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View Diary: The New Cancer Treatment Republicans Should Refuse (10 comments)

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  •  That's not entirely accurate . . . (5+ / 0-)

    it's probably more spot on to say that the government and industry focus on different stages of drug development.

    The government funds a considerable amount of basic research that never (directly) makes it to the clinic, while, for drugs that do - the bulk of the money comes from private sources (translational research - involving clinical trials, etc, is much more expensive than the basic research . . . )

    Overall, there is more private research dollars (if you count clinical trials) spent in the US than government $$s in the biomedical sciences.

    •  The problem with private (0+ / 0-)

      industry paying for clinical trials is that the people paying for the trials cannot be objective.  That's what worries me.  It wasn't too long ago that taxes (the FDA) paid for clinical trials, which encourages (but still does not guarantee) objectivity.

      I may be misremembering some things; my source for most of my issues with big pharma is Marcia Angell.

      Je suis inondé de déesses

      by Marc in KS on Tue Jul 22, 2008 at 06:10:01 AM PDT

      [ Parent ]

      •  There is a tremendous incentive for clinical (1+ / 0-)
        Recommended by:
        Marc in KS

        trials to be "objective" - heck, if they're not, it's not like things can be swept under the rug when the patients start dying.

        Generally, the earlier a problem can be uncovered, the better.

        Of course, there are huge competing interests at work, for example, what is better - 1,000,000 to gain a moderate benefit while 10 put at substantially greater risk, and that type of thing.  Perhaps if clinical trial were publically funded, this type of issue could be addressed in a more open matter than behind closed doors in secrecy, which puts a huge taint over the entire process.

      •  Clinical trials are expensive. (2+ / 0-)
        Recommended by:
        Roadbed Guy, ebohlman

        If the FDA pays for all clinical trials, there's going to be incredible political pressure regarding what drugs they should and shouldn't be looking at.  Currently, a failure of a drug during Phase III clinical trials is a tragedy for the drug company, the company's employees, and the shareholders.  A failure of an FDA-funded clinical trial -- or, worse yet, withdrawal of a drug some time after approval -- would be a political disaster.

        Worse yet, the FDA itself is subject to political pressure that drug companies are largely immune to.  Right now, NIH has proposed testing the efficacy of chelation therapy as an autism treatment, even though all double-blinded scientific studies to date have found that chelation therapy has no effect upon autism, and may even cause long-term damage in patients without heavy metal poisoning.  They're not doing that because they think it will work -- they're doing it because they're faced with incredible political pressure by the anti-vaccination lobby.  If the FDA not only is able to approve drugs, but also to decide which ones should be tested, then you can expect more such trials -- which will be repeated ad nauseum until some effect, however little, is found.  Not to mention the morality issues -- do you really want a Republican-controlled FDA deciding whether or not to test birth control methods or morning-after pills or RU-486?  Say what you will about drug companies, they're incredibly pragmatic -- they're not about to spend millions of dollars on something because they're being confronted by angry lobbyists.

        Finally, the FDA simply doesn't have the manpower to fund clinical trials or drug testing, nor does it have the skill.  Try to socialize the drug industry, and you're going to guarentee that all drugs in the pipeline today will be delayed significantly -- years, even.  That's going to hurt a lot of people who are currently waiting for effective cancer treatments and other types of medication, and it's not clear it'll do much good.

        The system we have currently isn't perfect, but neither is it as flawed as anti-pharma organizations would have you believe.  As far as priorities, fixing the drug approval process is, IMHO, pretty far down the list.

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