A balance has to be struck. You can't test a drug exhaustively unless you try it out on everybody. We have to accept that a rigorously tested drug may, when it goes into general use, prove to have previously unsuspected side effects. That's why there is a reporting system, as Andy pointed out earlier, to try to ensure that such side effects are spotted as early as they might be.Originally Posted by JiveLad
Neither the USA nor Europe permits pharmaceutical companies to introduce drugs without going through a statutory testing process. The mistake is in assuming that every drug that goes through the process is deemed to be absolutely safe.
If you have a drug that could reverse the effects of a stroke if it administered within 30 minutes, how much testing needs to be done before the deaths and debilitations of further testing outweigh the risks to patients who would otherwise be dead? That's a tricky issue, and decisions like that are going to be, sometimes, wrong or mistaken. Doesn't mean that we throw our hands up in despair and say 'no new drugs' or alternatively 'let's just take sugar pills labelled as 'medicines'
That's the sort of 'statistic' that sets off alarm bells with me. I'm sure you heard aright; I just want to know a bit more about the statistical analysis which led to the announcement. Although you can pick up information about drug companies from the prospectus and their audited accounts, the precise figures necessary to enable such a statement to be made would, I suspect, be very difficult to obtain.
all very interesting -
ref sales and marketing spend - any one know the % split between prescription and non-prescription ?
Any one on here still buy brand name Anadin, Panadol, Nurofen etc rather than the 59p box of Ibuprofen from the bottom shelf to take with half a can of Coke and believe there's added benefit?
I was listening to the PM progam on monday morning on radio 4 on my way to work and I heard a discussion between the interviewer, someone from the National institute for clinical excellance (NICE) and the Association of the British Pharmaceutical Industry (ABPI) when I heard the guy from NICE come out with this.
Us guys who work in laboratories know just how difficult it is discover and develope these drugs and get them to the point of being an approved drug (If a scientist works on one drug that makes it to being approved for sale in their lifetime they are considered lucky) and most drug candidates never even make it to the point of being tried on volounteers. So we often look at the highly paid marketing people and wonder just how hard can it be to sell something that is going to relive the symtoms of a disease or save a life. Of course, it is a classic example of not valuing someone elses job because you don't understand what they do. Even so it was a shock to hear this guy from NICE coming out with "twice as much is spent on marketing as is spent on Research". I assume he is talking about the UK since he is a leading figure in a UK organisation.
If you are interested you could catch the radio show on iPlayer.
There was a very good programme about the Placebo Effect on Radio 4 last night. Listen Again here.
It had examples of how powerful it is, and some interesting effects. For example people given 4 placebo pills a day recovered better than people given 2 placebo pills a day. Red placebo pills had a different effect to blue ones. Fascinating stuff!...but according to research mentioned in the Placebo programme, placebos in brand-name packaging (with lots of advertising behind them) do cure people better than identical placebos in generic packaging. So (however illogical it seems) there is added benefit to buying brand-named medicine!
Love dance, will travel
I really do think you can think yourself better. And the more convinced you are by the placebo the more you will "think yourself better".
There is definitely a physical effect from thinking - consider blushing as a simple example. This is best shown by hypnosis. There is some evidence that hypnosis can improve healing time for things like burns and post op wounds. However there is not much research and more needs to be done to properly prove the effect. There is also evidence that you can think youself sick or at least sicker.
It may be that the mumbo-jumbo that goes with homeopathy, reiki, etc makes it act as a more convincing placebo. Perhaps it really does work for some patients, but only if they truly believe.
Me? I haven't stopped believing in fairies since I saw Peter Pan in 1966
There's a news story today about this (although it's a small study and they're slightly equivocal about it).
BBC NEWS | Health | Positive thinkers 'avoid cancer'
Love dance, will travel
Big pharma in the news again:
Drug companies accused of spending millions on conference trips for doctors | Society | The Guardian
Joe Collier, the recently retired professor of medicines policy at St George's hospital, London, a former member of the Medicines Commission and an adviser to the select committee, said: "Through its orchestrated campaigns affecting all those involved in the use of medicines, the pharmaceutical industry enormously influences what patients are prescribed. On the whole these influences are detrimental to best practice."
Joe Collier is the retiring from his editorship of Drugs & Therapeutics Bulletin. Throughout his time in the job he has been stridently anti-industry. He doesn't really represent the views of most of the medical profession and is, very much, at one extreme. There will always be someone who stands at one end of the spectrum and in this case it is Joe Collier. Somebody had to do it and Joe Collier has performed this role well and has been single-minded in his approach.
In my opinion there is a place for people like Joe Collier and the world of medicine has lost a great influence with his retirement. Why do I say this? Because all the time there are people saying you are wrong, you will take more care proving you are right - and making sure you are right in a way that can be proved and audited.
In this particular case I believe that Joe Collier is probably talking about the influence of the the pharmaceutical industry over the whole of his career. And, taking the long-term, historical view he is, at least in part, correct. Although I do take issue with his use of "on the whole". However, there are many things that were permissable twenty years ago that could get your MD appearing in court nowadays! Things have changed, especially in the largest companies, perhaps it's time for some of the old guard to realise - or retire
I found an MP3 download version of this programme on Ben Goldacre's website (I didn't realise originally but he was the presenter).
Episode 2 is tomorrow night - Radio 4 at 9pm.
Love dance, will travel
New Scientist this week also has an article on the Placebo effect
Does the placebo effect include the belief that big capitalistic pharma is best for us?
If there is an indication that chocolate sponge cake taken five times a day is a treatment for dancitis does big pharma do clinical trials on chocolate sponge cake?
Or does it isolate the active ingredients at great cost, patent them if it can, do the clinical trials on those, and, if they are approved, sell them at a high price and profit margin?
If there is an indication that dandelion tea might cure dancitis in a single dose does big pharma jepordise its profits from the daily treatment and investigate, or does it denounce dandelion tea as "unproven"?
I believe that the profit motive alone is not sufficient to ensure that we get the best medicinal bang for our buck and there probably should be a bigger proportion of state money going into medical research.
This would solve a lot of problems with funding, and make it a level playing field for Alternative medicines to be tested.
There has already been a small amount of testing of "alternative medicines". The findings so far are that they don't work.
By whom Andy?
At one time germ theory was "alternative". Who was going to believe that something too small to be seen could kill what were perfectly healthy human beings. It was a try anything, even the unproven, doctor who discovered that what was killing more of his patients was his enthusiasm, his more frequent examinations. All it took to change things was to wash his hands in something alleged to kill something he could not see. It is not one of the medical professions finer moments.
Childbed Fever: A Nineteenth Century Mystery - Case Study Collection - National Center for Case Study Teaching in Science
Semmelweis, Ignaz Phillip
There is a big difference between discovery and blind faith. Eventually it was discovered that there were organisms that you can't see that were causing certain diseases. People already knew that the diseases existed, they just didn't know what was causing them. That is completely different from the situation with alternative medicines. We know they exist and have been around for years. In all that time it has not been possible to prove that they work. As I said, what little evidence there is proves that they do not work any better than placebo. I'm not going to do the google searches, do them for yourself and you might be more inclined to believe what you find.
In fact, germ theory was not proposed until after we were able to see things too small to be seen. Leeuwenhoek in Holland invented the microscope and saw things which astonished him. Some clever scientists realised that 'miasma', and 'spontaneous generation', might be accounted for by the actions of such things.
Apparently not; he noticed that infection acquired from a corpse greatly resembled puerperal fever, and EXPERIMENTED to confirm his theory by seeing what happened if hygiene practices were improved - washing hands between carrying out autopsies and examining pregnant women.It was a try anything, even the unproven, doctor who discovered that what was killing more of his patients was his enthusiasm, his more frequent examinations.
It is that step - working out how a theory can be tested in order to falsify it - that is entirely absent from 'alternative' medicine. There, the theory is 'affirmed' by advertising, on-line catalogues and personal appearances.
Well, that sounds uncannily like big pharma!
Add in a dose or two (make it two because we like to sell more) of dodgy trials which ignore the side effects until there is a class action, invention of a few new conditions to be treated, endorsement by a few medical professors and illuminaries on the payroll and bingo! it's blockbuster time.
Only to an idiot. Not you, right?
Pharmaceutical companies, at least in the UK, are not allowed to advertise to the general public, they aren't allowed to sell to the general public, and no scientist who works for a pharmaceutical company has, to the best of my knowledge, ever made a public appearance plugging the drugs he has discovered/invented. (Over-the-counter drugs can be advertised in the UK.)
Prescription drugs can be advertised in the US but under controlled circumstances; the other prohibitions apply there too.
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