Published 31 March 2009, doi:10.1136/bmj.b1107
Cite this as: BMJ 2009;338:b1107

Analysis

Commentary: Risks of doing as the Romans do

¹ Tremblay Consulting, Brabourne Lees, Ashford, Kent TN25 6RJ

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

Garattini and Chalmers (doi:10.1136/bmj.b1025) make four suggestions to improve the evaluation of drugs—involve patients in establishing research priorities, improve the transparency of drug evaluations and studies, fund independent drug evaluations, and require evidence that new drugs have added clinical value. Although controversial, many of their proposals would benefit patients. However, their suggestion to follow the Italian approach to funding independent clinical trials is unlikely to be a good idea.

In 2003, Italy decided to establish a tax on the drug industry of 5% of their medicines advertising budget. This money is used by the state medicines agency, AIFA, to fund clinical research on the efficacy of orphan drugs, comparisons of drugs for the same indication, observational outcome studies, and pharmacovigilance.^{1 2}

We know that there are real problems with clinical trials as currently conducted, such as the use of surrogate end points, weak information on long term efficacy, and . . . [Full text of this article]

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Rapid Responses:

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Competing interests of Tremblay Consulting

Paolo Tomasi
bmj.com, 6 Apr 2009 [Full text]

The Romans maybe getting it right

Krisantha Weerasuriya
bmj.com, 5 Apr 2009 [Full text]

conflict and other matters

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Reply to "conflict and other matters"

Krisantha Weerasuriya
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what? more on conflict?

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Who pays for what

Joan McClusky
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Further thoughts

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