Big pharma may charge monopoly prices when they can get away with it, but they do have substantial R&D and regulatory compliance costs. The price gouging isn’t as extreme outside the US, either, because there are saner drug pricing mechanisms.

For the record, I’m a fan of the FDA, for all its failings. Drug approval and surveillance are looked after some very astute and rigorous people. Under the US freedom of information act (which, incidentally, makes me embarrassed that we have a piece of legislation in Australia bearing the same name) you can read the full approval package (hundreds of pages) of just about any pharmaceutical marketed in the last 20 years or so, and the level of analysis is impressive.

If the FDA was given the legislative framework and needed money to regulate complementary and alternative medicines they’d be more than capable. I don’t see much sign there’s any political will to ask them to do it, though.

From the drug company’s point of view, they want to maximize profit. Since the profit on the drugs is much higher than the profit on the supplements, they only need to convert a small number of supplement buyers to drug buyers in order to come out ahead. So the fact that they wouldn’t convert all supplement users is no reason for them to keep marketing supplements. The drug companies would make the most money if they could block supplements.

This isn’t just a theoretical fear. There were efforts to start controlling supplements, and while it is hard to be sure who was behind them, at the time several investigators turned up information linking the efforts to the drug companies — indirectly, of course, and there were the usual denials. The fact is someone was trying to interfere with supplement availabiity. That led to the call for protection that led to the DSHEA. It has been so long ago that the details have faded from my memory.

Let me point out again that I don’t like the current situation. I just think the likely alternatives are worse, at least worse according to the measures I think important.

I do agree that the comment was poorly written. Sorry about that.

So another try: There obviously is a market here. Not selling to that market, when you (the drug companies) already have the production capabilities, and when no R&D money needs to be spent, seems silly — not to mention what your stock holders will think. (And you seem to agree.)

You say alternative treatments compete with drug companies’ products and threaten their profits. I say, from a hypothetical drug company perspective, “alternative treatments compete with our competitor’s products, lets hurt their profits!”. There’s more than one of them, and they are already going at each other.

And, even if they were to block every small producer from marketing supplements and alternatives, there would still be a segment of the population that would prefer something other than their main product. I’ll go so far as to say they’d be missing out on a certain group of people altogether, people who won’t put anything “unnatural” in their system if they can at all avoid it. They would profit from selling them the supplements you insist would not be availabe, and profit from it they will.

So that’s why I think your argument doesn’t work.

According to a survey published in the Medical Journal of Australia, people in South Australia spent about A$64 each (on average) on complementary and alternative medicines, and about A$25 on visits to complementary therapists.

Australian Government Statistics had per capita spending on pharmaceuticals on A$400 (most of which is paid through taxes via the PBS).

As an Australian consumer, I’d like government regulation of CAM to be at least 6% as good as regulation of prescription drugs…

I’m afraid I couldn’t figure out what you are saying. You seem to say that I claimed the drug companies don’t market supplements, but that isn’t what I said. Perhaps you could reword your thought to make it clearer?

The American “dietary supplement” industry is good for about $20 billion a year. I don’t know if this counts as David and Goliath.

Nice straw man, Dan.

Look who’s talking. For some reason in your scenario, your straw-evil drugs companies seem inable to bring supplements to market when they compete directly even with their competitors products; and yet they don’t seem to have that problem now, when it comes to prescription real medicine.

We can have a competing product on the market right now? With no need for expensive clinical trials at all? Can you say “no-brainer”?

And there is a market for it. A market which they, in your scenario, seem willing to leave completely untapped. In short, you ask us to believe that they are completely insane, and I’m not sure why we should want to believe that.

This claim has been made many times, but it makes no sense at all.”

Nice straw man, Dan. Of course the drug companies produce supplements. There is demand they can supply and make some money at it. But they can’t make as much money at that as they can at selling their drugs. If the supplements were regulated and the drug companies had their hands on the regulation levers, what do you think they’d do? Block the supplements for which they had competing drugs — they’d be stupid not to, and that is just what was threatening before 1994. You said yourself that the drug companies do what makes the most money, not what is best for their customers.

I’ve already admitted that the current system is not ideal. I’d much prefer a system in which all potential treatments were carefully evaluated and the quality of products sold was assured. But we don’t have that and don’t have much prospect of getting that, so I think what we have is better than cutting off access to supplements. You clearly don’t.

“If it it is your position that only one out of a thousand (if that) alternative practitioners lives up to your high standards, then I agree, but your argument becomes one in favour of government regulation, because clearly the industry is almost completely rotten.”

I doubt you have any solid base for taking one of a thousand as the ratio than I have for any other figure. I only had to get appointments with five or six doctors before I found one who seems to me to be trustworthy. Perhaps I was lucky; perhaps I was fooled. Yes, he has personally investigated the manufacturers of some of the supplements he prescribes. He takes advice from other similar doctors about sources of other supplements. He sells only a few products himself — the ones that are not pretty easy to get at stores in the area. Government regulation in the current environment would shut down the good guys along with the bad. You seem not to believe that, and maybe that is the reason we disagree. Or maybe you do believe that, but feel losing the good ones is worth it to shut down the bad ones.

I don’t like the current system. Like the old saying about democracy goes, its a bad system, but the others are worse. I can imagine a better system, but I don’t see how to get there, so I’m settling for the best I think we can achieve.