Joel Hirschhorn

Delusional Confidence in Drug Effectiveness



Posted: Tuesday, December 30, 2008

by
http://www.delusionaldemocracy.com

Talk about mass delusion! Now I find out that medical experts say that most drugs, regardless of what disease or condition they are designed to help, actually work for only about half of the people who take them. Did you get that? We are deluding ourselves that the various, highly researched and regulated, and damn expensive prescription drugs that doctors tell us we should take only have a 50 percent chance of actually working for us. I find that totally amazing.

One really big implication is that much of the national spending of about $300 billion annually on drugs is wasted. Worse, my own spending on drugs is largely wasted. Wait, still worse, millions of us gullible people have suffered all kinds of nasty side effects from drugs unnecessarily. Is this even comprehensible? Does all this make any sense relative to anything we have been told before?

This whole situation is a condemnation of the one-size-fits-all approach that apparently all drug research, development and approval has been based on. Now we are being told that we need to pursue the alternative of "personalized medicine." This means finding out which drug works best for which patient. If I am understanding these new medical revelations correctly, and I think I am, then this could mean, for example, that perhaps one of the many statin drugs for cholesterol treatment might be best for me, but not necessarily the one I have been taking for many years. Ditto for heart medications I take. Ditto for blood pressure medications I take. And so on.

Now we are being informed that our individual genetic makeup explains why drugs may not work for us, even though enormous sums of money have been spent to have them proven safe and effective so they could be available to the public.

Did any physician ever tell you that a drug he or she was prescribing might not actually work for you because of your genetic makeup? No doctor ever even hinted at that for me.

All this is coming to a head because of findings that incredibly expensive cancer drugs have not been working for many patients because of variations in genetic composition. When many thousands of dollars are spent every month for a needed life-saving drug this revelation sure makes sense.

Now for the really bad news about the need to shift to personalized medicine: "It's going to take 20 to 30 years for all this to fall into place," said Dr. Gregory Downing, who heads efforts by the Department of Health and Human Services to spur personalized health care.

One huge problem seems to be that genetic testing has not reached a high enough level of accuracy, reliability and reproducibility. Another is that pharmaceutical companies may not be very enthusiastic about the new genetics-based approach; it certainly adds cost and complexity to drug research, development, testing and commercialization.

Here is the link to the New York Times article Patient's DNA May Be Signal to Tailor Medication that informed me about all this disturbing information: http://www.nytimes.com/2008/12/30/business/30gene.html?_r=1 & th= & adxnnl=1 & emc=th & adxnnlx=1230668543-R0lCQLCN31qdEsWw/sFakQ

Joel S. Hirschhorn has succeeded as: a full professor, University of Wisconsin, Madison; a senior staffer, U.S. Congress (Office of Technology Assessment); head of an environmental consulting company; Director of Environment, Energy and Natural Resources, National Governors Association; now an author and consultant. Recent books are: Sprawl Kills - How Blandburbs Steal Your Time, Health and Money, and Delusional Democracy - Fixing the Republic Without Overthrowing the Government. He has published hundreds of articles in newspapers, magazines, journals and on many web magazine sites. He has given hundreds of talks at a wide range of conferences worldwide. He focuses on American culture, politics and government, and health issues.
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Top-level comments on this article: (1 total)
» left by Susan Thom
 3 years 12 days ago.
174 fans.
hi joel,
 
i have known about this for years. i had health insurance until a divorce last month. my medications were 130.00 a month, without insurance, over a thousand! so, when i run out, i'm out.
 
drug companies give samples to doctor's like they are candy, and yet let the people who may need them go without.
 
the drug business is a big enterprise, too bad we don't have a clue what's in the medication we take to make us feel better and live longer.
 
thanks for sharing,
 
sue thom
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