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Inverse benefit law

From Wikipedia, the free encyclopedia
Drug benefit-harm ratio falls with marketing

Theinverse benefit law states that the ratio of benefits to harms among patients taking newdrugs tends to vary inversely with how extensively a drug ismarketed. Two Americans, Howard Brody and Donald Light, have defined the inverse benefit law, inspired byTudor Hart'sinverse care law.[1]

A drugeffective for a seriousdisorder is less and less effective as it is promoted for milder cases and for other conditions for which the drug was not approved. Althougheffectiveness becomes more diluted, the risks of harmfulside effects persist, and thus the benefit-harm ratio worsens as a drug ismarketed more widely. The inverse benefit law highlights the need forcomparative effectiveness research and other reforms to improveevidence-based prescribing.[1]

State of affairs

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The law is manifested through 6 basic marketing strategies:

  • reducing thresholds for diagnosing disease,
  • relying on surrogate endpoints,
  • exaggeratingsafety claims,
  • exaggeratingefficacy claims,
  • creating new diseases,
  • encouraging unapproved uses.

Impact

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This is the reason why organizations like "Worst Pill, Best Pill"[2] recommend not to use/prescribe new medications before being in the market for at least ten years (except in the case of important new drugs that treat previously unsolved problems).

Agencies of drugs, committee of ethics and organizations of patients' safety should consider:

  • Requiring that clinical trials run long enough to pick up evidence of side effects and record all adverse reactions, including in subjects who drop out.[3]
  • Paying companies more for new drugs in proportion to how much better they are for patients than existing drugs, and marketing according to the value of the new drugs (ratio of benefits to harms and marketing).[4]
  • Considering that market could be a force against the best use of medications.[5]

See also

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References

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  1. ^abBrody, Howard; Light, Donald W (2011)."The Inverse Benefit Law: How Drug Marketing Undermines Patient Safety and Public Health".American Journal of Public Health.101 (3):399–404.doi:10.2105/AJPH.2010.199844.PMC 3036704.PMID 21233426.
  2. ^"Worst Pill, Best Pill. Public Citizen's Health Research Group". Worstpills.org. Retrieved2014-02-17.
  3. ^Wood, Alastair J. J (1999). "The Safety of New Medicines".JAMA.281 (18):1753–4.doi:10.1001/jama.281.18.1753.PMID 10328077.
  4. ^"Astellas' lawsuit against Prescrire: French court rules that Prescrire did not "denigrate" Protopic° (tacrolimus). Prescrire. 2 March 2011". English.prescrire.org. 2011-03-02. Retrieved2014-02-17.
  5. ^Gérvas J. Garum. Acta Sanitaria. 07/03/2011.

Bibliography

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External links

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