Drug Companies Funding Clinical Trials Should Be Illegal

With each passing year, there are fewer and fewer truly independent, truly publicly-financed drug trials.

Possibly the worst thing about science naysayers and deniers is that they’re slightly correct — just not precisely in the way they think. Many people across the globe are skeptical about science because it is a human institution just like any other, and therefore as susceptible to bribery and other pressures as any other.

But the dots these “skeptics” usually fail to connect is that the conflicts of interest within the scientific community are entirely, or at least mostly, preventable. There’s no clearer example than the role corporate money plays in clinical trials for new pharmaceuticals.

Big Pharma Is Not Your Friend

First, some background. As you’re likely aware, the Food and Drug Administration is responsible for approving prescription drugs before they reach the market. The approval process usually takes the form of a battery of clinical trials with the goal of verifying the drugs do what they claim and that they don’t cause extreme or unexpected side-effects.

So the next question is: who provides the funding and the resources for these trials to take place? The answer, more and more with each passing year, is “big pharmaceutical companies.” Over the last several decades, two things have happened simultaneously:

· Taxes on successful corporations and very wealthy individuals has steadily fallen and placed more and more of the tax burden on poor and middle-income families.

· Simultaneously, as a result of this artificial “austerity,” the government reduces spending on so-called trivial matters, such as scientific research and, you guessed it, clinical trials.

Today, private enterprise spends six times as much on clinical trials than the federal government does. That’s not okay. In fact, it should be illegal.

Why Does This Matter?

You can shut your eyes every time you drive past a post office or pretend you’ll never have to draw from Social Security when you live out your golden years. But the fact remains: government exists, fundamentally, so that the people of a country can protect themselves from destructive, predatory or just uncivilized actors who would wish to do us harm.

Watchdogs keeping an eye on Big Pharma are on full alert about American people’s “market share” of clinical trials — and they don’t mince words about the possible fallout. It’s not difficult to imagine how this type of regulatory capture — where the entities meant to do the protecting are protecting themselves instead — will result in big pharma companies downplaying or failing to disclose the more egregious side-effects of their newest drugs. Down the line, this results in doctors prescribing (likely very expensive) drugs that might not perform as expected or might have debilitating or deadly side-effects.

It's not a logical stretch, right? When people are left to police themselves, they very frequently disappoint us. Government interest in science isn’t government “control” or “overreach” — it’s public oversight. But how much attention are you paying, really? Are we spending any time screening our political candidates based on the money they’ve pocketed from Big Pharma? Have we thought at all about Big Pharma’s motivations here?

Everybody knows healthcare and pharmaceuticals are uniquely expensive in America. The cost of bringing a new drug to market is usually between $160 million and $2 billion. With their very financial solvency wrapped up in these projects, it’s clear to see they won’t abide any “dead ends,” so to speak, in their research, that would result in lost revenues and wasted effort.

So? They’ve bought the whole process from us, The People, lock stock and barrel. And by becoming their own financiers and their own watchdogs, they’re not just subverting the clinical trial process — they’re undermining the public’s very trust in science as an institution.

Public vs. Private Funding of the Future

We have a choice before us. Unfortunately, taxes are a big part of that choice.

So long as democracy holds, we can choose how to spend our tax dollars. We can choose to restore corporate tax rates to their previous values, when opportunity was more widely enjoyed by all, and then redouble our efforts to bolster funding for the sciences, or we can continue on our present trajectory, which will see private and unaccountable interests steal more and more of our future from us.

In a span of just one year, The New England Journal of Medicine published 73 articles detailing the alleged effectiveness of experimental new drugs. It was later discovered that 60 of those articles were funded directly by a big pharma company and 37 of the lead authors had received direct compensation from a drug company, typically in the form of a grant or a speaking fee.

There are two important takeaways from this story:

· The clinical trial process itself is a vitally important one. And when done properly, by scientists who don’t have conflicts of interest and who aren’t under pressure to “sign off on” a questionable product, they deliver untold good for suffering human beings.

· The government — that is to say, voters — has a responsibility to insulate the institution of science from those who would hijack it for their own purposes or accidentally or deliberately undermine our trust in science as an objective process.

By the end of 2014, 6,550 trials had received funding from private enterprise. Only 1,048 were paid for by the National Institutes of Health.

But our hands aren’t tied here, people. Check in with the politicians who claim to represent you. It’s not easy to find out who’s in Big Pharma’s pocket and who isn’t. Between 2017 and 2018, Orrin Hatch, Greg Walden, Paul Ryan, Bob Casey and Kevin McCarthy led the pack in terms of campaign donations received from private pharmaceutical companies.

It’s not a partisan issue, precisely. “Only” four of these five men is a Republican.

For the time being, though, there’s no easy fix here. Progressive senators like Bernie Sanders have set their sights on predatory pharmaceutical company CEOs. But as we’ve seen, this issue is wrapped up tight with tax policy and a host of other issues that need fixing too, including campaign finance reform. With each passing year, there are fewer and fewer truly independent, truly publicly-financed drug trials. But it could be very different if we hired honest public officials instead of “letting the market decide” for us — and followed through with holding wealthy people accountable for the damage they’re doing.

For now, the best thing we can do is make sure we’re not actively putting people in government who have clear-as-daylight conflicts of interest. Like Orrin Hatch, or Paul Ryan, or Scott Pruitt, or Ajit Pai or Papa Trump himself. In other words, let’s stop letting the foxes into our henhouses.

Comments
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Gabbyhobbs
Gabbyhobbs

The gov't spends as much money on drugs much like the pharmaceuticals https://www.brookings.edu/blog/up-front/2017/04/26/the-hutchins-center-explains-prescription-drug-spending/ what needs to be done now is yes to hire more independent legislators who will see to it that we get reforms through laws that will change restrictions on negotiating powers of the gov't to lower prescription drug prices

ThreePatriots
ThreePatriots

Editor

While I agree that self-funding of studies by pharma companies can cause an inherent bias in the study design, performance and reporting, there's not much of an option otherwise. @felixculpa is correct in his assertions and more money by the government is a non-starter from the beginning. According to EvaluatePharma, in 2011, there were approximately 5,400 active compound trials in the U.S. Let's then eliminate almost 90% of those compounds that will never make it to market (see more at: https://www.themaven.net/politicalstorm/independent/let-s-talk-prescription-drug-prices-LmZE6mECa0uaFupnLXkkww/?full=1) Only 10-12% of those that start drug trials will succeed in bring in revenue, the rest go back to the drawing board, or are scrapped altogether. Then, let's take the absolute bottom dollar that a clinical trial costs in the U.S. $500 million dollars and apply that to the 12% of the 5,400 trials... $500 million X .12 X 5400 = 324000000000 or 324 Billion dollars. That is more than the Medicaid program costs the U.S.

And the $324 billion (very conservative estimate - could be upwards of $1.3 trillion with using more liberal figures) is only for the 12% of drugs that make it to the market. Someone still has to pay for the ones that flop in Phase 1 or 2.

So, while pulling big pharma out of the trials to try to eliminate bias in the trials sounds great, when you boil it down to numbers, it's not so practical anymore. And trust me, if big pharma could create a drug, ship it to the NIH and say, study it for us, then reap the profit when it comes to market without any other expense; I can guarantee you that they would jump at the idea.

FelixCulpa
FelixCulpa

You're correct that the self policing of drug companies is, and should be, highly suspect. Unfortunately it'll be hard to get to house and senate to agree to spending yet MORE money. Also, if the NIH takes over a larger portion of the trials, what's to stop drug companies from abusing that and taking on a flyer on a molecule that only has a very slim chance of performing? If it's at government expense why not take the shot and if it fails no big deal since there's no financial loss. I'd say an independent oversight committee would probably be best; but of course who pays for it, and how to maintain it's independence? I agree, it's definitely a mess. Pay for play "scientific" journals also really grind my gears and should require labels that list them as advertising.

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