Planck said that “science advances one funeral at a time.”
So we can now safely see that the Efficient Market Theory is dead. As we know, the EMH theory postulated that all information is reflected in current market prices. Well, as we slog our way through this financial meltdown with economic lava pulling at our heels and ankles, we recognize that the EMH theory holds less water than my grandmother’s sieve.
Hmmn, now what about clinical trials? We all would hesitate to say that science advances one funeral at a time, even though that is what sometimes happens. Max never worked at a pharmaceutical company nor was he a clinical investigator. However, his view reflects the dark underside of participating in a clinical trial.
I have recently been ruminating on rheumatoid arthritis for a client. The variability of results for the clinical trials for different drugs is astounding and confounding. As a result, it is critical to evaluate each Randomized Clinical Trial in the context of demographic and baseline disease characteristics of each population as no two trials have similar patient populations, even with similar designs.
Unfortunately, there is still a lot of suffering out there in RA. There are 4.5 million cases of RA in the US, EU and Japan, with 200,000 new cases diagnosed every year. Treatment goals in RA are reduction in signs and symptoms, prevention of structural damage, and induction of remission. Nothing is going to stop the pain, but, with the drugs currently available, methotrexate, Enbrel, Remicade, Humira, etc., sufferers can still enjoy a reasonably good of quality of life.
The other good news is that the pipeline of new drugs is very active with some promising new drugs.
The challenge, though, is that there is no efficient market theory. Even with all the information available, the heterogeneity of the disease itself and the diverse patient population and their individual sufferings indicate that there is no one drug cures all.
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