From time to time, I am asked by someone about participating
in a medical research study. These
situations are usually when an individual, or someone close to them, has unmet
medical needs. Understandably, a patient
with a condition who is not improving on standard treatment, would be amenable
to participating in a clinical trial to receive experimental treatment.
I find that most folks misunderstand and exaggerate the
benefits they may receive as a medical study participant. Sometimes, I feel their ‘misunderstanding’ is
fueled by study investigators who may overtly or unconsciously sanitize their
presentation to patients and their families.
There is no malice here.
Investigators have biases and likely believe that their experimental
treatment actually works. Their optimism
is likely evident in their communications.
Here’s what an investigator might say to a patient.
I thought you would be
interested in a new clinical trial testing a new medicine for your
disease. Preliminary data show promising
results.
If you were a patient, wouldn’t you infer that the drug
might help you?
Patients, I have found, are of the mistaken belief that they
may directly benefit from the drug being tested. Of course, this makes sense to them. Their rheumatoid arthritis drug isn’t
working. They are informed of a clinical
trial of a new treatment for patients who do not respond to conventional
treatment. Obviously, they enter this
trial with the hope that their condition will improve. Unfortunately, this is the wrong way to
approach a medical study.
Louis Pasteur - Legendary Medical Researcher
Clinical trials are not designed to benefit the
participants. They are performed to
generate new knowledge that may help future patients. This is the key point that so many study
participants are not fully aware of, and they should be. The investigators do not know important data
about safety, efficacy and dosing. These
are among the fundamental data that the study – and future studies – will determine. If medical investigators knew that the drug
actually worked, then there would be no need for a clinical trial. There’s a reason behind the term experimental treatment.
If you want to enter a clinical trial, know that you are
doing so to help others who will come after you. This is a selfless and praiseworthy
event. Indeed, we have all benefited
from the sacrifice and altruism of prior patients who agreed to create new
knowledge to help us. If we enter a study we may not
personally receive a return on investment for our efforts, but we are paying it
forward to others.
I have a theory that if you receive a free dose of Exceedingly Expensive Brand New Medicine X (EEBNMX) in a Doctor's office, and if your insurance refuses to pay for EEBNMX, and if you take the "zero-copay medical assistance card" for EEBNMX so that you can continue to get EEBNMX for a year 'while insurance issues are being worked out', then you are really participating in a thinly veiled research trial. Sure, it's post-approval of the med, but it'll become the data mine for "post-marketing reports" and "early adopters' experiences".
ReplyDeleteAm I wrong? Paranoid?
I'm just a lowly public school educator but I'd love to know if my theory is correct. I look forward to my next dose of EEBNMX that I'll get with the zero-copay medical assistance card.