nc33/MultiSpan_SQUAD huggingface dataset:
Pharmaceutical_industry

During the years 1940-1955, the rate of decline in the U.S. death rate accelerated from 2% per year to 8% per year, then returned to the historical rate of 2% per year. The dramatic decline in the immediate post-war years has been attributed to the rapid development of new treatments and vaccines for infectious disease that occurred during these years. Vaccine development continued to accelerate, with the most notable achievement of the period being Jonas Salk's 1954 development of the polio vaccine under the funding of the non-profit National Foundation for Infantile Paralysis. The vaccine process was never patented, but was instead given to pharmaceutical companies to manufacture as a low-cost generic. In 1960 Maurice Hilleman of Merck Sharp & Dohme identified the SV40 virus, which was later shown to cause tumors in many mammalian species. It was later determined that SV40 was present as a contaminant in polio vaccine lots that had been administered to 90% of the children in the United States. The contamination appears to have originated both in the original cell stock and in monkey tissue used for production. In 2004 the United States Cancer Institute announced that it had concluded that SV40 is not associated with cancer in people.

Question: When was the Polio vaccine created?
Answer: 1954

Question: Who announced that SV40 was not associated with cancer?
Answer: United States Cancer Institute

Question: Who identified the SV40 virus?
Answer: Maurice Hilleman

Question: What was a complication of the SV40 virus?
Answer: cause tumors

Question: Who funded the Polio vaccine?
Answer: National Foundation for Infantile Paralysis

Question: In what year was the polio vaccine created?
Answer: 1954

Question: Who created the polio vaccine?
Answer: Jonas Salk

Question: What virus caused tumors in most mammals?
Answer: SV40

Question: Who identified the SV40 virus?
Answer: Maurice Hilleman

Question: SV40 was present in what vaccine?
Answer: polio
Pharmaceutical_industry

On 2 July 2012, GlaxoSmithKline pleaded guilty to criminal charges and agreed to a $3 billion settlement of the largest health-care fraud case in the U.S. and the largest payment by a drug company. The settlement is related to the company's illegal promotion of prescription drugs, its failure to report safety data, bribing doctors, and promoting medicines for uses for which they were not licensed. The drugs involved were Paxil, Wellbutrin, Advair, Lamictal, and Zofran for off-label, non-covered uses. Those and the drugs Imitrex, Lotronex, Flovent, and Valtrex were involved in the kickback scheme.

Question: How much was the settlement GlaxoSmithKline agree to?
Answer: $3 billion

Question: What was one of the causes of the health-care fraud case?
Answer: illegal promotion of prescription drugs

Question: When did GlaxoSmithKline plead guilty?
Answer: 2 July 2012

Question: What drugs were related to a kickback scheme?
Answer: Imitrex, Lotronex, Flovent, and Valtrex

Question: What drugs were used for off-label uses?
Answer: Paxil, Wellbutrin, Advair, Lamictal, and Zofran

Question: In what year did GlaxoSmithKline pay a $3 billion dollar settlement?
Answer: 2012

Question: How much was the largest healthcare fraud case in the US settled for?
Answer: $3 billion

Question: What company was sued for promoting medicines for unlicensed uses and bribing doctors?
Answer: GlaxoSmithKline
Pharmaceutical_industry

In the US, starting in 2013, under the Physician Financial Transparency Reports (part of the Sunshine Act), the Centers for Medicare & Medicaid Services has to collect information from applicable manufacturers and group purchasing organizations in order to report information about their financial relationships with physicians and hospitals. Data are made public in the Centers for Medicare & Medicaid Services website. The expectation is that relationship between doctors and Pharmaceutical industry will become fully transparent.

Question: What is the speculation of the relationship between doctors and the drug industry?
Answer: become fully transparent.

Question: What is the Physician Financial Transparency Report part of?
Answer: Sunshine Act

Question: Where can you obtain information about the Sunshine Act?
Answer: Centers for Medicare & Medicaid Services website

Question: What information is collected by Centers for Medicine & Medicaid Services?
Answer: financial relationships with physicians and hospitals.

Question: When did Centers for Medicine & Medicaid Services have to start collecting information?
Answer: starting in 2013

Question: The Physician Financial Transparency Reports was part of what other act?
Answer: Sunshine Act

Question: In what year were Medicaid and Medicare required to disclose information about their relationships with doctors and hospitals?
Answer: 2013

Question: Where can financial relationships between Medicaid, Medicare and pharmaceutical companies be found?
Answer: Centers for Medicare & Medicaid Services website

Question: What is expected when the relationships are made public?
Answer: relationship between doctors and Pharmaceutical industry will become fully transparent
Pharmaceutical_industry

A Federal Trade Commission report issued in 1958 attempted to quantify the effect of antibiotic development on American public health. The report found that over the period 1946-1955, there was a 42% drop in the incidence of diseases for which antibiotics were effective and only a 20% drop in those for which antibiotics were not effective. The report concluded that "it appears that the use of antibiotics, early diagnosis, and other factors have limited the epidemic spread and thus the number of these diseases which have occurred". The study further examined mortality rates for eight common diseases for which antibiotics offered effective therapy (syphilis, tuberculosis, dysentery, scarlet fever, whooping cough, meningococcal infections, and pneumonia), and found a 56% decline over the same period. Notable among these was a 75% decline in deaths due to tuberculosis.

Question: What disease had the biggest decline of deaths?
Answer: tuberculosis

Question: What was responsible for the decline in spreading diseases?
Answer: use of antibiotics, early diagnosis, and other factors

Question: What period was the report issued in 1958 cover?
Answer: 1946-1955

Question: Who issued the report in 1958?
Answer: Federal Trade Commission

Question: What were eight diseases examined for?
Answer: mortality rates

Question: How much did the mortality rate of common bacterial infections decline between 1946-1955?
Answer: 56%

Question: How much did the mortality rate of tuberculosis drop between 1946-1955?
Answer: 75%

Question: Who issued a report describing the effects of antibiotic developments?
Answer: Federal Trade Commission

Question: In what year was the FTC's report issued?
Answer: 1958
Pharmaceutical_industry

In March 2001, 40 multi-national pharmaceutical companies brought litigation against South Africa for its Medicines Act, which allowed the generic production of antiretroviral drugs (ARVs) for treating HIV, despite the fact that these drugs were on-patent. HIV was and is an epidemic in South Africa, and ARVs at the time cost between 10,000 and 15,000 USD per patient per year. This was unaffordable for most South African citizens, and so the South African government committed to providing ARVs at prices closer to what people could afford. To do so, they would need to ignore the patents on drugs and produce generics within the country (using a compulsory license), or import them from abroad. After international protest in favour of public health rights (including the collection of 250,000 signatures by MSF), the governments of several developed countries (including The Netherlands, Germany, France, and later the US) backed the South African government, and the case was dropped in April of that year.

Question: How much did treatment for each patient in Africa cost?
Answer: 10,000 and 15,000 USD per patient per year

Question: Who backed the South African government which caused the case to be dropped?
Answer: The Netherlands, Germany, France, and later the US

Question: Who brought litigation to South Africa?
Answer: 40 multi-national pharmaceutical companies

Question: How many signatures were collected by MSF?
Answer: 250,000 signatures

Question: When was litigation brought to South Africa?
Answer: March 2001

Question: How many companies sued South Africa for its Medicines Act?
Answer: 40

Question: South Africa's Medicines Act allowed for the generic production of what kind of drugs?
Answer: antiretroviral

Question: How much did ARV drugs cost patients yearly?
Answer: between 10,000 and 15,000 USD

Question: How many signatures were collected supporting public health rights?
Answer: 250,000
Pharmaceutical_industry

Prior to the 20th century drugs were generally produced by small scale manufacturers with little regulatory control over manufacturing or claims of safety and efficacy. To the extent that such laws did exist, enforcement was lax. In the United States, increased regulation of vaccines and other biological drugs was spurred by tetanus outbreaks and deaths caused by the distribution of contaminated smallpox vaccine and diphtheria antitoxin. The Biologics Control Act of 1902 required that federal government grant premarket approval for every biological drug and for the process and facility producing such drugs. This was followed in 1906 by the Pure Food and Drugs Act, which forbade the interstate distribution of adulterated or misbranded foods and drugs. A drug was considered misbranded if it contained alcohol, morphine, opium, cocaine, or any of several other potentially dangerous or addictive drugs, and if its label failed to indicate the quantity or proportion of such drugs. The government's attempts to use the law to prosecute manufacturers for making unsupported claims of efficacy were undercut by a Supreme Court ruling restricting the federal government's enforcement powers to cases of incorrect specification of the drug's ingredients.

Question: What Act forbade misbranded drugs?
Answer: Pure Food and Drugs Act

Question: What caused a Tetanus outbreak?
Answer: contaminated smallpox vaccine and diphtheria antitoxin

Question: What act allowed premarket approval for drugs?
Answer: The Biologics Control Act of 1902

Question: When did the Pure Food and Drugs Act get implemented?
Answer: 1906

Question: Who restricted the federal government's enforcement powers?
Answer: Supreme Court

Question: What was the name of the law that required premarket approval for producing drugs?
Answer: Biologics Control Act of 1902

Question: What law banned the interstate distribution of mislabeled food and drugs? 
Answer: Pure Food and Drugs Act

Question: In what year was the Pure Food and Drugs Act passed?
Answer: 1906
Pharmaceutical_industry

Patents have been criticized in the developing world, as they are thought to reduce access to existing medicines. Reconciling patents and universal access to medicine would require an efficient international policy of price discrimination. Moreover, under the TRIPS agreement of the World Trade Organization, countries must allow pharmaceutical products to be patented. In 2001, the WTO adopted the Doha Declaration, which indicates that the TRIPS agreement should be read with the goals of public health in mind, and allows some methods for circumventing pharmaceutical monopolies: via compulsory licensing or parallel imports, even before patent expiration.

Question: Who adopted the Doha Declaration?
Answer: World Trade Organization

Question: What did the TRIPS agreement accomplish?
Answer: countries must allow pharmaceutical products to be patented

Question: Why are patents criticized?
Answer: thought to reduce access to existing medicines

Question: What did the Doha Declaration do?
Answer: indicates that the TRIPS agreement should be read with the goals of public health in mind, and allows some methods for circumventing pharmaceutical monopolies

Question: When was the Doha Declaration adopted?
Answer: 2001

Question: What has been accused of reducing access to medicines in developing countries?
Answer: Patents

Question: The Doha Declaration allows for what ways for monopolies to be bypassed?
Answer: compulsory licensing or parallel imports

Question: When did the World Trade Organization adopt the Doha Declaration?
Answer: 2001
Pharmaceutical_industry

Pharmaceutical fraud involves deceptions which bring financial gain to a pharmaceutical company. It affects individuals and public and private insurers. There are several different schemes used to defraud the health care system which are particular to the pharmaceutical industry. These include: Good Manufacturing Practice (GMP) Violations, Off Label Marketing, Best Price Fraud, CME Fraud, Medicaid Price Reporting, and Manufactured Compound Drugs. Of this amount $2.5 billion was recovered through False Claims Act cases in FY 2010. Examples of fraud cases include the GlaxoSmithKline $3 billion settlement, Pfizer $2.3 billion settlement and Merck & Co. $650 million settlement. Damages from fraud can be recovered by use of the False Claims Act, most commonly under the qui tam provisions which rewards an individual for being a "whistleblower", or relator (law).

Question: How much money was recovered through the False Claims?
Answer: $2.5 billion

Question: What are some of the schemes used to defraud the health care system?
Answer: Good Manufacturing Practice (GMP) Violations, Off Label Marketing, Best Price Fraud, CME Fraud, Medicaid Price Reporting, and Manufactured Compound Drugs.

Question: What is pharmaceutical fraud?
Answer: deceptions which bring financial gain to a pharmaceutical company

Question: Who had the biggest fraud case settlement?
Answer: GlaxoSmithKline

Question: What provision rewards "whistle-blowers"?
Answer: qui tam

Question: What kind of fraud financially benefits a drug company?
Answer: Pharmaceutical fraud

Question: Who is affected by pharmaceutical fraud?
Answer: individuals and public and private insurers

Question: How much money lost to pharmaceutical fraud was recovered in 2010?
Answer: $2.5 billion

Question: Which act allows whistleblowers to recover money lost from pharmaceutical fraud?
Answer: False Claims Act
Pharmaceutical_industry

A 2009 Cochrane review concluded that thiazide antihypertensive drugs reduce the risk of death (RR 0.89), stroke (RR 0.63), coronary heart disease (RR 0.84), and cardiovascular events (RR 0.70) in people with high blood pressure. In the ensuring years other classes of antihypertensive drug were developed and found wide acceptance in combination therapy, including loop diuretics (Lasix/furosemide, Hoechst Pharmaceuticals, 1963), beta blockers (ICI Pharmaceuticals, 1964) ACE inhibitors, and angiotensin receptor blockers. ACE inhibitors reduce the risk of new onset kidney disease [RR 0.71] and death [RR 0.84] in diabetic patients, irrespective of whether they have hypertension.

Question: What drugs reduce the risk of death and other events in people with high blood pressure?
Answer: thiazide antihypertensive drugs

Question: Who conducted the review on Thiazide Antihypertensive drugs?
Answer: Cochrane

Question: What were Thiazide Antihypertensive drugs used with?
Answer: combination therapy

Question: What do ACE inhibitors do?
Answer: reduce the risk of new onset kidney disease [RR 0.71] and death [RR 0.84] in diabetic patients

Question: In what year did Cochrane release the report?
Answer: 2009

Question: What reduces the risk of new onset kidney diseases and death?
Answer: ACE inhibitors

Question: What type of drugs reduced the risk of strokes and heart disease for people with high blood pressure?
Answer: thiazide antihypertensive drugs

Question: In what year was thiazide antihypertensive drugs shown to help those with heart problems?
Answer: 2009
Pharmaceutical_industry

Others have argued that excessive regulation suppresses therapeutic innovation, and that the current cost of regulator-required clinical trials prevents the full exploitation of new genetic and biological knowledge for the treatment of human disease. A 2012 report by the President's Council of Advisors on Science and Technology made several key recommendations to reduce regulatory burdens to new drug development, including 1) expanding the FDA's use of accelerated approval processes, 2) creating an expedited approval pathway for drugs intended for use in narrowly defined populations, and 3) undertaking pilot projects designed to evaluate the feasibility of a new, adaptive drug approval process.

Question: Who put out a report in 2012?
Answer: President's Council of Advisors on Science and Technology

Question: What has been argued restricted innovation?
Answer: excessive regulation

Question: What was a recommendations brought about from the report?
Answer: expanding the FDA's use of accelerated approval processes

Question: What is one thing excessive regulations causes?
Answer: therapeutic innovation

Question: What can be used to evaluate new approval processes?
Answer: pilot projects

Question: What is excessive drug regulation said to suppress?
Answer: therapeutic innovation

Question: In what year was a report made to reduce the burdens of drug development?
Answer: 2012

Question: What was argued to be holding back new knowledge for treating diseases?
Answer: current cost of regulator-required clinical trials
Pharmaceutical_industry

In 1952 researchers at Ciba discovered the first orally available vasodilator, hydralazine. A major shortcoming of hydralazine monotherapy was that it lost its effectiveness over time (tachyphylaxis). In the mid-1950s Karl H. Beyer, James M. Sprague, John E. Baer, and Frederick C. Novello of Merck and Co. discovered and developed chlorothiazide, which remains the most widely used antihypertensive drug today. This development was associated with a substantial decline in the mortality rate among people with hypertension. The inventors were recognized by a Public Health Lasker Award in 1975 for "the saving of untold thousands of lives and the alleviation of the suffering of millions of victims of hypertension".

Question: Who discovered Hydralazine?
Answer: researchers at Ciba

Question: Why were the researchers recognized in 1975?
Answer: the saving of untold thousands of lives and the alleviation of the suffering of millions of victims of hypertension

Question: Who developed Chlorothiazide?
Answer: Karl H. Beyer, James M. Sprague, John E. Baer, and Frederick C. Novello of Merck and Co

Question: What is  Chlorothiazide used to treat?
Answer: hypertension

Question: What was the main shortcoming in the drug Hydralazine?
Answer: lost its effectiveness over time

Question: What was the name of the first oral vasodilator?
Answer: hydralazine

Question: What is the most used antihypertensive drug today?
Answer: chlorothiazide

Question: Beyer, Sprague, Baer, and Novello received what award in 1975?
Answer: Public Health Lasker Award

Question: In what year was hydralazine discovered?
Answer: 1952

Question: Chlorothiazide helped reduce the mortality rate among those with what disease?
Answer: hypertension
Pharmaceutical_industry

In the U.S., a push for revisions of the FD&C Act emerged from Congressional hearings led by Senator Estes Kefauver of Tennessee in 1959. The hearings covered a wide range of policy issues, including advertising abuses, questionable efficacy of drugs, and the need for greater regulation of the industry. While momentum for new legislation temporarily flagged under extended debate, a new tragedy emerged that underscored the need for more comprehensive regulation and provided the driving force for the passage of new laws.

Question: What act needed provisions?
Answer: FD&C

Question: Who led the congressional hearings?
Answer: Senator Estes Kefauver

Question: What were the major issues that needed to be addressed?
Answer: advertising abuses, questionable efficacy of drugs, and the need for greater regulation of the industry

Question: What caused a need for more regulation?
Answer: a new tragedy emerged

Question: When did this push occur?
Answer: 1959

Question: Congressional hearings emerged addressing revisions to what act?
Answer: FD&C

Question: Who led the Congressional hearings in 1959?
Answer: Senator Estes Kefauver

Question: Did the US Congress call for more or less regulation of pharmaceuticals?
Answer: greater
Pharmaceutical_industry

Other notable new vaccines of the period include those for measles (1962, John Franklin Enders of Children's Medical Center Boston, later refined by Maurice Hilleman at Merck), Rubella (1969, Hilleman, Merck) and mumps (1967, Hilleman, Merck) The United States incidences of rubella, congenital rubella syndrome, measles, and mumps all fell by >95% in the immediate aftermath of widespread vaccination. The first 20 years of licensed measles vaccination in the U.S. prevented an estimated 52 million cases of the disease, 17,400 cases of mental retardation, and 5,200 deaths.

Question: What did the first measles prevent in it's first 20 years?
Answer: an estimated 52 million cases of the disease, 17,400 cases of mental retardation, and 5,200 deaths

Question: Who originally created the measles vaccine?
Answer: John Franklin Enders

Question: How much did the occurrence of serious diseases shortly after the release of the measles vaccine?
Answer: >95%

Question: When did the Rubella vaccine come out?
Answer: 1969

Question: Who recreated the measles vaccine?
Answer: Maurice Hilleman

Question: In what year was the measles vaccine made?
Answer: 1962

Question: Who helped refine the measles vaccine?
Answer: Maurice Hilleman

Question: In what year was the mumps vaccine made?
Answer: 1967

Question: How much did rubella, measles, and mumps infections drop after vaccination?
Answer: >95%

Question: Measles vaccinations helped prevent how many estimated cases of the illness?
Answer: 52 million
Pharmaceutical_industry

The thalidomide tragedy resurrected Kefauver's bill to enhance drug regulation that had stalled in Congress, and the Kefauver-Harris Amendment became law on 10 October 1962. Manufacturers henceforth had to prove to FDA that their drugs were effective as well as safe before they could go on the US market. The FDA received authority to regulate advertising of prescription drugs and to establish good manufacturing practices. The law required that all drugs introduced between 1938 and 1962 had to be effective. An FDA - National Academy of Sciences collaborative study showed that nearly 40 percent of these products were not effective. A similarly comprehensive study of over-the-counter products began ten years later.

Question: When did the Kefauver-Harris Amendment become a law?
Answer: 10 October 1962

Question: What did this new law require?
Answer: all drugs introduced between 1938 and 1962 had to be effective

Question: What did the National Academy of Science's study discover?
Answer: nearly 40 percent of these products were not effective

Question: How long after the National Academy of Science's study did a study on over the counter drugs occur?
Answer: ten years later

Question: What brought up enhancement of drug regulations?
Answer: The thalidomide tragedy

Question: When did the Kefauver-Harris Amendment became law?
Answer: 10 October 1962

Question: What federal agency regulated the advertising of prescription drugs?
Answer: FDA

Question: Drugs made between which years had to be tested before going to market?
Answer: 1938 and 1962

Question: What percentage of drugs were shown to be ineffective after an FDA study?
Answer: 40 percent