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[sluissa]

Herman Cain faces the corona judgement

"Life can be a challenge. Life can seem impossible. It's never easy when there's so much on the line. But you and I can make a difference. There's a mission just for you and me....Just look inside and you will find just what you can do." - Herman Cain

[Max™]

Florida broke the 10k mark for new cases yesterday, California came in close behind at 9k, and Texas rounds out the podium at 7k.

Georgia and Arizona, not to be underestimated, are both still in the game at over 3k each, while Alabama, Tennessee, Louisiana, New York, and BOTH Carolinas are all over the 1k mark.

Keep your eye on hot new prospects Mississippi, Arkansas, Ohio, Illinois, and Pennsylvania though, as they're all eager to break into the big leagues now.

The US almost hit 60k new cases yesterday and shows no sign of letting off the gas any time soon.

We're #1, unfortunately.

[Iduno]

Herman Cain faces the corona judgement

He was also bragging about how the political rally he was attending wouldn't have people wearing masks, because they aren't afraid.


Edit to add US-related Corvid news:
https://twitter.com/meyevee/status/1277836277178683392
https://www.bbc.com/news/world-52406261

It's useless, has too many side effects, and they're going to charge 5-figures for it. Good thing we threw so much taxpayer money at the research to make sure we get the drug cheaply (the usual argument for private-public partnerships like this).

[Reelya]

It's fair enough to be upset about the high price, but the person tweeting that complaint in the first link doesn't understand how the economics work. She claims that the company got $70 million from the government to make the drug, but that's patently false. The $70 million was because they paid lower taxes on the money the company spent on the R&D. So they spent a lot more money than $70 million, their own money, and because it was approved R&D spending they pay a lower tax rate on whatever they spent.

Average costs to develop a new drug are about $3 billion. Also, they don't know which drug is going to work, so it's not just a case of making the one winning drug, companies need to investigate many drugs, and only a few of them will come to fruition. The market costs must cover not just creating the working drug, but the costs of all the dead-end research they needed to do as well. So even if you had the full costing of the money directly spend on remdesivir, that's only a fraction of the total costs spent investigating drugs that might have been effective.

Shit costs a lot of money basically, and just throwing "but the taxpayer paid $70 million!" in is a pretty ignorant statement, especially since that wasn't even a cash payment in the first place. That $70 million is hypothetical tax the company would have owed if they did the same R&D but there were not tax breaks for R&D in place. And of course, if those tax breaks never existed they would have invested their money differently, so the government probably wouldn't have got that anyway.

Some people don't seem to understand the difference between direct subsidies and tax credits. If you actually give someone $70 million dollars then you've lost $70 million you could have used for some other purpose, but if you offer tax breaks to encourage investment, then you're not actually "down" that money, since if you don't offer the tax incentives then the investment probably never occurs in the first place. See for example the campaign against Amazon opening a HQ in New York, and the $3 billion in tax credits they'd be entitled to if they did that, then when the deal fell through, people claiming the $3 billion could be spent on other things. Well no, that's really not true. The $3 billion was hypothetical tax Amazon could have paid if they so chose to open their HQ in New York rather than somewhere else, and if the various tax credits didn't exist. It's not money the city "saved" by not having Amazon. In fact the city lost a lot more money by not going through with the deal, tax breaks or no tax breaks.

[Starver]

I've worked in (but non-clinically) the pharma-study industry and know a little of the process. If it's as the BBC link says (just seen, edited in after I'd read the original post content) then this one study is far from 'proving' the efficacy.

If the percentages were reversed, it wouldn't be distinguishable from chance aberation[1], and if the trial is preventing other interventions[2] then I'm not surprised it was stopped early.

This doesn't sound the death-knell for the drug, but it's a datum-point that needs not to be forgotten for the meta-analysis if/when more favourable trial results come back from elsewhere. It's a stringent world out there (at least post-thalidomide) and if the company behind it are just trying to say "it's not as bad as you seem to assume" then I'd agree with them. If they're trying to say "it's better than it looks", then they need to have other preliminary study results in their back pocket (needing a final step or two of signing-off before publishing) to justify their words.


On the pricing issue, I'm aware(ish) of how expensive drug development (and then regulatory hurdle-jumping) can be, but that markup looks excessive. A little-used drug (but important, where it is, so can't be quietly let fallow) that has eaten up much of its patent-protection time in the run-up to full approval may have to be priced up to recoup development/etc costs before it becomes subject to Generic competitors rushing in. But with the "great white hype" of this one, its immediacy/scale of likely need and the probability that there'd be a willing rush of buy-ins to procure "pre-generic" generic-production if the owner can't serve all the demand, that pricepoint seems self-defeating. As if they're aiming at the "miracle cure" believers in the consumer market before the belief-bubble bursts. (i.e., they don't have any useful pre-preprint studies in their back pocket.)

Or there's tricksier shenanigans going on, but I don't have any reason to believe that. Much as I've spent zero time looking for history on the product[3], so some of my other speculation could also be a bit off.



[1] Which might mean they had the bad luck to see a bad roll of adverse events flipping an actually useful outcome, rather than a good roll of chance improvements in the right cohort masquerading as what they were hoping to see. But to claim this would unsupportable.

[2] Larger studies can probably allow freedom to vary, outside the core treatment/control dichotomy, but this (probably Phase II, and IIa at that, combined with the immediately life-threatening condition) would have to be constrained as you can't then eke out enough match-for-match equivalent confounding factors across the divide.

[3] I presume it's not come out of the blue, probably developed for/into another pathology and thus far closer to end-of-patent than a novel Phase I graduate would be, but I'm well out of the clinical study field, these days, and am content to not look it up, or recontact old colleagues to see if they know anything.

[martinuzz]

The EU was quite upset last week, when Trump announced he had bought up the entire production for the next three years of Remdesivir.
If it turns out to be ineffective, as sad as that may be, I'll laugh out loud, because the deal has already been signed and the US will need to pay up.
If it is effective though, expect diplomatic riots and possible nationalization of Gilead Sciences, which might be owned by US investors, but the factories making the drug are in Europe.

EDIT: in other news, Donald Trump Jr's girlfriend, Kimberly Guilfoyle, who is in charge of fundraising for Trump's campaign team, has contracted corona.
The couple were to attend Trump's 4th of july celebration at mount Rus-more, but have returned home.

[ChairmanPoo]

Worth noting that at the same time the study which was used to approve it (and which ONLY showed a modest decrease in the symptomatic period, no survival advantage or even early discharge) came out, a chinese study (admittedly, smaller, but still randomized) came out which was negative for that as well.

I was fairly disappointed given the hype that had surrounded remdemesvir. Not too surprised as it was also a fiasco with ebola, though.
Heck. Last time I checked the company was claiming it did best with mild cases. Yeah. Cool. But even assuming its true thats the segment that needs it the least

But yeah, while the attitude it belies is awful, its not a pandemic-deciding event.

If it is effective though, expect diplomatic riots and possible nationalization of Gilead Sciences, which might be owned by US investors, but the factories making the drug are in Europe

Have you got a source for that? I did some quick research and apparently they make it in Canada and bottle it in the US. That's the main reason they are able to do this. There were plans to license its manufacture to generic factories in Asia.

I do think there are behind-the-scenes talks with Gilead and that they're being leaned on by the EU. And I do think that there is a big chance not of outright nationalization, but of generic authorization by decree.

Btw: trump bought 3 months not 3 years

[martinuzz]

Oh, I seem to have misremembered. The same article about Gilead also states that a French company also 'sold' a future vaccin to the US.
https://www.volkskrant.nl/nieuws-achtergrond/amerika-koopt-voorraad-remdesivir-op-europa-staat-buitenspel~b5ff653c/

In reaction to the US buying all the remdesivir, the German ministry of health said that Gilead is obliged to also sell to the EU once the medicine is allowed on the market.

[ChairmanPoo]

I suspect they'll end up compromising a biosimilar license as in Pakistan.

Thst being said there is far less xovid in the RU than the US right now so odds wre the demand will be much higher too

[martinuzz]

Medicine for corona should be fairly distributed to every country in the world, taking into consideration the severity of the outbreak in countries.
Sure, I would not object to the US getting more, for you are one of the heaviest hit countries in the world.  But just buying it all up and going fuck you to the rest of the world.... That would warrant a joint declaration of war by the rest of the world IMO.  Or at the very least, a confiscation of all means of it's production that are not in the US.

[ChairmanPoo]

This shit has been going on from minute one. It took an intervention from the EU comission to keep EU countries from doing this to each other.

Yeah, Trump is the ur-example and the worst culprit. And I wouldnt be surprised if Gilead comes to grief if they dont amend this somehow. Despite remdemesvir's crappyness (nonwitshtanding the BMJ editorial pointing out that its so crappy that if the US wants to push an unproven treatment at 3000 usd a pop, they are welcome to it

[Starver]

Interested to know if the corporate Gilead predated The Handmaiden's Tale (not quite, nor The Dark Tower and many other references, but it probably wasn't an obvious thing on their radar, and at least it isn't like genre-blindly calling your sun-skimming spaceship "Icarus" or just about any new vessel "Titanic" or "Marie Celeste") and learning they specifically refer to the biblical balm, I came across another lesser-known biblical reference that's just dying to be taken out of context...

@martinuzz, but, but... surely America First and All Hail (or Heil?) The Mighty Dollar!

[Naturegirl1999]

@martinuzz, but, but... surely America First and All Hail (or Heil?) The Mighty Dollar!

As a citizen of the USA, I don’t agree with the America First thing, or The Mighty Dollar. ((I am aware this is a joke but still)). Remember that there are people here who understand that we are but one country sharing the planet with other countries, and that multiple countries need to cooperate for the benefit of all. Not all Americans are blindly patriotic as shows and movies would suggest. Some of us are sensible.

[kaijyuu]

Toxic attitudes deserve mockery. I don't think anyone's saying all 'merricans are MAGAs, either. So... don't take it personally when it's not directed at you.

[Naturegirl1999]

Toxic attitudes deserve mockery. I don't think anyone's saying all 'merricans are MAGAs, either. So... don't take it personally when it's not directed at you.

ok. Sorry.