Clinical trials are done mostly by the industry. I’m an advocate of controlled trials but we have an overblown estimate of how useful they can be. So hasn’t evidence-based medicine helped? But most doctors, while they probably are influenced by these things, are even more influenced by the evidence. Companies offer free gifts for doctors, trips to the Caribbean to meetings, and so on. The consumer, from the industry’s point of view, is the doctor who prescribes the drug. Then we made these drugs prescription-only, so the true consumers of a drug are not you and me. Worldwide product patents give companies such extraordinary returns that they have got a tremendous incentive to hype the benefits of drugs and hide any possible risks. Medicine as we had it will cease to exist. In the same way, the climate of healthcare is being pushed towards the brink by doctors giving patients expensive and risky drugs – and failing to notice when things go wrong. But we don’t connect it to the fact that we may be pushing the climate towards the brink. When we hop in our cars to go to work, this seems to be a good thing. “Pharmageddon” refers to a change in healthcare that’s rather like climate change. “I’m an advocate of controlled trials but we have an overblown estimate of how useful they can be.”
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