Wednesday, January 16, 2008

The file drawer effect

"Researchers call it the "file drawer effect" — the quiet filing away of disappointing medical experiments"

I came across this article earlier "Many unfavorable drug studies aren’t published" ( Jan 16th 2007, which is certainly not the first I have heard of this topic. All the way back in 2000 the USA today wrote Filed under F (for forgotten) (May 17th 2001 which basically describes the scenario where unfavorable drug studies are simply discarded.

In the second article Sidney Wolfe of the Public Citizen Health Research Group asks "How can the public believe drug companies if they only release data from studies with results palatable to company executives, stockholders or potential stockholders?" I think that is a very valid question to ask.

Another question is "if a drug doesn't work why do people take it?" Is it possible that if a company spends enough money marketing their drug people will believe it works regardless of its clinical efficacy?

The United States is one of only two countries that allows direct to consumer advertising of prescription drugs. (

In the article "Creating Demand for Prescription Drugs: A Content Analysis of Television Direct-to-Consumer Advertising" when doctors considered the controversy surrounding this practice for the Annals of Family Medicine, they concluded "Despite claims that ads serve an educational purpose, they provide limited information about the causes of a disease or who may be at risk; they show characters that have lost control over their social, emotional, or physical lives without the medication; and they minimize the value of health promotion through lifestyle changes. The ads have limited educational value and may oversell the benefits of drugs in ways that might conflict with promoting population health. "

Marketing is a power tool that can directly influence consumer behavior and choice. In my opinion there should be specific limits on what can be advertised and if information is gather and published, it should be published in its entirety not selectively to promote the companies financial interests.

If a system was created whereby scientifically conducted double blind studies were recorded by a government agency before and after completion this would create a process to authenticate successful studies and would prevent the destruction of studies which were unfavorable to the companies interest. I think this is especially important when safety or efficacy studies are paid for by the company that stands to gain from their success or approval.