Friday, 9 April 2010

4 Reasons why you might not trust drug companies

4 Reasons why you might not trust drug companies - or why a new drug is the background for my novel ‘A Rag Doll Falling.’

Temptation 1 The price. A patent protects the invention when a new drug comes out, but it doesn’t last forever. The company has to take out the patent as soon as they invent the drug and at that stage they have no idea what it does. They have to try it out on different diseases. Usually they’ll try it on cells in test tubes and then in animals and eventually in people. They test for safety in normal volunteers and then on people who are very ill, the last chance saloon and eventually if things go well it gets on the market, licensed for a particular set of conditions. All that testing takes time and the clock is running down on the patent. The more that the public demand safety, the longer it takes. As soon as it is on sale the company has to try to recover the investment and make a profit. So there is a big temptation to charge the highest possible price.

Temptation 2 Keep testing to a minimum. Do the shortest clinical trials you can get away with. If possible test your new drug against a placebo, rather than head to head with the best drugs so far. That way no one can tell for sure if the new drug is really an improvement.

As the New England Journal of Medicine says “Placebo-controlled trials require smaller sample sizes than active-comparator trials, are less expensive to conduct (and therefore reduce the costs of market entry), and present less risk of producing unanticipated unfavorable findings…Yet placebo-controlled trials that are not supplemented by active-comparator trials leave clinicians, patients, and payers in the dark, providing no guidance on a new product’s advantages or disadvantages relative to existing products.” From (10.1056/NEJMp0906490) published on August 12, 2009, at

Temptation 3 Stretch the licence. Encourage doctors to prescribe the drug for all sorts of other conditions where it might do some good. It’s not legal to do that and every year we hear of companies being fined by regulatory agencies for going too far. The fines often run into many million, which gives some idea of the profits that are at stake.

Temptation 4 Fund patient groups so that they demand the drug. If you can’t persuade the doctors with advertising and salesmen, maybe their patients will do the job for you. Why don’t patients tell their doctors to stick to the older drugs that are tried and tested? Mostly because illness scares people, cancer in particular, and it’s easy to assume that a new drug must be a better drug. All that media reporting about science and breakthroughs pushes us in that direction. Some of that must be set up by the dug companies mustn’t it - who else can they ask?

OK I don’t want to overdo it, but you have to admit it’s a good backdrop for a novel. Of course in fiction you can throw in some very unethical ambition and the odd murder that I’m sure don’t happen in real life – well I hope not anyway.

Read the book as an ebook at

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