Hope or Hype: The Obsession with Medical Advances and the High Cost of False Promises

By Richard A. Deyo; Donald L. Patrick | Go to book overview

18

For Insurers and Researchers
Pay Now or Pay More Later

Without the data generated from clinical research, even expert opinions on novel
medical treatments are not much better than a coin toss. —Jose A. Bufill, MD1

Modern medicine has left in the public mind the conviction that we know almost
everything about everything. This is as good a time as any to amend the impres-
sion biomedical science good as it is, is perhaps not entitled to all the credit
it gets from the general public. —Lewis Thomas, MD2

MAYBE THIS GOES without saying, but more and better scientific research will be the main source of better treatments for our common ailments. The problem is that good clinical research, and especially clinical trials, require lots of time, money, patience, and patients. There's no substitute for randomized trials to test the effectiveness and safety of most treatments in medicine. But as we've seen, the randomized trials we need are often delayed for years or decades.

If the ALLHAT study of drugs for high blood pressure had been done twenty years earlier—which it could have been—it would have saved countless dollars and complications from high blood pressure. If the Women's Health Initiative trial on hormone replacement therapy had been started fifteen years earlier—which it could have been—it, too, would have saved countless dollars and avoidable complications. If the randomized trial of encainide and flecainide had been done years earlier, it would have saved thousands of lives. If the trials of bone marrow transplant for advanced breast cancer had been completed faster, they would

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