Drug companies vs doctors

Ezra Klein reports that

A review of seventy-four clinical trials of antidepressants found that thirty-seven of thirty-eight positive studies were published. Of the thirty-six negative studies, thirty-three were either not published or published in a form that implied a positive outcome. … To a doctor reading the published literature, 94% of the trials conducted were positive. In reality, 51% were positive.

He concludes that “[i]f the pharmaceutical companies will not fund research, then someone else must.” I’m not so sure.

Is the issue really that the researchers’ work is inaccurate? The fact that a large number of studies return results which do not favour the funders suggests the problem is not with the studies. Indeed, I wouldn’t expect a drug company to fund a study unless they were confident of some success, yet there are still many which do not find in their favour.

The problem is really that the published sample of the studies doesn’t represent the population value. That’s because the companies are blocking publication of the other results, and understandably so. Ezra thinks that funding the studies elsewhere will improve doctors’ information. While that may be true, it’s an expensive way of ensuring that studies are published.

The drug companies have the best information about which drugs are worth testing. They also reap significant benefits from a positive trial. It makes sense for them to pay for the trials.

What we really need is a way to ensure that the studies published are representative of the studies conducted. While I’m not au fait with the details of how to do it, could it be that hard to to require the results of all trials to be publicly available? It’d be a lot easier and more efficient than funding research from elsewhere.

  • One way around this is to require studies to be registered before starting as well as after. That way all studies are open to enquiry from woah to go, and hiding inconvenient truths is almost impossible. Secondly, the need for proper peer review on publishing as a check on experimental rigorousness.

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  • Makes sense to me