[venomsnake]

Healthcare is unlike the rest of the economy. Drugs don't need marketing and market research. Because in healthcare you don't give what patients want but what they need.

If a drug is best in its class doctors will not need "seminars", "education" to use it - it will be self evident by the trials and outcomes. Oh but wait - you cannot compare drugs to other drugs. You only compare them to placebo thanks to the cuffs put on the various government agencies by the intense lobbying of the industry.

Edit: To get the drugs past the FDA you only need to show it behaves better than placebo. Comparative trials of drugs are a minority and rarely done.

[anoncow]

>You only compare them to placebo

I am not an expert, but look at the following study which compares two drugs.

http://clinicaltrials.gov/ct2/show/NCT00364806

[danielweber]

To get the drugs past the FDA you only need to show it behaves better than placebo

Not really. You need to show how it works compared to the current regimen.

If someone suffering from a disease currently takes drugs A, B, and C, and you have what you think is a better C (let's call it C++), then the study would compare people on (A,B,C) to people on (A,B,C++).

Unless there is no treatment at all for the disease, in which case, go for the placebo.

[twoodfin]

Because in healthcare you don't give what patients want but what they need.

Where's the line? Maybe I don't "need" a new prescription painkiller with substantially fewer gastrointestinal side effects than the OTC one I'm taking, but if it would greatly improve my quality of life, I certainly might want it. Maybe I'm lucky enough that I see my doctor regularly and he keeps up (without any pharmaceutical marketing?) on every medicine that might help me out, but why should consumers be force to depend on that?

The idea that there are hordes of people making doctor's appointments to demand brand name drugs they heard about on TV, and doctors are "forced" to write what they consider useless or overpriced prescriptions for these drugs seems silly to me.

[npsimons]

Maybe I'm lucky enough that I see my doctor regularly and he keeps up (without any pharmaceutical marketing?) on every medicine that might help me out, but why should consumers be force to depend on that?

You think that marketing helps? Maybe your doctor is unduly influenced by pharma marketing and prescribes you the worse drug that give you IBD; hell, maybe he prescribes you the wrong drug altogether because of marketing, and you die. It may sound beyond the pale, but borderline cases involving antidepressants (perhaps the most overmarketed drugs) have already happened.