Re: Big Brother and vested interests?

This post not CC'd by email
On Fri, 25 Nov 2005 19:00:05 -0500, Jenny
<lottadatacarbs@xxxxxxxxxxx> wrote:

>Alan S wrote:
>>
>> Completely agreed. On the opening page (I must admit I
>> stopped there, the temperature was rising):
>>
>> "Patients decline invitations to enroll for a number of
>> reasons. Some people are uncomfortable with the idea of
>> being part of a testing process, or with the possibility
>> that which treatment they will receive will be decided
>> randomly.[9] Many of these patients are concerned that the
>> physicians are more interested in the research study than in
>> the patient's care.[10] Patients also cite concerns about
>> the burden of extra tests and appointments and the
>> uncertainty of the consequences for their health from
>> participation.[1"
>>
>
>Well, let me just add that my response to this proposal was made knowing
>there isn't a snowball's chance of it ever happening.

G'day G'day Jenny,

I'm not so sure it couldn't happen. US ethics committees appear to
permit trials where a new drug is tested against a placebo. Generally
speaking these weren't permitted in NZ as it meant a patient who was
being treated could without knowing it be left untreated. We have
some dark history here ... a trial of minimal treatment of cervical
cancer. History like that hardens the resolve of ethics committees
for it never to happen again.

>But, that said, in the U.S. right now, patients participate in very poor
>"research" every time they take a brand new pill. It's research because
>the real effects of the drugs are often unknown when the drug hits the
>market, and because their doctors "enroll" them, without consent, in the
>research to see what the drugs really do, every time they write a
>prescription.

Very sadly true if the revelations concerning the efficacy and side
effects of SSRIs are anything to go by.

>I didn't put a lot of attention into the article, but it seemed to me
>that it was talking about situations where a new drug was being
>prescribed where there were already proven existing treatments, so the
>goal of the study was to see if the new drugs were more or less
>effective and at what side effect cost.

Actually no. The hypothetical they gave was for two established
treatments where it was not known which gave the better recovery rates
and fewer side affects. The difference probably isn't all that
important.

>So let me amend my statement. It seems to me that it would be a very
>good idea to legislate that any time a patient decides to take a new
>drug (especially one heavily promoted on TV and in magazine
>advertisements) they would have to be enrolled in a study for which the
>doctor was not compensated beyond the modest amount needed to pay for
>clerical staff time.

OK. A reasonable proposal. The aim would be to collect more follow up
data on side effects so that drugs don't continue to be used for years
and years when serious side effects that should have been recorded
aren't.

>This would have the effect of causing doctors to STOP pushing every
>brand new drug on their patients, using them instead for those patients
>for whom older effective treatments no longer work. It would have the
>effect of putting patients on notice that this exciting new drug might
>harm them and that the drug company will take no responsibility for that
>harm should it happen.

In all trials the company must provide insurance cover. FWIIW many
patients in New Zealand are better off than they would be if they
weren't in a trial. Put simply the recompense they would receive from
the New Zealand ACC is much, much less than they would receive from US
companies.

>All in all, an excellent state of affairs.
>
>I suspect those of you in countries with more enlightened health care
>establishments cannot imagine the climate here in the U.S. where doctors
>in many cases do earn more from pushing new and untested drugs on
>patients than from the appointment itself, and where a typical doctor's
>office may be festooned with posters, calendars, coffee cups, pens,
>pads, and a host of other drug company promotional materials, all
>promoting the latest, most hyped, and not so coincidentally, most
>expensive, drug treatment!

I don't think it is confined to the US. Yes, it could be worse in the
US, I simply don't have the experience to make a judgment.


>--Jenny
>
>http://www.geocities.com/lottadata4u/ Type 2 Diabetes info
>http://www.geocities.com/jenny_the_bean/ Low Carb info

Best wishes,

--
Quentin Grady ^ ^ /
New Zealand, >#,#< [
/ \ /\
"... and the blind dog was leading."

http://homepages.paradise.net.nz/quentin
.

Relevant Pages

  • Re: Big Brother and vested interests?
    ... >>> Making Research A Requirement of Treatment ... this could be a benefit for us patients. ... >>there is NO follow up as to how the drug performed. ... >that some cardiologists told their patients that they would treat the ...
    (alt.support.diabetes)
  • Dying for Lifesaving Drugs
    ... An MRI revealed the cause of that seizure: a tumor deeply ... Along with 43 other patients, Gotschall would have a chance at a ... The drug attacks the tumor under the ... The treatment proved immediately effective in the most dramatic way ...
    (alt.support.mult-sclerosis)
  • Re: ~*Online WACOC News 2007 July 21*~
    ... although a few patients later noted that clues emerged as the weeks ... Carter declared it to be "a study of unprecedented scope," a statement ... abundance of hard scientific data about the disease. ... collaborated on the trial published a study reporting that the drug ...
    (alt.med.fibromyalgia)
  • Re: Drug Combination Fuels Hope for MS Fight
    ... many of the other patients in the study experienced ... The results of the initial trial, led by Dr Mike Boggild ... Mitoxantrone is an anti-cancer drug so powerful that it is potentially ... mitoxantrone treatment -- Boggild says the majority of patients ...
    (alt.support.mult-sclerosis)
  • Re: New RA drug shows promise, without immune system suppression!
    ... Researchers at the University of California, San Diego (UCSD) School of Medicine have announced successful completion of Phase II clinical trials of a novel drug for the treatment of rheumatoid arthritis, ... sponsored by the National Institutes of Health, which took place between 2000 and 2005 and involved 160 patients enrolled in centers nationwide including UCSD, Stanford University, Johns Hopkins University, the Mayo Clinic, and Virginia Mason Medical Center in Seattle. ...
    (alt.support.arthritis)