I think this is the key point in this debate. If a drug has negatively affected your family your view of this is massively different from one who produces the drug and relies on it’s sales to support your family. If you’ve lost a family member only to find out a year later that the risk was known and not revealed….yup, you’re VERY angry.

So it comes down to trusting the drug information. The only way to achieve that trust is full disclosure. Risk/benefit is different for everyone based on their own situation. The only way to measure this in each persons situation is to have all of the information made available.

I know many people who would love to have Vioxx back on the market and are willing to take the cardiac risk that goes along with it. But others would opt to take something different, not willing to take that risk. The key is…they know the risks. That’s where the risk/benefit decisions become not as clear.

I don’t want to have information withheld for the greater good. I want all the information to make the decision that is best for the individual taking the pill.

Nathan…my comments on the recent suicide stats. When they publish how many of those suicides were on an ssri, or psychotropic drug and what the true prescribing numbers were for 2005 I’ll look at it seriously. These stat’s have been spun for the last 4 years and we still don’t have solid, non biased data.

I generally agree with what you say on this site. Industry has to be held accountable when it lies and covers up the truth (as it surely has on many occasions). However, the risk-benefit calculation that I’m talking about is really a discussion that has to take place outside of pharma. Doctors, patients, and insurance companies have to decide if the risk/benefit profile for a particular drug is worth the cost being charged. It’s our goal in industry to design drugs that DO meet those criteria. But those criteria will change over time. I think a time is coming very soon when custom made stem cells will be able to cure a number of currently incurable diseases. The problem will be that the treatments will be very individualized. They will likely cost millions of $$ PER PATIENT. Is it worth the cost? Does insurance cover it? Are only the “elite” of society going to be able to receive such treatments? Is world class medical treatment a right or a privilege?
We don’t like to think about those questions — but we will have to address them sooner or later.

We as consumers don’t know the details formulating these decisions but we must live or die with the results. I, fortunately or unfortunately have heard and seen enough about the pharma industry to form an opinion about whether pharma does enough to insure our safety. Above and beyond statistics, saddly I have to say in my humble opinion today’s pharma management in partnership with the FDA is failing America.

I have always believed that a child’s life is priceless,and common sense is free.

Yes I did see the teen suicide report, and its a carbon copy of other studies that have been touted over the last 2 years, and like the others, it is severely flawed and isnt worth the paper its written on.

At some point, you must come to the conclusion that the reduced risk isn’t worth the cost. It’s a variation on the law of diminishing returns. There are safety devices that give a good return for the money. Car seats are one great example that you bring up. Other safety devices are not worth the cost. The nanny with an M.D. is a good example of that category.

By the way, a video monitoring system linked directly to the police station might reduce the risk of kidnapping by 90%. (relative risk) But it would only decrease the chance of death of my child by an infinitesimally small amount. (absolute risk)

By the way, did you see the report on teen suicide this afternoon? What do you make of it? Link below.
http://www.cnn.com/2008/HEALTH/09/02/teen.suicides.ap/index.html

Re: the relative risk issue, I agree with you. I was just having some fun in my response - as we sometimes do. You obviously understood that.

Beyond that, I have no good answer to the relative/absolute risk issue on a policy level. I’m sure there are folks with actuarial tables who try to sort this through - beyond my scope, even to think about well.

So, yeah, it was more about pts knowing what it means when they hear drug x increases MI risk by 30% or drug y reduces MI risk my 30%. As you know, most folks assume that means a lot more than it usually does - in either risk or benefit direction.

What are your thoughts on Infant Car Seats? How much is your child’s life worth?… Priceless?

I agree we need to be open about relative-risk vrs absolute risk. But it also has to be put into perspective with other risks which we weight every day without thinking about it.”

Just a few notes on what you said there Nathan..

First of all, I think you are quite mistaken when you describe the debate about the benefit and risk ratio of medications as “ideological”.
You seem to perceive those whom speak out against the (often suppressed) dangers of medications as your enemy, as if we are on two side of an ideological divide. A kind of “us against them” mentality. This doesn’t help anybody, we should all have access to safe medications, and we should all be told the truth about pharmaceutical drugs, full disclosure and complete transparency is what is needed here. There is no anti-pharmaceutical industry agenda, most who post here do so independently and they do it because they try to bring awareness. If pharma was honest from the outset , then there would be no need for patient blogs, petitions, public outrage, disdain or even sites like pharmalot.

You talk about risk and benefit, absolute risk and relative risk. When you come to a situation, as we have now, where people do not trust the industry or the medicines they are prescribed because of dishonesty and a culture of denial about side effects emanating from the industry itself, that is not the fault of the consumer. It is the fault of Pharmaceutical companies and it all boils down to greed. The pharmaceutical medical model has lost its way, and a hell of a lot of people have been damaged because of this.

People need to know that they can have faith in medicine , that is in everyones interest, whether you are a pharma employee or not. We all need to be able to trust that the drugs we are prescribed are safe, and when there are risks discovered, we need to know what they are. Unfortunately this is far from the case. Rather than create an “us against them” mentality, why not embrace the change and inspire a better model of pharmaceutical practice? One where ethics and consumer concerns are trusted, regarded and respected. One where human life is worth more than profit. Surely this would be a better way for everyone?

Thankfully with the advent of the internet and particularly Web 2.0, this change can be a reality and could be attainable. The industry needs to recognize this, and the industry needs to realize that it is imperative that we can trust in it. Pharma needs to change its ways, is a quick profit on a drug more important than the long term health of humanity? Is marketing the diseases more important then searching for real cures and innovation? I hope someday you can see that the ones who have spoken out about Pharma’s misdeeds on this site and others have had no immediate reward except perhaps the knowledge that they have spoken out because they had to do so for their own conscience. Maybe that’s another concept Pharma could incorporate into its new business model? …

Conscience..

Second, I cracked up reading you post. However, it begs the question: Just how much is that one extra life worth? It’s a serious question that the FDA, doctors, and (to some degree) the public must decide. Is it worth it to treat thousands of people in order to save a few of them?

Let’s look at a different (but similar) question: Is it worth it to force car manufacturers to provide airbags to all cars in order to save a few dozen lives per year? (it probably adds a few hundred dollars to every car purchase) What about flame-retardent matresses? How muh money do we spend? How many lives are really saved? What about the flotation devices on airplanes? When is the last time one of those “required” devices saved a life?

I agree we need to be open about relative-risk vrs absolute risk. But it also has to be put into perspective with other risks which we weight every day without thinking about it.