医学人类学 14 - Pharmaceuticals 医药品

Pharmaceuticals

Snapshots of Pharmaceutical Industry

1942, Penicillin first used to treat infections

2007, Purdue Pharmaceutical pleads guilty to misleading the public about OxyContin

2015, Turing Pharmaceuticals purchases license for the Drug Daraprim and raises prices 5000%

Critiques of Pharmaceutical Industry

Life-saving, but low public trusts (in economics)

Marcia Angell

Major pharma companies invest little in R&D while profiting off of publicly funded research (for new Drugs) - more money goes to salaries / marketing

Legislative context for rising pharma profits in the US: Bayh-Dole Act (1980) - patent public-funded research, Hatch-Waxman Act (1984) - expand menapuling rights for new Drugs

Joseph Dumit

Pharma companies maximize Drug prescriptions by redefining conditions as medical problems - profit from not only illness, but also illness risks

Medical research system designed to only develop new Drugs.

Medicalization

The defining of a condition as a disease or in need of medical surveillance.

Pharmaceutical Industry - changes the recommended threshold for people to take medicine to control - lowered threshold, increased number of risky people

Pharmaceuticalization

Pharmaceutical Research - Clinical Trials

Pharmaceutical research involve clinical trials

Stages: Lab Studies (years) - Phase 1: Human Safety (tens, days or weeks) - Phase I/II: Expanded Safety (hundreds, weeks or months) - Phase III: Efficacy & Safety (Thousands, years)

Tuskegee Syphilis Experiment

Study of syphilis in rural African-American men in Alabama, ran from 1932 to 1972;

Study subjects received free health care, but were not treated for syphilis;

Studied “natural progression” of syphilis

Ethical Variability

Globalization of clinical trials (research populations around the world) - fewer regulations, cheaper, less Drug use;

Scandal surrounding AZT trials in 1990s;

Ethical Variability: Ethical guidelines are applied differently in different contexts.

- Standard of care: in the Home country or the Research place?

Drug Use, Addiction & Recovery

- The meaning and experience of intoxicants is shaped by its cultural context, eg alcohol - may not be alcoholic people;

- Can be part of the pursuit of a meaningful life in dire circumstances;

- Macro-level social structures and relations of power structure Drug use and recovery, eg some people may suffer more in the society;

- Drug Use, Addiction & Recovery are all shaped by cultural contexts.