Saturday, October 27, 2007

Hate crime legislation as punishing speech.

Wendy Kaminer had a great piece in the October 26th Wall Street Journal. In "The Return of the Though Police" she characterizes hate crimes as punishment of the thought or ideas that accompany a criminals commission of an act. That is, a "hate crime" is nothing more than a package of a crime and the thought that goes along with it. As such, it is a false concept, and leads to the politicization of crime.

Still, distinguishing hateful bias crimes from other hateful acts of violence punishes ideas and expression, no matter how scrupulously the legislation is crafted. When someone convicted of assaulting one woman is subject to an enhanced prison sentence or a more vigorous prosecution because his assault was motivated by a hateful belief in the inherent inferiority of all women, then he is being punished for his thoughts as well as his conduct.

I went searching for other expressions of this opinion and found two great op-eds at ARI. One by Robert Tracisnki and the other by ARI Director Yaron Brook.

Yes, cancer is as difficult to cure as I said it was.

In a follow up to this week's post on the state of cancer therapy, Opinion has a great piece on the state of cancer therapy. Bottom line, early detection, a good surgeon, and diagnostics to determine which of the few drug therapies might benefit you are still what gives one the best chance of survival.

Tuesday, October 23, 2007

Legalize Drugs Now!

Got your attention? Think I'm going to talk about marijuana? Not on your life. I want to talk about real drugs; experimental cancer drugs to be exact. Earlier this year, a federal appeals court ruled that cancer patients cannot have access to experimental cancer drug therapies that have not been approved by the FDA.

For an agency supposedly chartered to protect the health and safety of the public, I can think of nothing more reprehensible than forbidding access to any medication to patients who may likely be dead before the medication is approved. Who's life is it, anyway? The state's? But then it's because the FDA ought not to exist as an agency, that the government has no business regulating healthcare or any other industry. Seeking justice after crimes are committed? Sure. Clogging up the system with bureaucratic red tape in the name of preventing as-yet-uncommitted crimes? That does one thing. It kills people. Literally.

Pharma companies are rued for making too much money on drugs, and cancer drugs are among the most expensive. As Stella Daily explains to us on ReasonPharm, that is due to very explainable reasons. Cancer is fragmented; it's not a single disease, but rather 300 separate individual, somewhat-related diseases. Compared to the market for cholesterol lowering drugs like statins, cancer is microscopic. But it still costs a fortune to develop any drug, and cancer is one of the tougher disease areas for which to develop. Most cancer drugs today are successful if they can extend a patient's life for a year or two, and most are targeted at late stage cancers. A cure is viewed as an almost unattainable holy grail. Compared to other diseases, cancer drug therapy is in the dark ages.

Pharmaceutical companies need one thing desperately to find new cancer cures: profits. Given small markets, large up front investment costs, and stunningly long approval times, rational companies seek greener pastures than oncology. That's not what I want. I want cancer to be profitable, because profits draws profit-seekers. And it is profit-seekers, the Atlases of the world, not bureaucrats, that discover life-saving medications. If people value their lives, they'll want the same thing.

This one is a matter of life and death, and also, it's personal. You see, I'm a cancer survivor. I'm a number in a box. 2001; Hit "Go"; Select "Incidence Counts"; white male; cancer type: testis. It was summer, so I'm guessing I'm around number 3,000 out of 6,596 diagnoses that year. 6,000 - 7,000 patients per year. That is hardly a market that will justify drug research. Luckily, early diagnosis, surgery, radiation therapy, and five years of monitoring have left me "cured". My chance of recurrence in my lifetime is probably less than 1%. But if it should happen, then between now and then I want drug companies working round the clock seeking huge profits on new cancer drugs. I titled this post "Legalize Drugs..." What I really meant was "Abolish the FDA"; it's the same thing really. I want the FDA gone, out of the way, so that these companies can work as quickly as possible and make as vast sums of money such that the best and brightest are drawn into the area of research. Any thing else is less than "life-saving".

Monday, October 22, 2007

Microsoft to EU: "Uncle..."

Today Microsoft said that it would not appeal a recent EU anti-trust judgement against it. This means it will allows itself to become subject to fines measured in 100's of millions of dollars, and coercive action to break up software bundling and allow competitor access to it's operating system.

It's a sad day, as this case sets poor precedents for other pending EU anti-trust cases.

Sunday, October 21, 2007

The Embattled Republicans

In a follow up to my post on the tribulations of the Republican Party, the Wall Street Journal Friday chronicles more of that party's woes for the upcoming elections. From the article "Republicans Running Uphill" it seems that Democrat National Committee is outpacing its Republican counterpart for campaign contributions, including from large corporate donors. This at a time when Republicans have more seats to defend than they would need to recapture the house.

I find this whole situation, though not ideal, satisfying. I'm not a fan of the Democrats, but the Republicans are hardly defenders of my principles, namely laissez faire capitalism. And until the social conservative faction no longer dominates the party, it might just do the trick to see them out of power.

Inhaled Insulin a Bust; Drug Development isn't that easy.

Free millions of diabetes patients from daily injections. Sounds intriguing, doesn't it? If there was a way to do this, then the replacement product would make a mint, right? Not so fast. Drug giant Pfizer announced this week that it was pulling it's groundbreaking version of insulin, Exubera. Launched little over a year ago, Pfizer and it's licensing partner, biotech Nektar therapeutics, had big plans for Exubera, projecting ultimate revenues of $2 billion. Both spent over a decade working on the drug, and pulling it from the market will come with a big write-off, almost $2.8 billion, one of the costliest drug failures ever.

Just another sign that finding blockbusters (the term for drugs that net over $1billion at maturity) is getting harder to do. Many pharmaceutical companies have begun targeting smaller niche indication areas because of reduced cost to develop and market such drugs. Most people look at market successes such as Pfizer aging Lipitor franchise, which earns the company $13 billion in revenue, and flush with envy. But this does not count the cost and risk that companies face in bringing drugs to market. All of those successes must pay for drug development and for the failures, such as Exubera, and still yield the next generation of winners.

The irony is that Exubera is a technical success. It works. But it was also a big risk. Diabetes is a widespread chronic disease, and therefore treatments for it must undergo very large clinical trials to understand their effects on such a broad target market, and over the long periods of time that the drug must be taken. Exubera failed due to a number of factors, all market driven, which illustrates the tricky nature of making decisions to launch new products like these.

First off, it costs too much. Insulin is not a particularly cheap drug to make, and because much of the drug is broken down in the lungs before it reaches, Exubera requires ten times the normal dosage for injected insulin! The normal rule of thumb for daily therapies such as diabetes or cholesterol treatments are that they are affordable at a rate of about $2-3/day. Exubera costs $5/day.

Secondly, it is somewhat complex to administer. One would think that a diabetes patient might to anything to avoid giving himself daily injections, but the reality is that companies have made injected insulin therapy fairly straight forward. Such innovations as pen injectors, and insulin pumps have taken much of the difficulty out of administering an injected therapy. Exubera's inhaler is a wieldy device that takes some time to learn and is used very differently from traditional injected therapy.

Finally, even though Exubera was shown safe to the lungs over long periods during its clinical trials, FDA was fairly tough on Pfizer and required warnings on the drug label. Doctors, continued to have concerns over the long term use of the therapy. This is again, not so much a technical issue as one of market acceptance, and consumer preference.

The outcome at the intersection of all of these factors are difficult to predict, but the investment required to go through clinical trials is not. This means that someone had to make a call on whether to invest the money to prove the drug worked, before they knew if the drug would sell. Sometimes those decisions succeed, and sometimes they fail, and the people who make them, instead of being reviled for making too much profit as the pharmaceutical industry is, should be allowed to make more profit.

Saturday, October 06, 2007

Who's Staying and Who's Leaving

Social conservatives and Fiscal Conservatives, that's who's staying and leaving the Republican Party. Some of us pointed to this trend after the last elections, but now it's front page news on the Wall Street Journal.

Already, economic conservatives who favor balanced federal budgets have become a much smaller part of the party's base. That's partly because other groups, especially social conservatives, have grown more dominant. But it's also the result of defections by other fiscal conservatives angered by the growth of government spending during the six years that Republicans controlled both the White House and Congress.

The most prominent sign of dissatisfaction has come from former Federal Reserve Chairman Alan Greenspan, long a pillar of Republican Party economic thinking. He blasted the party's fiscal record in a new book. In an interview with The Wall Street Journal, he said: "The Republican Party, which ruled the House, the Senate and the presidency, I no longer recognize."

The debate about which political party best serves our interests has been ongoing in Objectivist circles since before the start of the Iraq War. Many claim that we, and those who at least nominally think like we do are too small a population to make a difference, and that since the Republicans still have the business vote, they will serve our interests best. Look again. When the Republican party loses the business vote, what will it have that is of interest to anyone with Objectivist leanings? Answer: nothing.

Political dynamics in the US are much like swings in commodity pricing, where demand and supply is usually very balance, and small shifts in either cause huge swings in prices. So too, the country is split roughly 50/50 Republican/Democrat and that means that the swing vote calls the shots, so fewer voters need be of moderate persuasion to significantly impact election results. Witness the 04 election results. So it is that the so-called "fiscal conservative" or "libertarian" wing of the Republican party is a large faction and the Republican party cannot stay dominant without them, and the Democratic party would love to have them. And when factions are courted, one has an opportunity to try to make fundamental change.

I have no illusions that politics will change overnight, but it is the continued exercise of political will based upon rational principles, and the continued communication of those principles that will ultimately see shifts in both parties for the better.