Biased reporting of clinical trials

I couldn’t believe my ears when I heard revelations about so-called evidence-based medicine.

It has huge ramifications for our health, and even for our national economy.

I’ll tackle the economic ramifications first.  Let’s talk about Tamiflu.

Bond University Professor of Public Health Chris Del Mar is reported as saying “The manufacturer, Roche, has made some $4.6 billion worldwide from sales of Tamiflu, most of which is down to governments buying it and stockpiling it in warehouses,” Professor Del Mar said. “Australia bought almost $200 million worth of Tamiflu. That’s an enormous opportunity cost if the stuff doesn’t work. So it’s really important that it undergoes the most rigorous analysis.

“We can’t do that analysis if the manufacturer doesn’t make it available for us to look at.”

Ben Goldacre's TED Talk on what doctors don't know about the medicines they prescribe

Ben Goldacre’s TED Talk on what doctors don’t know about the medicines they prescribe

So why might there be doubts about the clinical trials?  In a recent impassioned TED Talk, Ben Goldacre reported that in the publication of the results of trials “Positive findings are around twice as likely to be published as negative findings. This is a cancer at the core of evidence-based medicine.”

This makes it significantly more likely for drugs that are little better than placebos to make it into common medical practice, and to make billions of dollars for Big Pharma.

In issue 457 of the New Internationalist magazine, Nick Harvey writes of the stoush between Swiss drug company Novartis and the Indian government, which has refused to patent its cancer drug Glivec.  Generic versions of Glivec have been available in India at less than a tenth of the Novartis price, and India is a major exporter of generic alternatives.

Health should be a social goal, not the province of excessive commercial profits, and major reforms are needed. So what are the alternatives?  Here are the essentials:
Results of all trials must be made public
Only approve new drugs if they are equal or better than existing alternatives
– Support the more widespread application of compulsory licenses for the production of generics, not just in cases of “national emergency”
– Demand a more rigorous approach to evidence-based medicine, that circumvents the power of Big Pharma to influence published clinical evidence
– Support the work of NGO’s such as Healthy Skepticism  that seek to reduce the harm caused by misleading health information.

Leave a Reply

Your email address will not be published. Required fields are marked *