Abolish the FDA

[GH253]

The benefit would be at least twofold:

1) The price of prescription drugs would come down substantially. Pharmaceutical companies would no longer have to waste billions of dollars and years of time getting their products past regulators, and these costs would not be passed on to consumers. Furthermore, with the arbitrary barrier to market entry removed, vigorous competition would bring prices down dramatically.

2) There would be an improvement in the standards of practice. Doctors would prescribe, and consumers would use prescription drugs far more responsibly. There would be an intellectual shift in the medical community from the reliance on arbitrary government authority to improved scientific rigor. The body of reserach on which physicians rely to make medical decisions would not include "official" government-sanctioned clinical trials paid for by drug companies, and hence a major conflict of interest would be removed. Without the government's rubber stamp of approval, doctors would have to prescribe with extreme caution rather than handing "meds" out like candy.

In summary: abolish the FDA for a healthier America.

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[psy]

I hope this isn't a troll post but I'll bite anyway.

If there is no 3rd party oversight of big pharma, what is there to keep them from pumping toxic or ineffective drugs in the market at ridiculous prices? I fail to see how a lack of oversight of the meds would lead to improvement in standard of practice. The rest of the post...well I face palmed myself and stopped reading. >___>

 

[GH253]

I hope this isn't a troll post but I'll bite anyway.

If there is no 3rd party oversight of big pharma, what is there to keep them from pumping toxic or ineffective drugs in the market at ridiculous prices? I fail to see how a lack of oversight of the meds would lead to improvement in standard of practice. The rest of the post...well I face palmed myself and stopped reading. >___>

Companies do not stand to maximize profits by killing their customers. Doing so would expose them to massive liabilities from disgruntled family members, destroy their reputations, and lead to a lack of repeat business. After all, few consumers would be willing to pay exorbitant prices for toxic, ineffective drugs. If Company A offers a drug laced with poisons and sells it at a high price, and Company B offers a drug in the same category which is safer and less expensive, customers seeking a better value will tend to go with the product offered by company B. Therefore, the incentive is for companies to compete for customers by creating safer, more effective drugs and selling them at lower prices, as opposed to pumping their medications full of toxins and charging unaffordable prices.

The FDA disrupts this process in several ways. It prevents competitors from entering the market since newcomers generally cannot afford the billions of dollars needed to purchase FDA approval. In the absence of competition from small companies, established corporate giants are able to keep prices high. Regulation also has an extremely deletrious effect on consumer psychology; it causes intellectual atrophy on the part of dotors and patients who accept government as authoritative. They learn to accept FDA approval as the "gold standard" of safety and effectiveness and subsequently fail to apply rigorous scrutiny to the FDA-approved drugs which they prescribe/consume. The end result of FDA regulation is inferior products, higher prices, and reckless drug use.

 

[GH253]

Several years ago while at a doctor's appointment I mentioned my concern that a certain medication the doctor had prescribed was known to cause diabetes in some patients, a fact which I had become aware of through my own research.

The doctor's reasponse? "It's FDA approved."

The doctor accepted FDA approval as sufficient to guarantee the drug's safety and simply was not bothered by a need to inquire any further.

Needless to say, I disgarded his advice and terminated my relationship with him.

 

[facetguy]

I agree the FDA has its problems. But are you suggesting that each individual physician should need to dig through all the research for each medication and formulate an opinion on that medication? If so, that will obviously never happen. Not to mention the fact that unfavorable drug data get buried frequently, so on what information are these opinions supposed to be based?

 

[GH253]

I agree the FDA has its problems. But are you suggesting that each individual physician should need to dig through all the research for each medication and formulate an opinion on that medication? If so, that will obviously never happen. Not to mention the fact that unfavorable drug data get buried frequently, so on what information are these opinions supposed to be based?

Fundamentaly there is only one alternative: use your own judgment or accept someone else's in place of your own. I agree that it's probably unrealistic to expect physicians to personally assimilate all availible data on every drug they prescribe. To the extent that physicians have to rely on the conclusions of others, it's infinitely preferable for private parties to handle the task of testing drugs and analyzing data. A government agency like the FDA wields an intellectual monopoly with which nobody can compete. Whatever they say, goes. Drug companies know this and manipulate regulators to their advantage. If regulation was abolished, private firms would form to disseminate their own conlcusions and physicians and consumers would at least be able to use their best judgment to choose which schools of thought they found the most persuasive. If any of these firms were discovered to have conflicts of interest, their reputations would be ruined and they would be out of business. Also, if research were handled by the market, there would be no formal structure of authority and the intellectual chain from the people performing the research to the physicians using it would be much shorter than with a single government agency dictating the standards of practice of an entire nation.

 

[cpants]

I appreciate your idealism. I am a firm free-market believer myself. However, in this case, a completely free market is not ideal. The main reason is that the consumer (it doesn't matter whether you consider the consumer to be physicians or patients) does not have all the information they need to make a choice about which drugs will be safe and effective for treatment. In the case of patients as consumers, they don't have access to the information and in most cases, do not have the background knowledge and clinical judgment necessary to assess the information even if they did have access to it. In the case of the physician, there just isn't enough time in the day to analyze each individual pharmaceutical and supplement on a case by case basis to make recommendations. Therefore we rely on things like the FDA to provide a minimum standard which a company has to meet for safety and efficacy to gain approval to treat a certain pathology. We also rely on peer-reviewed research to provide ongoing assessment of efficacy and safety and to find new, off-label uses for existing drugs.

To extend your argument even further, there are those that advocate the abolishment of medical licensing altogether. They think that anyone should be able to call himself doctor and prescribe medications, and leave it up to the patients to determine who is qualified.

In general, regulation is bad. However, it can be useful to society. In both of these cases, deregulation is just too risky. Without drug approval and medical licensing, patients won't know what they are getting, and people will be hurt.

Your physician's response to your question about a side effect was nonsensical. However, FDA regulation does have an important role in our profession.

 

[psy]

Fundamentaly there is only one alternative: use your own judgment or accept someone else's in place of your own. I agree that it's probably unrealistic to expect physicians to personally assimilate all availible data on every drug they prescribe.

Depending on their specialty, there are approximately 100-150 drugs that physician prescribe to about 95% of their patients. The manual on new drugs is about 3-5 thousand pages thick. New data on drugs come out each month. How long do you think it would take to research each of these drugs?

To the extent that physicians have to rely on the conclusions of others, it's infinitely preferable for private parties to handle the task of testing drugs and analyzing data.

What would happen when these private parties start putting out fudged data? I used to work in a lab for 2 years, I know how researchers can modify data to fit their hypothesis, especially when money is riding on the results. It made me much more skeptical of research papers.

A government agency like the FDA wields an intellectual monopoly with which nobody can compete. Whatever they say, goes. Drug companies know this and manipulate regulators to their advantage. If regulation was abolished, private firms would form to disseminate their own conlcusions and physicians and consumers would at least be able to use their best judgment to choose which schools of thought they found the most persuasive.

Please provide proof of how drug companies manipulate regulators to their advantage. And where do you get the idea that private companies pumping out their own data would be less likely to fudge their research papers? You are also assuming physicians and consumers are well trained to analyze research papers. To be able to properly analyze a research requires time, familiarity with the subject and process, and knowledge in the intricacies of research. Physicans do not have the time, nor do many physicians participate in research. They spend their time treating patients. The majority of consumers aren't trained to analyze research papers. When the patients say they "research" something it means they looked at the abstract of a research paper, opinions of "experts", and anecdotal evidence.

If any of these firms were discovered to have conflicts of interest, their reputations would be ruined and they would be out of business. Also, if research were handled by the market, there would be no formal structure of authority and the intellectual chain from the people performing the research to the physicians using it would be much shorter than with a single government agency dictating the standards of practice of an entire nation.

Reputation can be built and destroyed and rebuilt. There is no way you can put them out of business, short of suing them into bankruptcy. If they lost their reputation they can just rename themselves and get back into the market. ie. Blackwater Security is now named Xe Services LLC after that Iraq incident and is back in the security game.

The FDA provides a method to keep consumer safe. It provides standards of efficacy and care so physicians can practice medicine instead of spending hours looking at research data. It's like physicians having to do their board exams to ensure a standard of medical knowledge before they are let loose on the unsuspecting public. Would you rather just trust the word of a person saying he's a competent doctor without some form of standardized examination and certification of training to assure you of that?