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« Tap Tap Five Minutes | Main | More on Marketing Over Medicine »

January 21, 2008 |Permalink |Comments (1)

Marketing Over Science

Out here in the real world, researchers understand that so-called negative results can be just as helpful as positive results.

For example, a positive result can look like this:

Drug X is more effective than a sugar pill when it comes to treating the symptoms of major depression.

A negative result, in contrast, might read like this:

Drug Y is no more effective than a sugar pill when it comes to treating the symptoms of depression.

For a scientist, both results are important and useful.

Because marketing and science are two very different things, companies which are interested in maximizing sales are likely to emphasize positive results while attempting to bury negative results.

It turns out that is exactly what is happening.

The makers of antidepressants like Prozac and Paxil never published the results of about a third of the drug trials that they conducted to win government approval, misleading doctors and consumers about the drugs’ true effectiveness, a new analysis has found.

In published trials, about 60 percent of people taking the drugs report significant relief from depression, compared with roughly 40 percent of those on placebo pills. But when the less positive, unpublished trials are included, the advantage shrinks: the drugs outperform placebos, but by a modest margin, concludes the new report, which appears Thursday in The New England Journal of Medicine.

Previous research had found a similar bias toward reporting positive results for a variety of medications; and many researchers have questioned the reported effectiveness of antidepressants. But the new analysis, reviewing data from 74 trials involving 12 drugs, is the most thorough to date. And it documents a large difference: while 94 percent of the positive studies found their way into print, just 14 percent of those with disappointing or uncertain results did.


Some people believe that the market and market mechanisms are the key to solving our shared health care crisis.

I disagree.


A market system has powerful built in incentives which value sales over science. If we have learned one thing over the past century it is that the careful, skillful and unbiased application of science to the problem of human disease and suffering is powerfully effective.

This powerful historic insight is undermined whenever and wherever marketing is given dominion over the unbiased application of clinical research.

Comments ( 1)

This is one of the major flaws in studies of antipsychotic drugs for behavioral symptoms of dementia. Most of the (drug company-funded) studies which claim their medicine is "safe and effective" are putting major spin on the data. A JAGS editorial in 2006 stated that when these studies are examined as a whole, the overall benefit comes out to about 18% over placebo. And that's if you overlook many other flaws in the studies and their conclusions!
I ask my doctor audiences, "How many of you would prescribe an antibiotic or a heart drug that had a less than 1-in-5 chance of working? No one, of course.
Why do we use them? Because there's no better pill we can prescribe. The basic flaw, however, is that we are looking for a pill!

Al Power

Posted by Al Power [TypeKey Profile Page]
January 23, 2008 9:22 AM

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