Prominent doc proposes drug scorecard to keep DTC ads honest

Dr. Richard Friedman
Dr. Richard Friedman. Photo by John Abbott / Courtesy Weill Cornell Medical College

In the prescription drug game, it’s often hard for consumers to tell who’s on first. But New York Times contributing opinion writer Richard Friedman has an idea to help change that. He has proposed a universal scorecard for drug ads that would list the costs and comparative effectiveness of similar drugs.

Writing in the NYT last week, Friedman, who is also a professor of clinical psychiatry and the director of the psychopharmacology clinic at Weill Cornell Medical College, compared the scorecard to a baseball player’s batting average. He said people don’t judge how good a hitter is by the number of his home runs, but rather by the number of his hits per at-bat, which averages success and failure into one number.

His proposed scorecard would list the price, clinical trial information and the number needed to treat for similar drugs. The last is a measure of the number of patients that need to be treated for one patient to see a benefit. That means the lower the number, the more effective the treatment. 

The comparison is important to help doctors and consumers evaluate their choices, Friedman said, by going beyond the FDA current standard, which only requires that a drug beat the control or placebo in at least two randomized clinical trials. 

“I’ve always been struck by the intellectual dishonesty of drug companies,” he said in an interview with FiercePharma. "When it comes to things like withholding of safety and efficacy data or selective reporting or all of the things I mention in the piece. They spend so much money advertising and telling the public the good news, now the public is ready to hear the entire story, meaning the good and the bad."

Creating a universal drug ad scorecard would require legislation, Friedman realizes, although the FDA could be empowered to implement and enforce it. Friedman said he likely won’t launch a lobbying effort for the scorecards on his own, but would be glad to join the efforts of any group that might. 

Scorecards for drugs aren’t totally new, although none had yet been suggested for advertising. Last year, the American Society of Clinical Oncology published its idea for a framework assessing the value of cancer drugs.

After the NYT column ran, Friedman said he received many phone calls and emails from people who liked the idea. 

“If you knew that there were other drugs in the same class that are generic why would you take them if the number needed to treat is exactly the same, but the cost is triple or 10 times the amount?” he said. “It’s sort of a mix or efficacy and value. What is the person actually paying for?"

- read the NYT article

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