FDA: Can We Trust Them?
The majority people think as our guardian of the FDA, scrutinizing up large pharma and all their corporate research studies on every new medical device and each new drug for potential acceptance. FDA approval means something really vital that you us: an unquestionable degree of validity, effectiveness, and safety. We feel sorry for folks in states which have no such high degree a system of well educated, well-trained evaluators and critical inspectors. We fear for the public health and welfare when gains and cash appear to take precedence. Sometimes, those of us in the health care community will hear some griping the cost for all this security is not too low. That the acceptance procedure takes too long (a year or more?), or costs too much to get through (frequently almost a million dollars for one device or drug?) And that this inhibits producers from making matters that although valuable, will not create enough to recoup cash and all that time in a timely manner. Might it be possible that these problems and other public and political pressures have affected upon the FDA in ways that may induce us to question nowadays, how much we can trust the FDA? The reply is – perhaps so.
2015 , in August, Forbes Magazine commissioned the data to be analyzed by Biomed Tracker on FDA approvals – this has clear enormous consequences for success and corporate direction. Biomed Tracker is a firm well known among large pharma investors who rely on Biomed for the tracking and coverage of pharmaceutical business data and in the pharmaceutical sector. Forbes was looking at the sector from a company operation perspective, but some quite startling info came to light about the FDA.
In 2008, the FDA rejection rate was general about 50%. But as of August, 2015 the rejection rate was about 4.0%! How strenuous, methodical and demanding would you believe a final exam test for a school class to be with a pass rate of 96%?
Many producers look to produce more income for a drug or device by getting enlarged FDA approval for signs or added applications. These “new advertising claims” had about a 50% acceptance rate in 2008. But in 2015, the acceptance rate had soared to almost 90%!
The odds maker would say this is practically like insider trading – a business with a brand new drug or new signs upward for acceptance has a high probability of getting it. Up for FDA approval? That stock price might not be unlikely to go up only predicated on the acceptance chances alone – Time to invest?
What’s happening? It kind of seems such as the acceptance procedure has become more of a fast “rubber stamp” than it ought to be. Or could it be that the FDA is simply doing its job?
There are the ones that say that the FDA is doing considerably better about what they anticipate in the way of the bowed research, the testing conditions, etc., in guiding large pharma Sort of like telling you what is anticipated for an excellent score on such course job or what to study for because it’ll “be on the test”. However there’s a fine line between this encouraging kind of assistance and downright real training to sort of rig the game, like telling you both the questions, as well as the right vs. wrong responses.
The FDA has required plenty of political heat about meeting deadlines, and seeming overall less “negative” in their strategy to their significant occupation. Has this resulted in better protocols, a more efficient team as well as the improvement of streamlined attempts or has this pressure carried possible, the powers that be to simply reduce the entire procedure, cut several corners and err more on the side of acceptance? What do you really believe is the less expensive, simpler, and less time consuming way to really go? What do when similar problems arise with other government agencies, we usually expect to find? A recently proposed bill, the “21st Century Remedies Act”, is intended to streamline FDA acceptance speed and reduce red tape – But who does this actually gain? Is public safety precedence one?
There’s also been some not so subtle people pressure – the public awareness a drug with marginal gain to those in need but carrying serious side effects may not be worse than nothing. It is frightening to think where those deciding on the acceptance destiny of drug X. could be led by this kind of logic We’d not all agree on what signifies a true “demand” scenario, as well as the same could be said for as to what (short of passing) a “serious” side effect really is.
Should the standards for acceptance be lower for a drug which treats a health problem that is infrequent or serious? Researchers at MIT say yes. They say the FDA is “overly risk averse” for the most deadly disorders. The researchers proposed creating a “danger threshold” for each disorder that will lower regulation standards predicated on disease prevalence, severity, lethality and accessible treatment limits. But do we need a fresh chemotherapy drug with horrible unwanted side effects, quantified against a mortality rate of 60% without any treatment or the unwanted effects and a 50% mortality rate? Perhaps we do need that opportunity, even if it’s a long shot. California has a “Right-to-Attempt Action” up for consideration which would permit patients with life threatening illnesses to get the right to get experimental drugs (i.e. not approved by the FDA in any manner). Maybe it will be useful in such circumstances to at least possess the FDA give the drug a relative risk/benefit ratio evaluation predicated on an evaluation of all available data to help patients make a more educated choice.
And if something isn’t for the therapy of a life threatening sickness but has quite borderline evidence for gain and certainly no side effects (maybe some new wrinkle erasing laser, as an example) does that justify lesser standards and more simple acceptance? Should large pharma be permitted by means of an FDA nod to take the people’s hard-won cash for something that actually does not work, but “at least it does not hurt anybody”? A recent FDA suggestion about the 510(k) approval process for medical devices proposed only that. The FDA is thinking about exempting more than one hundred medical devices from acceptance requirements saying that these devices are “comprehended well enough” as well as the “dangers low enough”. But will not that create more of the chance that we could all be spending our money on nothing more than FDA approved “snake oil”?
Do these names sound familiar: Vioxx, Accutane, Phen Fen? These medicines are in a distinctive group – devices or drugs accepted by the FDA, when serious issues surfaced after public use, then having their acceptance revoked. But how exceptional is this group? Not much! A recent internet search turned up a record of some 30 -40 drugs which are in this “club”! More than half of these authorized-then-not-approved drugs were from within the last ten years. More than half of them were pulled from the market within FIVE years of their total FDA approval! How can research, and rigorous testing, poured around at great length and in great depth by minds that are great create a drug that turns out to be dangerous in so brief an amount of time? One could claim that when used by huge numbers of individuals for a long time, an extremely infrequent but dangerous side effect could finally be disclosed. But a revoking of acceptance within only 5 years of public use actually implies that something might have been lost in the acceptance procedure. At least three FDA approved drugs were remembered within significantly less than a year of FDA approval! About just what the strength of our trust in the acceptance procedure needs to be, what exactly does that imply?