A senior executive with Britain's biggest pharmaceutical 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.
Most prescription drugs work in only 30 to 50% of patients. Old news, you say? It made headlines in the UK when Allen Roses, PhD, senior vice president of genetics research at GlaxoSmithKline, said it in front of a reporter in London. The Times of London ran a story on December 8, 2003 covering the statement; The Independent ran two articles and an editorial.
Why was this news to the editors of the UK papers? Roses has said as much in many different public places. He wrote it in the pages of Drug Discovery & Development, August 2003, p. 15), though admittedly, the general public probably missed that article. And Roses is not alone. Brad Spear and colleagues published a piece in Trends in Molecular Medicine in 2001 detailing the efficacy of most drugs in the general population, and those figures have been widely referenced by a number of researchers. Spear is the source, in fact, of the 30 to 50% figure cited by Roses.
An academic geneticist from Duke University in North Carolina, Roses also cited figures on how well different classes of drugs work in patients. For example, Alzheimer’s drugs work in only 30 percent of patients, SSRI antidepressants in 62 percent of patients, hepatitis drugs in 47 percent of patients, migraine medicines used to treat acute attacks in 52 percent of patients, cancer drugs in 25 percent of patients and rheumatoid arthritis drugs in only half of patients. The majority of drugs, Roses said, only work in 30 or 50 percent of the people taking them.
"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 drug business based on using genes to test for who can benefit from a particular drug."
Dr. Roses, whose background is in the field of "pharmacogenomics," the application of human genetics to drug development, may be trying to nudge the industry into realizing that its future rests on targeting drugs to a smaller number of patients with specific genes. Although this would be an immense improvement from the status quo—marketing as many drugs as possible to a large number of patients—it neglects an important aspect of pharmaceutical drugs: that even if they work they’re often associated with numerous side effects, some of them life threatening. It also continues the policy of treating symptoms of a disease rather than modifying the nutritional deficiency that may have contributed to it in the first place.
Dr Roses said doctors treating patients routinely apply 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.
Given most conventional physicians’ overconfident assurance that drugs are the only approach to disease treatment, Roses’ statement is both sobering—and ironic.
There exist alternatives such as combining nutritional supplements with lifestyle modifications. Only when conventional doctors take this approach will the consumer be the one to profit—not the pharmaceutical companies.
Therapeutic area: drug efficacy rate in percent
Editorial: Drug Discovery and Development. http://www.dddmag.com/ShowPR.aspx?PUBCODE=016&ACCT=1600000100&ISSUE=0312&
B. B. Spear et al. Trends in Molecular Medicine in 2001, vol. 7, pp. 201–204.