3 ms·

Pharma researcher here (on the early science side, not market research or that kind of thing) I think people vastly overestimate their physicians' ability to s

Pharma researcher here (on the early science side, not market research or that kind of thing) I think people vastly overestimate their physicians' ability to stay on top of newly published research, and that includes new drugs' safety and efficacy profiles. If I want the stuff I work on to reach patients (and I do), then I want doctors to know about it. In the absence of pharma marketing dollars aimed at doctors and patients, I would like if there were some way to bring doctors the new information. Maybe that should be handled by a third party that doesn't have the interests of pharma companies in mind, funded by all of the drug companies at the time of a new drug approval.

pmyteh 9y ago
In Britain, we rely more on guidance from the National Institute for Health and Care Excellence (NICE). It does comparative reviews to make recommendations on the most suitable drugs to use. Motivation is primarily to restrict crazy-expensive drugs to those situations where they're actually going to represent value for (the public's) money, but also to point clinicians towards new approaches which can improve the quality of treatment. So hugely expensive advertising towards physicians is not the only way to do it.
- jonlucc 9y ago
  That sounds like a fantastic resource that I can not imagine passing in the United States any time soon. Is it funded along with the rest of the NHS?
  - pmyteh 9y ago
    Yes. In fact, its major remit is to improve value for money by targeting NHS treatments better. All of its meta-analyses and treatment guidance are available at http://www.nice.org.uk http://www.nice.org.uk, if you want to explore.
    - jonlucc 9y ago
      This is really great; thank you for pointing me to it.
- GeekyBear 9y ago
  In the United States, policy debates about implementing this sort of body led to them being referred to as a "death panel". There is no logical reason why we shouldn't prefer an older generic medication if it treats the symptoms of a condition just as effectively and with fewer side effects than a newer option that is no more effective and has more side effects, but doing what is best for patients has to compete against the profit motive of our pharmaceutical companies.
  - jonlucc 9y ago
    > There is no logical reason why we shouldn't prefer an older generic medication if it treats the symptoms of a condition just as effectively and with fewer side effects than a newer option that is no more effective and has more side effects There are checks on this, and I'm not sure if you are thinking of a particular case, but I can't really see how this would happen. In order to get approval, a new drug almost always has to demonstrate that it is at least "non-inferior" to the standard of care. Additionally, there is a lot of pressure in the United States from payers. Insurance companies just won't pay for a drug that is in no way better than the previous standard of care with more detrimental side effects. There are definitely cases where the FDA made a mistake for one reason or another (allowed an entity to move through the wrong approval mechanism, were duped by fraudulent AE reports and didn't catch it, failed to require the appropriate screens for AEs, etc), but the system has some checks on drug companies.
    - GeekyBear 9y ago
      >I'm not sure if you are thinking of a particular case, but I can't really see how this would happen. Does Purdue Pharma's decision to push opioids as a safe treatment for everyday pain ring a bell? https://www.newyorker.com/magazine/2017/10/30/the-family-that-built-an-empire-of-pain https://www.newyorker.com/magazine/2017/10/30/the-family-tha... Oxycontin was certainly profitable, but it was not good for patients with chronic pain. This is a case where a Pharma company deliberately misled doctors, patients and regulators because doing so was exceptionally profitable. >The company that makes the narcotic painkiller OxyContin and three current and former executives pleaded guilty today in federal court here to criminal charges that they misled regulators, doctors and patients about the drug’s risk of addiction and its potential to be abused. http://www.nytimes.com/2007/05/10/business/11drug-web.html http://www.nytimes.com/2007/05/10/business/11drug-web.html
- mft_ 9y ago
  To support the commenter you're replying to, I have seen --first hand-- examples of patients receiving better treatment with very cost-effective drugs (which sailed through NICE) due to the efforts of staff from pharmaceutical companies. Don't assume that all doctors are committed to making the latest advances (or even older advances) available to patients. They are human, just like all of us, and you'll find stubborn doctors on the conservative (or laggard) end of the spectrum just as much as within any other group or career.

pmyteh 9y ago

In Britain, we rely more on guidance from the National Institute for Health and Care Excellence (NICE). It does comparative reviews to make recommendations on the most suitable drugs to use. Motivation is primarily to restrict crazy-expensive drugs to those situations where they're actually going to represent value for (the public's) money, but also to point clinicians towards new approaches which can improve the quality of treatment. So hugely expensive advertising towards physicians is not the only way to do it.

jonlucc 9y ago
That sounds like a fantastic resource that I can not imagine passing in the United States any time soon. Is it funded along with the rest of the NHS?
- pmyteh 9y ago
  Yes. In fact, its major remit is to improve value for money by targeting NHS treatments better. All of its meta-analyses and treatment guidance are available at http://www.nice.org.uk http://www.nice.org.uk, if you want to explore.
  - jonlucc 9y ago
    This is really great; thank you for pointing me to it.
GeekyBear 9y ago
In the United States, policy debates about implementing this sort of body led to them being referred to as a "death panel". There is no logical reason why we shouldn't prefer an older generic medication if it treats the symptoms of a condition just as effectively and with fewer side effects than a newer option that is no more effective and has more side effects, but doing what is best for patients has to compete against the profit motive of our pharmaceutical companies.
- jonlucc 9y ago
  > There is no logical reason why we shouldn't prefer an older generic medication if it treats the symptoms of a condition just as effectively and with fewer side effects than a newer option that is no more effective and has more side effects There are checks on this, and I'm not sure if you are thinking of a particular case, but I can't really see how this would happen. In order to get approval, a new drug almost always has to demonstrate that it is at least "non-inferior" to the standard of care. Additionally, there is a lot of pressure in the United States from payers. Insurance companies just won't pay for a drug that is in no way better than the previous standard of care with more detrimental side effects. There are definitely cases where the FDA made a mistake for one reason or another (allowed an entity to move through the wrong approval mechanism, were duped by fraudulent AE reports and didn't catch it, failed to require the appropriate screens for AEs, etc), but the system has some checks on drug companies.
  - GeekyBear 9y ago
    >I'm not sure if you are thinking of a particular case, but I can't really see how this would happen. Does Purdue Pharma's decision to push opioids as a safe treatment for everyday pain ring a bell? https://www.newyorker.com/magazine/2017/10/30/the-family-that-built-an-empire-of-pain https://www.newyorker.com/magazine/2017/10/30/the-family-tha... Oxycontin was certainly profitable, but it was not good for patients with chronic pain. This is a case where a Pharma company deliberately misled doctors, patients and regulators because doing so was exceptionally profitable. >The company that makes the narcotic painkiller OxyContin and three current and former executives pleaded guilty today in federal court here to criminal charges that they misled regulators, doctors and patients about the drug’s risk of addiction and its potential to be abused. http://www.nytimes.com/2007/05/10/business/11drug-web.html http://www.nytimes.com/2007/05/10/business/11drug-web.html
mft_ 9y ago
To support the commenter you're replying to, I have seen --first hand-- examples of patients receiving better treatment with very cost-effective drugs (which sailed through NICE) due to the efforts of staff from pharmaceutical companies. Don't assume that all doctors are committed to making the latest advances (or even older advances) available to patients. They are human, just like all of us, and you'll find stubborn doctors on the conservative (or laggard) end of the spectrum just as much as within any other group or career.