I want to come back to the fact that new drugs are tested against placebos. It is important to understand that the scientific research that the pharmaceutical and medical sectors engage in is set up like a marketing campaign. Private research serves to produce private arguments that support the sale of a product. The issue is whether the product is better than the other guy's.
For example, a study conducted by Merck will show that its product is better than the other guy's. Otherwise, there's no way Merck would publish the study in medical journals. A competitor, Johnson & Johnson, will claim its product is better than Merck's. Who cares. What doctors want to know is which is the better drug to prescribe to a specific population with a specific problem.
That research doesn't happen in the private sector. Pharmaceutical companies aren't going to engage in that kind of research. Their sole aim is to research their own drugs to find out whether they are more effective than a placebo, plain and simple. Then, they more or less choose the data they want published, that which demonstrates the most beneficial properties.
I know this opens another door, but the important thing to consider is, where is this research being done. Where is the research that seeks to answer questions for the public good being done? Who is determining the best treatment option for the population suffering from condition X?
In the U.S., the National Institutes of Health produces this kind of research from time to time. Every time, the agency does extraordinary studies based on public clinical trials that can show whether prescription habits are problematic and whether the best drugs are not being prescribed. That's the kind of public research needed.
As long as we continue to dump public funding on a private sector that produces therapeutic innovations based on rather mediocre testing, nothing will change. We won't be able to equip ourselves with the techniques or the health technology assessment capacity needed to support the best possible innovation outcomes.