In Defense of Comparative Effectiveness Trials

The following letter ran in today's Wall Street Journal:

I was surprised by the anti-capitalist undercurrent of Scott Gottlieb's attack on comparative effectiveness clinical trials -- "The War on (Expensive) Drugs," editorial page, Aug. 30. When I took Economics 101, it was axiomatic that efficient markets required consumers to pursue their own economic interests -- like choosing less expensive drugs if they provide the same or better therapeutic benefits as more expensive options.

Unfortunately, today's pharmaceutical marketplace operates inefficiently because it doesn't provide consumers or prescribing physicians the information needed for medically or economically rational decision-making. The comparative effective trials authorized in the children's health insurance bill would help eliminate this information gap.

Dr. Gottlieb brackets his defense of marketplace inefficiency by complaining about secrecy and the selective interpretation of government-funded clinical trials. That's as inexcusable as when companies do it. That's why consumer groups have been pushing for full transparency of all clinical trials -- from their initial registration to the posting of their final results. Dr. Gottlieb's case would have been stronger had he endorsed that aspect of the FDA reform legislation now moving through Congress.

Merrill Goozner
Director
Integrity in Science Project Center for Science in the Public Interest
Washington