i prefer the cock

 

[KFunk]

To me, the common man isn't going to completely appreciate what the test is detecting and what the results mean. I over heard a conversation today where a woman was telling another that BRCA1 and 2 cause cancer, and now they won't be able to access a technology that will tell them if they'll develop cancer.

That's why we need good genetic counsellors and doctors with communication skills. The average person should be able to grasp something like genetic risk if it is spelled out clearly. The media is a whole other story of course.

 

[KFunk]

i think, at this early stage at least, that such tests should act purely to encourage women to get regular checks, which in itself is a good thing. As you have said, a lack of understanding and education leads to hysteria which can only be bad when it comes to disease and it's prevention and/or control.

Given the lifetime risk confered by BRCA1/2 I think a certain level of anxiety, short of hysteria, is warranted. We're looking at something in the order of a 70% lifetime risk of developing breast cancer. You're less likely to get heads on a coin flip. Those are not comfortable odds.

 

[katie tully]

That's why we need good genetic counsellors and doctors with communication skills. The average person should be able to grasp something like genetic risk if it is spelled out clearly. The media is a whole other story of course.

And public awareness. If people don't understand on a basic level what these technologies are for, they won't seek them.

I still have women coming into work who haven't had a pap smear ever, or wait 10 years between smears because they don't appreciate/understand what an effective prescreening tool pap smears are. It needs to be made more public, rather than relying on people to seek the information from doctors.

You can lead a horse to water.

Given the lifetime risk confered by BRCA1/2 I think a certain level of anxiety, short of hysteria, is warranted. We're looking at something in the order of a 70% lifetime risk of developing breast cancer. You're less likely to get heads on a coin flip. Those are not comfortable odds.

I didn't think the statistics were that high.

"It appears that mutations to this gene only play a role in the development of approximately one-half of familial breast cancer, which accounts for 2-19% of all breast cancer, and about 10% of the cases of early onset breast cancer. That the BRCA-1 gene has not been found to be mutated in sporadic breast cancers" (2).

In other words, in familial breast cancer penetrance is less than 50%. Above all, most sporadic breast cancer patients do not carry this mutation. In the majority of breast cancer patients the model fails to describe variation adequately. And such models serve for risk estimates. This dangerous misconception convinced some genetic counselors to suggest bi-lateral mastectomy for breast cancer prevention in so called "high risk" patients.

Among non-Jewish individuals (likelihood of having any BRCA mutation):

* General population (non-Jewish): 1 in 500 (0.002%)
* Women with breast cancer (all ages): 1 in 50 (2%)
* Women with breast cancer (under age 40): 1 in 11 (9%)
* Men with breast cancer (regardless of age): 1 in 20 (5%)
* Women with ovarian cancer (all ages): 1 in 10 (10%)

BRCA 1 mutations were identified in 9/124 (7%) women where there was a family history of breast cancer without ovarian cancer, 10/57 (18%) where family members had bilateral breast cancer, 28/60 (47%) with family members with both breast and ovarian cancer or a single member with both cancers.
Implication for screening
This suggests that even when subjects are selected from families with a strong history of breast cancer only about 7 in 100 will be found to have BRCA 1 mutations. So more than 9 out of 10 tests would be negative, with 10% or fewer positive, if screening for BRCA1 mutations were instituted. The implication is that BRCA1 mutations may account for fewer than half of hereditary cases of breast cancer, not much higher figures suggested previously (see Bandolier 18 ).

But please correct me if I'm right off track.

 

[madsam]

personally i believe this lab is acting in an unethical manner.
i don't give a shit if they hold a patent for this screening method/technology.
what is more important to the company, money or saving the life of many women???
if they force other clinics or labs from using this lifesaving screening method, let's hope that they get shamed & get a bad reputation and go bankrupt.

Just a question for all those people who say its unethical to patent health care,

Patents are there to protect the original designer of something and give incentive to build new technologies. Without patents as soon as a new product were developed another person would then make an exact replica, but with not research and development fees, so can charge alot less than the original owner. After a while, business owners would catch on to this and stop making new technologies, merely copying existing ones at a lower price.

So the question is this, if patents didn't exist, who would you expect to willingly create new products, knowing that they would eventually succumb to a loss, forfeiting the entire point of running a business?

The only feasible way this would work would be if the government subsidized all R + D costs, but then the entire medical industry would go in a frenzy and spend like mad.

While ideally medical things should be free, with a universal health care system, if that were the case either the industry would not advance, or the government tax payers would ultimately suffer

 

[nikolas]

I still dont get it, its freaking retarded. How can you own a method of testing? Could someone explain this.

If the patent relates to a machine that tests for breast cancer it would be completely different.

 

[ASNSWR127]

Just a question for all those people who say its unethical to patent health care,

Patents are there to protect the original designer of something and give incentive to build new technologies. Without patents as soon as a new product were developed another person would then make an exact replica, but with not research and development fees, so can charge alot less than the original owner. After a while, business owners would catch on to this and stop making new technologies, merely copying existing ones at a lower price.

So the question is this, if patents didn't exist, who would you expect to willingly create new products, knowing that they would eventually succumb to a loss, forfeiting the entire point of running a business?

The only feasible way this would work would be if the government subsidized all R + D costs, but then the entire medical industry would go in a frenzy and spend like mad.

While ideally medical things should be free, with a universal health care system, if that were the case either the industry would not advance, or the government tax payers would ultimately suffer

Nice theory but i don't think that is the case...

look at Sweden and other 'socialist' countries. They have great health systems!

Plus most researchers aren't purely moved by profit and even if they were if they knew that everyone could have a 'slice of the pie' then I am sure that would motivate them even more...

My two cents worth...

 

[The_highwayman]

Given the lifetime risk confered by BRCA1/2 I think a certain level of anxiety, short of hysteria, is warranted. We're looking at something in the order of a 70% lifetime risk of developing breast cancer. You're less likely to get heads on a coin flip. Those are not comfortable odds.

perhaps, but making people freak out thinking they're definitely going to get Breast cancer if they have this mutant gene is not a good thing. surely it would lead to a reduction of stall in the number of women doing/getting regular checks, for fear of the unknown. Openness and honesty is the best approach when it comes to healthcare. Sure, tell that that their risk is higher, but in doing so encourage regular checks because early detection is best if a tumour does eventuate.

 

[madsam]

Nice theory but i don't think that is the case...

look at Sweden and other 'socialist' countries. They have great health systems!

Ok, well straight from wiki

Since the late 1960s, Sweden had the highest tax quota (as percentage of GDP) in the industrialized world, although today the gap has narrowed and Denmark has surpassed Sweden as the most heavily taxed country among developed countries...The health care is governed by the 21 landsting of Sweden and is mainly funded by taxes, with nominal fees for patients. One major criticism leveled at Swedish health care are long waiting times before treatment.

So they have better health care, but at the expense of the taxpayer, as i suggested as an option earlier. In fact, i would not be surprised if their government had little R + D and merely bought it off other countries and made it freely available.

Plus most researchers aren't purely moved by profit and even if they were if they knew that everyone could have a 'slice of the pie' then I am sure that would motivate them even more...

While researchers may not be driven by a need for profit, they certainly do not want to incur a major loss, do they? The process of R + D is very expensive, especially in the medical industry, requiring large sums of money to trial and modify potential products.

If you personally had to take out a 400k loan from a bank to start a small company, lets say it only just started breaking even after you resold already invented products like a pharmacy, a simple retailer. You then go out and take another 400k loan, using your business and house as security to the loan, and you discover a life saving drug that is expensive to make. You now have two options;
Sell it at base cost and make no money, so the banks foreclose on your belongings and you ultimately lose at life.

Or you can sell the product, make profit, use your existing knowledge to help expand the process and create a more efficient, cost effective similar good, that can save more lives for the same price.

Obviously you choose the second option, not because you dont like saving others, but because you want to at least maintain a living and potentially save more lives in future.

 

[KFunk]

I didn't think the statistics were that high.

But please correct me if I'm right off track.

We're talking about different figures. The statistics that you are citing refer to prevalence of the BRCA1/2 mutations in certain populations and the proportion of breast cancer cases in the community attributable to BRCA1/2.

The 60-85% (hence ~70%) figure I was citing is the individual's lifetime risk of breast cancer given the presence of mutations in either BRCA 1 or 2. This is the important figure when interpreting a positive test result because it tells you how a patient's risk profile has changed. (Note: lifetime risk of breast cancer is close to 10% for Australian women in the absence of knowledge of any risk factors).

Your figures are important at the population level when determining how useful the test is as a screening tool (is it cost effective? will it reduce mortality? etc). Of course, for the individual they also demonstrate that a negative test for BRCA 1/2 mutations does not protect one from breast cancer (given that BRCA mutations are not the sole cause.

 

[nikolas]

I Think people are missing the point. These fuckers think they own my genes.

 

[katie tully]

Ok cool KFunk, sorry for the confusion.

 

[KFunk]

perhaps, but making people freak out thinking they're definitely going to get Breast cancer if they have this mutant gene is not a good thing. surely it would lead to a reduction of stall in the number of women doing/getting regular checks, for fear of the unknown. Openness and honesty is the best approach when it comes to healthcare. Sure, tell that that their risk is higher, but in doing so encourage regular checks because early detection is best if a tumour does eventuate.

You wouldn't tell someone that they are definitely going to get breast cancer. However, it is important for them to understand that present evidence suggests that they are more likely than not to develop breast cancer during their lifetime if a BRCA 1/2 mutation is identified. Some women in this situation consider prophylactic removal of the breasts (mastectomy) in order to significantly reduce breast cancer risk. The identification of a BRCA 1/2 mutation is not a diagnosis, sure, but it is also not a result which can be passed over lightly. One needs to break bad news as a human being of course - you shouldn't hit the anxious patient over the head with doom and gloom - but a certain degree of frankness is nonetheless required. This is part of being honest.

 

[nick3157]

I still dont get it, its freaking retarded. How can you own a method of testing? Could someone explain this.

i did on page one. this is no different from your doctor charging u above and beyond what is require by medicare. and this isnt something new either; people buy expensive medication that is protected by patents all the time. it is up to the government to subsidise the cost of that medication or in this case, a genetic test. the right of the manufacturer to charge what they like is protected by australian law. again, the government has the final say here.

Nice theory but i don't think that is the case...

look at Sweden and other 'socialist' countries. They have great health systems!

Plus most researchers aren't purely moved by profit and even if they were if they knew that everyone could have a 'slice of the pie' then I am sure that would motivate them even more...

theres nothing wrong with the way that our system works (in regards to this kinda stuff anyway). the government massively subsidises what we need, and in many cases if you and your doctor can prove to the government that u need a subsidy for something that isnt already subsidised, then they will pay for it anyway. we have a powerful breast cancer lobby in australia so if they belive the test is worthwhile for all women to get, the government will fork out for it.

im sure most researchers arent purely moved by profit but the people who fund them most certainly are. no money = no more research. this company is just the same as every other company in the world - they are entitled to run their business and make a profit.

 

[katie tully]

No I disagree.

Patenting a gene might be profitable for one company, but it inhibits other researchers from making breakthroughs. A discussion paper by the Nuffield Council on Bioethics said;

atents might inhibit innovation by increasing the cost of research to other scientists interested in the same sequence. If rights to several DNA sequences were needed, a company might decide not to develop a therapeutic protein or diagnostic test because of the number of royalty payments required.

Which is what I don't understand about those who harp on about the original company needing the money to further research. There is no reason why other companies can't use this same genome to further research and just pay a royalty fee to the original research company. It works in music, it works in T.V, why wouldn't it work in science?

Protection by patents of specific diagnostic tests which are based on DNA sequences could provide an effective means of rewarding the inventor while providing an incentive for others to develop alternative tests

It makes discovering new technologies stagnant. If one company has the monopoly over a genome, who is to say that other companies can't find better or more effective therapeutic uses?

Some points to consider;

1.
Patents benefit society through innovation and promoting progress.

2.
The definition of “invention” vs. “discovery” with the identification of genes, mutations, links between genetic defect and disease are deemed to be discoveries by some and thus would be unethical to patent.

3.
Patenting novel technical tools for genetic testing is a good way to promote investment and allow for invention.

4. Genetic tests that examine a panel of genes will be impacted negatively by gene patents.

5. Genetic tests combined with protein or metabolite measurements will also have to consider multiple patents.

6. Patent applications do not take into account clinical validity and utility.

7. There are international differences in patent systems which affect the availability of genetic services worldwide.

8. Gene patents are overly broad and include not just the sequence but also protein and antibodies, etc.

http://www.eyeondna.com/2008/04/29/gene-patents-and-genetic-testing/

 

[katie tully]

i did on page one. this is no different from your doctor charging u above and beyond what is require by medicare. and this isnt something new either; people buy expensive medication that is protected by patents all the time. it is up to the government to subsidise the cost of that medication or in this case, a genetic test. the right of the manufacturer to charge what they like is protected by australian law. again, the government has the final say here.




theres nothing wrong with the way that our system works (in regards to this kinda stuff anyway). the government massively subsidises what we need, and in many cases if you and your doctor can prove to the government that u need a subsidy for something that isnt already subsidised, then they will pay for it anyway. we have a powerful breast cancer lobby in australia so if they belive the test is worthwhile for all women to get, the government will fork out for it.

im sure most researchers arent purely moved by profit but the people who fund them most certainly are. no money = no more research. this company is just the same as every other company in the world - they are entitled to run their business and make a profit.

I think you're making the PBS scheme out to be a little more than it is.

Pertussis, which is whopping cough is one example of where the PBS scheme fails.
http://www.mja.com.au/public/issues/184_06_200306/letters_200306_fm-5.html
Keeping in mind that article is from 2006, but I haven't found anything else to suggest that azithromycin has been allowed for pertussis treatment in AU. It's already on the PBS scheme as treatment for Chlamydia.

Another example from the Optometrists Association Australia shows that out of 45 available treatments, 12 are subsidised by the PBS.

Another question I have for you is, how long do people need to wait to gain clearance for subsidised medicine?

Not all medications used for the treatment of asthma come through the PBS. In particular, short-acting bronchodilators are often bought without a prescription, and are usually only acquired through the PBS when the patient holds a government concession card.

One suggestion to PBS reform was to make all drug companies put the generic name of the drug above the brand name, allowing consumers the option to buy a cheaper, generic brand.

 

[nick3157]

I think you're making the PBS scheme out to be a little more than it is.

Pertussis, which is whopping cough is one example of where the PBS scheme fails.
http://www.mja.com.au/public/issues/184_06_200306/letters_200306_fm-5.html
Keeping in mind that article is from 2006, but I haven't found anything else to suggest that azithromycin has been allowed for pertussis treatment in AU. It's already on the PBS scheme as treatment for Chlamydia.

Another example from the Optometrists Association Australia shows that out of 45 available treatments, 12 are subsidised by the PBS.

if the treatment course for pertussis is 5-7 days and the azithromycxin costs 30 bucks its hardly a massive shortfall of the system. absolutely it should be covered, but in reality it wouldn't be much cheaper for anyone except veterans.
as for the optometry association i dont know anything about that.

 

[katie tully]

So people who contract STD's should only pay $5 for antibiotics, but parents with children should pay $30 for the same medication?

EDIT: Off MIMS

Pack: 500 mg [2] : Restricted - PBS/RPBS
[Restricted benefit indication(s): Uncomplicated urethritis and cervicitis due to Chlamydia trachomatis.] PBS: $23.46
Pack: 500 mg [2] : Restricted - PBS/RPBS (Rp 2)
[Restricted benefit indication(s): Trachoma.] PBS: $23.46
Pack: 500 mg [3] : Restricted - RPBS
[Restricted benefit indication(s): Upper and lower respiratory tract infections.] PBS: $34.67
Pack: 600 mg [8] : Section 100 - Highly Specialised Drugs Program PBS: $67.82

 

[nick3157]

did i not say it should be subsidised?

but am i right when i say that if the azithromycin costs 30 bucks, then it wont matter whether or not its is on the pbs list (unless you're a pensioner/concession or veteran) because the cost this year is 31.80?