Published 31 March 2009, doi:10.1136/bmj.b1025
Cite this as: BMJ 2009;338:b1025

Analysis

Patients and the public deserve big changes in evaluation of drugs

¹ Mario Negri Institute for Pharmacological Research, Via Giuseppe La Masa 19, 20156 Milan, Italy , ² Summertown Pavilion, Oxford OX2 7LG

doi:10.1136/bmj.b1107

Silvio Garattini and Iain Chalmers argue that ending the secrecy surrounding drug trials would benefit all parties

The first 150 words of the full text of this article appear below.

The drug industry has an image problem, and big changes are needed to restore public confidence. The reasons why it has got itself a bad name are well rehearsed. They include research agendas distorted by priorities that are important to industry but not to patients¹; inappropriately restricted study populations that exclude patients with multiple health problems² and children³; uninformative trial designs that fail to assess whether new drugs are better than existing treatment options⁴; outcome measures that ignore the effects of treatments on morbidity and mortality or on the quality of life⁵; biased under-reporting and over-reporting, not only of whole studies,^{6 7 8} but also of outcomes within published reports of research⁹; and specious promotion of drugs, including disease mongering.¹⁰

Industry makes much of the expense of bringing a new drug to market. In fact, directly and indirectly, the public provides most of the support for developing . . . [Full text of this article]

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