Who's doctoring the facts?

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My father is over 80 years old. To look at his bulging waistline and to hear about his history of heart disease is to wonder how it is that he is still alive. I can't prove it to you, but I believe that at least part of this answer lies with Lipitor, daily aspirin, and the beta blocker which lowers his blood pressure and relaxes his heart.

In the 40 years that this magazine has been in existence, there has been a burgeoning in life-saving and life-extending medications, the likes of which have never been seen before. While the drug research pipeline has been criticized for being so expensive, millions of chemicals are screened until just the right combinations can be found.

Of course, even with the most advanced technologies, some of the greatest discoveries have occurred by accident. Viagra was being studied as an agent to lower blood pressure when nurses conducting the trial noticed that many of the subjects developed erections. Zithromax was about to be discarded for having low blood levels when the chemist who invented it discovered that it had persistently high tissue levels and could therefore be dosed over a short period of time. He argued to save it from the trash bin and it went on to become a revolutionary drug in the treatment of upper respiratory infections. Discoveries like this could never occur without the best bench scientists and the best equipment.

From the treatment of HIV disease to the treatment of diabetes to the treatment of acid reflux
disease, new drugs have reduced suffering and improved the quality and length of life all over the world. Unfortunately, rather than receive credit for this, drug companies are often the target of media blame. Arthritis drugs effectively reduce pain and inflammation in the joints, and they have evolved effectively over the past decade, but Vioxx has given its drug manufacturer a big black eye because of a statistically increased risk of heart disease. This black eye may obscure the elaborate and effective process to ensure drug safety, from the test tube to humans. It is impossible to predict side effects 100% of the time. When a drug goes from clinical trials, where thousands are tested, to the post-approval marketplace, where millions consume the drug, sometimes unexpected side effects are revealed. Discovering a new side effect does not automatically cast aspersions on the integrity of the company that made it.

The biotechnology industry has created enzyme cures for deadly neuromuscular diseases, from Gaucher's to Pompe's, and has made exciting advances in the area of genetic research that are beginning to have applications for cancer. In 10 years we may be able to keep cancer from occurring by modulating an aberrant gene in those most susceptible.

Just as the media has a responsibility to investigate claims of fraud and drug safety, it also has a responsibility not to overhype or otherwise inflate a risk. Bad publicity and frivolous lawsuits can erode a drug company's resources in ways that can spill over to production plans for the next blockbuster drug.

Perhaps, in the interests of full disclosure, it should be mandatory for critics of the drug industry—who themselves rely on state-of-the art medications to remain healthy—to include a listing of the medications they take whenever they make negative comments. After all, lecturers must list their drug company affiliations, so why shouldn't drug company critics have to list their medications?

Marc Siegel, MD, is an internist and associate professor of medicine at New York University, and the author of False Alarm: The Truth About the Epidemic of Fear


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