In a small clean room tucked into the back of San Diego–based startup Organovo, Chirag Khatiwala is building a thin layer of human skeletal muscle. He inserts a cartridge of specially prepared muscle cells into a 3-D printer, which then deposits them in uniform, closely spaced lines in a petri dish. This arrangement allows the cells to grow and interact until they form working muscle tissue that is nearly indistinguishable from something removed from a human subject.

The technology could fill a critical need. Many potential drugs that seem promising when tested in cell cultures or animals fail in clinical trials because cultures and animals are very different from human tissue. Because Organovo’s product is so similar to human tissue, it could help researchers identify drugs that will fail long before they reach clinical trials, potentially saving drug companies billions of dollars. So far, Organovo has built tissue of several types, including cardiac muscle, lung, and blood vessels.

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So why isn’t the pill sold next to aspirin in every pharmacy or gas station? Commercial greed and a strong patriarchal streak in American politics.

Prescription medicines bring higher profits than over-the-counter drugs. As a doctor, I would recommend my loved ones use a low-dose generic pill whose safety has been well documented over a generation of use. A good generic manufacturer can make a packet of pills for under 20 cents, and they could be sold for $8 a month or less and still make a profit.

Sooner or later, one generic manufacturer will break ranks and ask the FDA to let the pill be sold without a prescription. Let’s hope it’s sooner.

Uhm, no. The pill is already available in multiple generic forms. Walmart and Target pharmacies both already sell it for about $9 / month. Dr. Potts is conflating two different things: prescription vs OTC and name-brand vs generic. Many generic drugs are still prescription only and many name-brand drugs are already OTC.

Drug companies make a large chunk of their profits by having a patent on a drug. Once that patent expires, any generic manufacturer can make and sell their own versions. But that doesn’t automatically make the drug available over-the-counter. It just gives your doctor multiple options, at multiple price points, of what to prescribe for you.

No, the pill is still prescription only because the FDA is one of the most paranoid and risk averse Federal agencies. The pill won’t be available OTC until there is enough public pressure to make it OTC or until Congress or the President forces them to make it OTC. Given that various governments are busy cracking down on Sudafed and taking it from OTC to prescription only, I’m not holding my breath for a happy ending for the pill.

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In a study that provides provocative support for a new approach to treating obesity, a drug that kills a particular type of fat cell by choking off its blood supply was shown to cause significant weight loss in obese monkeys.

After four weeks of treatment at M.D. Anderson Cancer Center in Houston, obese monkeys given daily injections of the drug, called adipotide, lost an average of 11% of their body weight. They also had substantial reductions in waist circumference and body-mass index and, importantly, striking improvement in the ability to respond to insulin, researchers said. The drug didn’t have any effect on weight when given to lean monkeys.

Results of the study, published online Wednesday by the journal Science Translational Medicine, confirmed a 2004 report from the same research team showing marked weight loss in mice treated with the agent.

My first reaction was: “I want to take this drug”. My second reaction was “I should invest in this drug. Everyone is going to want to take it.”

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Mr. Frank, Rep. Ron Paul (R., Texas) and others will make the bill’s language public Thursday. It would be the first bill of its kind ever introduced in Congress, the release said.

“The legislation would limit the federal government’s role in marijuana enforcement to cross-border or inter-state smuggling, allowing people to legally grow, use or sell marijuana in states where it is legal,” the release said.

“This is not a legalization bill,” a spokesman for Mr. Frank said.

More than a dozen states have laws that allow the sale of marijuana for medical use, but the practice isn’t legal under federal law, and federal authorities have raided marijuana dispensaries.

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A few days ago, tens of thousands of Mexicans in scores of Mexican cities participated in public protests against the War on Drugs and the use of the Mexican army as anti-drug warriors. The violence that has accompanied the Mexican government’s attempts to defeat the drug dealers during the past several years has claimed perhaps as many as 40,000 lives. Some cities, especially Ciudad Juarez, across the river from El Paso, Texas, have become virtual battlefields.

All of this would be sufficiently dreadful if it had accompanied legitimate efforts to suppress real criminals. But although the drug dealers have committed murders, robberies, and other genuine crimes, to be sure, the foundation of this entire “war” is the U.S. government’s attempts to suppress actions — possessing, buying, and selling certain substances — that violate no one’s natural rights. Not to mince words, the War on Drugs is completely evil, from alpha to omega. No one who believes in human liberty can coherently support it. That its prosecution should have resulted in death and human suffering on such a vast scale constitutes an indictment of every person who has conducted or supported this wicked undertaking from its outset.

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We can now answer the question: “Where do new drugs come from?”. Well, we can answer it for the period from 1998 on, at any rate. A new paper in Nature Reviews Drug Discovery takes on all 252 drugs approved by the FDA from then through 2007, and traces each of them back to their origins. What’s more, each drug is evaluated by how much unmet medical need it was addressed to and how scientifically innovative it was. Clearly, there’s going to be room for some argument in any study of this sort, but I’m very glad to have it, nonetheless. Credit where credit’s due: who’s been discovering the most drugs, and who’s been discovering the best ones?

Spoiler: Overall 58% of all new drugs come from the pharmaceutical companies. BUT, 53% of all drugs for unmet needs came from either biotech companies or universities and 56% of all truly novel drugs came from either biotech companies or universities.

My conclusion: all 3 sources are important parts of the drug innovation system and we shouldn’t bash or diminish the importance of any of the 3 sources.

Obamacare delenda est

we continue to spend more on drugs — in part because of the increasing use of so-called biologic medicines, which cost, on average, 22 times as much as ordinary drugs. In 2008, 28 percent of sales from the pharmaceutical industry’s top 100 products came from biologics; by 2014, that share is expected to rise to 50 percent.

Biologic drugs can be more expensive to manufacture; they are grown inside living cells rather than put together chemically, as conventional drugs are. But this does not fully account for their high prices. Another important factor is that they very rarely face competition from generic copies.

Congress has an opportunity to change this by including in health care reform incentives for generic drug makers to compete in the biologics marketplace. But unfortunately, both the House and the Senate versions of health care reform contain provisions that would discourage the development and significantly delay the approval of generic biologics.

In general, I’m in favor of swinging the pendulum back towards less intellectual property protection. This sounds like a bad idea to me.

This is insane. This is seriously insane. This law — and Federal laws requiring Sudafed to be kept behind the pharmacist’s counter — have done nothing to curtail access to meth. These laws have accomplished one thing and one thing only: meth production has been shifted from small labs to super high tech Mexican labs. Meth is still plentiful in the United States. But it’s now fueling the growth of Mexican drug gangs and Mexican smugglers. If anything, the status quo ante was better in that it wasn’t creating sophisticated cross-border smuggling operations.

Now, every Mississippi resident suffering from allergies, sinuses, or colds will have to go to a doctor before they’re able to get any effective relief. Doctors’ offices and emergency rooms will become more crowded and the entire state population will be vastly inconvenienced. All for a law that will have no practical effect whatsoever.

For the record, Governor Barbour will not be getting my vote, should he decide to run in the Republican presidential primaries.

My wife and I enjoy our Flex Spending Account. We put in enough money each year to cover the various drugs we’ll need to buy (both prescription and non-prescription), a new pair of glasses, and money to cover any other medical expenses we anticipate. Next year, I’m planning on putting in an extra $4000 for corrective laser eye surgery, so that I can finally stop wearing glasses. We like the plan we have.

Well, under the Senate healthcare bill, we’ll no longer have that plan.

Both the House and Senate bills include a change in the definition of a “qualified medical expense” that impacts reimbursements and withdrawals under all types of health care accounts (i.e., FSAs, HRAs, HSAs, and Archer MSAs). As of 2011, expenses incurred for over-the-counter (OTC) medications and products will no longer be eligible for payment or reimbursement from any of the health care accounts. The House bill definition appears to apply to all OTC medications. However, the Senate bill would still allow OTC medicines obtained with a prescription and insulin to be reimbursed or paid tax-free from the health care accounts.

The most significant change likely to be enacted is an annual limit on contributions made by employees to flexible spending arrangements (FSAs) for health care. Both the House and Senate versions of health reform legislation would limit contributions to no more than $2,500 annually. The limit would be indexed to inflation for future years. Under the House bill, these changes would not take effect until 2013. In the Senate bill, these changes would take effect in 2011.

If the current “reform” bills, I wouldn’t be able to buy OTC drugs — Sudafed, Mucinex, ibuprofen, Tylenol — tax free. If the “reform” bills pass, I wouldn’t be able to save tax free for corrective eye surgery. I would no longer have the plan I like.

It’s just one more broken promise from a president that’s building quite a pile of them. Apparently, “yes we can” act just like any other politician.

Do you have a right to health care? Yes. And no. My answer ultimately depends on what you mean by a “right” to health care.

Rights come in two varieties: negative and positive. A negative right can be thought of as the right to be left alone. It’s the right to do something without the fear that someone else will restrain you. A positive right can be thought of as the right to be served. While a negative right requires only that someone leave you in peace, a positive right requires that someone actively do something for you.

I believe you have the right to work with the doctor of your choice — whether or not that doctor has been credentialed by a government.

I believe you have the right to take the drugs of your choice — whether or not those drugs have been approved by a government panel of experts. I believe you have the right to take experimental cancer drugs, especially as a last ditch attempt to save your life. I believe you have the right to take marijuana to treat pain, to build appetite, and to relax.

I believe you have the right to buy insurance from any company, located in any state, covering any combination of conditions. I belive you shouldn’t be limited to only the health insurance that covers a government approved list of condition from a government approved list of companies.

I believe in a strong negative right to health care. That’s something that doesn’t really exist in America today. Right now, you are not free to receive health care from anyone you trust, you are not free to take the drugs of your choice, and you are not free to buy whatever health care you desire. I am in favor of more freedom in health care. I believe you have a right to consume health care as you see fit, even if the majority of people around you disagree with your decisions. That’s freedom.

I don’t believe you have a right to force someone else to pay for treatment, medications, or medical supplies. I don’t believe you have a right to force a doctor to work with you. It’s one thing if you and the doctor can come to a mutual agreement regarding pay and hours of availability. It’s something else entirely to require a doctor to treat you at a price of your choosing (not his) and at a time of your choosing (not his). I don’t believe you have a positive right to health care.

To be blunt, I don’t believe you have a right to turn doctors into slaves (by requiring them to treat for free or at a steep discount) or a right to turn your fellow citizens into slaves (by requiring them to work in order to pay the bills for your health care).

The current discussion of health care rights revolves almost entirely around positive rights — getting someone else to pay for our health care. It includes an “exchange” that would strictly limit the options available. It includes subsidies forcibly taken from some people through taxes and used to pay for someone else’s health care.

It includes a requirement for insurance companies to charge everyone the same price for health care. This practice, known as community rating, allows sicker people to pay less than the cost of their care and requires healthier people to pay more. In effect, community rating is a subsidy to the sick courtesy of the healthy. Community rated health care is a very bad deal for young, healthy individuals. So the current discussion revolves around a health care mandate. Most of the plans under consideration would require young people to purchase something that’s a bad deal. They would be required to do this solely to provide a good deal to sick people and the elderly.

Claiming a positive right to health care is nothing more nor less than the claiming the right to enslave your fellow man. I don’t believe you have that right.