You'd like to think that companies have factories with quality control laws and there are local people trying to ensure that all of their product are up to the local standards. What you don't expect is that they are binning them like Intel CPUs, where they just make a batch and hope for the best, take cream off the top until the priority orders are done and then everyone else gets whatever is left. You might get a slightly better product sometimes but not be so lucky the next time.
In the UK I know the NHS buys generics, which implies they are effective, but I wonder.
Instead this mostly comes down to how effective each countries regulations are.
Generics are effective
I pay the 2$ it cost for brand name ventolin (my insurance cover the cost generic and I pay the difference) as the generic give asthma attack. But I would not pay one cent more for the brand name Vyvaanse. Effect wise the generic is indistinguishable (but damm the pills colors make them looks like a cheap gray market knock-off).
My wife has a paper from her oncologist for original femara because the generic made her faint a few times ( the insurance cover the whole cost because of that paper)
My friend the John the Pharmacist explained that the binders etc can accelerate absorption. His advice was be careful the first two days of a new generic formulation.
I would assume the NHS (like the TGA here in Oz) looks _very_ carefully at the side-affect profile before they buy any particular generic. Government agencies tend to try not to poison voters.
You shouldn't be able to sell what is basically sugar water in Somalia and call it cyclophosphamide. That's fraud if I do it as a private citizen.
In fact it's even fraud for me if I buy actual cyclophosphamide, and cut it with a bio compatible totally non reactive filler compound. How are these people getting away with it without the president and senators being on the take? When they'd run you or I down in less than a month for effectively the same act?
To be clear, I don't believe you or I should be able to do this. But I know what happens to private citizens who try to do things of this nature. So there is no question that this is a crime. The only question is why is it not prosecuted for larger corporations.
its like everyone learning during covid their neighbors would kill every service worker to avoid the inconvenience of making their own coffee. it leaves a mark.
see what happened to the poor n-gate.com fellow, burned him out
Not the primary reason, but it was part of it.
You can get SNAP (free food), Section 8 (free housing), Medicaid (healthcare, CHIP for kids is easier than adults, but still many people get it), and if you manage to raise smart kids despite poverty they will get college for free as well (most highly-selective universities are free for the poor, but extremely expensive for even the middle class).
I own a lot of rental property and I have a Section 8 tenant who has never worked, completely gamed the system with a subjective disability that renders her unable to ever hold a job (supposedly). A good tenant but is constantly trying to give away tons of food she buys because she always tries to spend the SNAP she gets every month. And she gets free heat, and electricity, and public transportation pass, and on and on.
Cancer treatment effectiveness has improved substantially, with many treatments now achieving high cure rates or significantly extending survival.
Highly effective treatments:
Surgery remains the most curative treatment when cancer is localized and can be completely removed. Complete surgical resection often leads to cure for early-stage solid tumors.
Chemotherapy can be curative for several cancers, particularly blood cancers like leukemias and lymphomas. Some testicular cancers and certain pediatric cancers also respond extremely well to chemotherapy alone.
Radiation therapy achieves excellent local control and can be curative, especially when combined with surgery or chemotherapy. It’s particularly effective for head and neck cancers, early-stage lung cancers, and certain brain tumors.
Revolutionary newer treatments:
Immunotherapy has transformed outcomes for melanoma, lung cancer, kidney cancer, and others. Some patients with advanced disease achieve long-term remissions that were previously impossible.
Targeted therapies work exceptionally well when tumors have specific genetic mutations. Examples include imatinib for chronic myeloid leukemia (transforming a fatal disease into a manageable condition) and HER2-targeted drugs for breast cancer.
CAR-T cell therapy has achieved remarkable results in certain blood cancers that failed other treatments, with some patients achieving complete remissions.
Combination approaches:
Modern treatment often combines multiple modalities - surgery plus chemotherapy plus radiation, or immunotherapy plus targeted therapy. These combinations frequently outperform single treatments.
Current limitations:
Some cancers like glioblastoma and pancreatic cancer still have limited treatment options, though research continues. Metastatic disease remains challenging, though increasingly manageable as a chronic condition rather than immediately fatal.
Hopefully those countries don't reduce standards due to lobbying.
I'm not going to cast stones at this practice because as always the alternative isn't some magical world where all produce is perfect, the real alternative is that it gets thrown in the trash and wasted, and everyone is worse off despite feeling better about themselves.
kurthr•5h ago
firesteelrain•5h ago
nathan_compton•5h ago
hinkley•5h ago
amluto•4h ago
Today, most of the Cabinet positions are held by people who love to talk, who are generally extremely wealthy and/or well connected, and who are generally unqualified for their jobs. And, even more relevantly, they have been very heavily interfering in the operation of their respective departments.
labster•3h ago
dmoy•3h ago
thfuran•3h ago
protocolture•2h ago
Australia wont import FDA certified beef. For great reason.
firesteelrain•1h ago
Australia doesn’t allow most USDA beef because of strict biosecurity rules.
Australia’s one of the world’s biggest beef exporters. There’s not much incentive for them to open the door to a competitor unless the protocols align perfectly.
ggm•4h ago
It wouldn't work, but when I see appeals to authority (FDA) enter the room, it's usually to feel superior because its a logical fallacy in argument but the place it actually fits (which btw, is here, in this thread) is that compliance to standards and policing them, is not "argument" it's the "you only had one job" part of the gig.
"yes Mr Kennedy, these friends of yours are very nice at parties, but unfortunately they are neither qualified, nor actually capable of fulfilling their role and so no, you won't be appointing them" is what the Bund would do.
Being able to take a compliance body oversight function and leverage it to remove adjuvents because of one paper, despite overwhelming evidence to the contrary, is precisely whats wrong in the current politicised situation.
If people making generic cancer drugs for use in africa had to be held to the standards in the west, we'd all be better off. I have said elsewhere that if the US rejects flu vaccines because of the mercury, they should be checked for other compliance and standards, and subject to cold chain integrity shipped to economies who usually can't afford them, and can use them.
gsf_emergency_2•3h ago
just wanted to point ou his most famous patent, the Einstein-Szilard fridge
(considerably less famous than the Einstein-Szilard letter, so I feel there's another argument for or against technocracy right there)
ggm•3h ago
elcritch•3h ago
There was a fascinating article I read years back about how much of China’s top leadership had engineering degrees, unlike in western countries. Then the article pointed out how that led to things like the one-child act based on research in the 1970s predicting mass starvation. That one child policy is now leading to possible demographic collapse after causing decades of social strife.
Be careful what you wish for, as you’re possibly a variable which could optimized out.
Alternatively consider the long term ramifications of leaving pandemic responses purely in the hands of unelected epidemiologists whose primary focus is a virus and not the overall welfare of a population. Those are not the same thing after all, even if they seem like it at first glance.
IMHO, alternative means of thinking are needed in a governmental system for the best overall outcomes.
ggm•3h ago
(he wrote rather bad scifi about talking to dolphins. Somebody else, Pierre Boule wrote it much more sexy/exciting, that became "the day of the dolphin")
elcritch•2h ago
Bad dolphin sci-fi sounds a bit too much for my tastes. Though it’s often the border line crazy folks who give us some of the best ideas or stories. Though they also often need refinement by, uh, more standard people. I say that as an ADHDer who sometimes benefits from the same.
See more rational for needing mixed viewpoints!