Tuesday, December 09, 2003

What? Saw this.
    A senior executive with Britain's biggest drugs company has admitted that most prescription medicines do not work on most people who take them.

    Allen Roses, worldwide vice-president of genetics at GlaxoSmithKline (GSK), said fewer than half of the patients prescribed some of the most expensive drugs actually derived any benefit from them.

    "The vast majority of drugs - more than 90 per cent - only work in 30 or 50 per cent of the people," Dr Roses said. "I wouldn't say that most drugs don't work. I would say that most drugs work in 30 to 50 per cent of people. Drugs out there on the market work, but they don't work in everybody."
I guess I'll stay with homeopathy. At least I don't worry about side effects. I'm still curious. What is going on here?

Update: After reading the companion article, I am creeped out. On the surface, it's a fairly innocuous article. But stay with me because it does get scary.
    As Bill Clarke, the executive vice president of research at Amersham, a British diagnostics company, said: "It's just not right to spend that amount of money on drugs that don't work." For the sake of a relatively cheap genetics test that can be carried out on the wider population of patients, it would be possible to target drugs more effectively and more safely, Dr Clarke said.

    It could also lead to a revolution in the way drugs are tested, he said. If "responders" to a new drug can be identified easily, it will be possible to simplify the expensive phase 3 clinical trials which can involve thousand of people being followed over many years.

    Dr Roses agreed: "You can pick out people who respond a lot to the drug, can you pick out people who do not respond at all to the drug and can you pick out people who are sort of in the middle.

    "By eliminating the people that we predict will be non-responders we'll be able to do smaller, faster and cheaper drug trials."

    That could be the incentive that will lead to a change in the "one-drug-fits-all" culture of the drug industry, he said.

    "I can't speak for other companies but I can tell you absolutely for sure that there is a change in the culture of GSK," Dr Roses said. And the advent of pharmacogenomics will not necessarily mean a fall in sales.

    "If you can determine who is going to have a response [to a drug] and who is not going to have a response, you can take your next molecule and aim it specifically at the people who haven't had a response with the first one so that you can create a set of drugs that cover the population, and then you are back to selling to everybody," he said.
To determine who are the 'responders', here is more info:
    Dr Roses is one of the pioneers in a field of genetics that promises to help to identify those people who could benefit from a drug. It is called single nucleotide polymorphisms (SNPs) and it is a way of distinguishing the smallest possible genetic differences between individuals.

    The use of SNPs has already led to the discovery, for instance, of a test to detect the 5 per cent of the population who inherit a predisposition to a potentially fatal side effect of an anti-HIV drug called abacavir.

    Now it is possible to test HIV patients before the drug is given to them in order to weed out those patients who will suffer a severe adverse reaction - a violent rash on the body.

    Scientists believe that SNPs can be used to test people not just for their vulnerability to a drug's side-effects, but also to whether it will work or not.
I take this to mean that the drug companies are now thinking of doing genetic testing to determine whether you are a responder or not. It would be much more efficient and cost-effective. But this opens the door to a whole slew of issues including that of privacy, the problems inherent with genetic labelling, and, of course, the real biggie, genetic discrimination.

So the corporate guys finally admit their drugs don't work well. Conveniently, they have come up with an interesting solution: wholesale genetic testing to help us out. I wonder how the new Medicare law will handle this new development.