What Doctors Don't Know About the Drugs They Prescribe

[slimvictor]

TEDTalks can sometimes portray science in triumphalist tones, with fabulous innovations that are changing the world forever. But the real action in science is often around dirty, messy, angry problems, and my TEDTalk is about the dirtiest I've seen yet.

Doctors need the results of clinical trials to make informed choices, with their patients, about which treatment to use. But the best currently available evidence estimates that half of all clinical trials, for the treatments we use today, have never been published. This problem is the same for industry-sponsored trials and independent academic studies, across all fields of medicine from surgery to oncology, and it represents an enormous hidden hole for everything we do. Doctors can't make informed decisions, when half the evidence is missing.

Most people react to this situation with incredulity, because it's so obviously absurd. How can medics, academics, and legislators have permitted such a huge problem to persist? The answer is simple. This territory has been policed -- and aggressively -- by the pharmaceutical industry. They have worked hard to shut down public discussion on the topic, for several decades, with great success.

They say, for example, that the problem is modest, and that critics have cherrypicked the evidence: but this is a lie. The best evidence comes from the most current review of all the literature, published in 2010. It estimates that half of all completed trials are left unpublished, and that trials with negative results are about twice as likely to be buried.

cont at
http://www.huffingtonpost.com/ben-goldacre/prescription-drugs_b_3018272.html

 

[maxalfie]

If the evidence is there to be seen and it can be shown that test results showing unsafe drugs have been allowed to be launched onto the market then surely the heads of these Pharma companies should be bought to court?

 

[exists]

Doctors Not Informed of Harmful Effects of Medicines During Sales Visits

Apr. 10, 2013 — The majority of family doctors receive little or no information about harmful effects of medicines when visited by drug company representatives, according to an international study involving Canadian, U.S. and French physicians.

Yet the same doctors indicated that they were likely to start prescribing these drugs, consistent with previous research that shows prescribing behaviour is influenced by pharmaceutical promotion.

The study, which had doctors fill out questionnaires about each promoted medicine following sales visits, was published online today in the Journal of General Internal Medicine. It shows that sales representatives failed to provide any information about common or serious side effects and the type of patients who should not use the medicine in 59 per cent of the promotions. In Vancouver and Montreal, no potential harms were mentioned for 66 per cent of promoted medicines.

"Laws in all three countries require sales representatives to provide information on harm as well as benefits," says lead author Barbara Mintzes of the University of British Columbia. "But no one is monitoring these visits and there are next to no sanctions for misleading or inaccurate promotion."

Serious risks were mentioned in only six percent of the promotions, even though 57 per cent of the medications involved in these visits came with US Food and Drug Administration "black box" or Health Canada boxed warnings -- the strongest drug warning that can be issued by both countries.

"We are very concerned that doctors and patients are left in the dark and patient safety may be compromised," says Mintzes, an expert on drug advertising in UBC's School of Population and Public Health.
Doctors in Toulouse were more likely to be told of a harmful effect in a promotional visit, compared to doctors in Canada and the U.S., according to the study. Researchers suggested that this may reflect stricter regulatory standards for promotion of medicines in France.

continued at: http://www.sciencedaily.com/releases/2013/04/130410094337.htm

Not really the same issue, but the result is similar.