by Stephen Tall on January 25, 2013
Liberal Hero of the Week is chosen by Stephen Tall, Co-Editor of Liberal Democrat Voice, and Research Associate at CentreForum. The series showcases those who promote any of the four liberal tenets identified in The Orange Book — economic, personal, political and social liberalism — regardless of party affiliation and from beyond Westminster. If they stick up for liberalism in some way then they’re in contention.
Ben Goldacre and +AllTrials.net
Science writer and campaigner for transparent access to and use of evidence
Reason: For campaigning to ensure all clinical trials, past and present, on all treatments in current use are available to doctors and patients.
If Ben Goldacre didn’t exist we would have to invent him. The author of Bad Science, Bad Pharma and self-confessed “nerd evangelist” has long campaigned for a more rigorous approach to public policy, with transparent access to data and evidence informing the actions of government and other organisations. As I argued here, this stress on evidence-based policy (using controlled trials where possible) should be good news for liberals:
Not only because they help promote the kind of rational-sceptical approach to policy-making that’s our natural bent anyway; but also because they encourage devolved, local experimentation, and the piloting of new ideas.
His latest campaign – All Trials Registered, All Results Reported – sees him join with others to push a campaign to open up clinical trials and their results to doctors and patients. Here’s why it matters:
Doctors need the results of clinical trials to make decisions about which treatment is best. Currently, drug companies and researchers are allowed to withhold the results of clinical trials from doctors and patients if they wish to, alongside other information. This means that we are misled about the benefits and risks of treatments. We can be misled into prescribing an expensive new drug, for example, when in reality an older cheaper one is more effective. Patients are harmed and money is wasted.
And this isn’t something that can simply be left to the regulators to look after. Practitioners and patients also need to have the power of knowledge:
A medicine does not simply “work” or “not work”. Some drugs work very well, some work less well than other drugs, but are still better than nothing. A medicines regulator decides if a drug should go on the market at all, and they have a low bar for approval. This is good: we need some less effective drugs to come on the market. For example, a patient may have idiosyncratic side effects from the best available drug for their condition, in which case it is useful to have a less effective drug to try next.
Doctors and patients need all the information about all the clinical trials that have been conducted on drugs (and other treatments) in order to make informed decisions. A clinical decision (“should this patient receive this drug?”) is very different to a regulator’s decision (“overall, is it in the interests of society that this drug should be on the market for use at all?”).
Furthermore, regulators can sometimes miss important problems with medicines. For example, as with Tamiflu, the problems with the drugs Vioxx and Rosiglitazone – both now taken off the market – were spotted by academics and clinicians rather than regulators. This is not because regulators are incompetent: these are difficult problems, so it is good to have many eyes working on them. It is also good for patients if the evidence behind regulators’ decisions can be independently assessed, to ensure regulators have made good decisions.
And if you want to do just that, you can join with more than 10,000 other people and sign +AllTrial’s petition here.