It’s been a cold, rainy spring day in DC today, but just a few weeks ago we had this. Isn’t spring great?
Today I learned about ambroxol, a cold medication available over-the-counter, much like Mucinex and Robitussin, but unlike those two ambroxol may actually work. It’s been available in Europe for almost 50 years and costs around $5 per box, but alas:
You can’t get ambroxol in the U.S. because of the failure of the Food and Drug Administration to grant reciprocal recognition to generic medications approved by its European counterpart, the European Medicines Agency, when they have long been proven safe and effective. To get FDA approval for the sale of ambroxol in the U.S., a drug company would need to sponsor extensive and costly clinical trials. Since it is a generic, as cheap as aspirin, no drug company would bother.
If the drug is that good and that cheap a trial should be neither extensive nor costly — it would certainly be cheaper than the $10 billion the American tax payer gave for Paxlovid, with potentially many more people benefiting. So why not have the NIH run the trial and the FDA approve the drug? Would that not be faster than trying to pass any legislation through the United States Congress?
More generally, I would like economists, politicians and the general public to understand that well-run clinical trials do not have to be complicated and expensive. They are not a limited resource going up in price because of low availability and high demand, requiring us to think of workarounds. In fact, there are more patients than ever, more researchers than ever, and more technology than ever to make them economical and efficient.
Of course, if your notion of a clinical trial is one that includes mountains of paperwork and research bloodwork gathered on the off chance it may someday be needed then yes, it can get pricey. But that is like complaining that pianos are really expensive and unaffordable because the price of a Steinway piano has gone through the roof since the early 1900s. You can play music on a Casio just fine, and if I were an economist I would really want to know why on Earth almost everyone in the pharmaceutical and biotech industry was getting grand pianos instead of electronic keyboards.
(↬Alex Tabarrok, who as an economist interested in drug pricing may want to look into the cost of clinical trials)
Speaking of Sivers, his book on How to Live is my go-to gift for people who read. A step-up from that — and it is a yuuuge step — is Nassim Taleb’s Incerto, but I have to know someone really well because a five-book set is a bit of an obligation.
And speaking of Taleb, it looks like we were in the same building yesterday. Small world.
There is a phrase in Serbian when someone is bamboozling you that they are “trying to sell you a horn for a candle”. I have no idea how it came about, but here are some researchers trying to sell us social media for the internet and the phrase came to mind. (ᔥTyler Cowen)
🏀 With the Nuggets and the Knicks both knocked out of the playoffs on the same day, my basketball-watching season is officially over. Let’s see what 2024/25 brings to everyone, the Wizards in particular.
That’s it! I tend not to abandon books half-way through, but I just couldn’t swallow these three.
Should I revisit? Emerson had some good quotes, apparently, and Campbell (seems to have) inspired many good stories although his own did not persuade me.
But Catch-22, dear oh dear. You could not pay me to start reading that piece of work again.
Inspired by Derek Sivers, I now have a Now page. Thank you, Derek.
🍿 The Shining (1980) came out many decades ago, but from the opening I-can’t-believe-it’s-not-a-drone bird’s eye views through the masterful tracking shots of the Overlook Hotel to the anxiety-inducing stills of Jack Nicholson and his eyebrows it beats any and all of the modern-day perfectly-shot too-slick-to-be-real CGI trickery. I have been rewatching the movie several times over several decades and the cinematography is getting comparably better and better — quite damning for Hollywood.
This time around, however, I could better appreciate what’s truly scary about the movie: not the blood-filled hallway, or the hag soaking in that bathtub, or even the haunted twins*, but rather the ease with which a middle-aged man becomes bitter and starts blaming his family for holding him back. Not everyone is capable of extinguishing a star.
It’s been a cold, rainy spring day in DC today, but just a few weeks ago we had this. Isn’t spring great?
I wanted so very much to like morgen for its calendar helper services like automatic travel time, prep time, flexible meetings, etc. But then it throws this alert window with no explanation whatsoever for why on Earth it would need to access my microphone and nope, no way, hard pass.
The Beatles wanted to do a LotR movie, starring:
McCartney as Frodo, Starr as Sam, Lennon as Gollum and Harrison as Gandalf. The Beatles' choice of director? Stanley Kubrick, fresh from making 2001: A Space Odyssey.
But Tolkien didn’t like the idea of a pop group being associated with his books. I am not sure about that cast either, but just imagine Kubrick’s Lord of the Rings. In the style of Barry Lyndon, perhaps? (ᔥMarginal Revolution)