Prometheus 6

In Drug Research, the Guinea Pigs of Choice Are, Well, Human
By ANDREW POLLACK

Researchers at the University of Munich repeated the experiment 70 times: a healthy volunteer would receive a chemical injection, then be left alone to ride out an artificially induced panic attack.

From the next room, doctors watched the volunteer's restlessness via video camera, measured the quickening pulse and rise in blood pressure, and used an intercom to question the person about his or her feelings of impending doom. The attacks typically lasted 5 to 10 minutes.

Each volunteer was put through the same test a few days later, but this time most of them first received an experimental anti-anxiety drug. The drug quelled anxiety well enough in those experiments last year that its developer, the Swiss pharmaceutical company Novartis, gained the confidence to conduct large clinical trials.

The company's approach is part of a trend in the pharmaceutical industry. Drug researchers are conducting small, fast, relatively inexpensive tests on people to get a quick gauge of a drug's promise before committing to full-scale clinical trials that may involve hundreds of patients, millions of dollars and many years of study. Often called experimental medicine, the approach is meant to reduce the huge costs of drug development and speed the most promising treatments into the marketplace.

They advertise for guinea pigs, you know. The ads go something like:

Do you have this problem? This terrible, terrible problem that is embarrassing or painful or prevents you from having a normal life? We've seen it before and everyone knows you have the problem. So sad. So very sad.

But now there's hope. Researchers are testing an experimental medication for just your type of problems. If you ask us nicely we'll let you have some.

I figured this was the standard type of test vs. a placebo, so the implied promise of treatment was troubling. I assumed folks would be given the whole story before the trials actually begin, just as I assume those who volunteer for the "experimental drugs" are made to understand they are not being treated, just highly invasively monitored. It just wouldn't be smart (read legal and ethical) to proceed with a volunteer who wasn't absolutely crystal on the issue.

So there's no problem, really.

I'm actually a little irrational about health care issues. In an ideal world medical care and education would be pure public goods, things that are simply funded and provided. If you're the kind of person that takes that kind of thought seriously, it's frustrating to recognize there was simply no way that ideal world could have come into existence before now, and the players have no motivation to bring it about.