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Re: Is Medical Research Trustworthy in a Profit-Driven World?

Posted: June 4th, 2024, 1:31 am
by LuckyR
Sushan wrote: June 3rd, 2024, 6:00 am
LuckyR wrote: May 26th, 2024, 12:53 pm
Sushan wrote: May 26th, 2024, 1:46 am That sounds like a robust system designed to ensure the efficacy and safety of drugs before they are widely used, and it clearly has its benefits for both the healthcare system and patients. In my country, we have a similar setup, though not as sophisticated due to limited resources and the lack of a fully computerized healthcare system.

However, we've faced significant challenges with breaches in the system. Recent investigations have uncovered corruption involving high-ranking officials, including the Health Minister, leading to breaches in the drug evaluation and approval process. Many of these corrupt individuals are now in jail, including the minister, but the trust in our system remains severely damaged.

Given these challenges, do you have any suggestions on how we could implement stronger measures to ensure the integrity of the drug evaluation and approval process? What steps can we take to rebuild trust in our healthcare system and prevent such corruption in the future?
Like most things in Life involving humans, it's all about understanding motivations and designing systems to leverage that understanding. Our system is comprehensive (in the sense that the labs, pharmacies, insurance arm and ancillary services are all in the same corporation as the standard health delivery) and thus the various divisions are not in financial competition with one another. In addition as we started as a capitated system with provider paid for their time not procedures, there is no incentive to approve care beyond what is medically necessary. Since we're an individual corporation (not a whole country) no Pharma company is going to risk trying to bribe a Formulary Committee member to try to get a set of expensive drugs approved. The docs are financially tied to the financial health of the corporation since that's who provides their healthcare in their retirement. Thus everyone's incentives are aligned to provide only necessary, cost effective care.
I am quite impressed by your system. As you mentioned, motivations are crucial when dealing with humans. However, in my country, these motivations are often difficult to discern and are primarily driven by corruption, in stark contrast to your system. It's challenging to find individuals who neither take bribes nor offer them. Those who strive to work honestly often find themselves penalized by the corrupt majority. Unlike your capitated system, ours relies mostly on welfare, yet it seems the mindset of many is still geared towards maximizing personal gain. We also lack competition between organizations, which may be why every part of our system is deteriorating uniformly, creating a uniformly detrimental impact on everyone involved.
I'm sorry that the system you're dealing with has the level of corruption you describe. Obviously much has been broadcast about the shortcomings of the US system, though generally corruption (out and out stealing) is uncommon, since companies and docs can get rich through less legally risky behaviors, such as doing semi-unnecessary procedures or refusing to see government insured patients. One positive of the US system is that the competition between corporations CAN but doesn't always, lead to true efficiencies (as in our case), as opposed to denying necessary care as a cost cutting measure to increase profits.

Re: Is Medical Research Trustworthy in a Profit-Driven World?

Posted: June 4th, 2024, 3:20 am
by Adaboo
The trustworthiness of medical research in a profit-driven world is a complex and multifaceted issue. While many researchers and scientists are dedicated to advancing knowledge and improving human health, the influence of profit motives can lead to biases, conflicts of interest, and unethical practices.

Some concerns include:

- Pharmaceutical companies funding research to promote their products
- Selective publication of positive results, while neglecting negative findings
- Manipulation of study design, data analysis, and interpretation
- Suppression of adverse effects or safety concerns
- Ghostwriting and fraud

To maintain trust, it's essential to:

- Promote transparency and open data sharing
- Ensure diverse funding sources and independent review
- Implement robust ethical guidelines and regulations
- Encourage replication and verification of findings
- Support whistleblower protections and investigative journalism

Ultimately, critical evaluation and scrutiny by the scientific community, regulators, and the public are crucial to ensuring the integrity of medical research in a profit-driven world.

Re: Is Medical Research Trustworthy in a Profit-Driven World?

Posted: June 12th, 2024, 3:03 am
by Sushan
LuckyR wrote: June 4th, 2024, 1:31 am
Sushan wrote: June 3rd, 2024, 6:00 am
LuckyR wrote: May 26th, 2024, 12:53 pm
Sushan wrote: May 26th, 2024, 1:46 am That sounds like a robust system designed to ensure the efficacy and safety of drugs before they are widely used, and it clearly has its benefits for both the healthcare system and patients. In my country, we have a similar setup, though not as sophisticated due to limited resources and the lack of a fully computerized healthcare system.

However, we've faced significant challenges with breaches in the system. Recent investigations have uncovered corruption involving high-ranking officials, including the Health Minister, leading to breaches in the drug evaluation and approval process. Many of these corrupt individuals are now in jail, including the minister, but the trust in our system remains severely damaged.

Given these challenges, do you have any suggestions on how we could implement stronger measures to ensure the integrity of the drug evaluation and approval process? What steps can we take to rebuild trust in our healthcare system and prevent such corruption in the future?
Like most things in Life involving humans, it's all about understanding motivations and designing systems to leverage that understanding. Our system is comprehensive (in the sense that the labs, pharmacies, insurance arm and ancillary services are all in the same corporation as the standard health delivery) and thus the various divisions are not in financial competition with one another. In addition as we started as a capitated system with provider paid for their time not procedures, there is no incentive to approve care beyond what is medically necessary. Since we're an individual corporation (not a whole country) no Pharma company is going to risk trying to bribe a Formulary Committee member to try to get a set of expensive drugs approved. The docs are financially tied to the financial health of the corporation since that's who provides their healthcare in their retirement. Thus everyone's incentives are aligned to provide only necessary, cost effective care.
I am quite impressed by your system. As you mentioned, motivations are crucial when dealing with humans. However, in my country, these motivations are often difficult to discern and are primarily driven by corruption, in stark contrast to your system. It's challenging to find individuals who neither take bribes nor offer them. Those who strive to work honestly often find themselves penalized by the corrupt majority. Unlike your capitated system, ours relies mostly on welfare, yet it seems the mindset of many is still geared towards maximizing personal gain. We also lack competition between organizations, which may be why every part of our system is deteriorating uniformly, creating a uniformly detrimental impact on everyone involved.
I'm sorry that the system you're dealing with has the level of corruption you describe. Obviously much has been broadcast about the shortcomings of the US system, though generally corruption (out and out stealing) is uncommon, since companies and docs can get rich through less legally risky behaviors, such as doing semi-unnecessary procedures or refusing to see government insured patients. One positive of the US system is that the competition between corporations CAN but doesn't always, lead to true efficiencies (as in our case), as opposed to denying necessary care as a cost cutting measure to increase profits.
Thank you for your understanding and insights. In our context, the lack of competition and the prevalent corruption undermine the system's effectiveness. Your point about the your (US) system's ability to achieve efficiencies through competition is interesting and something we could potentially learn from. It’s clear that incentivizing honesty and efficiency is crucial, but the challenge lies in implementing and maintaining such a system in a corrupt environment, like the one which I am stuck in.

Re: Is Medical Research Trustworthy in a Profit-Driven World?

Posted: June 12th, 2024, 3:08 am
by Sushan
Adaboo wrote: June 4th, 2024, 3:20 am The trustworthiness of medical research in a profit-driven world is a complex and multifaceted issue. While many researchers and scientists are dedicated to advancing knowledge and improving human health, the influence of profit motives can lead to biases, conflicts of interest, and unethical practices.

Some concerns include:

- Pharmaceutical companies funding research to promote their products
- Selective publication of positive results, while neglecting negative findings
- Manipulation of study design, data analysis, and interpretation
- Suppression of adverse effects or safety concerns
- Ghostwriting and fraud

To maintain trust, it's essential to:

- Promote transparency and open data sharing
- Ensure diverse funding sources and independent review
- Implement robust ethical guidelines and regulations
- Encourage replication and verification of findings
- Support whistleblower protections and investigative journalism

Ultimately, critical evaluation and scrutiny by the scientific community, regulators, and the public are crucial to ensuring the integrity of medical research in a profit-driven world.
You raise several valid points about the potential for bias and manipulation in medical research, especially when it's funded by pharmaceutical companies. It's a complex issue with no easy solutions, but fostering transparency and accountability is certainly key.

One example of how transparency can help is the AllTrials initiative, which advocates for all clinical trials to be registered and their results reported. This initiative aims to prevent selective publication and ensure that negative findings are also made public, thus providing a more balanced view of the effectiveness and safety of medical treatments.

Another important aspect is the role of regulatory bodies. The European Medicines Agency (EMA) and the US Food and Drug Administration (FDA) have made strides in increasing transparency, such as releasing clinical study reports for public scrutiny. This helps mitigate the influence of profit-driven interests and ensures that independent reviews can be conducted.

Moreover, supporting independent research through public or non-profit funding can reduce reliance on pharmaceutical companies and their potential to bias outcomes. For instance, the National Institutes of Health (NIH) in the US and similar organizations worldwide play crucial roles in funding unbiased research aimed at public health benefits rather than profit.

It’s also worth considering the impact of scientific journals and peer review. Ensuring that these journals adhere to strict ethical guidelines and have rigorous peer review processes can help identify and eliminate biased or fraudulent studies.

Given these measures, do you think it's feasible to build a more trustworthy system for medical research? How can we further enhance the integrity of the research that guides public health policies, particularly in profit-driven industries?

Re: Is Medical Research Trustworthy in a Profit-Driven World?

Posted: June 12th, 2024, 3:50 am
by Joule Mwendwa
Any business person will do their best to remain influential in the market. Those whose business is in the medicine sector are not an exception. We all saw how many COVID vaccine types were there. One disease but different vaccines. I can't trust them, but those in desperate need of medical attention have no option.

Re: Is Medical Research Trustworthy in a Profit-Driven World?

Posted: June 29th, 2024, 2:20 am
by Sushan
Joule Mwendwa wrote: June 12th, 2024, 3:50 am Any business person will do their best to remain influential in the market. Those whose business is in the medicine sector are not an exception. We all saw how many COVID vaccine types were there. One disease but different vaccines. I can't trust them, but those in desperate need of medical attention have no option.
I appreciate your perspective and understand your concerns about the influence of profit in the pharmaceutical industry. It's true that the presence of multiple vaccines for the same disease can be confusing and may lead to skepticism, especially when considering the potential for financial motivations behind their development and promotion.

However, I believe it's important to approach this issue with a balanced view. While financial interests can indeed shape the presentation of scientific data, the rigorous peer-review process and regulatory oversight are in place to ensure that medical research adheres to high standards of integrity and transparency. It's also worth noting that many researchers and medical professionals are committed to public health and base their recommendations on extensive evidence and clinical trials.

In times of crisis, such as the COVID-19 pandemic, the rapid development of vaccines was a monumental scientific achievement that has saved countless lives. It's essential to critically evaluate medical research and remain vigilant about potential biases, but we should also recognize the significant benefits that these advancements bring to society.

Your point about the desperation for medical attention is valid. People often have to trust medical interventions because they are the best available option to protect their health and well-being.

Re: Is Medical Research Trustworthy in a Profit-Driven World?

Posted: July 6th, 2024, 12:28 pm
by Nessa Vee
No, in a world where making money is a top priority, medical research often deals with problems like conflicts of interest. Pharmaceutical companies might affect study results to support their products. Everyone in business, including those in medicine, wants to be influential. We saw many COVID vaccines created for the same disease, which proves there were lots of options.

Re: Is Medical Research Trustworthy in a Profit-Driven World?

Posted: July 8th, 2024, 5:47 am
by Sushan
Nessa Vee wrote: July 6th, 2024, 12:28 pm No, in a world where making money is a top priority, medical research often deals with problems like conflicts of interest. Pharmaceutical companies might affect study results to support their products. Everyone in business, including those in medicine, wants to be influential. We saw many COVID vaccines created for the same disease, which proves there were lots of options.
I understand your skepticism about the influence of profit motives in medical research. It's true that the involvement of pharmaceutical companies in funding studies can introduce conflicts of interest. For instance, studies have shown that industry-sponsored research is more likely to produce favorable results for the sponsor's product. This raises legitimate concerns about the potential for bias and the integrity of the findings.

However, it's also important to recognize the complexity of this issue. While financial interests can affect outcomes, the scientific community has mechanisms to mitigate these risks. Peer review, transparency in funding sources, and the requirement for researchers to disclose potential conflicts of interest are all designed to uphold the credibility of scientific research. Additionally, replication of studies by independent researchers is a critical part of the scientific process that helps validate findings.

Regarding the multitude of COVID-19 vaccines, the diversity of options reflects not just commercial interests but also the global effort to address a severe public health crisis swiftly. Different vaccines were developed using various technologies to maximize the chances of success and to cater to different populations and logistical needs. For example, mRNA vaccines like Pfizer-BioNTech and Moderna have different storage requirements and efficacy rates compared to viral vector vaccines like AstraZeneca and Johnson & Johnson. This variety has been crucial in achieving widespread immunization.

It's also worth considering that regulatory bodies like the FDA, EMA, and WHO rigorously evaluate the safety and efficacy of vaccines before approval. These organizations rely on extensive clinical trial data and post-market surveillance to ensure public safety.

Would you agree that while vigilance is necessary to guard against conflicts of interest, the broader scientific and regulatory framework provides checks and balances that help maintain the integrity of medical research? How do you think we can improve these systems to further ensure trust in medical research?