December 28, 2015
Austin Frakt has an interesting discussion in the NYT of patterns in clinical testing of cancer drugs suggesting a bias towards testing drugs treating late-stage patients with little chance of survival as opposed to more promising drugs treating people at early stages or even prevention. However the remedies involve a less demanding testing process by the Food and Drug Administration and increased use of marketing exclusivity to provide more incentive to testing.
Incredibly, there is no discussion of publicly funded clinical trials. In addition to overcoming the bias reported in the piece, publicly funded trials would also have the advantage that the drugs would be available at generic prices as soon as they are approved. In addition, all of the data from the trials would be fully available to other researchers and physicians to help in their prescribing choices.
For those worried about the inefficiency of government testing, the process could be contracted out to private companies, just as the Defense Department contracts out the development of weapon systems. (A big advantage of drug testing over weapon development is that there is no excuse for secrecy in drug testing. Complete openness should be a condition of any contracts.)
The reluctance to consider public funding for clinical trials seems to stem from some strange belief that if the government touches the money, then the resulting process is hopelessly inefficient. It is difficult to understand the basis for such a view.
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