Friday, April 08, 2005

Bextra - costs and benefits.

In an interview on All Things Considered today, a physician who specializes in pain treatment argued that maybe the pain doctors have been drowned out by the cardiologists in the decisions on Bextra and Vioxx and the other NSAIDs.

His point was something like this: It's true that there are real cardiovascular (and other) risks associated with taking these drugs, especially at high doses and for a long time. However, it's not clear that the FDA really considered the benefit of these drugs to people with severe pain, or the harms done to these patients if their severe pain is left untreated. The doctor argued that, with what drugs are left after Bextra and Vioxx were pulled, there will be patients whose pain cannot be adequately treated. And even the over-the-counter NSAIDS left (like ibuprofen and naproxen) have non-negligible side effects (especially at doses at which they'd make any kind of dent in real pain).

So maybe the FDA is not aware of all the costs and benefits that ought to be balanced? Or maybe the FDA is being paternalistic here? (Or is my brother the law student gonna explain to me how this all hinges on reducing someone's legal liability?)


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