
An anarchist takes on Big Pharma by teaching patients to make their own meds - anarbadalov
https://www.statnews.com/2017/10/12/michael-laufer-drug-prices/
======
leggomylibro
That seems both super dangerous, and super awesome.

It's not something that we should have to consider. But this is the world we
live in, now; legitimate supply lines of life-saving medicine have collapsed
for a fair number of people. I understand why people might be troubled by
someone actively going out and advocating this as opposed to simply making the
information available, but if you're offered medicine with 95% efficacy that
you can afford and use vs. a well-regulated 99.99% that only exists
theoretically...well, come on.

~~~
WalterSear
The cost of medicine I require to be functional enough to hold down a job has
risen so much that the copay is the equivalent of the entire out-of-pocket
cost from a few years ago.

The medication was discovered in 1969. The application method, which is the
shitty excuse for the patents protecting its $2,200/month price tag, was first
approved for use by the FDA in 1979. The drug has been for sale in it's
current form for over a decade.

~~~
octaveguin
Enbrel? They just received another patent extension, too.

This is what government granted monopolies look like.

~~~
dv_dt
This is what the breakdown of working competitive markets look like, and in
this case it takes both government monopolies, as well as well as overwhelming
short-term greed on the part of the private companies.

Long term don't these companies think that charging outrageous prices for
drugs will cause a future voter/government backlash of some sort... or maybe
they think they should extract profits now because of a chance of drug price
regulation coming to the US in the future?

~~~
Sangermaine
>Long term don't these companies think that charging outrageous prices for
drugs will cause a future voter/government backlash of some sort

No, because it demonstrably won't. People say they're angry and then do
nothing about it. The US has an entire political party angrily decrying any
effort to regulate healthcare as socialist slavery.

The drug companies know they'll be just fine. Maybe some token slaps on the
wrist and public performance of cosmetic changes to appease people now and
then, but nothing will happen to them.

~~~
alexanderstears
_the US has an entire political party angrily decrying any effort to regulate
healthcare as socialist slavery._

Argubly regulation is the problem we're in this mess. Do you think an epipen
would cost $600 if there weren't a Government granted monopoly?

We have two parties who love the current amount of regulations on competition
- you need to go to an AMA approved medical school to become a doctor, there
aren't H1Bs for health care workers, and the government gets to pick and chose
who's allowed to sell medication.

They just disagree on the amount of subsidies for poor people. One party
thinks prepaid consumption with cross subsidies is insurance and the other
party thinks that insurance shouldn't be so binding if you get sick.

~~~
dv_dt
Regulations can put pressure on prices (and if you look at epipens in
particular, part of the regulations allowing the increase of their price have
nothing to do with monopoly and a lot to do with getting policy placed into
areas where organizations are required to keep an epipen on hand by
regulation...).

But in terms of overall effect, one can't ignore other nations which pay much
lower prices for healthcare with both regulation for drug patents, as well as
regulation on drug prices. That combination manages to deliver better care at
lower costs than the US (we pay on average double per capita). So I don't
think one can generically fault "regulation" for a poorly performing health
market in the US.

~~~
alexanderstears
_So I don 't think one can generically fault "regulation" for a poorly
performing health market in the US._

You're absolutely right, however, I do think the worst parts of our medical
system exist as consequences of regulation.

The mandate that emergency rooms treat anyone who enters is onerous and
there's no free lunch, paying customers are stuck with the bill.

The licencing system isn't optimal for cost effective care.

There's a lot to be desired for people who favor supply side solutions to
expensive problems.

~~~
dv_dt
> The mandate that emergency rooms treat anyone who enters is onerous and
> there's no free lunch, paying customers are stuck with the bill.

I don't think that's onerous, I think that is a minimal, and admittedly
imperfect, expression of our societal intent that people shouldn't die
unnecessarily in emergency rooms - either from lack of being able to pay; nor
from a practical standpoint, lack or delay of on-hand proof of ability to pay.

Removing those regulations would cause all sorts of other problems. Someone
arrives in an ambulance near-death, if I lack morals then one level of
maximized extraction price is to have those patients commit to pay a value
that represents the earning potential for that person for the rest of their
life. They have to agree before getting admitted. Even more profitable, if I
judge that person as having a well connected social network, I can charge even
more because I know their friends and colleagues would chip in to save them...
I'm not sure how a competitive market with no regulation changes the worst
case for this transaction - if someone is near death then moving on to another
emergency room is out of the question.

I see universal healthcare with a shared cost-pool as the lowest overhead way
to provide for our social moral desires (but then I'm not in fear of the
regulation with may be needed to implement that policy).

Insurace with a shared risk pool is a technically workable, but adds even more
overhead, and ends up a more expensive way to do the same thing... but again
regulations are involved (and fixing very flawed ones at that).

~~~
alexanderstears
I don't defend the status quo. I think this is the right way to resolve
healthcare.

I agree with about 95% of this: [https://market-ticker.org/akcs-
www?post=231949](https://market-ticker.org/akcs-www?post=231949)

We just need smarter regulations:

> every medical facility needs to have a price for each billing code

> every healthcare facility has to publish their prices

> heatlh care facilities must honor their published prices for everyone

> if someone needs car and they can't pay, the government will pay for the
> care but the government holds a debt and can garnish wages / use tax refunds
> / credit welfare to cover the debt

If people could shop on price for routine care, medical companies would become
more efficient and extend those prices to people in an emergency

~~~
candiodari
Have you seen healthcare regulations ? The lengths hospitals and drug makers
have to go through to prevent ANY mistakes are simply not reasonable.

That's not 1/1000\. Not 1/1000000\. Not 1/1000000000\. Zero. Entire companies
get shut down because of a single mistake. Think about how ridiculous that is.
A company owns 5 separate factories, and in one of them a product was produced
that _may_ , in a panel of doctor's opinions, have caused the death of a
patient (mostly one who would have died without the medicine), and all 5 are
immediately shut down until an extensive investigation is not just run, but
run in an approved manner by outside experts, and the resulting cause was both
found, approved by the panel of doctors and the government.

And of course, a company is supposed to take care of any patient they damaged,
for life, full treatment for all ailments (not just the one that had something
to do with what they did), ...

We used to let people prepare medicines in corner shops with at least a few
ingredients they procured themselves. Needless to say, pretty cheap. Mistakes
were ... not common, but certainly more so than today.

Until we find a balance between care provided and acceptable risk there will
be no reasonably priced healthcare. Until we stop giving health at any cost,
and count on "management" mistakes to do cost saving (regulating that people
get thrown out of hospital the day after open heart surgery unless there are
complications. Well, if you want to survive, you bloody well hope your doctor
finds some complication. Needless to say, proposals for making it same day are
on the table. Good luck).

And of course, like good capitalists faced with demands like this, companies
don't say "are you bloody insane ? This will bankrupt the entire country",
they say "How secure do you want it to be ? Perhaps even a bit more ? I mean
we can always do better. That'll be $xxx(xxxxxxxxxxxxxxxx)".

~~~
alexanderstears
I 've seen a ton of healthcare regulations and apprently we're in agreement
they leave a lot to be desired.

------
rayiner
> “To deny someone access to a lifesaving medication is murder,” he said. And
> “an act of theft [of intellectual property] to prevent an act of murder is
> morally acceptable.”

I agree with the conclusion, but for a different reason. "Theft" is the wrong
way to think about IP. The economic function of IP is not to protect producers
from consumers, but to protect producers from free-riding by other
producers.[1] Thus, for example, stealing pills does not offend a drug
creator's IP monopoly. Teaching people to make their own pills, who couldn't
afford pills anyway, does not really do so either. It doesn't implicate the
real purpose of the patent monopoly, which is to keep _some other company_
from profiting by free-riding on the R&D of the original drug creator.

[1] To use a copyright analogy, copyright does not exist to protect content
creators from downloaders, but to protect them from companies like Youtube,
which make their profits by selling other peoples' content.

~~~
akira2501
> The economic function of IP is not to protect producers from consumers, but
> to protect producers from free-riding by other producers.

The function of IP, from a government point of view, is to promote the useful
arts and science and to ultimately make them available to the public after a
limited amount of protection to the creator. Otherwise, there's no purpose in
the government being involved in enforcing monopolies.

~~~
rayiner
Promotion of the useful arts and sciences is the language the framers used,
but the framers didn't know much about economics. The _economic function_ of
IP is to address the market distortion that could result if people were
permitted to free-ride on the capital-intensive R&D or other people.

The economic definition is also far more useful. Who knows what specific
policies will result in "promoting the useful arts and sciences." Preventing
free-riding is a more concrete issue that can be addressed with specific
policies.

~~~
Silhouette
If you're making an economic argument to justify the existence and nature of
copyright law in today's society, which in itself I have no problem with, then
surely you also have to consider that exponential propagation via entirely
non-commercial sharing could still severely undermine the commercial value of
a work. If that sort of work then becomes prohibitively expensive to create,
doesn't that mean copyright is not doing its job as an incentive and everyone
loses out? After all, if I make the next great independent TV show, it doesn't
much matter whether 99% of my potential market sees it on YouTube or just
torrents it, if either way those potential customers no longer pay me in
return for enjoying the work. This seems counter to your original position
that the economic function is copyright is about rival producers and not
consumers.

------
jfarlow
Open Insulin @ Counter Culture Labs: [https://experiment.com/projects/open-
insulin](https://experiment.com/projects/open-insulin)

If you want to look at templates for your own immunotherapy, CRISPR,
optogenetic tools etc.:
[https://serotiny.bio/notes/proteins/](https://serotiny.bio/notes/proteins/)

Which, once built can be then be ordered as DNA, shapeways-style using:
[https://serotiny.bio/notes/pinecone/](https://serotiny.bio/notes/pinecone/)

The cure for certain kinds of blindness, just approved by the FDA yesterday
is, in total, a well-delivered sequence of ~10,000 base pairs of DNA (mfg cost
@ 7¢/bp = $700): [http://www.businessinsider.com/spark-therapeutics-
hereditary...](http://www.businessinsider.com/spark-therapeutics-hereditary-
blindness-gene-therapy-advisory-committee-2017-10)

~~~
moh_maya
Oh man. I agree with your sentiment, but this is a remarkable over
simplification!

The sequence may cost 700$ to synthesise. But it's delivery vector is a virus.
Synthesizing the DNA, encapsulating the DNA in the virus.. not trivial stuff.

While I agree that drug prices in the US are absurd beyond comprehension or
justification, and I've had a ring side view of life sci research, drug
development as well as the drug pricing; to posit that, hah, a path breaking
gene therapy product just costs a few hundreds or a couple of thousands to
produce is misrepresenting the complexity as well as the significance of the
achievement.

The amount of research (largely public funded but for the clinical trials,
which may also have been public funded: no idea) to get to this point is
staggering. the company also likely invested large amounts to Shepard a lab
possibility into a viable treatment. FDA approval is a big deal because they
are, justifiably, exceedingly strict. It is an arduous process.

There has to be a better solution, which would start with allowing the US CMS
/ Medicare & Medicaid to negotiate drug prices with the manufacturers. The
problem is policy.

~~~
jfarlow
It is a bit of a simplification - but not by that many orders of magnitude ;).
The really hard part (like small molecules) is the R&D to come up with that
sequence. Unlike small molecules though, most people have the technological
prowess to brew beer, make yoghurt, or buy an espresso. I've encapsidated
plasmids into viruses for viral delivery in the lab and it took a day or two
of work in a BSL2 hood to produce thousands of units of the virus - delivery
in that case was relatively trivial; though you are right, I've never
delivered the virus to humans - and that is not (yet) trivial. But neither is
it as complicated as even the most basic of surgeries - literally. As far as
I've heard, the 'treatment' to cure blindness with the above (and similar
therapies) is a puff of air (containing aerosolized AAV) into a patient's eye,
once - while alternative treatments are things like a syringe inserted behind
the eyeball every few weeks for the rest of one's life.

I'd argue that the significance of the achievement of these modern gene
therapies _is_ in just how simple the technology is relative to other medical
procedures. In this case 'simple' is very much a result of an astounding
amount of knowledge and work. It's so powerful precisely _because_ it is
simple.

And to be clear - I don't actually think anyone should be trying to cure their
own cancers with garage-built immunotherapies today. Home-grown insulin-
kombucha, maybe... But the technologies of today realistically enable that
possibility in the nearish future precisely because they are so elegantly
built. Recouping the cost of that R&D to produce something so simple &
powerful is always a challenge - and that challenge is far more social in
nature than scientific.

~~~
moh_maya
// offtopic

BTW, big fan of what you and serotiny are trying to do. I've just moved back
to my home country.. am dabbling in other stuff at the moment, but the dream
is to join with friends and start an automated high throughput industrial
biotech company. PhD work used a lot of robotics and high throughput screening
& mutagenesis and what have you.. and services like serotiny give me the
comfort that my pie in the sky idea has a chance..

------
zackmorris
We used to have government-funded research programs at universities, now we
have for-profit big pharma which by definition creates treatments that cost
more. It could be argued that this was by design. So open sourcing cures like
this is a natural free market reaction to that.

Since most of the cost of any new medication today is research, we should
decouple that cost from production.

The main reason this doesn't happen is that conservatives preach personal
responsibility, so want people with hepatitis C to pay for their own treatment
at $80,000 a pop. But even if the cost to develop that cure was a billion
dollars, that's a tiny amount for the government to absorb. We should be
having a space race to cure the worst diseases and then give those cures to
the world for free (or nearly free), much like penicillin or the polio
vaccine.

Please keep in mind that I'm not politicizing this - it's already been
politicized. I'm just explaining what happened.

~~~
apsec112
The NIH budget, the largest US government funder of medical research, is
bigger now than at any time before 2000 (although it's down a bit from the
2003 peak, adjusting for inflation).

Source:
[https://www.aaas.org/sites/default/files/NIHMech_1.jpg](https://www.aaas.org/sites/default/files/NIHMech_1.jpg)

~~~
zackmorris
Thank you, if that's true then I stand corrected. Something to consider though
is the NIH is under constant threat of cuts which might discourage going deep
on hard problems:

[http://www.npr.org/sections/health-
shots/2017/03/16/52039014...](http://www.npr.org/sections/health-
shots/2017/03/16/520390147/trump-administration-proposes-big-cuts-in-medical-
research)

Also $30 billion is only 0.75% of the projected $4 trillion federal budget for
next year. Just percentage-wise this seems like something that should be low
on the list for cuts.

------
dnautics
>A decade ago, while he was volunteering with aid workers in El Salvador,
Laufer said a nurse at a remote health outpost told him she’d run out of
antibiotics and birth control pills — cheap, generic medicines that even her
suppliers couldn’t immediately replenish. “This is ridiculous. They should be
able to build their own simple lab” to make the pills, he recalled thinking at
the time.

This is pure crazy. If these drug were generic (versus patented), the problem
of getting them to El Salvador is not a price problem, it's a supply
chain/infrastructure/corruption and theft/political (in the case of birth
control in a very Catholic country) problem. Some of these drugs are highly
complex and building, supplying, and feedstocking chemicals for a lab to make
them is even harder than finding the money for a $5/pop or less prescription

~~~
steve19
I would be horrified to think what kind of havoc DIY birth control pill, s
that were not manufactured correctly, might do.

I would say a better solution would be to start a not for profit manufacturer,
but when India produces dirt cheap genetics, there does not seem much point.

------
jaggederest
For people who are interested, it's referenced in the article, but NurdRage
did a synthesis of Pyrimethamine "from scratch".

Only took 2 years and ~$22k, but of course, replicating his synthesis would be
a little bit easier... for another PhD Chemist.

[https://www.youtube.com/watch?v=ddCuWX4vtOA&list=PLU79801KtV...](https://www.youtube.com/watch?v=ddCuWX4vtOA&list=PLU79801KtVAU1XsTwHaKkqQoBgz_VYmPS)

~~~
jmiserez
Not only “from scratch”, he even did it from widely available household
products.

I think he said in the last video that it would have been cheaper and faster
if he had bought some of the precursor chemicals directly instead of having to
make them first.

~~~
jaggederest
Well, from my limited 100-level-chemistry-plus-youtube education, he could
have just bought the immediate precursors directly for pyrimethamine itself,
i.e. possibly even 2-(p-chlorophenyl)-3-oxopentanenitrile, guanadinium
chloride, and Trimethyl Orthoformate, which would make it a 3-step synthesis
instead of a 17-step synthesis, so yeah, pretty easy. At the very least he
could cut out ~2/3rds of those steps for a 7-step or 6-step synthesis.

So cheaper by easily an order of magnitude, possibly ~$100 a batch or less. Of
course, if you want FDA grade instead of technical grade your prices for
everything skyrocket and your workup has to improve a bunch.

------
computator
Interesting assertion from the FAQ on Michael Laufer's website[1]:

> _Q: What about quality control? A: It’s important to know that making small
> quantities of a chemical is vastly different than making it on an industrial
> scale. The chemistry isn’t even the same. This is a big reason why chemical
> engineering is an entire field of study. With smaller reactions, while you
> do have to be more precise in your measurements sometimes. There are fewer
> things to go wrong._

Why would making small quantities be _vastly different_ than making it on an
industrial scale?

I've heard the same thing about cooking and baking. Supposedly, if a recipe
calls for 1 tablespoon of baking powder, then you scale it up 50 fold, you
can't simply use 50 tablespoons of baking powder. The claim was that you had
to use way more baking powder or much less (I forget which). It sounded like
nonsense, but now I'm wondering.

[1] [https://fourthievesvinegar.org/faq](https://fourthievesvinegar.org/faq)

~~~
jcranmer
The most obvious element is heat: heat production grows at the same rate as
volume, but heat dissipation grows at the same rate as surface area. So larger
scales invariably end up running hotter (particularly when energetic
exothermic reactions are involved), and temperature plays a major role in the
kinematics of chemical reactions.

The same surface area/volume issue in bulk also plays into reactions that
happen at the margins of materials rather than the bulk--metal-catalyzed
reactions are a common example.

------
fabian2k
Synthesizing some simpler drugs sounds feasible even with amateur equipment,
but still far from trivial. But I can't see that working reliably without the
ability to do proper analytics on all steps. And regular people don't just
have an NMR spectrometer at home.

Chemical reactions usually don't have a single product, other side reactions
are possible. And they also don't use up 100% of the educt, so you have to get
rid of that as well. Purifying your products and making sure they're actually
what you want is essential.

Getting the dose right is also hard if you don't know how pure your product
is, and if you don't have analytical scales (or work at a very large scale
that a kitchen scale is enough).

~~~
zokier
> And regular people don't just have an NMR spectrometer at home.

I've only watched NurdRage videos, but it seems like sending samples to
commercial NMR labs is pretty feasible as he does that regularly. So that
might not be as big of an issue.

------
intro-b
I can't imagine the size of the overlap between people
savvy/interested/experimental enough to attempt this sort of remedy and those
desperately poor AND ill enough to do so. While the idea of bio-hacking as a
hobbyist or proof-of-concept is becoming less and less uncommon, and people
generally appreciate efforts to raise awareness toward a broken and
inefficient healthcare and insurance system, attempting to "market" that DIY
process using a fancy name, logo, and "mad scientist hacker anarchist
intellectual" persona seems disingenuous at best, and potentially dangerous.

------
fhood
Honest question: What does it even mean to be an anarchist these days? What is
the default "anarchist"? Because Wikipedia isn't really helping.

~~~
jchanimal
“”” Noam Chomsky: Well, anarchism is, in my view, basically a kind of tendency
in human thought which shows up in different forms in different circumstances,
and has some leading characteristics. Primarily it is a tendency that is
suspicious and skeptical of domination, authority, and hierarchy. It seeks
structures of hierarchy and domination in human life over the whole range,
extending from, say, patriarchal families to, say, imperial systems, and it
asks whether those systems are justified. It assumes that the burden of proof
for anyone in a position of power and authority lies on them. Their authority
is not self-justifying. They have to give a reason for it, a justification.
And if they can’t justify that authority and power and control, which is the
usual case, then the authority ought to be dismantled and replaced by
something more free and just. And, as I understand it, anarchy is just that
tendency. “””

[http://www.alternet.org/civil-liberties/noam-chomsky-kind-
an...](http://www.alternet.org/civil-liberties/noam-chomsky-kind-anarchism-i-
believe-and-whats-wrong-libertarians)

~~~
kemiller
Vs the classical conservative world view in which order, even if it's unjust,
is usually better for everyone, even the people on the bottom, than chaos; and
that dismantling power structures, if done suddenly or without care, is more
likely to result in chaos than in a new, more just, order. I've been wondering
lately if there is room for the notion of a conservative anarchist, who
questions hierarchy but dismantles carefully and incrementally.

~~~
icebraining
_I 've been wondering lately if there is room for the notion of a conservative
anarchist, who questions hierarchy but dismantles carefully and
incrementally._

Sure! Those are the collaborationists, and are the first against the wall when
the revolution comes.

I'm only half-joking, see what happened to the Mensheviks in 1917-1921.

~~~
fallingfrog
Sad but there's a lot of truth to that: if you are fighting against a nation
state with an army, you have to have your own army to fight it. And on the day
when you are victorious, you'll find yourself sitting on a large plot of land
and people and the only intact organization around will be.. your army. And
the government you form will closely resemble an army in form and function,
and the high ranking members of the army will tend to become high ranking
members of the new government. Hardly a blueprint for universal freedom.
That's what tends to happen to violent revolutions.

~~~
avdempsey
The natural response would be instead of fighting a government with an army,
experiment and build the structures that you would like to see, without dogma,
learning as you go. When these structures solve enough problems for your
community, a democratic country may peacefully transition.

~~~
fallingfrog
Yes!

------
wccrawford
>Then he took another sip from a flute of Taittinger Champagne.

What?

>Swaggering, charismatic, and complex,

Gag me.

>Michael Laufer has become a fixture in the growing biohacker movement ever
since he published plans last year for a do-it-yourself EpiPencil — a $35
alternative to the pricey EpiPen.

That couldn't possibly go wrong, eh?

>It’s not clear whether anyone has actually ever used a homemade EpiPencil to
prevent anaphylactic shock.

So nobody's quite crazy enough to try?

>But that seems almost an afterthought to Laufer’s bigger goal — trying to
build a DIY movement to attack high pharma pricing and empower patients.

Or, judging by the tone of this article, his attempt to build his own ego.

This is ridiculous and crazy. It's incredibly dangerous to claim to have
produced something _life saving_ but not have any actual testing to back it
up.

Even lesser drugs that are just designed to lessen symptoms or relieve pain
could go horribly wrong if they aren't prepared properly. We have such strict
medical requirements because of that.

~~~
kentosi
Agreed that the article is a little too flattering to his ego, but what about
people desperate for medical aid, can't afford it, and would probably end up
with pain/death without this as an alternative? What should they do?

~~~
Sangermaine
Not listen to this guy. As the article notes none of his ideas or creations
have ever been tried by anyone, including himself, and require fairly
sophisticated ability to set up and make.

In fact from the article it's not clear at all what exactly this guy is
offering or how it helps anyone beyond his self-aggrandizing bluster.

------
arthurjj
If anyone's interested in a fiction that partially explores this try Corey
Doctorow's new novel Walk Away [1]. It's about people who 'walk away' from
regular society. They to create their own high tech society because they
completely ignore IP rights, and instead aggressively share techniques using
the wiki model.

1\. [http://amzn.to/2ymP8EM](http://amzn.to/2ymP8EM)

------
Chiba-City
I imagine a curate Wiki of credible home non-invasive therapies and management
regimens would garner more positive response than "anarchic" direct
confrontations. There are tons of such therapies underwritten by medical
researchers across countries. These infantile theatrics mostly subtract from
sound cost containment.

------
Overtonwindow
DIY pharmaceuticals is ....well it sounds immensely dangerous. Not only is the
chemistry frightening but quality and chemical availability. It reminds me of
Naturopaths and herboligists claiming to cure and treat ailments with
supplements. As much as I hate the pharmaceutical industry, I think it's best
for now to leave the drug making to them.

~~~
joering2
DIY pharmaceuticals sounds dangerous. Sure! So is eating 47 teaspoon of salt,
480 bananas, or drinking 179 expressos [1].

If you happen to be unable to afford so much coffee, just rent a car and smash
into a tree at 100 miles per hour. So driving cars is also immensely
dangerous!

I really hate that nany state we are living in where an average 16 year old is
lawfully allowed to drive 5,000 pounds metal machine and kill people at even
limited speeds of 50 mph, but yet when it comes to DIY pharmaceuticals we
immediately see a vision of most population dying at home because they mixed
something wrong.

[https://gizmodo.com/how-many-x-would-you-need-to-eat-to-
die-...](https://gizmodo.com/how-many-x-would-you-need-to-eat-to-
die-1684237567)

------
AKifer
Given the level of education nowadays and the wide access to knowledge, I'm
convinced that it's legitimate that the average person should at least have
the basic medical knowledge, let's say equal to what a doctor in the 30's had
known, and be able to treat 90% of the diseases that he/she encounter in his
life.

------
iskander
There's also a much more conservative and narrowly scoped effort to help late
stager cancer patients make their own therapeutic peptide vaccines:
[http://alunglife.com/goal-cure-cancer-method/](http://alunglife.com/goal-
cure-cancer-method/)

------
Sir_Cmpwn
There's a guy who has a chemistry YouTube channel and synthesized
Pyrimethamine recently, check it out:

[https://www.youtube.com/watch?v=5kZi3J2S52E](https://www.youtube.com/watch?v=5kZi3J2S52E)

------
Florin_Andrei
Next up - DIY Lasik surgery.

~~~
Overtonwindow
I got LASIK at 21. It was a miracle. It wore off at 31. I must've gotten it
too soon. Back to glasses.

~~~
kemiller
Nah, it just does that sometimes. I got it at 35 and it started to wear off 6
years later.

------
zipwitch
Sci-fi is increasingly struggling to keep up with reality.

Here's a novel with a similar premise (but more SF setting) that isn't even
out yet: [https://www.tor.com/2017/09/18/excerpts-annalee-newitz-
auton...](https://www.tor.com/2017/09/18/excerpts-annalee-newitz-autonomous/)

~~~
kanzure
my thinking on this is that science fiction authors are lazy and are not often
scientifically trained; so they haven't been thinking about these topics at
all. This is why science fiction is so dry and boring compared to
neuroanatomy, molecular biology, neurophysiology, computational neuroscience,
synthetic biology, etc.

------
mirimir
Let's say that you need some pharmaceutical that's not available at a
reasonable price. Perhaps because there's no generic available. Or because
there are only licensed generics, priced just marginally less than the brand.
And/or because you have crappy health insurance, or none at all.

Depending on the drug, the best option is either an equivalent from a
compounding pharmacy, or one from a low-price country, such as India, Mexico,
etc.

Making your own is only worth the hassle and risk if neither of those options
is workable. The EpiPen is an unrepresentative example, because it's mostly
about mechanics. With most drugs, you need to bulk out the active
ingredient(s) to get a reasonably sized capsule or tablet. For capsules, with
mannitol or whatever. For tablets, that plus binding agent(s).

The challenge is that thorough mixing is nontrivial.

------
AlexCoventry
I'm a bit skeptical about this. You should see what it takes to manufacture
useful amounts of clinical-grade penicillin. It's fairly capital-intensive,
and requires a special strain of the mold.

------
ar-nelson
DIY pharmaceuticals will never be safe, unless the recipes are regulated, at
which point there's no point to them anyway.

Imagine this situation: you Google for a recipe for a drug, and find two
different recipes. Recipe A is the real one, while Recipe B will kill you
instantly. The troll who posted Recipe B went around the internet claiming
that Recipe B is real and Recipe A will kill you. There's no authoritative
source to consult, because the actual recipe is patented. How do you know
which is real?

~~~
neilparikh
Aren't patents published publicly? So you could just check the patent
(Although it may require some knowledge of biology/chemistry to understand).

------
microcolonel
Lots of medicines are straightforward to manufacture, and as long as you're
careful and follow the same sorts of risk-mitigating procedures and quality
assurance steps that you would expect from a manufacturer, you would be served
no worse by your own generic brand.

That said, ideally we could fix the medicine-specific patent law craziness
(and the regulatory inefficiency which necessitates it). Obviously, the
specifics are much more complicated than anyone with a side to pick is willing
to admit.

------
shadowtree
People struggle to cook food for themselves. Just saying.

------
dreta
This is an article written by the biggest fan of a guy with an inflated ego, a
child-like view of the world, and nothing to show.

------
phkahler
What if he instead made a more reliable setup and recipe? Then someone could
make a lab and rent it out to people wanting to make their own stuff. It would
still be DIY but it would be in a more controlled environment. This model does
involve some risk to the lab, but hey have the renter agree to binding
arbitration or something.

------
heydenberk
Flash Forward did an excellent (as usual) episode about this, just a week or
so ago:
[https://www.flashforwardpod.com/2017/10/03/piraceuticals/](https://www.flashforwardpod.com/2017/10/03/piraceuticals/)

------
tyingq
_" He’s developing a desktop lab and a recipe book meant to equip patients to
cook up a range of medicines, including a homemade version of the expensive
hepatitis C drug Sovaldi, on their kitchen counters."_

Any chemists here? Is it really plausible to synthesize C22H29FN3O9P at home?

------
quickben
If a person doesn't have access to medicine and dies:

\- in the East, that's a victim of Communism. \- in the West, that's a poor
lazy bum.

In both cases, the person is gone and the society failed him.

So, this guy rebels. Let's not paint him in political colors.

------
trapperkeeper74
Wow. Cool. I wonder how hard are the synthesises of the useful antidepressants
like mirtazapine.

Also, I found ASX-05 (Phase III) uses a DM metabolite that is retained much
more by the addition of brupropion. DM is the stuff in some cough syrups.

~~~
nv-vn
Well, mirtazapine isn't scheduled in the US so you can probably get some
precursors with relative ease. You can find the synthesis info online [1] and
at least some of the chemicals used in the synthesis are available online [2],
though for the price it seems like it might be more economically feasible to
just buy a pill from a pharma company.

[1] [http://www.arkat-usa.org/get-file/22868/](http://www.arkat-usa.org/get-
file/22868/) [2]
[http://www.sigmaaldrich.com/catalog/product/aldrich/648434?l...](http://www.sigmaaldrich.com/catalog/product/aldrich/648434?lang=en&region=US)

------
trevorhartman
Related: If you want to understand how and why the American Healthcare system
is broken, read the excellent book An American Sickness: How Healthcare Became
Big Business and How You Can Take It Back by Elisabeth Rosenthal.

------
mnm1
This brings to mind a very common ethics 101 class dilemma. Do you steal
medicine to keep your loved one from dying? Of course, the answer to that is
extremely obvious. I only wish we could help people steal more.

------
rubatuga
The premise in the article, that denying access to medicine is essentially
murder is completely untrue. The following premise that people should be able
steal is therefore not necessarily true.

------
louithethrid
The day anyone can get dna-programmable yeast and a reactor to grow it- big
pharma is goone. What a nice woody sort of word.

~~~
goatlover
Because I'm going to trust the kid's medicine down the street with no
oversight?

Isn't this kind of like the day 3D printers become affordable, mass
manufacturing is done?

~~~
blacksmith_tb
If 3D printers were not just affordable but infallible, yes. It would be
easier to have a bioreactor bubbling away to synthesize your pharmaceuticals
than to try and make a lab-in-a-box kit that was equally robust (more like
brewing kombucha in your kitchen than Breaking Bad for Dummies), but either
way you still need to assay the results...

~~~
goatlover
> If 3D printers were not just affordable but infallible, yes.

Infallible and easy to use. But you still need to buy the raw materials,
unless we're talking Star Trek energy-matter conversion, which isn't on the
horizon.

Otherwise, why would an average consumer think that buying the raw material
and feeding it to their 3D printer is that much more convenient than just
stopping by Walmart or ordering off Amazon? And would it even be cheaper,
since the consumer loses the economy of scale in their individualized
production?

------
45h34jh53k4j
I watched Michael present one of the most engaging and exciting talks at
HOPE11 in NYC last year. On stage, he proceeded to make Deraprim (The pharma
bro's jacked up price anti-toxiplasmosis drug) live on stage and then throw it
in the audience. He then called Martin live and said he was his arch rival.
Brilliant!

Michael you are a legend and hero for our new dystopian pharma world.

~~~
zokier
> On stage, he proceeded to make Deraprim (The pharma bro's jacked up price
> anti-toxiplasmosis drug) live on stage and then throw it in the audience

I'm not familiar with the case, but I feel like probably NurdRages "cake mix"
comment probably applies:
[https://www.youtube.com/watch?v=Rd7hXFnSHZc](https://www.youtube.com/watch?v=Rd7hXFnSHZc)

The question always is that when you are making something, what are your
dependencies, where are you starting from. Afterall, to make an apple pie from
scratch you need to invent the universe.

------
Mz
Can anyone give me any insights into how stuff like this (and Goop) gets any
traction?

------
ithilglin909
I like the _idea_. And I can't possibly see how this could go badly...

------
a3n
Something like this will be needed in the event of a civilizational reboot.

------
moonbug22
TL,DR Merkin heathcare sucks.

------
flour_power
only in america...

------
0xbear
Just push Trump to do what he promised to do during his campaign: allow the
importation of drugs. The rest of the world is mostly paying more reasonable
prices, it’s only us, USians who are getting reamed by the pharma cartel.

