Chloramphenicol as intervention in heart attacks

by G Gordon Worley III 1 min read17th Feb 20205 comments

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If the claims of this post are true, this could be an interesting target of EA effort and funding. Assuming the $25 million figure for approval is true, guessing at a $5 million cost for additional overhead for the life of the project, and estimating an average of 20 counterfactual additional QALYs generated per application of the therapy, that's $30 mm / (400k * 20) = $3.75 per QALY (assuming only applied for one year; cheaper per each year the intervention is used). Valuing a QALY at $50,000, that's a discount of 99.9925% per QALY and a payback period of approximately 600 patients.

Chloramphenicol is an antibiotic used mainly to treat eye infections, though it was originally developed 70 years ago to treat bubonic plague. Chloramphenicol is an ancient medicine, its patent long ago expired. Any generic drug company can make it in any country. Overseas it costs under $2 per dose ($40+ in America — why is that?).

When administered in a large intravenous dose within a couple hours of a heart attack, Chloramphenicol seems to prevent the heart muscle from being damaged. The mechanism by which Chloramphenicol works still isn’t well understood, but it seems to bump the heart into autophagy, which is a condition where the heart muscle cells eat their own cellular garbage for energy, thus avoiding damage. Autophagy is the direct physical benefit of fasting, in this case, imposed on the heart, thus saving it.

Every hospital, every emergency room, every EMT and ambulance should have a big dose of Chloramphenicol ready for those 800,000 heart attack victims per year. Doing so would not only save 400,000 lives per year, it would send 400,000 people back to whatever it was they were doing before their heart attack.

Emergency treatment is not a substitute for treating coronary artery disease, but it would save lives and allow second chances.

Published a decade ago, these facts have saved no lives. Four million Americans have died who didn’t have to die.

Four million Americans died because Chloramphenicol is off-patent so no drug company will touch it.

Chloramphenicol is an approved drug, but not approved for this purpose. Approving Chloramphenicol as a coronary treatment requires human trials that will probably cost $25 million.

That’s $25 million spent once to save 400,000 lives per year in the U.S. alone.

Such an expense would be a no-brainer for Big Pharma if they could somehow re-patent Chloramphenicol for this new purpose and charge $1000 per dose ($800 million per year) for a medicine that costs essentially nothing to produce.

But that’s not how patents work, so no company or government has been willing to fund human trials.

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