364 



of date, or prescribing- on the basis of insufficient information. "Ade- 

 quately controlled comparisons" of drugs were "almost impossible to 

 iind." There was a "plethora of poor compounds, and of new mixtures 

 of old agents." In short: "I think the physician today no longer serves 

 as a satisfactory shield for the patient against drug toxicity, ineffective 

 drugs, and high costs * * *," ^° 



Nathan S. Kline, M.D., director of research, Rockland State Hos- 

 pital, Orangeburg, N.Y., said that some ch"ug firms "seem to have 

 adhered to the statement of ethics set up by the Pharmaceutical Manu- 

 facturers Association, but others [did not]." He said there was need for 

 an authoritative source of information on new dnigs, with particular 

 respect to "psychopharmaceuticals." He concluded : 



Misrepresentation of the properties of drugs can only contribute to the confusion 

 of the general practitioner and ultimately discourage him entirely from their use. 

 As a result, there are unquestionably thousands upon thousands of patients today 

 who would show marked improvement if the appropriate drugs were adequately 

 administered, but who are not being properly treated. The industry does do much 

 by way of educating the general practitioner, and if the distortions could be cor- 

 rected its service would be truly commendable." 



Many of the medical witnesses expressed variations on the theme 

 that "no drug study is foolproof." ^^ For example, there was always a 

 considerable uncertainty factor which the layman did not generally 

 appreciate. 



But the amount of work that goes into testing any compound is almost 

 incredible, and the amount of work that goes into the establishment of one simple 

 scientific truth is enormous. People expect that everything will come out in black 

 and white. Sometimes these are matters of judgment. That is to say, there is a 

 certain amoimt of subjective evaluation. 



Somebody is an enthusiastic observer and his resiilts may be a little bit better. 

 This is not to say that he is dishonest. He may be by his enthusiasm able to make 

 his patients feel better without regard, say. to the specific pharmacologic effect 

 of what he is giving. This is, I think, well recognized by most investigators. They 

 try to back away as far as they can. They have got what they call the double blind- 

 fold method of testing, so that a blank pill and an action pill are given under 

 certain circumstances when neither the physician nor the patient knows when he 

 is getting an active substance or something that is not active. Then after the 

 results are in, the doctor finds out which way the patient reacted. Did this drug 

 in fact produce the effect or was the effect nearly as good with inert material? " 



There was an "almost unbelievable barrag-e" from the "advertising" 

 and public relations specialists" of the pharmaceutical firms to exploit 

 the products of "questionable" research, primarily for profit, according 

 to Dr. Haskell J. Weinstein, director of the Chest Hospital, Hope 

 Medical Center, Duarte, Calif. One example was "the molecule 

 maniDulation intended to bvDass patents * * * which has resulted in the 

 flood of 'me-too' products." ^* 



The physician's problem [he went on] is further multiplied by the fantastic 

 number of new drugs appearing constantly. Many of the.se are marketed before 

 the definitive information about them is available. The physician's problem 

 is complex and it is not fair, even impossible to demand that he bear almost the 

 entire brunt of the defense of the patient from such an overwhelming onslaught. 

 The pharmaceutical manufacturers must bear the burden of proof that their 

 products are exactly what they say they are, and further that they will do what 



w Administered prices. Hearings * • • on Administered Prices in the Drug Industry, 

 pt. 14. op. clt., pp. 8138-8141. 



" Ibid., pt. 16, pp. 9319. 9321. 



^ "Administered Prices, Drugs." Report of the * * ♦, op. clt., p. 182. 



13 "Administered Prices." Hearings * * • on administered prices in the drug industry, 

 pt. 16, op. clt., pp. 10341-10342. 



" Ibid., pt. 18, p. 10242. 



