I wasted $40k on a fantastic startup idea

I remember reading this the last time and it was posted and I still think the core failure is that the author didn't actually recognize the issue he was solving. He thought the problem was choosing the most effective medicine when the real problem was decision fatigue looking at endless shelves of things that all seem to do the same thing. Those two problems sort of look the same, but the latter cannot be resolved by selling the tool to doctors in their offices.

The tool should have been designed (IMO) as a consumer tool, either a kiosk at CVS/Walgreens/pharmacies to assist with OTC med selection or possibly as a website with ads/referrals. I would absolutely choose a pharmacy over another as a result of them having something to help through that process, especially when I have a headache.

I'm grateful for this comment because it put into words the thing I couldn't.

I'm reading the epiphany part of this post, to quote:

You have a mind-shattering headache. You're standing in the aisle of your local CVS, massaging your temples while scanning the shelves for something—anything—to make make the pain stop.

What do you reach for? Tylenol? Advil? Aleve?

Most people, I imagine, grab whatever's cheapest, or closest, or whatever they always use. But if you're scrupulous enough to ask Google for the best painkiller, here's how your friendly neighborhood tech behemoth would answer:

[Screenshot of Google Search Results]

Oh thanks Google that's just all of them.

---end quote---

The author immediately identifies that this isn't a real problem, by their own admissions that "Most people, I imagine, grab whatever's cheapest, or closest, or whatever they always use." Yea, most people when they have a headache and know that most painkillers on the market will result in about the same degree of relief, don't bother to cross reference a medical meta-analysis, because they have a headache and if the $0.01 worth of aspirin doesn't make it feel better they will just take a second pill and eat the penny.

I like the author's conclusion about how to quickly validate business ideas, but even in the title the author still holds firm to the belief that this was a "fantastic startup idea" even though reality seems to think otherwise. Was this such a great idea, do most consumers actually want to review a meta-analysis when picking their OTC medicine, or do most people just try a few things, get influenced by advertising, and purchase the most reasonably priced medicine they think will help. I am just a single data point, but I don't normally feel naked and unscrupulous when I just read the symptoms that a medicine treats and pick one, and that strategy generally works just fine.

Solution in search of a problem and also in search of humans that act in this weird atypical fashion.

Waiit - "You have a mind-shattering headache. [..] What do you reach for? " - isn't this where you're supposed or even required to ask the pharmacist? You know, the person who has the years-long training to know drug effects, limitations and interactions with other drugs?

I'd say yes but the last time I was truly sick (flu) my roommate went to the store and asked the pharmacist what to give me and came back home with a bunch of homeopathic sugar pills. My trust in other humans is pretty low for this sort of stuff.

> The tool should have been designed (IMO) as a consumer tool, either a kiosk at CVS/Walgreens/pharmacies to assist with OTC med selection or possibly as a website with ads/referrals.

Sure but... would you really need any clinical data to make this valuable? A pharmacy could just make a decision tree with some common symptoms and do the same thing based on their own recommendations. Including data from studies is a neat enhancement but not necessary IMO.

I think perhaps there's greater value in the platform or methodology the author built for doing this type of meta analysis for medication. Could it be applied to other research fields I wonder. Could the software be licensed?

> A pharmacy could just make a decision tree with some common symptoms and do the same thing based on their own recommendations.

Sure, and I’d go to a pharmacy who did this based off of science instead of whoever paid for an end cap advertisement that month.

My million dollar medicine idea: print the dosage info in huge type on the bottle (e.g. "Take 2 every 8 hours") with more detailed info in smaller type on the back side of a peel away label.

The only time I use headache medicine is when I have a headache and that is the exact time I don't want to be trying to read a huge block of 6 point type to see how many I should take. (A couple of times in the past I've written the dosage in Sharpie on the piece of masking tape that I wrap around the bottle but I'd rather it was done for me as I'm lazy)

That's pretty awful. On the flipside, here in Montreal I've been very impressed with my local pharmacists at the nearby chain drugstore. They pay attention to drug interactions to the extent of flagging a risk the doctor missed but in retrospect admitted is valid, give me a consult every time I get a new medicine, remember things well enough that I was once asked how my wife was doing with her own recovery from something, and so on.

I used to live in the US and I'm certainly not used to that either. I wish that kind of great pharmacist care were more widespread as a norm.

> most people when they have a headache and know that most painkillers on the market will result in about the same degree of relief

I've not had this experience. For me, Ibuprofen works, aspirin and acetaminophen have zero noticeable affect. It's been that way my entire life. The other two might have some affect on fever? (no idea) but none on pain, at least for me.

That's sad

In many countries the pharmacist is a doctor and they are there to handle simple cases. Thailand, Singapore, Malaysia all seem this way. VS the USA (and Japan?) where all the pharmacist does is handout the medicine some other doctor prescribed.

Also, the author completely missed the fact that different people react differently to different treatments.

It's basically akin to looking at Google Analytics and trying to predict what your next website visitor will do. You'll have an idea of what someone's going to do, but you can't perfectly predict it.

For some reason, people seem to have evolved to consider nicotine products (for instance) more opposed to the abstract mission of a drugstore than homeopathic products.

I have never smoked or vaped or anything, but it's the homeopathic OTC meds that viscerally upset me, that they should be allowed on the shelves.

I'd be skeptical that would work.

A friend did a ton of user testing of improvements to a price-comparison site back when those were the rage. With some frequency the engineers would come up with a way to help people make a better buying decision. E.g., picking a TV is a problem, so they'd make a wizard that would ask you questions and then give you a recommendation. Problem solved, right?

Alas, no. Turns out most of these user guidance things wouldn't help, because people had no reason to trust the thing. They might go through the process, but their behavior didn't change. I'd expect to see the same effect with a kiosk. Most wouldn't engage, and those who did wouldn't weight the recommendation very highly.

A website would have an even deeper trust problem, and would add an SEO problem on top. Imagine a referral is worth $1 on average and you spend $0.50 on coming up with good answers, $0.49 on making sure you're on the first page of Google results, and take $0.01 in profit. You'll very quickly have a competitor with that spends $0 on research and $0.99 on being ahead of you on Google. Sure, their data will be garbage, but the page will be just as convincing to somebody who doesn't know anything, which is your target market.

I suspect the real outcome, as with many would-be startups, is that this is a feature, not a business. Somebody like Wirecutter or Consumer Reports could turn this into solid content that would be a nice addition to what they have already. They've already built a trust relationship with their users, and they don't have to specifically find people in the (very rare) moment of choosing a new medication.

>The tool should have been designed (IMO) as a consumer tool, either a kiosk at CVS/Walgreens/pharmacies to assist with OTC med selection or possibly as a website with ads/referrals. I would absolutely choose a pharmacy over another as a result of them having something to help through that process, especially when I have a headache.

You're making a similar mistake to OP. You're considering the end user, the pharmacy, but are now ignoring manufacturers, suppliers and wholesalers. Why would a major supplier provide their goods to a pharmacy who ranks them last in their kiosks? Why wouldn't they give preferential pricing to pharmacists that give better rankings?

Perhaps large chain pharmacists have buying power here, but they don't need help attracting customers. Perhaps small pharmacists could benefit from this system to attract customers, but if the system ranks Pfizer products last they wont be in business for long.

Point is, perhaps you want it, and perhaps you think pharmacists should want it for you, but the entire supply chain does not want it.

Yes, for headaches no one wants to read a meta-analysis, they just want to buy something quickly and feel slightly better.

On the other hand, for depression medication, they don't want their doctor to look at an online tool and choose the most effective antidepressant. They want their doctor to look at THEM and say "hmm, we'll try you on X but if it doesn't help with the intrusive thoughts we'll maybe switch it out to Y and up the dosage of Z". Or they want to tell the doctor what they think they want to be prescribed. They are paying big bucks to see a psychiatrist. Most of them are not on a self-optimization trip, they just want to feel better, and also feel like someone takes an interest in how they are getting on. Using a snazzy tool would probably lead to the patient being less satisfied with the doctor's service, even if they have slightly better outcomes by whatever questionable metric is in the study.

Isn't there a social benefit in letting the 10% (or whatever) of people that believe in them get a safe and effective placebo, for many conditions where that's all that's needed?

Then for you, a meta-analysis would be even more useless, as your own experience is much more valuable.

Also, people feel differently about different treatments, for particular reasons. If your mom always took one brand of Tylenol when she had a cold, taking it might reassure you more than the theoretically optimal painkiller. Customers were quite happy to pay more for the exact same Ibuprofen labelled with 'Back Pain' or 'Period Pain', because they felt it worked.

If you think about it, the author's desire to choose 'the scientifically proven to be the most effective' is just another example of such a superstition. If you could convince him that a particular medication was the winner in the meta-analysis, he would probably objectively feel better, even if it wasn't actually true.

I see belief in the "placebo effect" as a mind virus. Because it is not just a justification for lying to patients, but entails medical people lying to themselves.

I get tired trying to explain, and if I'm not convincing anyone, maybe it's me who doesn't understand...but, I feel like the key is to ask yourself, if the placebo effect is something that you can scientifically demonstrate, how would you arrange a control group?

Failure to identify a reason for an apparent effect cannot be turned into proof that "nothing" has an effect. It's just a mental short circuit that people get trapped in.

> if the placebo effect is something that you can scientifically demonstrate, how would you arrange a control group?

Easy, just don't give the control group any medicine. Give the other group a placebo. If outcomes are better for the second group, it's evidence that placebos work, just as clearly as the usual trial provides evidence that medicines work.

It's true people don't trust new user guidance things, but if your product is useful you can build trust over time or not?