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Practicing medicine in the dark

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That’s how researchers Michael Hochman of USC and Danny McCormick of Harvard described medicine’s lack of evidence for many treatments in an opinion piece in the Los Angeles Times that reflects on the authors’ paper published in the Journal of the American Medical Association this week. Excerpt of the op-ed piece:

“.. we analyzed 328 medication studies recently published in six top medical journals and found that just 32% were aimed at determining which available treatment is best. The rest were either aimed at bringing a new therapy to market or simply compared a medication with a placebo. Whether the therapy was better or worse than other treatments was simply not addressed.

Reform is also necessary to ensure that commercially funded research is designed in a way that is more helpful to doctors. Our study showed that two-thirds of commercially funded randomized trials compared medications with a placebo rather than with another active therapy. Though placebos are appropriate when no alternative therapies are available, in many of the trials we examined, we suspect alternative therapies could have been used instead. For this reason, we believe that regulatory agencies such as the Food and Drug Administration should only approve new therapies that have been shown to be at least as good as existing therapies whenever such alternatives exist. Alternatively, though more controversial, some experts have proposed that pharmaceutical companies should be allowed to fund — but not design — clinical studies.”

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DoctorSH

March 12, 2010 at 7:52 am

OK then.
So let us take this one step further.
If I want to purchase a car, average price $20,000, upkeep and maintenance $3-5000 a year, for a total cost of $32,000 over three years, about the amount of time people have held onto cars in the past, then new cars should not be allowed into the marketplace if they have not been proven to be better in some way to other cars.
If we followed this scenario, GM would be out of business!
Choice is important. No matter what a study says, medications have different effects on people, and limiting availability based on whether a study shows it is better than an other medication, would only limit the availability of treatments, decrease competition among manufacturers, and ultimately raise costs.
I am far from a Big Pharma fan, and even further from a fan of government regulators, but new products should be allowed to market if they are proven safe and effective. Then it is up to the manufacturer to try to make a buck.

Dr. Jason

October 25, 2010 at 11:15 am

So, what you are saying is that these drug companies should just keep pumping out medications that may have little or no effect on the symptom but comes with a ton of side effects and then take another drug for that. That is what these companies do. That do not take care of anyone but themselves. People need to have better nutrition and exercise in their lives.