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Monday, November 24, 2008

Drug Trials Only Adverts?

An exquisite essay on just how it is!
Clinical Drug Trials: See them for what they often are — advertisements
by Warren Bell, MD

Just about every week, an announcement is made about research concerning some sort of new treatment. In just about every case, the treatment is a drug.

This does not mean, however, that drugs are the most important or valuable type of therapy, but rather that modernday, multi-national “big pharma” drug corporations have enormous, financial clout. Due to their patent-based monopolistic profits, drug companies earn 10 times more than all other types of treatment combined. Cnsequently, they can afford to hire the best advertising and public relations experts to relentlessly promote their products in the industry and public media.

So-called announcements from big pharma can more accurately be described as advertisements. They are, in point of fact, carefully crafted propaganda for the latest product generated by clever drug development teams, whose most important members are often public-relations experts and lawyers.

Reading between the profit lines

Let’s look at a hypothetical but typical drug announcement, one piece at a time:

“The results of a double-blind, multicenter trial of the new drug Zaronda, announced today by a research team at the University of Great Hill, reveal that this new breakthrough treatment significantly lowered levels of LDL cholesterol compared to placebo. Dr. Ronald McDonald, chief researcher and Head of the Department of Internal Medicine at UGH’s University Hospital, noted that this new drug represented “An exciting development in the battle against the growing epidemic of heart disease.”

Zaronda was developed in the research laboratories of Muck, Rake and Klink. Share values for the company rose 18 percent after the results of this study were announced.”

Double blind, multi-center trial:

This kind of phrase is used to make the ad sound scientifically impressive. “Double-blind” is thought of as the golden star of study models because neither the subject nor the researcher knows who is receiving the actual treatment in comparison to the placebo (dummy pill). The model and term are used in this case to create the impression of impartiality and rigour.

Multi-center trial: Using such a phrase suggests that large numbers of experimental subjects were involved, implying that it was a serious trial that cost a lot of money.

In actual fact, of course, size counts for nothing in many cases. In 1747, an experiment using only 12 subjects proved that limejuice prevents scurvy and ensured British naval dominance for 150 years.

The new drug: Drug companies want you to believe that what you’re reading about is “hot off the press,” creating the impression of excitement and hope.

Zaronda: Believe it or not, advertising geniuses in the drug industry have
figured out that certain letters are more “sexy.” The letters Z, X, and Y, for example, sell more drugs than most others. That’s why you see strange names for drugs, such as Xanax, Zostrix and Zyloprim.

Research team at the University of Great Hill: Drug companies know that there is still a veneer of respectability attached to educational institutions. They strive to mention either a university or hospital in association with any new drug research. Even if the research is carried out in the company’s own laboratories, the university or hospital connection will likely always come first.

Breakthrough: A key of almost all drug advertisements is the “breakthrough.”
Once again, the word creates the sense of excitement and drama that drug companies know will help to sell their product to desperate people. However, in a typical year, with say 800 new drug submissions, no more than half a dozen can actually be termed useful, let alone a breakthrough.

Significantly lowered levels of LDL cholesterol: Contrary to what many people think, high or low cholesterol is not a significant measure of your health, which makes this phrase a surrogate marker. Getting sick or dying is significant, but changing the amount of a substance in your bloodstream is not. (Some skeptical experts believe that there is no direct connection between cholesterol and heart disease.)

By taking advantage of the fact that many people—including many doctors—mistakenly
equate the lowering of cholesterol with improving a person’s health, drug companies cleverly create the impression that their drug can help. One of the most famous drug trials in medical history involved a drug that lowered cholesterol dramatically but markedly increased the number of deaths from gallbladder disease.

Compared to placebo: Here is one of the best tricks of the drug industry. Instead of comparing a new treatment to older, established treatments, the industry almost always compares a new product to a placebo. That way, they don’t have to worry that the public will compare the new drug to something already on the market—something that might be as good as the new product or even better.

Dr. Ronald McDonald... Chief...Head: The impression created here is of a researcher with an armload of qualifications and exceptional scientific expertise. What is never mentioned is that the good doctor is undoubtedly receiving substantial sums of money from the company making the drug being tested. Numerous studies in medical literature have shown that when this happens, research studies almost always show that the drug works well. He who pays the piper, plays the tune.

An exciting development in the battle against the growing epidemic of heart disease: Once again, this phrasing is attempting to drum up the impression of action, movement and excitement.

Heart disease is mostly caused by over consumption of food, lack of exercise and other lifestyle factors. Taking an expensive pill to deal with this behaviour can hardly be considered an effective weapon. Nevertheless, drug companies use military jargon and scare tactics to drum up business.

Share values for the company rose 18 percent: This kind of information is increasingly tagged onto the end of these ads. The fact that it’s there at all
reveals the true underlying purpose of these so-called treatment creations. They are designed to make money for shareholders of giant multinational corporations.

Patents for profit

By now you may think I’m against all drug companies, but I’m not. Evidence shows that approximately one percent of new drugs are significantly useful. I feel that the real problem with clinical trials is that the vast majority are done on patented drugs.

No one is eager to do trials on vitamins, herbal preparations, homeopathic remedies, physical therapies, or any of the other numerous non-pharmaceutical interventions that many people use every day. Why? Because the profit margin on these approaches
is trivial compared to the windfall profits earned by patented drugs.

If even one-tenth of the money currently wasted on patented drug trials were diverted into independent studies of natural health products, manual treatments and community health-related programs, therapy would be revolutionized overnight.

Treatments and interventions would become safer, less expensive, more accessible
and more sustainable.

Until that happens (and it will require public funding to be done properly)we’re going to have to go on swimming in a sea of flagrant advertisements for drugs of questionable value and unknown risk, disguised as legitimate.

My hope is that this article throws you a modest life raft to help you avoid

Warren Bell, MD, is a HANS member practicing in the heart of the Okanagan Valley. He’s also President of the Association of Complementary and Integrative Physicians of BC.
Courtesy magazine.

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