GESTIÓN EN SALUD PÚBLICA: BioEdge: One drug manufacturer’s moral universe

domingo, 16 de septiembre de 2018

BioEdge: One drug manufacturer’s moral universe

BioEdge: One drug manufacturer’s moral universe

Bioedge

One drug manufacturer’s moral universe

by Michael Cook | 15 Sep 2018 |

It’s important to establish an ethical framework before launching into debates on specific issues. And although he is being reviled on Twitter, at least Nirmal Mulye, the CEO of Nostrum Laboratories, a small pharmaceutical manufacturer based in Missouri, has a firm and clear ethical framework: to maximise profit.

In an interview with the Financial Times, he defended his decision to raise the price of an antibiotic for urinary tract infections from US$474.75 to $2,392, a 400% hike. “I think it is a moral requirement to make money when you can . . . to sell the product for the highest price.”

The product, nitrofurantoin, appears on the World Health Organization’s list of essential medicines. It comes in a tablet form as well as the liquid version which Nostrum makes. A competitor, Casper Pharma, is already selling a version of nitrofurantoin for $2,800.

“The point here is the only other choice is the brand at the higher price. It is still a saving regardless of whether it is a big one or not,” said Mr Mulye.

He also defended Martin Shkreli, who became notorious in 2015 for raising price of an AIDS and cancer drug from $13.50 to $750 per tablet. “I agree with Martin Shkreli that when he raised the price of his drug he was within his rights because he had to reward his shareholders,” said Mr Mulye.

In a tweeted response, FDA commissioner Scott Gottlieb said: “There’s no moral imperative to price gouge and take advantage of patients. FDA will continue to promote competition so speculators and those with no regard to public health consequences can’t take advantage of patients who need medicine.”

Sunday, September 16, 2018

Last year Sydney journalist Miranda Devine interviewed Australia’s first out-of-the-closet transsexual, Carlotta, a cabaret performer and TV actor. Carlotta had what is now called “gender-affirming” surgery in the early 1970s and built a career in show biz. Her advice to teenagers who want to transition to the opposite sex: “Don’t give the child hormones. Wait till 18. You shouldn’t fool around with the body until you’re mature.”

This seems common sense. However, as an article in JAMA Pediatrics (see below) reports, girls as young as 13 are receiving mastectomies to treat their gender dysphoria. Two years later (ie, when they’re 15) the transteens are supposedly as happy as Larry with their “top job”.

This doesn’t seem common sense. How can a girl of 13 give truly informed consent to a life-changing operation which removes both of her breasts? As a growing number of “detransitioners” bear witness, this is crazy. “I’m a real-live 22-year-old woman with a scarred chest and a broken voice and a 5 o’clock shadow because I couldn’t face the idea of growing up to be a woman,” says Carla in a YouTube video.

The risk of turning a young girl’s life into a misery is just too great to allow teen mastectomies before adulthood. In fact, it’s hard to describe it as anything other than child abuse by her physicians and psychologists. What do you think?