Re: re: In response to Nicholas Bennett 26 August 2004
Previous Rapid Response Next Rapid Response Top
Nicholas Bennett,
Infectious Disease Postdoc/Clinician
Department of Pediatrics, University Hospital, Syracuse NY

Send response to journal:
Re: Re: re: In response to Nicholas Bennett

Further to my previous answer, there are some further points that Pennee obviously needs clarification on.

1. If a drug is re-released with a new indication it is still off- patent. For this reason Aspirin is available over the counter to prevent coronary heart disease, even though it was originally used as a pain reliever and anti-inflammatory. Basic marketing dictates that you find a NEW drug, not a new use for an old one, which Pennee did state, so it seems silly that she then argues that drug companies would want to use Viracept to treat herpes...

2. Inderal is a beta-blocker, meaning that it acts on the beta adrenoceptor (where epinephrine/adrenaline acts). It doesn't take much to realise that stopping adrenaline will (a) prevent the heart from being overstimulated and (b) stop hands shaking from stress! It is not a different mechanism, it is exactly the same mechanism. In the same way beta-blockers act in the lungs to promote asthma attacks in those prone to such things (here the beta-receptor causes bronchial dilation, so blocking it can cause constriction). Using this as an example of different mechanisms goes to underscore the importance of knowing the full facts before initiating an argument.

3. Even if a different mechanism were discovered (eg diamorphine as an agent to assist in pulmonary oedema) it would have no effect on patent lifetime, so the argument is wrong in any case. The patent describes the drug, not the application (which depends on licensing approval and the result of clinical trials).

4. Thinking outside of the box is indeed important, but practically in medicine can be limited by litigation and patient wishes ("What do you mean you want to try something out doctor...?!"). The privilege is reserved for those higher up the career ladder. However it is important at all levels in science, and it was for this reason I chose to combine research (PhD) with clinical practise (MD). I suggest Ms Atkinson is accusing the wrong person when it comes to "thinking outside of the box!"

Competing interests: None declared