Insurance companies don't have any LONG-TERM interest in the basic research, however.
That's a cynical view, btw, but one that I stand by. I'm pretty sure that pharma isn't making enough off of anyone with LTA that we 'matter' to them at all in terms of medication. Not unless there were a way to "fix" the underlying genetic atopy. I mean, even if you have a cure for FA, it won't do a thing for the asthma, environmental allergies, etc. etc.
ASTHMA, now
that is
expensive for insurance companies. That's why they'll cover preventative interventions.
The problem is that there isn't any MONEY to spare for the underlying basic research. And honestly, anything that the insurance industry would lobby for on this behalf is going to be about limiting
short-term costs. In the case of asthma, that's something they'll go to bat for, because the cost-benefit ration only requires going out three or four YEARS before it all makes perfect sense.
It does
not make financial sense (for anyone but patients) to 'fix' a LTFA in a person who successfully avoids ER treatment for a decade or more at a time. In other words, the majority of people carrying Epinephrine for an allergy.
It pays, I think, to recall that we're the unlucky minority even of FA families, mostly-- the ones with greater numbers of allergies, the ones with the greatest sensitivity/lowest reaction threshold. For
most people with FA, "don't you just know what you can't eat" is sufficient as a precautionary measure
most of the time.
So even if there ARE 12 million Americans with FA, it's highly probable that about 8-10 million of THEM think of it as "a pain, but not that big a deal."
Still, 2 million is a pretty big number. Granted.
The problem is that so many of those people are
children.Treatment of children raises a whole host of ethical constraints-- not the least of which is that we have NO long-term studies to evaluate the long-term impact of anything but antihistamines on those individuals. We
also don't have a mechanistic picture of the 'disease' state to begin with.
This is like treating arthritis a thousand years ago, basically.
How much money has been thrown at osteoarthritis in the past millenium--
in today's dollars?And that is
still a disorder that, while unfortunately common, doesn't really have a silver bullet type "cure."
It isn't that anyone is MAKING MONEY on people's suffering and is therefore motivated to retain the status quo. It just really
is that complicated.
Type I diabetes has had money thrown at it for nearly forty years-- and THEY still don't have a cure, either. But at least they are
starting to understand the mechanistic underpinnings of the disease state. THAT is what leads to a more coherent (rather than serendipitous) discovery process for innovations in treatment and eventually, one hopes-- CURES. Or at the very least, prevention which actually works.
We don't even know how to tell, using purely diagnostic tests, just WHO is at risk of anaphylaxis and who isn't even allergic in a clinical sense.
Baby steps. That's all. Baby steps.
I don't really anticipate much happening in the next twenty years, any more than it has in the past ten. Because until the basic research gets done, clinical researchers are fumbling around in the dark and hoping that they'll stumble over SOMETHING that happens to work... and crossing their fingers that there won't be anything about it that they DIDN'T see coming. <shudders> What other chronic health problem or disease would YOU trade LTFA for, hmmmm? (Not an idle question, btw...)
I know why the basic research doesn't get funding, and clinical trials of treatments DO...
basic research isn't sexy, it doesn't seem to have "real world applicability" and most people aren't that interested. But it's the fuel that REAL medical advances run on.
<SIGH>