When we are looking for relief remedies for a medical condition many in the community turn to their medical practitioner to help them find a remedy for their problem. In this they make the assumption that their doctor is the best person to advise them as to what can make them better. As a result of this belief most expect that any drug prescribed by their doctor will be effective, but is this the case?
That very much depends on what you mean by effective. As a health researcher I have been looking at this question for more than a year. Most people I ask expect a prescribed drug to be 90-100% effective, otherwise why would the doctor prescribe it? Doctors become very uncomfortable when I give these figures as they know that few drugs are that effective. They do understand that a high belief is likely to improve the outcome for the patient, but they also recognize that that is not what it necessarily all about. I have often heard them say, “Patients have unrealistic expectations of what drugs can do.”
There are a number of issues here. The first is the matter of evidence. The second is the matter of who is allowed to say what the evidence is and how this impacts on what can be offered to people who want to improve their health.
While this is obviously a very large topic I would like to draw out just a couple of points.
I accept that most medical practitioners mean well and care for their patients. However most medical practitioners, their employers and the pharmaceutical companies make enormous profits out of people who are ill. Whenever billions of dollars are at stake then we have to recognize the moral hazard that exists. It is just too easy to turn a blind eye to the lack of good outcomes and worse, the level and severity of side effects to say nothing of the effect of the cost on the patient’s wallet.
For example chemotherapy only adds just over 2% to the average 5-year survival rate of people with cancer with horrendous side effects for the vast majority of patients. Breast cancer patients have an average life span of 20 years and a 78-85% 5-year survival rate in Australia but chemotherapy only contributes 1.5% to that survival rate. A range of cancers for which chemo is prescribed add NO additional survivors. It is time that these figures became well known. Chemotherapy drugs are not the cancer remedies most of us have come to believe.
Statins, a drug prescribed to lower cholesterol levels also has very low rates of effectiveness. When I searched dozens of the top medical journal papers looking at the cholesterol issues, and buried right down into the data (ignoring the positive titles, introductions and discussions), I was gobsmacked. Firstly, the drugs had no improvement in death rates for women or the elderly. And secondly for men the number needed to treat to save one life was 250 for five years on the drugs. 1250 years of drug taking with many suffering side effects to save one life?
As a third example, the package insert of the H1N1 monovalent vaccine says [Section 12.1 Mechanism of Action] “the administration of the flu vaccine has not been correlated with protection from influenza illness”. This is amazing in its audacity. Here we have the government promoted drive for mass vaccination and its own covering paperwork says that there is no evidence that it offers protection.
These examples are just a few showing the moral hazard from profit making – pharmaceutical companies, hospitals, doctors and government are all involved.
So what does this mean to us as individuals? If you have an expectation of 90-100% efficacy for a drug prescribed then you need to tell the doctor – you are paying for their time and the drugs, after all. If you are asked to go on long term medication then you might like to ask for evidence in writing that the drug does come up to standard. When my own doctor tried to scare me into taking a particular medication and provided me with the scientific papers I discovered they didn’t say what the drug companies and doctor said they did. When I discussed the results with her she was quite perplexed.
Perhaps one way to think of it is that if the relief remedies being offered are bio-identical to what the body produces or is a nutrient normally found in foods known to be good for you then you can be reasonably comfortable in taking it. However if it is a pharmaceutical drug, then exercise caution and demand to see the “rigorous scientific evidence sufficient to substantiate the claims.” You want the actual medical journal papers, not the government guidelines. Even if you can’t make much sense out of the paper, it makes your doctor think several times before making unrealistic claims.