Conflict of interest for MSer

[glenmoor_guard]

I hope everyone is ok.

My neurologist observed symptom improvement for patients with MS who happened to use an IV antibiotic for non-MS problems. The neuro put in a patent application for a novel use of an already FDA approved drug.

Is this good business, is there a scientific reason for it or is it a craven expression of capitalism at work?

I feel conflicted:lucky that I benefited from this drug use by knowing the neuro but uncomfortable with the possibility of being exploited. What do you think? Glenn

[Redwings]

Well, Glenn, that's a new one on me. I didn't know it was possible for someone to get a patent on the use of a drug they don't hold the manufacturing rights/license to. I can't even imagine how it works that the price of a drug differs depending on the person it's going into.

Patents are purely for business/financial advantages. I don't believe the global economy will ever be what it used to be. Knowing how hard it is to arrange a secure financial future in this economy, it sounds like a smart business move on your neuro's part. With the same knowledge and opportunity, how many of us wouldn't have done the same thing? (Daddy, where am I going to go college? Well, son, I passed by that patent thing on moral grounds, so you won't be able to go to college.)

I don't see how, if the neuro doesn't already own the patent, using an FDA approved drug off-label would be a conflict of interest because the neuro didn't gain anything from it. Even if the neuro did already own the patent, whether it would be a conflict of interest is debatable because the drug is FDA approved and available from other sources.

As far as being exploited, it depends on the definition of exploitation. Is exploitation only defined by financial gain? Did your neuro gain anything extra (beyond medical fees) by prescribing the med for you? Did the neuro's office directly administer the drug to you and make an undue profit from it? Was the only reason you got the med that the doctor was looking for information to justify a patent application? Would you not have gotten the med otherwise?

Did the neuro do something unethical? Were you included as part of a clinical experiment without informed consent for the sole purpose of the neuro getting a patent? Is holding a patent exploitation if there's no increase in price based on how the med is used?

Is the gaining of knowledge by use of a drug in a particular patient exploitation? Is the gain of recognition/fame exploitation? Doctors write up and publish case studies all the time, and they gain professional recognition from publishing. Is being the subject of a case study (always anonymously) or part of a group described in a case study that gets published in a scientific journal exploitation? Should doctors not be allowed to publish their knowledge even if other doctors and patients can benefit?

[Sir-Voor]

I’d call it excellent doctoring, your neurologist is clearly vary involved in tracking his/hers patients’ treatments to notice something like it.
Doctor prescribes drugs for uses other then there main use all the time, that is nothing unusual. And doctors not profit from doing so even if they owned some stock in the drug manufacture, it would not cover the loss that bad PR legal troubles that could be create by prescribing unneeded drugs.

This is simply a case of good doctoring, which I’m sure is good for his business.
But seeing how he made the possible connection, I’m thinking the business aspect was not his main goal.

Now if the drug manufacture hears of this they well likely pay for a test studies to be done, in hopes to expand the market of the drug. And that is good for us and the good capitalistic manufactures.

[Justsayyes]

I was on daily doxycyline along with my weekly Avonex for about 9 months after a study showed a benefit. It was only a small study and didn't go any further, so I did not stay on the antibiotic. Other studies have been done with different antibiotics, so there is some science behind antibiotics being beneficial in MSers.

[asiel1]

Wow. I took antibiotics for a long time for adult acne. It was one of the most flare free periods of my life. I rode my bike 110 miles a week, and as long as I did not overheat I was good.

Hmm. Interesting.

LBJ

[Frederick1]

I don't see the problem. It sounds like a good thing for both you and the doctor. A win/win. Are you just anti capitalism?

[palmtree]

I'm no medical ethics expert, but i think this might be a good opportunity for you. Doctors are so afraid of being sued that they won't try anything that is off label.

This antibiotic thing is interesting. My cousin, who's mother had MS, has been researching for me. He is convinced that most MS is a result of Lyme disease and the only way to treat it is with long term, IV antibiotics. I was on antibiotics for a month and I was doing well then.

If you do it and it works, maybe this will lead to something.