醫(yī)學(xué)人類學(xué) 14 - Pharmaceuticals 醫(yī)藥品
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.