A bleak picture of medicine
Most of conventional medicine doesn’t work. Around 12 per cent of the drugs and treatments prescribed may help, while 57 per cent of what is dispensed will either have no effect whatsoever, or do you harm.
This picture of medicine has been created by a research team working with the British Medical Journal (BMJ).
The team has looked at the evidence for around 2,500 drugs and treatments used in hospitals, surgeries and health clinics.
The true picture could be even bleaker than the one presented by the research team as it is regularly updated in the Clinical Evidence Handbook (2012 BMJ Publishing Group). In order for a drug to be included in the 12 per cent, it does not mean that the drug is effective in everyone who takes it.
The team just has to find one study where that particular drug demonstrated a benefit that was greater than any harm recorded by the participants. In addition, the researchers also have to rely on studies that have been written, or carried out, without any medical spin or even fraud. In some cases, research and studies are paid for by the drug companies themselves and could therefore be biased and show an overly beneficial result.
Therefore, if the level of fraud or spin is as high as the researchers believe, these statistics could be even more shocking.
A book, published in 2012 (Fourth Estate) and written by Ben Goldacre, has opened a can of worms regarding medicine. His phrase ‘medicine is broken’ basically summarises the problem. Goldacre was a ‘quack busting’ researcher for The Guardian newspaper for a long time.
He wrote a column under the name of Bad Science. However, he changed his focus to compile the 448-page tome entitled Bad Pharma, his strap line being “how drug companies mislead doctors and harm patients”.
Goldacre believes missing data is the key to the whole story. He quite rightly explains that missing data “poisons the well for everybody”.
He explains that if negative results are withheld, then the true effects of a treatment cannot possibly be known. Doctors, in particular, can only work with the information they are given when prescribing drugs.
So what is going wrong? Essentially, the pharmaceutical industry’s model of the mass production of one-size-fits-all remedy may be delivering large profits, but it is not coming up with effective solutions for patients.
Drug companies are beginning to realise that people will start drifting away from a drug-based solution if the products don’t work. We are already seeing this trend among those who can afford to do so; they are prepared to pay for alternative and nutritional-based remedies to attain a safe and successful result.
The response from the drug companies is likely to be a switch to producing more customised drugs to fit the individual. One large drug company’s vice-president of genetics (Allen Roses) suggested this route during a private meeting and admitted that 90 per cent of his company’s (or any other company’s) drugs don’t work on the majority of patients.
There are many examples of a drug which has been championed for a particular condition and then found to cause a more serious disease. In one case, a particular drug company employed a PR company as a damage limitation exercise. Somewhere in this mess the patient is forgotten.
It isn’t about profits or share prices; it is about the health of one single person who could have suffered fatal side effects because one company couldn’t accept the financial loss on a drug that has not lived up to its promised status.
In his book, Goldacre deals with subjects such as missing data, where new drugs come from, bad regulators, bad trials, marketing and in the afterword he sets about listing ‘things you can do’. He addresses this section to everyone as well as individuals such as lawyers, doctors, patients, medical schools, professional bodies, ghostwriters, pharmaceutical companies and even nerds and academics.
His aim, clearly, is to address those who have read the book, and subsequently feel aggrieved, or who have even suffered from taking a drug in the past. He suggests how, if we all work together, we can change this mammoth situation to the better of all. The conclusion of all this, says science magazine New Scientist is that medical science is “built on shaky foundations” (New Scientist, September 2012).
Those foundations rest on the assumption that it is possible to mass-produce solutions to health problems. You can’t. As drug companies are beginning to realise (as alternative therapists have known all along), the patient, the disease and the remedy form a unique combination that often doesn’t fit standard issue medicine.
A more customised approach is required for each patient, even if it does take longer.