Saturday 1 September 2012

THALIDOMIDE; TIP OF A VERY LARGE ICEBERG

The manufacturers of the now notorious drug 'thalidomide' have issued an apology to the many people alive today who sufferred shocking birth defects as a result of the drug's side effects. Inevitably, the apology has been condemned as inadequate by various campaign groups who continue to demand more compensation from the company.
 
Without knowing all of the details it's hard to comment on the rights and wrongs of the campaigners' demands or the company's actions. However, it is very clear that thalidomide did have some very unpleasant effects which are still felt today, more than 50 years after the drug was withdrawn from use.
 
In common with all industries, drug companies want, and need, to make profits in order to survive. Proper drug research can very very expensive and take a very long time, which renders taking a few short-cuts highly desirable. In the 1950s, when thalidomide was developed, pharamceutical knowledge was much less than it is today and there was much less control over the activities of such companies. Exactly what research was undertaken in respect of thalidomide and what, if any, knowledge about side effects was suppressed are matters of which I am unaware though there seems to be strong evidence that the company did knowingly market a suspect drug.
 
Over the years the demand for ever more potent drugs to fight ever more resistant bugs has grown; so has the demand for drugs to combat conditions such as cancer, arthritis, heart disease and the rest. Today we appear to want pharmaceutical companies to produce drugs to help us stay thin, live longer, keep our hair and a thousand other things that are desires rather than medical needs; the companies will happily oblige if they can as "there's money in them thar products". The problem is that no one actually wants to pay the costs associated with carrying out the comprehensive research that's necessary before a new drug is brought to market and so corners are cut. Everyone connives in this, from the companies, through the regulators and government to the people.
 
I have no doubt that the manufacturers of thalidomide were wholly responsible for the long term effects of their drug and that they should make proper reparation to those who were affected. Equally, companies should be made to shoulder responsibility for the effects of more recent drugs that have been shown to have deleterious side effects, drugs such a librium and valium and a whole range of steroids spring to mind. These drugs have long lasting effects that may only be noticed over a period of many years, but many people have been affected. There are many others that have been introduced and then suddenly withdrawn, always because of the discovery of latent side effects; I've heard very little said about any of these, presumably because the side effects were considered relatively mild or affected patients were silenced with large pay outs.
 
The bottom line to all of this is that we can't have whatever we want at the price we'd like. If we want ultra-safe drugs, we must expect to pay much more than we do now and be prepared to wait much longer for them to be developed. If we're happy to accept a 90 or 95% likelihood that there'll be no serious side effects, then we can have the drugs sooner and at lower cost. The difference between now and the 1950s is that we're all much more involved today through our own demands and a maze of government inspired regulation; while today's pharmceutical giants must shoulder most of the responsibility when things go wrong, we and the government have to accept our own share and even the occasional disaster.

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