The inverse benefit law states that the ratio of benefits to harms among patients taking new
drug
A drug is any chemical substance other than a nutrient or an essential dietary ingredient, which, when administered to a living organism, produces a biological effect. Consumption of drugs can be via insufflation (medicine), inhalation, drug i ...
s tends to vary inversely with how extensively a drug is
marketed. Two Americans, Howard Brody and Donald Light, have defined the inverse benefit law, inspired by
Tudor Hart's
inverse care law.
A drug
effective for a serious
disorder is less and less effective as it is promoted for milder cases and for other conditions for which the drug was not approved. Although
effectiveness
Effectiveness or effectivity is the capability of producing a desired result or the ability to produce desired output. When something is deemed effective, it means it has an intended or expected outcome, or produces a deep, vivid impression.
Et ...
becomes more diluted, the risks of harmful
side effects
In medicine, a side effect is an effect of the use of a medicinal drug or other treatment, usually adverse but sometimes beneficial, that is unintended. Herbal and traditional medicines also have side effects.
A drug or procedure usually used ...
persist, and thus the benefit-harm ratio worsens as a drug is
marketed more widely. The inverse benefit law highlights the need for
comparative effectiveness research and other reforms to improve
evidence-based prescribing.
[
]
State of affairs
The law is manifested through 6 basic marketing strategies:
* reducing thresholds for diagnosing disease,
* relying on surrogate endpoints,
* exaggerating safety
Safety is the state of being protected from harm or other danger. Safety can also refer to the control of recognized hazards in order to achieve an acceptable level of risk.
Meanings
The word 'safety' entered the English language in the 1 ...
claims,
* exaggerating efficacy
Efficacy is the ability to perform a task to a satisfactory or expected degree. The word comes from the same roots as '' effectiveness'', and it has often been used synonymously, although in pharmacology a distinction is now often made betwee ...
claims,
* creating new diseases,
* encouraging unapproved uses.
Impact
This is the reason why organizations like "Worst Pill, Best Pill" recommend not to use/prescribe new medications before being in the market for at least ten years (except in the case of important new drugs that treat previously unsolved problems).
Agencies of drugs, committee of ethics and organizations of patients' safety should consider:
* Requiring that clinical trials run long enough to pick up evidence of side effects and record all adverse reactions, including in subjects who drop out.
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See also
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References
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Bibliography
Light DW (Editor). The Risks of Prescription Drugs. New York: Columbia University Press; 2010.
Evans I, Thornton H, Chalmers I. Testing Treatments: Better Research for Better Healthcare. London: Pinter & Martin Ltd; 2010.
External links
Equipo CESCA
Healthy Skepticism
Worst Pills, Best Pills
Better Healthcare
Pharmaceutics
Health economics
drug marketing and sales
Adages