Many new and promising medications have been approved by the FDA over the past few years. While these drugs offer novel benefits for difficult diseases like Diabetes Mellitus, heart disease and cancer, the science behind them is incomplete.
A recent plea by an expert physician for his colleagues to use a new type of diabetes drug reveals the danger of biased emotions in making medical decisions to use such new drugs.
1) This physician has disclosed significant financial ties to the pharmaceutical industry
2) He states real facts about these drugs, and those facts indicate that for now the drugs should be available in every physician’s armamentarium for treating patients with DM.
3) The bias is to loosen the criteria used to decide on when to use them. Their serious adverse effects are likely more common than reported, as is usually discovered once drugs tested on limited numbers of subjects are used on larger numbers of patients in less rigorously controlled community practice settings.
Additionally, there are unknown adverse effects that are likely to be discovered as they are used for longer periods than the initial testing covered.
Finally, although they were effective as tested, the effectiveness was in a small minority of all patients who received them. Their benefits only slightly outweighed the risks.
In this situation, each decision must rigorously account for the balance of benefits, risks, alternatives and unknowns. There are patients who should get them based on their situation without more established alternatives, but those patients should be carefully chosen, and be fully educated about the BRAU that goes into the decision.
These drugs may someday be widely used, or they may have a niche use, but enthusiasm is neither scientific nor disciplined medical practice.
It has no place in medical decisions.
Be sure to collaborate fully with your doctor to make a shared decision when he or she offers a new medication for any condition.
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