Bad news makes more headlines than good news. Some people even make a good living pointing out all the problems in certain industries (some of whom either make money in the exact same industry, or made all their money and now feel compelled to point out all the industry’s flaws). And nobody is a bigger magnet for critics than the thriving pharmaceutical industry.
But Reason Magazine, a bastion of libertarian thought, has an interesting article in its just-published October 2007 issue (which won’t be online for a few months) about the “overrated risks and underrated benefits of pharmaceutical research ‘conflicts of interest'” (Is Industry-Funded Science Killing You? by Ronald Bailey).
Now, the bias in this article is clear as well — it appears in a magazine where its publishers believe the free-market is best left alone, and government intervention kept to a minimum. So you’d expect that if Reason is going to publish an article about pharmaceutical research, it’s going to take the side of free markets — that is, the existing industry of pharmaceutical companies working with academia, for-profit journals, and other organizations that conduct clinical drug trials. They’d like to see the government stay out of the fray.
The article is a well laid-out argument for the status-quo, pointing out that the industry adapts to meet the needs of changing government and disclosure requirements. And that while there are some big-headline cases that occasionally make the news, the vast majority of clinical trials and drug research is conducted ethically and without safety problems. CenterWatch, which tracks clinical trials, estimates that more than 40,000 clinical trials are now in process, involving more than 20 million people. CenterWatch president Ken Getz says in the article, “The vast, vast majority of clinical trial participants ahve very positive experiences.”
What about all those conflicts of interest that bring otherwise unworthy drugs to market, as some claim? In 2005, Tufts University Center for the Study of Drug Development found that faster drug approval times do not correlate with more frequent drug withdrawals, and the data speak for themselves — the withdrawal rate in the 1980s was 3.2%, 3.5% in the 1990s, and 1.6% so far for this decade.
How do patients feel about researchers who might have some sort of ties to a drug company conducting research for them? Well, not all of them see it as a bad thing. That article points to a 2006 survey (published in NEJM) of cancer patients participating in five research trials, more than 80% thought it was ethical for researchers to receive speaking or consulting fees from the company. Most patients also said they would oppose a ban on relationships between researchers and drug companies, according to the article.
What about docs just being pushed to prescribe newer drugs that basically do the same thing as their older, less expensive counterparts? I would ask, Are doctors simple pushovers that are always looking to prescribe the latest, greatest drug? Or are there some real benefits (or perceived benefits) from such prescriptions, such as better side effect profile, less life-altering side effects (e.g., sexual side effects), or a quicker treatment response? According to the article in a 2002 study for the National Bureau of Economic Research, researcher Frank Lichtenberg estimated that, “on average, ‘reducing the mean age of drugs used to treat a condition from 15 years to 5.5 years […] increases prescription drug spending by $18, but reduces other medical spending by $129, yielding a $111 net reduction in total health spending.'” The reductions in other medical spending include less hospital and office visit expenditures.
Newer drugs are also the result of the type of society we live in — a free market society that values competition amongst competing firms to drive innovation and new treatments.
As I said, the Reason article is bound to make a good argument, as that is the point of such articles. But I still think it’s a good read for people who believe that pharmaceutical companies are all evil and just in it to make a buck. They’re not, and the articles makes a good argument for the system that is in place is flexible enough to adapt to meet the changing needs and demands of society. Is it perfect? No system designed by humans and with significant monies for all parties involved (even non-profits) is going to be perfect. Could it be better? Maybe, but I have yet to see any solution that demonstrates we’re in need of significant change, given that the vast majority of clinical trials and drug research is run ethically and responsibly.