HIV/AIDS Skepticism

Pointing to evidence that HIV is not the necessary and sufficient cause of AIDS

Privatizing clinical trials

Posted by Henry Bauer on 2010/03/01

From a review (“Neoliberal medicine”, by Nina Ayoub, Chronicle of Higher Education, 13 February 2009, p. B19) of Medical Research for Hire: The Political Economy of Pharmaceutical Clinical Trials (by Jill Fisher, Rutgers University Press; Fisher is at the Center for Biomedical Ethics & Society at Vanderbilt University):

About ¾ of clinical drug trials are now done by practicing physicians who recruit their own patients or other local people. Around 2001-3, 50,000 physicians were registered as principal investigators on such trials, and >3.5 million Americans were research subjects. Fisher ascribes the rise in such research to fiscal pressures on both physicians and the public: people who cannot afford health insurance and health-care welcome such trials as a way of possibly getting treatment. Drug companies find the arrangements desirable because they can be carried out faster than through academic research where institutional review boards can be typically slow-moving.

Ironically, those who become research subjects because they cannot afford health care will then be unable to afford treatment with the  drugs they helped to get approved. Conflicts of interest seem even worse here than in clinical trials in general. There’s always a dilemma between the Hippocratic injunction to do the best possible for a patient and the desirability in clinical trials of having a placebo group as controls. For example, a physician testing an obesity drug cannot recommend diet and exercise when the drug needs to be tested in absence of concomitant lifestyle changes. “Uninsured middle-class white women are the most common subjects for efficacy trials that require people with a given condition to test a new drug or do comparison studies. Low-income minority men . . . are the main source for healthy-subject trials that test the toxicity of new drugs and involve higher stipends but higher risks”.

Fisher also points out that “informed consent” does not amount to being given good advice about what is involved.

4 Responses to “Privatizing clinical trials”

  1. Francis said

    A rare confession from Kalichman

    From his latest posting

    March 1, 2010 3:47 PM
    Anonymous said…
    Seth, is working on this blog a part of your official work duties? Looking at the post times, you spend a lot of time during normal working hours on it.

    March 1, 2010 5:17 PM
    Seth Kalichman said…
    Luke, if you cannot laugh at them then what good would they be? I agree.

    “My time is 100% committed to preventing HIV infections, improving HIV treatment outcomes, and undoing the social harms of AIDS. My blog falls well within the aims and scope of my job. Plus, it offers an educational tool for psychology students…a sort of laboratory for the psychopathology of AIDS Denial.”

    As Kalichman and his department are funded directly through grants from the National Institutes of Health, it is now clear that the NIH directly fund various blogsites devoted solely to attacking dissidents. Perhaps Clark Baker was mistaken when he called them “Pharma Sluts”, I’d be open to suggestions on their correct nomenclature. I’ll start with Fauci’s Whores. And is this really a proper use of Taxpayers funds?

  2. dale dematteo said

    If one can still find on-line (perhaps through a secondary resource) an investigative series entitled “The Body Hunters” that appeared in the Washington Post around 2000, this series of newspaper articles documents the privitization and massive expansion — even shift — of the US/European clinical-trial apparatus (in large degree driven by “HIV/AIDS”) into less developed (i.e., poor/indebted) countries with often dire consequences for unwitting citizens. Poorly paid physicians in these countries (themselves victims of the imposition of IMF and World Bank Structural Adjustment Programs slashing national funding for health, education and social programs) recruit patients or local people (often the homeless) in return for substantial financial reward. This series remains one of the best explorations of this topic. Unfortunately, the Washington Post removed the series from on-line public access a number of years ago.

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