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Before the introduction of the big Pharma, people used to take Bovril to get better. Bovril was first used when there was flu pandemic in 1918 as a preventive measure. People also used Beecham’s pills to prevent bilious nervous disorders. There were other conditions that were cured by the Beecham’s pills including weak stomach, impaired digestion, constipation, female ailments and liver complaints. Also, before the introduction of the big Pharma, people used Cadbury’s cocoa as a preventive measure against ailments. Holloway ointment was also used to cure rheumatism, ulcers, sore breasts, sore heads and bad legs among others. Herbal medicine was also used to cure or prevent ailments.
When determining the results of a medical study, it is crucial to consider the source of funding for the research. Industry funded trials are likely to be positive compared to government funded trials because the drug companies are mostly concerned with the chances of success before funding a study unlike the state which is concerned with the research outcomes. The governments always tell the funders what to do and the funders in return tell academicians what they can get paid to do. A state-funded research cannot publish, analyze or discuss the data from the trials without the permission of the funder, and this means that the funder owns the data outright. The pharmaceutical industry is always selective in the studies as it is a regulated industry.
Missing or biased data may have practical effects on the real lives of patients. Missing data may mislead the doctors and patients on the effects of the medicines they use. Also, due to missing or bias data, patients and doctors can be misled to choose unnecessary expensive treatments because older and safer drugs are just effective or better. In many cases, patients who take part in the trials are betrayed especially if the outcomes are not favorable. It may be problematic to interpret any clinical trials when some information is missing or biased. Missing or biased data also leads to biased conclusions on the size and the existence of any treatment effects of a patient. A patient may be prescribed wrong treatment if some data on the clinical tests are missing.
Phase 1 or the early trials is conducted to test the general safety of a drug. In the developing countries, early trials are done on prisoners, homeless, and poor people. People without medical insurance in the US are used to test the drugs in phase 1.
In phase 2, the drugs are tested on the patients who have the disease that is to be cured. The test is done to a few patients only (not exceeding 200) and information is gathered on the short-term outcomes and the side effects of the drug. If there are side effects of the drug, they should be visible at this stage.
In phase 3, the drug is administered to a large population (not more than 3000) where there are randomized controlled trials.
The trials are outsourced from poor countries, and these countries cannot afford the new drugs which are trailing. One of the reasons for outsourcing from the poor countries is that it is cheap compared to the developed countries. Also, in the poor countries, the regulatory oversight is poor not to mention the poor medical care.
Ben Goldacre’s opinion that the when trials throws up the result which companies do not like, they hide them from doctors and patients is true. These companies aim at making profits and they would not accept any situation that ruins their reputation. They would only disclose the positive outcomes so as to attract more customers in their premises.
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