Drug Company Secret Shocks Patients

If you watch television you can’t miss the commercials for prescription drugs like Lipitor, Zoloft, Viagra and Vioxx. Judging from the smiles on the actors’ faces, you would assume that everyone is benefiting from the medicines they are taking.
But a surprisingly candid remark from one of the pharmaceutical industry’s senior executives suggests that many expensive medicines don’t work all that well.
Dr. Allen Roses, VP of genetics at GlaxoSmithKline, revealed a secret that drug companies would just as soon keep under wraps. “The vast majority of drugs-more than 90 percent-only work in 30 or 50 percent of the people.”
All medicines must be shown to be effective before the FDA grants approval, but the definition of effective is amazingly ambiguous. Imagine a brand of toasters in which only half actually browned bread and 25 percent burned it. People who got the non-working appliances would be outraged and demand their money back.
But in the realm of prescription drugs, 50 percent is a pretty good track record. Side effects (equivalent to burnt toast) can exceed 25 percent without causing the FDA any hesitation.
According to Dr. Roses, only about half of those taking migraine medications and about a quarter of those on cancer-fighting agents get the expected results. Alzheimer’s medicines, which just delay the progress of the disease, work in about a third of patients.
Highly-prescribed antidepressants like Prozac, Paxil and Zoloft are effective in about two-thirds of patients. When you compare such drugs to inactive sugar pills, though, the benefits are surprisingly slim. That’s because placebos consistently produce improvement in 30 to 50 percent of depressed patients.
That means the actual drugs are only a little bit better than the dummy pills.
In any other business, people would demand better results, especially when they have to pay so much. Nail fungus products are notoriously expensive. In this column, a pharmacist pointed out that the overall success rate of treatment with the anti-fungal drug Sporanox for the recommended 12 weeks would cost the uninsured patient more than $1,500. And the likelihood of cure, despite such a significant investment and the risk of side effects, hovers around 35 percent.
Despite the fact that drugs often don’t work, Dr. Roses surely doesn’t intend for us to give up on medicines. His expertise is pharmacogenetics. This emerging specialty helps determine which patients are most likely to benefit from a particular medicine and which might suffer side effects.
Using this gene technology could improve the odds of a successful outcome for individual patients. But it would mean that medicines should be marketed only to those most likely to respond. Drug companies currently sell their products to as many people as possible, whether they benefit or not.
Until doctors and drug companies come up with a better way to target treatment, patients will have to demand information on effectiveness. If they don’t get the desired results, they should complain. Just as consumers don’t tolerate defective toasters or CD players, they shouldn’t accept medicines that don’t work for them.