[sica07]

There were and are a lot of articles about the fact that many prescription drugs and many treatments are overrated and I totally belive that. But saying that "most" medical treatments & prescription drugs are worthless it's quite a radical view based on... pure speculation.

[rjf72]

I think your statement sounds perfectly reasonable, but it actually holds a pretty interesting corollary! If he is wrong that "most" medical treatments and prescriptions are worthless then that would necessarily mean that "most" are valuable. The reason this is interesting is because the exponentially increasing rate of both the amount of medication out there and the amount people are using. For instance from 1997 to 2016 the number of prescriptions filled grew from 2.4 billion to 4.5 billion [1]. And an exponentially increasing number of people, across all ages and demographics, are also being medicated with all sorts of drugs for various reasons.

So, if we assume that most medical treatments and prescriptions are not worthless we should see increases in healthfulness that are at least somewhat comparable with our increases in pharmaceutical usage. In reality we saw sharply diminishing returns on life expectancy that have now gradually shifted towards an ongoing decline in life expectancy over the past few years. By any standard of effectiveness, this is not looking good for pharmaceuticals.

So I suppose I'd turn it around. I think the view that medicines (and especially their recent exponential growth) are providing a substantial social benefit could be true, but it would seem to be the statement that needs to be explained. E.g. perhaps our own increasingly unhealthy lifestyles are contravening the gains from the medical technology? No idea there, but I do think occam's razor would tend to simply suggest that the reason we're not seeing improvements is because we're not improving.

[1] - https://www.webmd.com/drug-medication/news/20170803/american...

[sica07]

I agree with you but in a different way :) (what follows its a long text written in bad English but I hope I'll manage to make my idea clear)

Regarding your idea that "By any standard of effectiveness, this is not looking good for pharmaceuticals": This is a very complex topic and I don't think anyone has a clear and objective view/explanation about this.

For example, we have a big problem with the antibiotics. We eat a lot of meat from animals that where treated with antibiotics. We "overuse" antibiotics. Etc. Because of this, new antibiotics-resistant bacteria appeared and classical antibiotics became less and less effective in fighting against them. How should we categorize this issue? Should we see it as a proof of the fact that medicines are not as effective as advertised? It's not a problem with antibiotics per se. Or as a proof that modern medicine is overrated? Medicine correctly identified the problem(bacteria) and the treatment(antibiotics). In reality it is a problem generated by mostly by the rising popularity of automedication, lack of basic medical/pharmaceutical education and urban myths (antibiotics are good for anything), medicines used on animals (which is not a problem of human medicine), and, I would say, only a tiny part of the problem is the treatments that unnecessarily include antibiotics and are prescribed by medicine doctors. But, let's say that we don't know anything about the above mentioned facts and we study some statistics. What would we think when seeing a clear correlation between the increase in the number of antibiotics and decrease of the effectiveness of the treatments? We could see it as a proof that "the quality of medicine drugs has decreased resulting in an increase of ineffective treatment".

The point I'm trying to make is that the reason why the effectiveness of many treatments decreased and now we have a decline in life expectancy it's a very complex issue and it's not fair to see it as simple as a fact failure of pharmaceutics or/and medicine.

Regarding your last statement, I think that we are not seeing improvements because our modern environment and life style has changed and is changing in such a rapid and unpredictable way that medicine can keep the pace. Medicine it's improving, but it's improving too slow. It is as out environment and lifestyle is traveling by plane while medicine and pharmaceutics are traveling by bus...