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Medicijnen
werken NIET bij merendeel patiënten.!!!!
Allen
Roses, vice-voorzitter van de afdeling genetica bij farma-reus GlaxoSmithKlein (GSK),
heeft toegegeven dat minder dan de helft van de patiënten die - soms dure -
medicijnen nemen daar echt baat bij hebben. Met zijn uitspraken trapt Roses een
open deur in binnen de farmasector, maar het is wel de eerste keer dat een
topman uit de farmaceutische sector zo uit de biecht klapt, zo staat maandag te
lezen in de Britse krant The Independent.
Roses, een
genetica-specialist, deed zijn uitspraken op een medische conferentie in Londen.
Medicijnen tegen Alzheimer werken volgens Roses in minder dan één op de drie
gevallen, medicijnen voor kanker in amper één op de vier gevallen en middelen
tegen migraine, osteoporose en artritis in de helft van de gevallen. In het
algemeen werken de meeste medicijnen in minder dan de helft van de gevallen
omdat de patiënten vaak genen hebben die de werking van de middelen belemmeren,
aldus Roses.
"Het merendeel van de
medicijnen - meer dan 90 procent - werkt amper in 30 tot 50 procent van de
gevallen", aldus Roses. "Ik zou niet zeggen dat de medicijnen niet
werken. Ik wil enkel stellen dat de meeste middelen werken in 30 tot 50 procent
van de mensen. De medicijnen werken, maar niet bij iedereen", aldus nog
Roses.
De uitspraken van Roses
bevestigen het publieke geheim binnen de farmasector dat er vaak onnodig
geneesmiddelen worden voorgeschreven aan mensen die daar weinig of geen baat bij
hebben. Roses zelf is voorstander van een nieuwe aanpak binnen de sector waarbij
op basis van genetische informatie en genetische tests wordt nagegaan wie wel of
niet niet kan geholpen worden met bepaalde geneesmiddelen.
(08-12-2003)
Glaxo chief: Our drugs do not work on most patients
By Steve Connor, Science
Editor
08 December 2003
A senior executive with
Britain's biggest drugs company has admitted that most prescription medicines do
not work on most people who take them.
Allen Roses, worldwide
vice-president of genetics at GlaxoSmithKline (GSK), said fewer than half of the
patients prescribed some of the most expensive drugs actually derived any
benefit from them.
It is an open secret within
the drugs industry that most of its products are ineffective in most patients
but this is the first time that such a senior drugs boss has gone public. His
comments come days after it emerged that the NHS drugs bill has soared by nearly
50 per cent in three years, rising by £2.3bn a year to an annual cost to the
taxpayer of £7.2bn. GSK announced last week that it had 20 or more new drugs
under development that could each earn the company up to $1bn (£600m) a year.
Dr Roses, an academic
geneticist from Duke University in North Carolina, spoke at a recent scientific
meeting in London where he cited figures on how well different classes of drugs
work in real patients.
Drugs for Alzheimer's disease
work in fewer than one in three patients, whereas those for cancer are only
effective in a quarter of patients. Drugs for migraines, for osteoporosis, and
arthritis work in about half the patients, Dr Roses said. Most drugs work in
fewer than one in two patients mainly because the recipients carry genes that
interfere in some way with the medicine, he said.
"The vast majority of
drugs - more than 90 per cent - only work in 30 or 50 per cent of the people,"
Dr Roses said. "I wouldn't say that most drugs don't work. I would say that
most drugs work in 30 to 50 per cent of people. Drugs out there on the market
work, but they don't work in everybody."
Some industry analysts said Dr
Roses's comments were reminiscent of the 1991 gaffe by Gerald Ratner, the
jewellery boss, who famously said that his high street shops are successful
because they sold "total crap". But others believe Dr Roses deserves
credit for being honest about a little-publicised fact known to the drugs
industry for many years.
"Roses is a smart guy and
what he is saying will surprise the public but not his colleagues," said
one industry scientist. "He is a pioneer of a new culture within the drugs
business based on using genes to test for who can benefit from a particular
drug."
Dr Roses has a formidable
reputation in the field of "pharmacogenomics" - the application of
human genetics to drug development - and his comments can be seen as an attempt
to make the industry realise that its future rests on being able to target drugs
to a smaller number of patients with specific genes.
The idea is to identify "responders"
- people who benefit from the drug - with a simple and cheap genetic test that
can be used to eliminate those non-responders who might benefit from another
drug.
This goes against a marketing
culture within the industry that has relied on selling as many drugs as possible
to the widest number of patients - a culture that has made GSK one of the most
profitable pharmaceuticals companies, but which has also meant that most of its
drugs are at best useless, and even possibly dangerous, for many patients.
Dr Roses said doctors treating
patients routinely applied the trial-and-error approach which says that if one
drug does not work there is always another one. "I think everybody has it
in their experience that multiple drugs have been used for their headache or
multiple drugs have been used for their backache or whatever.
"It's in their experience,
but they don't quite understand why. The reason why is because they have
different susceptibilities to the effect of that drug and that's genetic,"
he said.
"Neither those who pay
for medical care nor patients want drugs to be prescribed that do not benefit
the recipient. Pharmacogenetics has the promise of removing much of the
uncertainty."
Response rates
Therapeutic area: drug
efficacy rate in per cent
Alzheimer's: 30
Analgesics (Cox-2): 80
Asthma: 60
Cardiac Arrythmias: 60
Depression (SSRI): 62
Diabetes: 57
Hepatits C (HCV): 47
Incontinence: 40
Migraine (acute): 52
Migraine (prophylaxis)50
Oncology: 25
Rheumatoid arthritis50
Schizophrenia: 60
(Noot: ImmunoPro, het natuurlijke "medicijn" werkt wel en bij iedereen!)