Despite its crucial importance to medicine, only a paltry amount of research actually addresses the question of whether one treatment is better than another.
According to a new paper published in the Journal of the American Medical Association, only 32% of the studies of medications published in the top six medical journals compared existing treatments, so called comparative effectiveness (CE) research. The rest either examined new treatments or used placebo.
“The fact that only 32% of the studies in these journals evaluating medications met our criteria for CE research supports previous concerns that only limited clinical research is currently devoted to helping physicians use existing therapies more effectively,” say study authors Michael Hochman and Danny McCormick.
The problem, according to Hochman and McCormick, is that a huge proportion of clinical trial research is funded by the pharmaceutical industry. And big pharma wants to develop and gain approval for new drugs.
“Once these products have won approval for clinical use, companies no longer have incentives to study exactly how and when they should be used,” the authors write in an LA Times opinion piece.
Their research found that 87% of comparative effectiveness studies were funded by non-commercial sources, including the US government. They say their finding supports recent moves to increase government support for comparative effectiveness research.
Hochman and McCormick also suggest that the FDA should require active-comparator trials before approving medicines, a suggestion that is likely to go down like a lead balloon with pharma executives.
In an accompanying editorial in JAMA, Patrick Conway and Carolyn Clancy write, “The United States leads the world in biomedical science and now must implement a framework for research that advances patient-centred care. This enterprise, both public and private, is by definition widely distributed so transparency and ongoing participation by all stakeholders – researcher, clinicians, patients, and health care leaders – is essential.”
See also
Nature feature: Health economics – Life in the balance