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By Bob Bohrer
Originally Posted on Health Affairs by Robert Bohrer
On February 20, 2015 http://healthaffairs.org/blog/2015/02/20/the-need-for-publicly-funded-trials-to-get-unbiased-comparative-effectiveness-data/
Comparative effectiveness
research was one of the hotly
debated components [1] of
the Affordable Care Act. The pharmaceutical industry is marketing driven, with
pharmaceutical companies spending more on marketing
[2] than they do on research and development. The
need for a marketing edge can also drive drug development.
As illustrated by the
discussion below of Gazyva and Nexium, drugs can be developed at higher doses
than the drugs they are intended to replace. When the newer, higher-dose drugs
are tested against the older, lower-dose drugs, the trials are intended to show
that the newer, higher dose drugs are superior to the older drugs that will
soon be available as a biosimilar or generic.
It can be very difficult
to tell whether the results of such trials reflect the differences between the
active ingredients or simply the difference in doses, but such trials are almost
certain to lead to increased use of the newer, higher-priced drugs. Because the
money at stake creates such an incentive for companies to stack the deck,
publicly funded trials are the only way to make sure that evidence-based
medicine is based on the best possible evidence. PDF of this post
