A ‘Public Option’ Means Independent Scrutiny of Medical Research

July 6th, 2010

A recent editorial in the New York Times tallied up statistics from more than 225,000 elderly diabetics taking Avandia or anther drug called Actos. These statistics were available to the public, courtesy of Medicare insurance being available to these patients. It appears to confirm the findings of another study that Avandia patients have a significantly increased incidence of cardiac events and strokes. Apparently, the makers of the drug under scrutiny are going to conduct further trials – which won’t be completed for another five years.

Meanwhile, Glaxo-Smith-Klein, maintains their earlier studies were conclusive in ruling out such adverse impacts for their product. However, if this item in the Triangle Business Journal is correct, legal settlements have already been made in more than 700 cases concerning this drug.

Wouldn’t it be cheaper to go to court and prove the drug did not have these adverse effects if the evidence were compelling? Or, are the costs of legal settlements merely part of the cost of doing business today? After all, given the enormous amount of dollars flowing into the coffers of some multi/trans-national corporations, settlements may be easily absorbed compared with the costs of further research and possible removal or modification of a product already in the marketplace.

This brings up important questions about plaintiffs’ attorneys. How moral it is to press for settlement after settlement in repetitive claims of harm for a product, rather than conduct a court-room trial on the matter? Trials set precedents and serve to limit future harm to those likely to repeat the experience of prior litigants and become the next generation of plaintiffs. Is litigation taken to the floor of a courtroom instead of a ‘back-room”, actually the most moral course of action?

Regardless, this may be indicative of how to best resolve discrepancies between a marketing firm’s data and the actual experiences of patients using a given product. The pool of available data about the incidence and nature of illnesses and injuries increases exponentially, when patients are enrolled in a public option for health care insurance. The potential savings alone from analysis of this data ought to pay for much of the costs for such coverage. This would certainly assist the FDA greatly in making tough decisions about approving drugs for sale, when to withdraw them or require further testing. As the public option would also be funding drug purchases, a great deal of attention would be paid to drug efficacy and the potential for adverse effects.

Here is the letter which went to the Times:

Re: NY Times editorial, “More Questions about Avandia” (7/5/10)

To the Editor,

Your editorial illustrates extremely important economic benefits to having a ‘public option’ in the provision of universal health care. Data regarding possible adverse outcomes from use of the drug Avandia, was only accessible because the 227,000 patients studied had Medicare coverage. Insured patients have records permitting impartial review of large numbers of cases.

Tallying the enormous price tag accompanying tobacco-related illnesses (CDC estimates $193 billion dollars annually in productivity losses, mortality and morbidity) led to ground-breaking legislation restricting smoking in workplaces. Diminishing rates of cardio-vascular disease have already reduced costs and much human suffering.

Universal health insurance in Europe brought about REACH, the requirement that vendors prove the safety of chemicals in products before marketing. The value of the ‘public option’ in matters of public health research and policy is clear.

Barbara Rubin

Postscript:

http://www.nytimes.com/2010/07/13/health/policy/13avandia.html?nl=health&emc=healthupdateema2

More history about the research and development of Avandia.

Categories: Letters, NY Times

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