Year: 2013

The FDA is preparing to ban partially hydrogenated oils (PHOs), the major source of trans fats in processed food. Jonathan H. Adler spots an irony:

[T]here was a time when groups like the Center for Science in the Public Interest were urging fast food chains and others to replace animal fats with PHOs. So while CSPI today praises the FDA for targeting trans fats, it also celebrated decisions by fast food chains like Burger King to start using trans fat-heavy PHOs. In other words, had it not been for the food nannies, American consumption of trans fats might not have been so high in the first place.

David Harsanyi has questions:

Ira Stoll sees inconsistencies:

The FDA says the “trans fat” in old-fashioned margarine causes heart attacks. But plenty of other things also cause heart attacks that the Obama administration has not yet prepared to ban.

Television causes heart attacks by encouraging sitting around on the couch and watching it rather than exercising. Cigarettes cause heart attacks. The Burger King Triple Whopper Sandwich meal will give you a heart attack. Too much Ben & Jerry’s Chocolate Fudge Brownie ice cream will give you a heart attack.

Yet the FDA has it in for margarine, not for hot fudge sundaes or television or even Triple Whoppers, all of which would, under the FDA’s proposed action, remain legally available for sale, unlike margarine. … Beyond the inconsistency of it, there’s the failure to accommodate individual preferences. Margarine use in my family was a consequence in part of the Jewish religious prohibition on mixing milk and meat. If you wanted a baked potato with your steak or a chocolate chip cookie for dessert, using margarine rather than butter was the kosher approach. Other margarine consumers may be vegans for philosophical reasons involving animal rights.

Denmark imposed a strict limit on trans fats in 2003. For perspective on the current debate in the U.S., Scientific American talked to Steen Stender, a Danish trans-fat expert who lobbied for the law:

How did industry respond?

Some bakers said that what you call a “Danish” can’t be made in the right way anymore, that we can’t get it to flake in the right way. Then one baker from one of the supermarket chains found that if he used a very meticulous scheme of temperature control during incubation of the fat and other ingredients at just the right temperature and time, he could make Danishes without any trans fat. This company put up a big poster saying “Have a Danish, we are baking for your heart without trans fat.” And in no time other bakers put up signs in their windows saying, “We are baking for your heart without trans fat.” So the industry went along with this initiative.

The industry is increasingly focused on developing treatments for uncommon ailments:

There’s good reason for big pharma’s attraction to rare disease treatments. Revenue from these products has been outpacing sales of mainstream drugs for the last decade, a trend that’s expected to continue for the next 30 years, continuing a trend from last decade. So-called “orphan drugs” (given this moniker because they are for diseases that historically were overlooked by the big drug companies) are protected against competition from generics for seven years in the US, compared to five years for non-orphan products.

The approval process for orphan drugs is also often fast-tracked, lessening the risks of lengthy, expensive and failed developments. Since 1983, when these advantages and generous tax credits for orphan drugs were introduced in the US, an estimated 350 drugs for 200 rare diseases have been approved by the US Federal Drug Administration.  No doubt this has improved countless lives, even if Botox (originally a treatment for uncontrollable blinking and spasms, but now largely used for Cosmetic purposes) and Cialis, the erectile dysfunction product, were both originally awarded orphan status.

But John McDuling warns that trouble may lie ahead:

Insurance companies in the US are typically willing to reimburse the costs of orphan drugs, because they are by definition rarely used, they tend to address life threatening treatments, and they are often prescribed to children and young adults, two groups that are predominantly healthy and therefore usually covered. But this policy could change as more money flows into the sector, attracted by the fat profits on offer, and more rare disease treatments are unearthed.

The are rising concerns that orphan drug treatments could be driving up the costs of healthcare for everyone. Already in Europe, where health care is universal, but public finances are stretched, governments are questioning high reimbursement rates for rare disease treatments.  As the world’s biggest economy struggles to reform its own absurdly expensive healthcare system, orphan drugs could soon be in the line of fire in the US as well.