Tuesday, October 12, 2010

Florey,Dawson's clashing business models

Florey and his many scientific supporters have always said that his interest in penicillin, beginning in early 1938, was the fact that it killed staph bacteria while the sulfa drugs did not.

Staph was not a big killer back then - not like strep bacteria - at least not in peacetime.

It tended to do its worst when it settled deep into big bones that weren't well supplied with blood - making it hard for white blood cells and sulfa molecules to get at the bacteria.

This condition is called acute or chronic osteomyelitis and it was rampant among the young children of the poor - in peacetime.

In wartime, surviving victims of war wounds - or the surviving wounded from the Blitz - often had huge deep wounds that involved their leg bones - a hard-to-get-at location that was ideal for staph bacteria to settle in for a long stay.

Patients affected went back and forth from convalescence bed to hospital bed while doctors and nurses strived to prevent the patient from getting worse in the hope the body would eventually seal off the infection without crippling the patient in the process.

Often they survived but were left crippled - other times the patient's resistance weakened and the staph spread widely till the patient died of general blood poisoning.

In war time, deep bone wounds infected by staph represented a massive cost to the military medical system - consuming resources for years while the affected soldier was unlikely to ever to return to full service. Blitz victims similarly taxed the overworked civilian medical system.

So Florey's business model for "war penicillin" - penicillin as a mere supplement for the sulfas, its wartime use to be strictly limited to healing military patients with deeply set staph infections of the bones and limbs - how did it sell ?

It didn't.

There is no record in all his biographies that any military medical types ever visited him until 1943 - nor is it recorded anywhere that he visited military doctors and was turned down.

Curious - the Navy, Air Force, 8th Army in North Africa, the Blitz victims - they had no end of deep staph infections of the bones to treat from September 2nd 1939 to September 2nd 1942 (three years - half of the entire war) but they avoided penicillin like it was plagued.

Florey was set up to supply an non-existent market.

By contrast,from 1940 to 1942, Dawson's main market had more customers than he could hope to fill.

Florey,Fleming, Heatley, Merck, Dawson of course, they all got requests (from around the world) for penicillin to treat SBE after Dawson announced that he had hopes to cure SBE with the new drug.

Dawson's business model for penicillin could not have been more different from Florey's.His Social Penicillinhe wanted to be made by a government factory and made available to all ( civilians and soldiers) in quantity and at a reasonable price - and made available like yesterday.

He thought penicillin could replace sulfa, not just supplement it, and used to kill all bacteria that was sensitive to it - not just staph.

Florey didn't directly treat any cases - he had no hospital rights unlike Dawson.

But the twenty serious systemic cases he
indirectly treated were almost all staph infected - so he kept to his business model in his own practise.

Similarly, Dawson had about 125 serious systemic cases that he directly dealt with and he too kept to his business model.

Those cases included all the types of bacteria that penicillin could kill---with about a third of them SBE cases.

Penicillin was promised to the military in mid-1943 after they finally decided that they wanted it ,by seeing it work well in military staph wounds in early 1943.

Score one for Florey.

But it only actually got delivered to the military and to the civilians when Dawson's
SBE success produced a patients' revolt across America and Canada ----inspiring Pfizer to go for broke.

Credit that to Dawson's business model--- and lets recall that by 1950 penicillin had completely replaced ,not supplemented, the mighty sulfas.....

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