[greenish_shore1]

If you don't trust people to compound a drug for their own use, why would you trust them to not jump off a bridge, to not kill or injure a passerby, or not to perform other serious antisocial actions? Of course this is a way deeper issue, but I tend to approach it this way. In the Western values, we tend to value freedom, also as freedom of people to self-define, very high, despite the risks it takes. And this, this is a modern part of exactly the same dilemma.

People already do exactly that, and with some basic knowledge (which should and probably will be in 20-30 years a common knowledge) it's much safer than one could expect.

Of course, it'd be ideal if they wouldn't need to worry about it and could leave this to a person who is guaranteed to be more knowledgeable in doing that, but with all the over-regulation burden, drug patents, drug schedules, it's not happening. Example of that is, precisely, the price of this. It could literally be 2000x smaller if we only get rid of that burden, which was created to give some people profit. And if we subside that with taxes, these taxes go to the pocket of a gatekept and protected-by-the-state manufacturer. That's not how taxes should even work, they should benefit the society instead.

TL;DR: This is a much wider issue.

[glial]

I mean, I wouldn't compound drugs for myself for the same reason I don't do maintenance on my car's transmission myself: I don't really know what I'm doing and would probably get myself killed.

From what I understand - may be wrong - the 2000x has more to do with IP protections than production safety.

[greenish_shore1]

Basically, I agree. Would be great if people wouldn't have to bother. But that's a perfect world which, apparently, isn't very real. Hence, let's try to think about a solution which, even though not ideal, could possibly be better than the existing state... Because always, there is, among others, the greed of some, and so on.

By the way, I'm not even sure does IP protections itself apply here. Both parts of this fixed combination drug were known for quite some time (particularly trospium chloride is very old, also often used in research settings). But if they would apply (if the molecule itself was patentable as someone's intellectual property), they would be additional HUGE problem. But what constitutes (or creates) that "2000x" problem here isn't even that, this is most likely the FDA regulations regarding drug approvals and so on, exclusively.

It could be a good idea to wonder about, what if FDA as a governmental agency limited itself to "trusted" information campaigns to the public on efficiency of all medicines, but not doing anything which touches, notably, revenue matters of pharmaceutical companies (as that's why, in my opinion, corporations actually lobby for big FDA influence, they can make more profit off that).

Also, definitely FDA in that model wouldn't be setting themselves as an "authority" for "approvals" of drugs and so on, which for my taste is completely contrary with both the whole putative role of (federal) government, and further, with the Western values (as I outlined in my previous comment) themselves.

That new role and "definition" of FDA would be exactly akin to what NIH is doing even now in the area of nutrition. If you don't know what they do, look at the USDA FoodData Central or all the micronutrient factsheet they publish - it's my go-to resource when I wonder anything about food.

But the FDA role would then be like that, but in regard to man-made substances of medicinal use, as opposed to these occurring in abundance in nature (which, in a great simplification, when they're essential to a human body, we consider "food"). And DEA's complementary role here would be to go after manufacturers who do not label their products according to the truth.

[lossolo]

The FDA exists to prevent us from repeating history[1] and to minimize the risk of people being killed, developing tumors, or buying placebos instead of real cures.

1. https://en.wikipedia.org/wiki/Snake_oil

[greenish_shore1]

That's why I said about them releasing science and evidence-based trusted information campaigns. Not about getting rid of the FDA entirely.

In the present information age, you don't need to give them such wide powers to avoid precisely what you're afraid about avoiding.

[lossolo]

That's a very naive view of the world. There are predators waiting for deregulation to flood the market with snake oil and profit from everyone. By the time the FDA can launch any campaign, people will already have been scammed or even killed. Moreover, the information age doesn't help or prevent these issues—just look at obesity rates, despite the wealth of information and science about junk food. What you're proposing might work for a small percentage of the most informed and intellectually capable individuals, but it creates risks for everyone else.

[greenish_shore1]

I don't agree and I think some of what you're pointing out is because we're still in a transitional period into a full information society (which we don't even fully know what it would be, even now, 30 years deep into that transitional period, but it's inevitable and I'm personally sure that it would be infinitely better that what we have now). I think of it as a duality, that usually, when we do something good, it usually creates some harm (for example, to a group we haven't even realized it existed!).

However, your point made me realize that, in fact, probably what you generally described as the most capable individuals, are probably even now mostly immune to the harm which FDA creates as "side effects" of what they consider good. So, if we assume that FDA's action don't "touch" them in most ways, should these most capable individuals be trying to reform it? But I don't think that the FDA's action don't affect the most capable individuals much. We're all one society and even if it doesn't influence them much directly, it still very much does so in more indirect ways.

Also think, why do you think that "predators" even exist? It could be either evil nature of the humankind itself, if we assume there is such, or something else creating a place for them. If it's the first one, we're fucked regardless. But maybe it's not?