Kodi Psychiatry Yawonongeka Mopanda Kukonzanso?

Zamkati

• Psychiatry Yofunika Kuwerenga
• Kuphatikiza Kusamalira Maganizo Pazinthu Zoyeserera Zoyambira

Tikudziwa kuti mabungwe amatha kuwonetsa zochepa pobisa kuwonongeka kwa zinthu zawo. Opanga ndudu amabisa ulalo wa khansa yamapapo kwazaka zambiri. Makampani opanga mphamvu zamagetsi ndi anzawo andale amakana kulumikizana kulikonse pakati pa mafuta ndi zotsalira zapadziko lonse lapansi. Koma palibe mafakitale omwe adachita zinthu mwadongosolo kapena opambana monga makampani azamankhwala omwe amalowerera pazidziwitso zazogulitsa zawo. Zotsatira zake zakhala phindu lalikulu. Makampani khumi opanga mankhwala mu Fortune 500 amapanga ndalama zambiri kuposa makampani ena 490 kuphatikiza .

Ingoganizirani izi: Bwanji ngati wasayansi aliyense yemwe akuphunzira kutentha kwanyengo adalipira ndi Exxon? New York ikanakhala ili m'madzi munthu aliyense asanadziwe kuti kutentha kwa dziko kulibe. Komabe, ndi momwe zimakhalira pakafukufuku wasayansi wazamisala. Oposa 80 peresenti ya kafukufuku wamankhwala omwe amachitika m'malo ophunzirira amathandizidwa ndi ogulitsa mankhwala. Ndipo ndiyo nkhani yabwino. Ndikuchulukirachulukira, Big Pharma ikulipira makampani otsatsa omwe alibe zibwenzi ku maphunziro kuti apange maphunziro omwe amaika zinthu zawo mwanzeru; amalipira ophunzira kuti alembe mayina awo pamaphunziro omwe amadzalembedwa ngati olemba, ngakhale sanatenge nawo mbali pazofufuzazo. Kuti muwone zotsatira zake, tengani chitsanzo cha Neurontin.

Pafupifupi zaka 12 zapitazo, ndinawona kuti ambiri mwa odwala anga amtundu wa bipolar II anali kuyikidwa mankhwala atsopano, Neurontin. Palibe wodwala wanga yemwe amawoneka kuti amalandila zambiri, ndipo ambiri amakhala ndi zovuta. Tsopano, ndikumvetsa chifukwa chake.

Tsopano tikudziwa kuchokera ku kafukufuku wodziyimira pawokha - kafukufuku yemwe sanalandiridwe ndalama ndi makampani azamankhwala - kuti Neurontin sapereka phindu lililonse pakuthandizira matenda abipolar. Palibe. Komano, ndichifukwa chiyani timakhulupirira kuti zidatero? Nkhani ya Neurontin ndi chitsanzo chochititsa chidwi kwambiri cha sayansi yomwe imathamanga, koma osati yovuta. Madokotala azamisala adanyengedwa kuti apereke mankhwala omwe anali osatetezeka komanso osagwira ntchito.

Phunziro lomwe Warner Lambert ankakonda onetsani Neurontin anali othandiza pochiza matenda ochititsa munthu kusinthasintha zochitika anali ndi zolakwika ndipo amatchedwa zotsatira zabwino, malinga ndi nkhani yaposachedwa yofalitsidwa mu Zosungidwa Zamankhwala Amkati . Choyipa chachikulu, umboni wazotsatira zoyipa phunziroli udaponderezedwa: Odwala 73 pamayeserowa adakumana ndi zovuta, ndipo odwala 11 adamwalira.

Zidachitika bwanji izi? Mu 1993 Warner Lambert anali ndi vuto. Neurontin, mankhwala awo atsopano olimbana ndi khunyu, anali atangopatsidwa chilolezo chochepa cha FDA chongogwiritsa ntchito ngati mankhwala achifuwa cha mzere wachiwiri - atha kugwiritsidwa ntchito ngati mankhwala ena akhunyu omwe ali kale pamsika alephera. "Neurontin anali Turkey." Adalemba Daniel Carlat mu Zosakanizidwa . Zoyenera kuchita?

Kampaniyo idalemba makampani otsatsa - osati asayansi - kuti apange zolemba zasayansi zosonyeza phindu la Neurontin wamavuto abipolar, ndipo adalipira madokotala $ 1,000 chidutswa kuti maina awo alembedwe ngati olemba maphunziro omwe sanachite kapena kulemba (ndi mwina simunawerengepo).

Ngakhale kuti FDA imafuna umboni wokwanira wasayansi kuti ivomereze mankhwala ochizira matenda ena, mankhwalawo akangovomerezedwa, madotolo ali ndi ufulu wopereka mankhwala aliwonse amtundu uliwonse, kuchoka pamakalata. Kuti awatsimikizire kuti achite izi, zofooka kapena zosisita zitha kuvekedwa kuti zitsimikizire kuti mankhwalawa ndi othandiza, ndipo palibe kuwunika kwa FDA komwe kumafunikira. Ndi mlandu kuti kampani yopanga mankhwala osokoneza bongo kugulitsa mankhwala kwa madotolo pazolemba, koma ndizomwe zidachitika. Marcia Angell, mkonzi wakale wa New England Journal of Medicine , analemba kuti: "kampaniyo idachita chiwembu chachikulu cholimbikitsira Neurontin kuti asagwiritse ntchito zilembo - makamaka polipira akatswiri kuti aike mayina awo pazofufuza zopanda pake."

Mankhwala osokoneza bongo amatsikira kwa azachipatala. Woyang'anira wamkulu wa Warner Lambert a John Ford adalimbikitsa ma reps ake kuti "agwire manja awo ndikuwanong'oneza m'makutu ... Neurontin wamavuto abipolar." Anapitiliza, kuwalimbikitsa kuti apitirire kuchuluka kwa FDA ya 1800 mg / tsiku, ndikuwonjezera "Sindikufuna kumva zopanda pake." Warner Lambert adalipira chindapusa miliyoni 430 chifukwa chotsatsa mwachinyengo komanso mosaloledwa kwa Neurontin kwa akatswiri amisala.

Kodi vuto lokhalo la Neurontin? Kulemba kwamaphunziro kwamaphunziro opangidwa ndi makampani otsatsa ndichinthu chokhazikika. Mu 2001, makampani opanga mankhwala osokoneza bongo adalipira $ 7 biliyoni kumabungwe zikwizikwi ofufuza zamakontrakitala kuti apange deta yomwe imawathandiza. Kodi izi zalowa bwanji m'maganizo? Mwachitsanzo, 57% yazolemba zasayansi zokhudzana ndi Zoloft, mwachitsanzo, zidalembedwa ndi kampani yotsatsa ya Current Medical Directions komanso mzimu womwe udalembedwa ndi akatswiri omwe sanatenge nawo gawo pamaphunzirowa. Zolemba izi zidalembedwa m'magazini apamwamba kuphatikiza American Journal of Psychiatry ndi Zolemba pa American Medical Association. "Chifukwa chake, kwa munthu m'modzi wotsutsa-depressant, ambiri mwa mabuku azachipatala adalembedwa ndi kampani yomwe idapanga mankhwalawa, zomwe zikuwoneka ngati zowononga sayansi monga momwe tingaganizire," adalemba Carlat. Ndipo mu New York Times Carl Elliot analemba kuti, "Makampani opanga mankhwala amalimbikitsa mankhwala awo ndi maphunziro abodza omwe alibe phindu lililonse asayansi."

Psychiatry Yofunika Kuwerenga

Kuphatikiza Kusamalira Maganizo Pazinthu Zoyeserera Zoyambira