Total absence of regulation would result in a drug industry that is only concerned with soundbites, drug colouring, and trademarks. Through most of our history, the medicine worked just like this.
We can’t know that. Regulation is not the only means by which information about what drugs are useful and who can be trusted can be disseminated. If the FDA was not around it could well be that a non-regulatory body would have developed to fulfill this role.
The fundamental problem of both FDA and such non-regulatory body is that the drug industry got the money to fake the signals. The valid argumentation must be substantially more effective at convincing public than invalid argumentation, for it to work at all.
(I do not think btw that people must be protected from themselves.)
This is basically the primary issue. It is possible for a hostile or simply incompetent drug company to spam the information sources of people with false or misleading information, drowning out the truth. The vast majority of humans in our society aren’t experts in drugs, and becoming an expert in drugs is very expensive, so they rely on others to evaluate drugs for them. The public bureaucrats at least have a strong counter-incentive to letting nasty drugs out into the wild.
Furthermore, it can take some time to realize a drug isn’t working, and the placebo effect is going to be in full force to make that even harder. By the time you realize you were sold snake oil, you may already be dead. “Reputation” may not be of use here, as fake drugs are much cheaper to develop than real ones, so the cost of throwing an old trademark or company shell under the bus every few years is minimal, especially compared to the cost of discovering that for individuals. Consider also the time in man-hours that must be spent hunting for information and evaluating safety, not just of the drugs themselves, but also the reputations of the private verification firms, by all individuals that need drugs. The FDA is cheaper.
Edit: I should say that “in my estimation, the FDA is cheaper.” It’s only back-of-the-napkin math. I generally take the position that we should protect people from themselves to the degree that it is reasonably practical to do so. We have all failed due to ignorance, irrationality, or inattention at some point. Of course, when someone tries to break open your high-voltage power line to steal the copper inside, well...
This comment and its parent are both true. And, strangely, we seem to exist in an universe where there are both known useful drugs and a lot of drugs of unclear benefit.
We can’t know that. Regulation is not the only means by which information about what drugs are useful and who can be trusted can be disseminated. If the FDA was not around it could well be that a non-regulatory body would have developed to fulfill this role.
The fundamental problem of both FDA and such non-regulatory body is that the drug industry got the money to fake the signals. The valid argumentation must be substantially more effective at convincing public than invalid argumentation, for it to work at all.
(I do not think btw that people must be protected from themselves.)
This is basically the primary issue. It is possible for a hostile or simply incompetent drug company to spam the information sources of people with false or misleading information, drowning out the truth. The vast majority of humans in our society aren’t experts in drugs, and becoming an expert in drugs is very expensive, so they rely on others to evaluate drugs for them. The public bureaucrats at least have a strong counter-incentive to letting nasty drugs out into the wild.
Furthermore, it can take some time to realize a drug isn’t working, and the placebo effect is going to be in full force to make that even harder. By the time you realize you were sold snake oil, you may already be dead. “Reputation” may not be of use here, as fake drugs are much cheaper to develop than real ones, so the cost of throwing an old trademark or company shell under the bus every few years is minimal, especially compared to the cost of discovering that for individuals.
Consider also the time in man-hours that must be spent hunting for information and evaluating safety, not just of the drugs themselves, but also the reputations of the private verification firms, by all individuals that need drugs. The FDA is cheaper.
Edit: I should say that “in my estimation, the FDA is cheaper.” It’s only back-of-the-napkin math.
I generally take the position that we should protect people from themselves to the degree that it is reasonably practical to do so. We have all failed due to ignorance, irrationality, or inattention at some point. Of course, when someone tries to break open your high-voltage power line to steal the copper inside, well...
This comment and its parent are both true. And, strangely, we seem to exist in an universe where there are both known useful drugs and a lot of drugs of unclear benefit.