Jerry Avorn, MD
speaker
49 appearances
1 recordings
1 series
first heard May 2025
last heard May 2025
Jerry Avorn, MD’s voice in public audio — every appearance, attributed to the second.
Trend
recordings per month · last 12 monthsNo recordings in the last 12 months.Older appearances are listed below; set an alert to hear about the next one.
Appearances
I think we just need to hold the FDA to the standard that it was really expected to meet back in 1962 when its legislation was established, that it needs to make sure the manufacturer showed the drug is safe and effective before approving it. And one of the maybe scarier points is that because FDA has gotten lax on that and has accepted changes in lab tests,
And then as a marker for approving a drug, even though it doesn't show that it helps patients. And I think even worse, FDA has then failed to follow up on requiring that the companies do the follow-up studies that the law requires them to, which of course the companies are happy to forget doing if they have a drug that may not pass those tests and they can leave it on the market.
charge full freight for it, and then it may be years before we find out that it really doesn't help people. So I think all we need to really expect is that the FDA will do its job better than it has been doing, and that companies essentially have their feet held to the fire and be told, look, you can charge a lot for this drug, and if it's a great drug, that's okay, and we'll pay for it.
But you can't not study it adequately and then not do the follow-up studies that the law requires you to do and expect that somebody is going to come up with either $50,000 or in some cases $300,000 a year, as we see in the drugs for muscular dystrophy, for drugs that have not been shown to help.
So I think one of the things that I, when I teach doctors, I urge my colleagues to do is just because it's new and shiny and there's a tremendous sales pitch that you're presented, you know, maybe over a delicious dinner at the best restaurants in town. I think all of us as doctors ought to have a, just a high level of,
wanting to see more about the evidence and that doesn't mean that every doctor needs to study every drug but to not assume that if it's new and it's expensive and it's fda approved it's got to be better than what we've already got sometimes it is and we need to be very open to that but sometimes it isn't and you know you can just turn on the tv and see all the different psoriasis and eczema
drugs that are so lavishly advertised. And frankly, a lot of them are not a lot better than the older ones that we have that are way cheaper. So I think doctors and patients alike need to basically have a high level of scrutiny about how do we know it's better. And doctors can ask that of the sales reps that come to visit them from the companies.
And I think patients can also ask their doctors, first of all, you should ask, what is this going to cost me? Because we've got an awful lot of prescribing that We, as doctors, do. We have no way of knowing what it's going to cost the patient.
And I've often had patients, I write them a script that looks like a good drug for them, and then they go to the drugstore and they find out what it's going to cost, even if they have health insurance and they can't afford it. So I think there is a responsibility of us doctors to learn more about what things cost.
And for patients, when you're with a doctor, I think it's perfectly fair to say, is there a related drug that is going to be more affordable and work just as well? And any doctor worth his or her salt ought to be willing to answer that question.
They do not volunteer it because that's not a selling point. They are trained heavily on what are the selling points and affordability is usually not a selling point. And I don't see sales reps anymore because it is not easy. way to learn about drugs. But when I used to, and if I would ask that question, they would say, Dr. Avorn, I'm just here to tell you about the new product.
I don't get into pricing. But what you can do is there's a couple of apps that are out there that people can look up and find out what is this drug going to cost. Doctors can look it up. Patients can look it up.
And to see if there's maybe another drug that works as well and is going to end up being much more affordable because one in five Americans cannot afford the drugs that we doctors prescribe for them. So something is wrong if we make a careful prescribing decision, the patient gets to the drugstore and then they can't buy what we prescribe because it's too expensive.
Absolutely.
Yeah, I think that is exactly, and I think you said it perfectly, that if we have a system in which any drug can show, all it really has to show is that it's better than placebo or better than nothing. That is the legal standard that unless it's a condition where you've got a treatment, you know, like HIV or cancer, where you have a drug you know works,
You can't test your new drug against just a sugar pill. But for a condition like eczema, which is not going to kill anybody, or psoriasis, it is okay. I mean, it's allowed by the law to test the drug against nothing. And the legal standard is that if you're a drug company and you can show your new drug works better than a placebo, the FDA is kind of legally obliged to approve it.
And that is problem one. Problem two is that the company then gets to decide what it wants to charge for it, and it can charge whatever in the world it wants to charge.
They would say we are under a ton of political pressure to not make enemies in high places. And this is the case for both the Democrats and the Republicans. This is an equal opportunity problem we've got. Most people don't know that about half of the salary that FDA pays to the doctors and other scientists who review the drugs that it's evaluating are actually paid by the drug industry.
And that... has a long history where the congress has not given fda enough money and that was before the current cutbacks hasn't got given fda enough money to hire enough people to review the drugs and back in 1992 the drug industry came along and said well That's a problem for us, too, because we want our drugs approved quickly. Why don't you let us pay something that's known as user fees?
And we will simply pay the FDA a huge amount of money for each drug that it reviews. And that's how you can meet salary for your scientists to review the drugs.
Showing 21–40 of 49 · page 2 of 3
← Previous
Next →