Wednesday 20 December 2006
Label nonsense again
Food labels are an unending source of amusement for me. The latest is from Sainsbury's, on their sirloin steak packaging. One line informs you to "cook raw meat thoroughly throughout until it is piping hot and no pink colour remains". A few lines down and you get the grilling times for cooking the steak rare......
Tuesday 19 December 2006
Drug development getting left behind
I constantly marvel at technological development and the free market capitalism that makes such progress possible. In a recent excellent podcast, Perry de Havilland at Samizdata mentions the cheap availability of 80GB hard drives as a symbol of such development. It got me thinking back to the first PC I built, a 386SX with a 170MB hard drive and a 256Kb (Yes I do mean Kb for any geeks out there) graphics card.
These days, my current PC has maybe 500 times the performance of my first, the progress in about 12 years in this area has been utterly phenomenal. I started to wonder, if only pharmaceuticals had progressed quite as quickly, we would all be reaping the benefits. Now many will say they are vastly different technologies and can't be compared, I'm actually not so sure, I can't help thinking of another reason for the difference. Markets. There is simply no absolutely free market in pharmaceuticals anywhere in the world, you pretty much get what your doctor chooses and your government or health insurer thinks is best value, indeed in the UK prescription drugs can't even be advertised to the general public.
So what effect does this have? Well, back to computers. Every year or so I upgrade my PC, partly because I like the latest games, partly because of bragging rights, never because I actually have to, it is a luxury. But because millions of others around the world think like me, small incremental increases in product performance give computer companies a substantial competetive edge, there is a massive incentive to do just a little bit better. Which over 10 or 15 years adds up to a huge amount better, including the cheapest, most basic PCs.
For pharmaceuticals, it is precisely this incentive I feel is lacking. As an example, a while back on a medical blog (I can't remember the link I'm afraid), NHS doctors were falling over themselves to state how they would never prescribe a new skin patch (for incontinence I think) at £1500 a year as opposed to the same drug in a pill for about £200, think of the budgets!
Now drugs, when taken orally, go from the intestines straight to the liver, which is actually pretty good at destroying foreign chemicals, then to the bloodstream. Patches avoid this process. As such, you have to take more of the drug orally than with the patch, exposing your intestines and your liver to a higher dose, with potentially more side effects. The NHS would probably say a few less side effects is really not worth the money, so the patches are out. Most people given the choice with their own cash would probably agree, take the cheaper pill and make do. A few however would pay extra for the patch in the same way a few geeks like me pay extra for the latest computer technology. Those few would drive the market forward, reward innovation, and soon enough as with computers, everyone would be getting those patches for £200.
Competition and the rewards of a marginal increase in product performance are great mechanisms, but they can't work when individuals neither control their choice of medication or the money which pays for it. Like in many areas, we all suffer when markets are constrained and choice is restricted.
These days, my current PC has maybe 500 times the performance of my first, the progress in about 12 years in this area has been utterly phenomenal. I started to wonder, if only pharmaceuticals had progressed quite as quickly, we would all be reaping the benefits. Now many will say they are vastly different technologies and can't be compared, I'm actually not so sure, I can't help thinking of another reason for the difference. Markets. There is simply no absolutely free market in pharmaceuticals anywhere in the world, you pretty much get what your doctor chooses and your government or health insurer thinks is best value, indeed in the UK prescription drugs can't even be advertised to the general public.
So what effect does this have? Well, back to computers. Every year or so I upgrade my PC, partly because I like the latest games, partly because of bragging rights, never because I actually have to, it is a luxury. But because millions of others around the world think like me, small incremental increases in product performance give computer companies a substantial competetive edge, there is a massive incentive to do just a little bit better. Which over 10 or 15 years adds up to a huge amount better, including the cheapest, most basic PCs.
For pharmaceuticals, it is precisely this incentive I feel is lacking. As an example, a while back on a medical blog (I can't remember the link I'm afraid), NHS doctors were falling over themselves to state how they would never prescribe a new skin patch (for incontinence I think) at £1500 a year as opposed to the same drug in a pill for about £200, think of the budgets!
Now drugs, when taken orally, go from the intestines straight to the liver, which is actually pretty good at destroying foreign chemicals, then to the bloodstream. Patches avoid this process. As such, you have to take more of the drug orally than with the patch, exposing your intestines and your liver to a higher dose, with potentially more side effects. The NHS would probably say a few less side effects is really not worth the money, so the patches are out. Most people given the choice with their own cash would probably agree, take the cheaper pill and make do. A few however would pay extra for the patch in the same way a few geeks like me pay extra for the latest computer technology. Those few would drive the market forward, reward innovation, and soon enough as with computers, everyone would be getting those patches for £200.
Competition and the rewards of a marginal increase in product performance are great mechanisms, but they can't work when individuals neither control their choice of medication or the money which pays for it. Like in many areas, we all suffer when markets are constrained and choice is restricted.
Tuesday 12 December 2006
Playing with flour
It's the folic acid issue again, the state wants to medicate you in a compulsory fashion and in the name of consultation it is preparing to ask you whether you want to be told what to do.
Now folic acid is good stuff, I take 400 mcg a day of it on the basis there is a reasonable amount of evidence it will be of some benefit to me. For expectant mothers it appears to be of special value and it is of great importance that they receive a reasonable intake. In fact if there was a charity whose sole purpose was to spread the word about it's value, I would possibly slip them some cash.
However I will oppose any moves by the state to force individuals to take it. While one can expect much debate about supposed pros and cons, the elephant in the room is that the state wants to take control of what I put into my body. For me that requires no debate at all.
Now folic acid is good stuff, I take 400 mcg a day of it on the basis there is a reasonable amount of evidence it will be of some benefit to me. For expectant mothers it appears to be of special value and it is of great importance that they receive a reasonable intake. In fact if there was a charity whose sole purpose was to spread the word about it's value, I would possibly slip them some cash.
However I will oppose any moves by the state to force individuals to take it. While one can expect much debate about supposed pros and cons, the elephant in the room is that the state wants to take control of what I put into my body. For me that requires no debate at all.
Thursday 7 December 2006
TVs are the latest puritan target
More government funded drivel trying to make us feel guilty about our nasty consumerist indulgences. Apparently plasma televisions use more electricity which is wasteful. Except it forgets about the first law of thermodynamics, that energy can't be created or destroyed. If your plasma tv "wastes" electricity, it is giving it out as heat, for at least half a year that means your central heating doesn't have to work so hard as you have a 42 inch radiator heating up your lounge along with showing "Desperate Housewives". Factor this in and the supposed "waste" tends to go down an awful lot, but that would mean state quangos such as the energy saving trust and the (frankly sinister sounding) market transformation programme would have less to lecture us about.
Saturday 2 December 2006
The bunnies are back
It's Christmas time and the Duracell adverts are ever more prevalent. "Lasts longer, much longer" is the strapline, with the small print "than ordinary zinc carbon batteries". Now if I had the time to be an undercover geek I would take a hidden camera round the high street in search of zinc carbon batteries, I haven't seen any on display for years, could it be they keep them under the counter? No, they are obsolete and no-one sells them any-more, so Duracell could well be accused of pulling a slight fast one.
But I'm quite grateful, one can well argue that it was Duracell's earlier adverts that made zinc carbon batteries obsolete in the first place, competitors switched to alkaline batteries as the public became more aware of their superiority and I can now buy 24 pretty decent chinese made alkaline AA cells for about £2.50. Which brings me to the point of this post, while Duracell is permitted by the state to advertise in it's own particular way, drug advertising to the general public is banned in the UK (freedom of speech anyone?). Maybe if we were allowed to see a Duracell style advert for certain pharmaceuticals we wouldn't be so willing to accept the medical equivalents of zinc carbon batteries the NHS often supplies.
But I'm quite grateful, one can well argue that it was Duracell's earlier adverts that made zinc carbon batteries obsolete in the first place, competitors switched to alkaline batteries as the public became more aware of their superiority and I can now buy 24 pretty decent chinese made alkaline AA cells for about £2.50. Which brings me to the point of this post, while Duracell is permitted by the state to advertise in it's own particular way, drug advertising to the general public is banned in the UK (freedom of speech anyone?). Maybe if we were allowed to see a Duracell style advert for certain pharmaceuticals we wouldn't be so willing to accept the medical equivalents of zinc carbon batteries the NHS often supplies.
It's the little things.....
A strange topic for my first post, but hey, what's this all for if you can't write about things that bug you.
For a long time now, the milk containers at Marks and Spencer carry the following on the label's information panel - "Pasteurised for longer". What does this mean? Heated up longer than your average pasteurised milk for some unspecified purpose? I can only suggest they missed "life" off the end of the sentence, but then longer life than what? Try finding unpasteurised milk at your local supermarket.
Now I know I need to relax more but surely someone else somewhere has noticed, it's been like this for years. It seems a banal, incorrect and meaningless statement can hang around because it sounds vaguely scientific and indeed somewhat reassuring. Or maybe no-one is tragic enough to point it out. I confess I've wanted to, but they would only replace it with "contains milk"
For a long time now, the milk containers at Marks and Spencer carry the following on the label's information panel - "Pasteurised for longer". What does this mean? Heated up longer than your average pasteurised milk for some unspecified purpose? I can only suggest they missed "life" off the end of the sentence, but then longer life than what? Try finding unpasteurised milk at your local supermarket.
Now I know I need to relax more but surely someone else somewhere has noticed, it's been like this for years. It seems a banal, incorrect and meaningless statement can hang around because it sounds vaguely scientific and indeed somewhat reassuring. Or maybe no-one is tragic enough to point it out. I confess I've wanted to, but they would only replace it with "contains milk"
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