Tuesday, January 19, 2010

In the business of making money.

When choosing non fiction to read, I have a weakness for books about class action lawsuits, or cringe worthy lawsuits where someone sued someone else for hurting their pride or their feelings. Not only is it fascinating, but the ruling often effects the country at large, even if they don't know or care what's going on.

Enter Alison Bass's Side Effects, about the antidepressant lawsuits of the 90's. She's not (and I'm certainly not) saying antidepressents are bad. They help a lot of people, and if they help you or someone you love, do not stop taking them without consulting your doctor.

The problem is with how the pharmaceutical companies go about testing and marketing their drugs. During investigations, it was found that some pharmaceutical companies buried studies showing their drugs could cause suicidal thoughts in young people, or that the drugs didn't work as well as older, cheaper drugs. Also, many universities and hospitals were doing the actual testing of the drugs, and were desperate for funding from where ever they could get it. The funding often came from the maker of the the drug. If the university's studies came back with negative results, they put their funding in jeopardy, so there was intense pressure to give the drug companies what they wanted. it brought "conflict of interest" to a whole new level.

Neither the author or myself is saying that all universities or hospitals that participate in drug trials are dishonest, nor are all pharmaceutical companies bribing people to publish only positive studies. The few dishonest groups make the entire industry look bad. Bass goes into detail regarding specific dates, locations, periodicals, pharma lobbying firms, board member lists, and websites where the studies can be found so the reader can come to their own conclusion.

Her point is if the FDA even bends just once to the pressure of a pharmaceutical company (which they have), the pharma industry immediately knows they have the FDA in their pocket forever. The FDA and other trusted government agencies quickly lose legitimacy in the eyes of the people. I choose to believe that 99% or more of FDA officials, hospital administrators, psychiatrists, physicians, and university professors are good honest people who do not take bribes. But that leaves the 1% who aren't so honest. Pharma marketing people are very saavy. You've worked your ass off for their studies, why not go out to dinner with them if they are paying for it? Why not take them up on their offer for an all expense paid trip someplace? it couldn't possibly do any harm, right?

People should be able to trust their doctors. But doctors are busy, and can't possibly be expected to read all of the studies on every single medication they prescribe. There is far too much data to sift through. If the FDA says a drug is safe and effective, you and your doctor should be able to believe that it is safe and effective, yes?

Is the FDA there to protect us?
Do pharmaceutical companies exist to help you?
If you're not sure, read the title of this post again.

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