Big Pharma vs. Comparative Effectiveness

An NPR story this morning dealing with how doctors make prescription decisions for their patients highlighted a serious void in our health care system.  What drugs doctors prescribe, for which problems is huge business!

Management of all manner of chronic ailments and debilities  uses prescription drugs.   Yet no comparative effectiveness studies are available for most of the most commonly prescribed ailments, like high blood pressure, cholesterol, heart disease and most other chronic conditions. 

This lack of easily accessible information on the comparative effectiveness of one drug vs. another is a real void that the pharmaceutical industry is more than happy nobody has filled. 

My practice is right next door to a pair of gerontologists and a half a dozen nurse practitioners.  There is hardly a day goes by but what there is a steady stream of drug company representatives bringing in breakfast,  lunch, or snacks so they might have the opportunity to "detail" the staff on the latest patent, prescriptive medication. 

How can prescribers not be swayed by such a constant stream of free samples, goodies and "best practice tips"  for how to prescribe their product for whatever is ailing their  patients.

Without broad based comparative effectiveness studies, doctors and patients are left in the dark about alternatives to what the patent medicine salesmen are peddling.  Neither has easy access to accurate information about some of the most important decisions being made, those about their health care.

If, we are ever to have a health care system that even begins to reign in costs, it simply has to include such studies.  By having them we certainly won't know what works best for everyone, but we will have a much better idea of what works best for most of us. 

And that is a far cry from the abundant ignorance faced each day by doctors and patients alike under the present system where only safety and effectiveness are studied, documented and published, not a drugs relative effectiveness, compared with other drugs of it's class, or even, with dietary changes, vitamin supplements, or simple exercise. 

That we do not already have a broad base of such information, easily accessible to the general public is a pox on the FDA and medical community in general and serves no one but the huge pharmaceutical companies.