Scrutable

I’ve just read this article on 404 Media (recommended follow) about the rise of pharmaceutical piracy. Some people in the US are so angry at the inflated prices of essential medications that they are now making DIY ‘pirated’ copies of pharmaceuticals. The group in question, Four Thieves, have software that tells you the pathways to synthesise a given molecule, and the specs for a prototype off the shelf lab that will do a whole chunk of those. They've used it to synthesise a whole range of drugs at a fraction of the price being charged by the industry.

The interviewer tells how a friend of his died in their early 20s because of lack of access to cystic fibrosis drugs that might of saved them. So I can see why you would want pirate otherwise unavailable medicines to save your life, or that of someone you care for.

So, what are the risks and ethics involved here?

The risks are obvious in that QA is likely not going to be up to the same standards as Pfizer, and if you or your supplier screw up the chemical synthesis the consequences can be dire.

Another risk is synthesis of malign compounds for nefarious purposes. Botulinum toxin by the kilo would not be a good thing (admittedly that would be a much harder synthesis than their lab is capable of, but you get the idea).

As for ethics, to a great extent, sod big pharma. When you have executives talking about using “value based pricing” for medicines, where the value is your life and well being, my violins are so very very small for how much revenue they may lose. The lack of ethics of big pharma execs has driven people to this point. Which all argues for a different model for pharmaceutical research and development over what we have now.

To risks add formulation and dosing. Formulation is not trivial Pharma spends a very considerable amount of time and effort creating and testing tablets et al for stability. If you think you're taking 10mg of drug but 80% of it is something degraded you're in trouble. How many people can manage to measure/dilute accurately? (Haven't followed link, but synthesis of a pure drug is only the start).

Ethics - agree, somewhat sod em. Not always Pharma though, in the US the pricing if frequent exacerbated by insurance companies. Most (99%?) of Pharma drugs don't make it to market, so if you do want new treatments the companies have to make some money somewhere.

Back when I directly made medicines for a living, I wouldn’t dream of taking an active pharmaceutical ingredient I made without access to prep HPLC, and a lab full of GCMS, IR, NMR and everything else. Doesn’t come cheap.

I agree that the US patients are subsidising the rest of the world, but cooking your own is not the answer.