This is a heavy topic for the first blog post of 2013, but I sense this issue may be nearing critical mass. Please look at the BBC article about Pharma’s lack of disclosure. Patients and clinicians are making decisions today with not just incomplete data.
The Cochrance Collaborative has long called for all findings in clinical trials to be made available. When only positive results are published the bias is obvious. How else can we know the full context of drugs that are on the market?
But we do not know because full disclosure is not common practice from the pharmaceutical industry. Daily patients and clinicians make decisions on inadequate information. This is no different than the saga of the mortgage and banking business during the “go-go” days of real estate. Everyone praised the value of ownership, politicians supported it, and the industry played a divide and conquer shell game because the focus was exclusively on profit.
The same misguided practices are happening in healthcare with drugs. If you doubt please look at this website www.exlpharma.com/adherence. In the conference description the obvious is stated. “Adherence is a very critical part of improving patient’s health but it is also important driver for the overall economic benefit of the pharmaceutical industry.”
Clearly, medications can benefit people in myriad ways. Just as home ownership is beneficial to the people who can tolerate all that entails so will some patients find great benefit in some drugs.
But who benefits if expectations are set for drug “adherence and advocacy” that is driven by a financial model? As a long time clinician I believe, in fact am passionate about the value of engaging patients in shared decision-making which means risks and benefits are discussed in terms that are relevant to that person.
Will patients be given the freedom to choose medications, or not, based on full disclosure of risk and benefit?