romikgosai/squad_modified_2 huggingface dataset:
In 1937 over 100 people died after ingesting "Elixir Sulfanilamide" manufactured by S.E. Massengill Company of Tennessee. The product was formulated in diethylene glycol, a highly toxic solvent that is now widely used as antifreeze. Under the laws extant at that time, prosecution of the manufacturer was possible only under the technicality that the product had been called an "elixir", which literally implied a solution in ethanol. In response to this episode, the U.S. Congress passed the Federal Food, Drug, and Cosmetic Act of 1938, which for the first time required pre-market demonstration of safety before a drug could be sold, and explicitly prohibited false therapeutic claims.

Q1: Who manufactured "Elixir Sulfanilamide"?
A1: S.E. Massengill Company
Q2: What was one of the things the Federal Food, Drug and Cosmetic Act do?
A2: explicitly prohibited false therapeutic claims
Q3: What year did Congress pass the Federal Food, Drug, and Cosmetic Act?
A3: 1938
Q4: What drug killed 100 people in 1937?
A4: Elixir Sulfanilamide
Q5: What is Diethylene Glycol commonly used for now?
A5: antifreeze
Q6: What company manufactured Elixir Sulfanilamide?
A6: S.E. Massengill Company of Tennessee
Q7: What drug killed over 100 people in 1937?
A7: Elixir Sulfanilamide
Q8: Diethylene glycol is mainly used today as what liquid?
A8: antifreeze
Q9: What law did Congress pass following the Elixir Sulfanilamide incident?
A9: Federal Food, Drug, and Cosmetic Act of 1938
Q10: The name "elixir" implied a solution in what liquid?
A10: ethanol
The aftermath of World War II saw an explosion in the discovery of new classes of antibacterial drugs including the cephalosporins (developed by Eli Lilly based on the seminal work of Giuseppe Brotzu and Edward Abraham), streptomycin (discovered during a Merck-funded research program in Selman Waksman's laboratory), the tetracyclines (discovered at Lederle Laboratories, now a part of Pfizer), erythromycin (discovered at Eli Lilly and Co.) and their extension to an increasingly wide range of bacterial pathogens. Streptomycin, discovered during a Merck-funded research program in Selman Waksman's laboratory at Rutgers in 1943, became the first effective treatment for tuberculosis. At the time of its discovery, sanitoriums for the isolation of tuberculosis-infected people were an ubiquitous feature of cities in developed countries, with 50% dying within 5 years of admission.

Q1: When was the first effective treatment for Tuberculosis discovered?
A1: 1943
Q2: 50% of tuberculosis-infected people died within 5 years where?
A2: cities in developed countries
Q3: What drug effectively treated Tuberculosis?
A3: Streptomycin
Q4: Who was Eli Lilly's work based off of?
A4: Giuseppe Brotzu and Edward Abraham
Q5: Where was Tetracyclines discovered?
A5: Lederle Laboratories
Q6: What was the first treatment for tuberculosis?
A6: Streptomycin
Q7: What percentage of patients infected with tuberculosis died within 5 years?
A7: 50%
Q8: In what year was streptomycin discovered?
A8: 1943
Q9: Many more antibiotics were made following the end of what war?
A9: World War II
Q10: What company funded the research that led to the discovery of streptomycin?
A10: Merck
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.

Q1: When was the Polio vaccine created?
A1: 1954
Q2: Who announced that SV40 was not associated with cancer?
A2: United States Cancer Institute
Q3: Who identified the SV40 virus?
A3: Maurice Hilleman
Q4: What was a complication of the SV40 virus?
A4: cause tumors
Q5: Who funded the Polio vaccine?
A5: National Foundation for Infantile Paralysis
Q6: In what year was the polio vaccine created?
A6: 1954
Q7: Who created the polio vaccine?
A7: Jonas Salk
Q8: What virus caused tumors in most mammals?
A8: SV40
Q9: Who identified the SV40 virus?
A9: Maurice Hilleman
Q10: SV40 was present in what vaccine?
A10: polio
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.

Q1: How much was the settlement GlaxoSmithKline agree to?
A1: $3 billion
Q2: What was one of the causes of the health-care fraud case?
A2: illegal promotion of prescription drugs
Q3: When did GlaxoSmithKline plead guilty?
A3: 2 July 2012
Q4: What drugs were related to a kickback scheme?
A4: Imitrex, Lotronex, Flovent, and Valtrex
Q5: What drugs were used for off-label uses?
A5: Paxil, Wellbutrin, Advair, Lamictal, and Zofran
Q6: In what year did GlaxoSmithKline pay a $3 billion dollar settlement?
A6: 2012
Q7: How much was the largest healthcare fraud case in the US settled for?
A7: $3 billion
Q8: What company was sued for promoting medicines for unlicensed uses and bribing doctors?
A8: GlaxoSmithKline
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.

Q1: What is the speculation of the relationship between doctors and the drug industry?
A1: become fully transparent.
Q2: What is the Physician Financial Transparency Report part of?
A2: Sunshine Act
Q3: Where can you obtain information about the Sunshine Act?
A3: Centers for Medicare & Medicaid Services website
Q4: What information is collected by Centers for Medicine & Medicaid Services?
A4: financial relationships with physicians and hospitals.
Q5: When did Centers for Medicine & Medicaid Services have to start collecting information?
A5: starting in 2013
Q6: The Physician Financial Transparency Reports was part of what other act?
A6: Sunshine Act
Q7: In what year were Medicaid and Medicare required to disclose information about their relationships with doctors and hospitals?
A7: 2013
Q8: Where can financial relationships between Medicaid, Medicare and pharmaceutical companies be found?
A8: Centers for Medicare & Medicaid Services website
Q9: What is expected when the relationships are made public?
A9: relationship between doctors and Pharmaceutical industry will become fully transparent
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.

Q1: What disease had the biggest decline of deaths?
A1: tuberculosis
Q2: What was responsible for the decline in spreading diseases?
A2: use of antibiotics, early diagnosis, and other factors
Q3: What period was the report issued in 1958 cover?
A3: 1946-1955
Q4: Who issued the report in 1958?
A4: Federal Trade Commission
Q5: What were eight diseases examined for?
A5: mortality rates
Q6: How much did the mortality rate of common bacterial infections decline between 1946-1955?
A6: 56%
Q7: How much did the mortality rate of tuberculosis drop between 1946-1955?
A7: 75%
Q8: Who issued a report describing the effects of antibiotic developments?
A8: Federal Trade Commission
Q9: In what year was the FTC's report issued?
A9: 1958
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.

Q1: How much did treatment for each patient in Africa cost?
A1: 10,000 and 15,000 USD per patient per year
Q2: Who backed the South African government which caused the case to be dropped?
A2: The Netherlands, Germany, France, and later the US
Q3: Who brought litigation to South Africa?
A3: 40 multi-national pharmaceutical companies
Q4: How many signatures were collected by MSF?
A4: 250,000 signatures
Q5: When was litigation brought to South Africa?
A5: March 2001
Q6: How many companies sued South Africa for its Medicines Act?
A6: 40
Q7: South Africa's Medicines Act allowed for the generic production of what kind of drugs?
A7: antiretroviral
Q8: How much did ARV drugs cost patients yearly?
A8: between 10,000 and 15,000 USD
Q9: How many signatures were collected supporting public health rights?
A9: 250,000
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.

Q1: What Act forbade misbranded drugs?
A1: Pure Food and Drugs Act
Q2: What caused a Tetanus outbreak?
A2: contaminated smallpox vaccine and diphtheria antitoxin
Q3: What act allowed premarket approval for drugs?
A3: The Biologics Control Act of 1902
Q4: When did the Pure Food and Drugs Act get implemented?
A4: 1906
Q5: Who restricted the federal government's enforcement powers?
A5: Supreme Court
Q6: What was the name of the law that required premarket approval for producing drugs?
A6: Biologics Control Act of 1902
Q7: What law banned the interstate distribution of mislabeled food and drugs?
A7: Pure Food and Drugs Act
Q8: In what year was the Pure Food and Drugs Act passed?
A8: 1906
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.

Q1: Who adopted the Doha Declaration?
A1: World Trade Organization
Q2: What did the TRIPS agreement accomplish?
A2: countries must allow pharmaceutical products to be patented
Q3: Why are patents criticized?
A3: thought to reduce access to existing medicines
Q4: What did the Doha Declaration do?
A4: indicates that the TRIPS agreement should be read with the goals of public health in mind, and allows some methods for circumventing pharmaceutical monopolies
Q5: When was the Doha Declaration adopted?
A5: 2001
Q6: What has been accused of reducing access to medicines in developing countries?
A6: Patents
Q7: The Doha Declaration allows for what ways for monopolies to be bypassed?
A7: compulsory licensing or parallel imports
Q8: When did the World Trade Organization adopt the Doha Declaration?
A8: 2001
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).

Q1: How much money was recovered through the False Claims?
A1: $2.5 billion
Q2: What are some of the schemes used to defraud the health care system?
A2: Good Manufacturing Practice (GMP) Violations, Off Label Marketing, Best Price Fraud, CME Fraud, Medicaid Price Reporting, and Manufactured Compound Drugs.
Q3: What is pharmaceutical fraud?
A3: deceptions which bring financial gain to a pharmaceutical company
Q4: Who had the biggest fraud case settlement?
A4: GlaxoSmithKline
Q5: What provision rewards "whistle-blowers"?
A5: qui tam
Q6: What kind of fraud financially benefits a drug company?
A6: Pharmaceutical fraud
Q7: Who is affected by pharmaceutical fraud?
A7: individuals and public and private insurers
Q8: How much money lost to pharmaceutical fraud was recovered in 2010?
A8: $2.5 billion
Q9: Which act allows whistleblowers to recover money lost from pharmaceutical fraud?
A9: False Claims Act
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.

Q1: What drugs reduce the risk of death and other events in people with high blood pressure?
A1: thiazide antihypertensive drugs
Q2: Who conducted the review on Thiazide Antihypertensive drugs?
A2: Cochrane
Q3: What were Thiazide Antihypertensive drugs used with?
A3: combination therapy
Q4: What do ACE inhibitors do?
A4: reduce the risk of new onset kidney disease [RR 0.71] and death [RR 0.84] in diabetic patients
Q5: In what year did Cochrane release the report?
A5: 2009
Q6: What reduces the risk of new onset kidney diseases and death?
A6: ACE inhibitors
Q7: What type of drugs reduced the risk of strokes and heart disease for people with high blood pressure?
A7: thiazide antihypertensive drugs
Q8: In what year was thiazide antihypertensive drugs shown to help those with heart problems?
A8: 2009
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.

Q1: Who put out a report in 2012?
A1: President's Council of Advisors on Science and Technology
Q2: What has been argued restricted innovation?
A2: excessive regulation
Q3: What was a recommendations brought about from the report?
A3: expanding the FDA's use of accelerated approval processes
Q4: What is one thing excessive regulations causes?
A4: therapeutic innovation
Q5: What can be used to evaluate new approval processes?
A5: pilot projects
Q6: What is excessive drug regulation said to suppress?
A6: therapeutic innovation
Q7: In what year was a report made to reduce the burdens of drug development?
A7: 2012
Q8: What was argued to be holding back new knowledge for treating diseases?
A8: current cost of regulator-required clinical trials
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".

Q1: Who discovered Hydralazine?
A1: researchers at Ciba
Q2: Why were the researchers recognized in 1975?
A2: the saving of untold thousands of lives and the alleviation of the suffering of millions of victims of hypertension
Q3: Who developed Chlorothiazide?
A3: Karl H. Beyer, James M. Sprague, John E. Baer, and Frederick C. Novello of Merck and Co
Q4: What is  Chlorothiazide used to treat?
A4: hypertension
Q5: What was the main shortcoming in the drug Hydralazine?
A5: lost its effectiveness over time
Q6: What was the name of the first oral vasodilator?
A6: hydralazine
Q7: What is the most used antihypertensive drug today?
A7: chlorothiazide
Q8: Beyer, Sprague, Baer, and Novello received what award in 1975?
A8: Public Health Lasker Award
Q9: In what year was hydralazine discovered?
A9: 1952
Q10: Chlorothiazide helped reduce the mortality rate among those with what disease?
A10: hypertension
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.

Q1: What act needed provisions?
A1: FD&C
Q2: Who led the congressional hearings?
A2: Senator Estes Kefauver
Q3: What were the major issues that needed to be addressed?
A3: advertising abuses, questionable efficacy of drugs, and the need for greater regulation of the industry
Q4: What caused a need for more regulation?
A4: a new tragedy emerged
Q5: When did this push occur?
A5: 1959
Q6: Congressional hearings emerged addressing revisions to what act?
A6: FD&C
Q7: Who led the Congressional hearings in 1959?
A7: Senator Estes Kefauver
Q8: Did the US Congress call for more or less regulation of pharmaceuticals?
A8: greater
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.

Q1: What did the first measles prevent in it's first 20 years?
A1: an estimated 52 million cases of the disease, 17,400 cases of mental retardation, and 5,200 deaths
Q2: Who originally created the measles vaccine?
A2: John Franklin Enders
Q3: How much did the occurrence of serious diseases shortly after the release of the measles vaccine?
A3: >95%
Q4: When did the Rubella vaccine come out?
A4: 1969
Q5: Who recreated the measles vaccine?
A5: Maurice Hilleman
Q6: In what year was the measles vaccine made?
A6: 1962
Q7: Who helped refine the measles vaccine?
A7: Maurice Hilleman
Q8: In what year was the mumps vaccine made?
A8: 1967
Q9: How much did rubella, measles, and mumps infections drop after vaccination?
A9: >95%
Q10: Measles vaccinations helped prevent how many estimated cases of the illness?
A10: 52 million