Hi:
For some reason I always have trouble picking up links from the messages on the PEN 
site - they never connect [Is this just my problem?].

So I did not read the full article.

Nonetheless:
The problems identifed as below, did not seem to me as simply & easily dealt with by 
the proposed solutions that were proffered by the writer. Again I could not read the 
whole lot...
But:

These four central problems - short of the profit motive itself - [With which 'short 
views' I do indeed entirely agree with as being key components] were identifed as:
"1) excessive marketing expenses, as firms seek to pursue the monopoly profits 
associated with patent protection   data from the industry suggests that marketing 
costs are currently comparable to the amount of money spent on research;
2) wasted research spending into duplicative drugs   industry data
indicates that roughly two thirds of research spending goes to
developing duplicative drugs rather than drugs that represent
qualitative breakthroughs over existing drugs;
3) the neglect of research that is not likely to lead to patentable drugs;
4) concealing research findings in ways that impede the progress of
research, and prevent the medical profession and the public from
becoming aware of evidence that some drugs may not be effective, or
could even be harmful."
............

Interestingly enough, a later message alerted to the FDA (Jim Devine) & issues to do 
with women's health - the FDA is a central part of the problem as I understand the 
matter.

A set of 'easier' methods that might part-reform the drugs industry include such as 
these:
(i) Mandatory legislation forcing all research on any human subjects, in any part of 
the world, to be filed in an easily accesible data-base for all biomedical reserchers 
& patients rights advocates & potential users of the drug;
(ii) Legislation backing up the Helsinki Declarations on Ethics to be made entirely 
mandatory for all physician bodies including those out of the reach of Review Ethics 
Boards (REB's)  such as family docs etc; this to be enforced up to risk of loss of 
licensure for transgressions.
(iii) Chains on the cosy relationships of the FDA to the drugs companies;
including perhaps - Patient representatives mandated to sit on all deliberation bodies 
of the FDA for approval drugs/devices;
Insistence that prospective Randomised trials do NOT include a placebo - but DO 
include an approved "standard of care" control arm.
(iv) Legislation forcing before any start-up of a research recruiting patients, that 
the prospective proposed research is registered/filed/ & possibly even peer-reviewed; 
by an independent above-the-fray body.
That this legislation ensures that there is a meta-analyis of all available studies on 
the question.

Of course scepticsm that this will ever happen under the rule of Mammon-Capital are 
entirely legitimate.

But SOME elements of these proposals, would possibly work as there is a huge resonance 
for them in the bio-medical community.

I have not yet read Catherine de Angeleis (former editor of the NEJM)  new book on 
related issues.
Has anyone?
H

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