Race, money and medicines

Journal of Law, Medicine and Ethics

Volumn 34, Issue 3, 2006, Pages 555-558

  Bloche, M Gregg ^a,b,c  

^a GEORGETOWN UNIVERSITY   (United States)

^b BROOKINGS INSTITUTION   (United States)

^c JOHNS HOPKINS BLOOMBERG SCHOOL OF PUBLIC HEALTH   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

HYDRALAZINE; HYDRALAZINE PLUS ISOSORBIDE DINITRATE; ISOSORBIDE DINITRATE; ISOSORBIDE HYDRALAZINE COMBINATION; ISOSORBIDE-HYDRALAZINE COMBINATION; VASODILATOR AGENT;

CIVIL RIGHTS; CLASSIFICATION; CLINICAL TRIAL; CONFERENCE PAPER; CONGESTIVE HEART FAILURE; CONTROLLED CLINICAL TRIAL; DRUG APPROVAL; DRUG COMBINATION; DRUG INDUSTRY; ECONOMICS; ETHICS; ETHNIC GROUP; FOOD AND DRUG ADMINISTRATION; GENETICS; HEALTH CARE COST; HEART FAILURE; HUMAN; MEDICAL RESEARCH; PATIENT SELECTION; RACE; RANDOMIZED CONTROLLED TRIAL; RANDOMIZED CONTROLLED TRIAL (TOPIC); SOCIAL PSYCHOLOGY; SOCIOLOGY; UNITED STATES;

BIOMEDICAL RESEARCH; CIVIL RIGHTS; CONTINENTAL POPULATION GROUPS; DRUG APPROVAL; DRUG COMBINATIONS; DRUG INDUSTRY; ETHICAL ANALYSIS; ETHNIC GROUPS; HEALTH CARE COSTS; HEART FAILURE; HEART FAILURE, CONGESTIVE; HUMANS; HYDRALAZINE; ISOSORBIDE DINITRATE; PATIENT SELECTION; PREJUDICE; RANDOMIZED CONTROLLED TRIALS; RANDOMIZED CONTROLLED TRIALS AS TOPIC; SOCIOLOGY, MEDICAL; UNITED STATES; UNITED STATES FOOD AND DRUG ADMINISTRATION; VASODILATOR AGENTS;

EID: 33749389945     PISSN: 10731105     EISSN: 1748720X     Source Type: Journal    
DOI: 10.1111/j.1748-720X.2006.00069.x     Document Type: Conference Paper

References (13)

1. D. E. Roberts, "Legal Constraints on the Use of Race in Biomedical Research: Toward a Social Justice Framework," Journal of Law, Medicine & Ethics 34, no. 3 (2006): 526-534.
2. J. N. Cohn, "The Use of Race and Ethnicity in Medicine: Lessons from the African-American Heart Failure Trial," Journal of Law, Medicine & Ethics 34, no. 3 (2006): 552-554.
3. R. Bhopal, "Race and Ethnicity, "Responsible Use from Epidemiological and Public Health Perspectives," Journal of Law, Medicine & Ethics 34, no. 3 (2006): 500-507.
4. This, of course, isn't necessarily true in a quantitative sense: what has happened is not an indicator of the probability of the thing-happening again, absent a sufficient number of similar past scenarios to make prior occurance statistically meaningful.
5. Id.
6. J. Kahn, "How a Drug Becomes 'Ethnic': Law, Commerce, and the Production of Racial Categories in Medicine," Yale Journal of Health Policy, Law & Ethics 4 (2004): 1-46.
7. Indeed, it once was, with disappointing results, achieved years before the current, state-of-the-art drug treatment for heart failure (an angiotensin converting enzyme (ACE) inhibitor) became standard. BiDil in conjunction with an ACE inhibitor has never been studied in a multi-ethnic population.
8. From a patent law perspective, BiDil's developers could have chosen a racial or ethnic group other than African-Americans. In this issue, the BiDil patent holder, Jay Cohn (who licensed his intellectual property rights to NitroMed, the drug combination's developer), summarizes the BiDil investigators' scientific rationale for selecting African-Americans. Cohn, supra note 2.
9. M. G. Bloche, "Race-Based Therapeutics," New England Journal of Medicine 351 (2004): 2035-2037.
10. See generally, J. Avorn, Powerful Medicines: The Benefits, Risks, & Costs of Prescription Drugs (New York, N.Y.: Knopf, 2004) (reviewing the pharmaceutical industry's responses to market and regulatory incentives).
11. J. Reichman, unpublished manuscript on file with author.
12. Conflicts-of-interest arising from relationships with pharmaceutical and biotechnology companies have become a matter of controversy for NIH-employed scientists as well as for researchers who receive regular funding from NIH's extramural grant programs. See J. Kassirer, On the Take: How Medicine's Complicity with Big Business Can Endanger Your Health (New York, N.Y.: Oxford University Press, 2004). These conflicts present serious problems, but the problems would be even greater absent a large, dependable flow of funding allocated in non-commercial fashion by NIH's peer review system.
13. This approach would fit well with more robust FDA efforts to induce drug makers to track prescription-related adverse events after the agency approves new medicines.