Monday, April 25, 2016

Ugh--those TV pharmaceutical ads AGAIN

Richard A. Friedman, professor of clinical psychiatry and director of the psychopharmacology clinic at the Weill Cornell Medical College, had a blog post in the Sunday NYT about all those dopey pharmco ads on TV.

They are so easy to mock, it's almost not sporting. One of my favorite comedians Jay Mohr, in his concert Happy and a Lot, remarked that daytime TV is  pretty much all side effects. And not just daytime...

Friedman singles out a new concoction called Latuda, for bipolar depression. It's supposedly effective for many people with this problem. Note the "many"--not all, for sure.

And of course, you get no side-by-side with Prozac/Zyprexa, Seroquel, and others. Clinical trials are..well, where are they? How many people have serious side effects? Can't say because side effects can take years to emerge and Latuda is new.

So basically, we are not told how many cheaper older drugs work just as well. In fact, Latuda is one of 10 "second generation" antipsychotic durgs that work the same way.

Friedman recommends a simple graphic to follow each of these ads...showing cost and effectivness compared with similar drugs.

How many total clinical trials were there? How many were positive, how many negative? How many times did it beat the placebo?

Positive trials are reported more than negative ones--duh.

He would also like to see a new measurement--number needed to treat. NNT means the number of patients who need to take the drug before one benefits measurably. The lower the NNT--the more effective the dug.

But, as I said and as Friedman said, beating the placebo is not enough--it needs to beat existing drugs.

But now we come down to it--most "new" drugs are not new at all but tweaks of old drugs.

Supposedly the Affordable Care Act created a nonprofit called the Patient-Centered Outcomes Research Institute to check comparative effectiveness, but don't start holding your breath now.

In fact, that could kill you. No--wait--"death could happen," as the ads say.

No comments: