
A Doctor Trying to Stop Heart Attacks - helloworld
http://www.npr.org/sections/health-shots/2016/09/23/495027377/this-doctor-is-trying-to-stop-heart-attacks-in-their-tracks
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darkerside
This is another example of a recurring theme where the profit motive is
failing to incentivize pharma companies to create products that can have an
immediate impact on saving lives or improving health outcomes. I'm no
socialist, but this seems to be a real (albeit very specific) failure of
capitalism. Does anyone know of a government agency that is chartered to solve
these kinds of problems?

~~~
nickff
The United States Department of Health and Human Services, whose motto is
"Improving the health, safety, and well-being of America", which has a budget
of just over 1.1 trillion dollars, and about eighty thousand employees.[1][2]

For comparison, the largest pharmaceutical company in the world is Novartis,
with annual revenues of approximately forty-seven billion dollars.[3]

The pharmaceutical industry is one of the most, if not the most heavily
regulated industry in the United States. This industry is also affected by
various government interventions into research and development, both in
funding and restricting options. If you believe there is a problem (and I
think there is), it seems difficult to believe that it is due to a lack of
government involvement.

[1]
[https://en.wikipedia.org/wiki/United_States_Department_of_He...](https://en.wikipedia.org/wiki/United_States_Department_of_Health_and_Human_Services)

[2] [http://www.hhs.gov/sites/default/files/fy2017-budget-in-
brie...](http://www.hhs.gov/sites/default/files/fy2017-budget-in-brief.pdf)

[3]
[http://www.pmlive.com/top_pharma_list/global_revenues](http://www.pmlive.com/top_pharma_list/global_revenues)

~~~
erentz
About 90% of this budget is providing Medicare and Medicaid.

~~~
nickff
Yes, and a large portion of that is spent on prescription drugs; the US
Government is one of (if not the) largest customers for most drugs.

~~~
pmoriarty
We need to stop thinking of the government and corporations as distinctly
separate.

Officials from government own stocks in corporations, serve on their boards,
and often get cushy jobs in the very corporations they "regulated" or acquired
government contracts for when they retire from "public service".

Corporate executives also demonstrate their selfless commitment to the public
good by going to work for the government and regulate their former employers.

Corporations are taxed and that tax money flows from the government back to
corporations. Corporations spend millions lobbying, bribing, and electing
government officials to enact laws and contracts favorable to them. Often it's
the same people who govern both corporations and the government, and profit
from both.

They have their hands in each other's pockets and scratch each other's backs.

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reasonattlm
Heart attacks are a downstream consequence of the molecular damage of aging.

Everything that isn't repairing the root cause damage of aging is going to be
a much less effective way of going about things if the goal is to avoid
cardiovascular events of that nature. Keeping a machine from a specific
failure mode without actually repairing the damage that raises the odds of
that failure mode is a much harder thing to do than to enact repair.

This is largely why medicine for age-related conditions has been an
incremental process over recent decades: advanced enough to do sensible things
with downstream consequences of damage, and so produce marginal effects at
sizable investment of time and resources but for various reasons unwilling or
unable to address the damage itself. The reduction in heart disease over the
past 30 years has been an enormous achievement when considered within these
bounds: really going above and beyond, finding ways to keep the accumulation
of damage from having the same level of consequences and juggling biochemistry
to keep running at a lower failure rate for longer.

But still incremental, and to really solve the problem you have to repair the
damage. Nothing else is going to do the job.

~~~
coldtea
> _Everything that isn 't repairing the root cause damage of aging is going to
> be a much less effective way of going about things if the goal is to avoid
> cardiovascular events of that nature._

Tons of heart attacks before the age of 60 can be avoided simply by better
diet and more exercise.

Given that, it doesn't matter if not ALL are.

Especially if the alternative is hoping for some unicorn anti-aging discovery.

> _But still incremental, and to really solve the problem you have to repair
> the damage. Nothing else is going to do the job._

Yeah, we're still are going to age and die in the end. But the job here is not
immortality, is not going down from a heart attack before that...

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csense
If big pharma's not interested, would the costs of getting this kind of
therapy into paramedics' hands be within the reach of private philanthropy
(e.g. Gates foundation or YC's recent non-profit efforts)?

~~~
Cass
Glucose, insulin and potassium are already readily available on every
ambulance, so all you'd need is a clinical trial proving that the mixture is
effective and safe to use for heart attack patients. The costs of a clinical
trial seem well within the reach of private philanthropy, especially since
this isn't an experimental drug where you'd have to start from scratch--all
three of those meds have been extensively studied both separately and in
combination. (Glucose and insulin is a combination commonly used to treat high
potassium levels, for example.)

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seatonist
Here's a slide deck with data about the results of the trial (of Glucose
Insulin Potassium) mentioned in the article.

[http://clinicaltrialresults.org/Slides/ACC2012/Selker_IMMEDI...](http://clinicaltrialresults.org/Slides/ACC2012/Selker_IMMEDIATEtrial.pdf)

From the conclusions slide:

"Composite endpoint of cardiac arrest or acute mortality was significantly
reduced, and FFA levels were lower, consistent with the proposed FFA link to
arrhythmias"

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gist
> And so I started talking to the pharmaceutical companies saying, 'You know,
> would you make this stuff?' And they basically weren't interested.

How many?

Which ones?

All of them or some or most of them?

So maybe a big name isn't interested.

There are tons of companies who make generics who would probably welcome the
opportunity to market a concoction like this or at least entertain the idea.

~~~
M_Grey
You seem very ready to assume that the author didn't do his homework, while
seeming equally willing to assume that there are some companies who would be
game.

~~~
mzw_mzw
Given their track record, _any_ "advocacy" type article that appears in the
news media should be considered written by someone who didn't do his or her
homework until proven otherwise.

~~~
M_Grey
That's certainly possible, but then I still prefer something tangible in
response, "Here is the homework you failed to do." You know?

It's too easy just to imply that someone didn't do it, and then sneak a claim
in on the side.

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mikehotel
A different [edit: diet based] approach to reduce heart disease (also
advocated by a physician):
[https://youtu.be/LXigmGZk5FU](https://youtu.be/LXigmGZk5FU)

This same approach also appears to address other leading causes of death.

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alecco
Yeah, let's get a pill to fix it and keep chugging processed industrial foods
and sugar water while sitting browsing social networks.

