With a hat tip to Kevin Drum, I post this link to a book review by Marcia Angell, "Drug Companies and Doctors: A Survey of Corruption," in the January 15, 2009, edition of The New York Review of Books. In the article, Angell reviews and discusses the following books: Side Effects: A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial, by Alison Bass; Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines and Hooked the Nation on Prescription Drugs, by Melody Petersen; Shyness: How Normal Behavior Became a Sickness, by Christopher Lane.
On his blog, Kevin Drum posts his favorite quote from the review: "Quote of the Day--12.29.08". This is what jumped out at me:
A recent survey found that about two thirds of academic medical centers hold equity interest in companies that sponsor research within the same institution. A study of medical school department chairs found that two thirds received departmental income from drug companies and three fifths received personal income....snip
In view of this control and the conflicts of interest that permeate the enterprise, it is not surprising that industry-sponsored trials published in medical journals consistently favor sponsors' drugs—largely because negative results are not published, positive results are repeatedly published in slightly different forms, and a positive spin is put on even negative results. A review of seventy-four clinical trials of antidepressants, for example, found that thirty-seven of thirty-eight positive studies were published. But of the thirty-six negative studies, thirty-three were either not published or published in a form that conveyed a positive outcome. It is not unusual for a published paper to shift the focus from the drug's intended effect to a secondary effect that seems more favorable.
snip
Many drugs that are assumed to be effective are probably little better than placebos, but there is no way to know because negative results are hidden.
As a patient who has been prescribed drugs "off-label," I found this article very interesting. Not too long ago, I was prescribed some drugs by a doctor at a well-known medical teaching institution. After my appointment, I went online to look up the purposes of those drugs, and I discovered that one of the drugs had been prescribed "off-label." Taking that drug with the others prescribed made me extremely drowsy, unable to function well had I taken them on a workday. Thus, I decided to discontinue the use of the "off-label" drug, and told my doctor I was doing so. The decision did not effect the efficacy of my treatment, which made me wonder whether the "off-label" prescription was necessary in the first place.
Now, I'm not accusing my doctor of malpractice at all. The conversation we had about the drug after I did my research satisfied me that my doctor had the best intentions. However, the experience did remind me of the necessity of one's being pro-active in determining the best treatment choices. I would love to trust my doctors fully, but articles such as this (and others) suggest that I should always do my research before relying on any doctor's medical decision.
Other Voices: "Playing the Doctor Card," Rahul K. Parikh, M.D., in Salon, Sept. 26, 2008.
No comments:
Post a Comment