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Comment by blaurenceclark | Hacker News Reader

We haven't done extensive research in populations outside of the United States, but for the last 50-100 years the US (and Europe) has been leading the charge, but in both these locations, Minorities have been a low percentage participation in research.

As well, many of these outcomes he mentioned are the indirect result of years of research. Think of diabetes, 100 years of research was 99% spent on a white population and that contains prevention, diagnosis, and treatment. Populations that aren't white begin to see detrimental effects that add up over time.

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> We haven't done extensive research in populations outside of the United States, but for the last 50-100 years the US (and Europe) has been leading the charge

I'm confused, I thought that over the last ten years a lot of the medical research formerly conducted by U.S. pharma companies has been outsourced to SROs, who in turn test their drugs on poor people in India or whatever. Is that not actually the case?

That only happens for certain drugs, typically treatment naive diabetes, IBD and other chronic disease patients where in the US there’s a standard treatment the patients receive right away so they have to go overseas to find untreated patients. That being said often those treatments will still have to come back to the US to run trials later on for approval on the population here.

So none of the asian countries (for example SK or Japan) retest the drugs on their own population before approval for use?

There is a much longer answer to that question. SK and Japan only make up 5% of the asian population, many parts of asia are not well tested for these drugs. We're actually in the process of working with a large pharmaceutical company on a multi-country diabetes prevention trial in Asia because traditionally they have not been tested on as much as necessary. As well the companies there will run many of their trials in the US as well as Asia but our larger population (as well as running the trials in mostly white continents such as Australia and Europe) still causes quite a large discrepancy. We could do a whole other article on this topic.

Japan retests, and interestingly recreates the same problems in a local way.

Taking medical checks for foreigners or minorities in japan means the guidance numbers are mostly irrelevant. Doctors might not know very well how to deal with you, a lot of advice for common but non critical illness can be summed up to “you do you”

> Minorities have been a low percentage participation in research.

That's not true at all if you consider PMS (Post Marketing Studies) which are an integral part of clinical development post launch.

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