US drug trials expand outside academic centres

Since the emergence of managed care in the United States in 1990, clinical trials of new drugs have shifted from researchers working in university hospitals and medical schools to individual doctors with little experience in clinical research.

The growth of drug testing can be seen in the numbers of doctors who participate. In 1990, 4307 doctors conducted research studies, but in 1997, 11662 doctors conducted studies. While the number of academic and medical school researchers doubled, from 2225 to 4431, their “market share” dropped from one third to a quarter of the total. This has led to real competition between academia, medical schools, and private doctors for the lucrative research dollar.

The New York Times, which carried out a 10 month study of the drug testing industry, recently reported a story about Dr Robert Fiddes, who is currently serving …