View source for Philosophy:Inverse benefit law

{{Short description|Drug benefit-harm ratio falls with marketing}}
The '''inverse benefit law''' states that the ratio of benefits to harms among patients taking new drugs tends to vary inversely with how extensively a drug is marketed. Two Americans, Howard Brody and Donald Light, have defined the inverse benefit law, inspired by Tudor Hart's [[Philosophy:Inverse care law|inverse care law]].<ref name=pmid21233426>{{cite journal |doi=10.2105/AJPH.2010.199844 |pmid=21233426 |pmc=3036704 |title=The Inverse Benefit Law: How Drug Marketing Undermines Patient Safety and Public Health |journal=American Journal of Public Health |volume=101 |issue=3 |pages=399–404 |year=2011 |last1=Brody |first1=Howard |last2=Light |first2=Donald W }}</ref>

A drug effective for a serious disorder is less and less effective as it is promoted for milder cases and for other conditions for which the drug was not approved. Although [[Physics:Effectiveness|effectiveness]] becomes more diluted, the risks of harmful side effects persist, and thus the benefit-harm ratio worsens as a drug is [[Finance:Marketing|marketed]] more widely. The inverse benefit law highlights the need for [[Medicine:Comparative effectiveness research|comparative effectiveness research]] and other reforms to improve [[Medicine:Evidence-based medicine|evidence-based]] prescribing.<ref name=pmid21233426/>

== State of affairs ==
The law is manifested through 6 basic marketing strategies:
* reducing thresholds for diagnosing disease,
* relying on surrogate endpoints,
* exaggerating safety claims,
* exaggerating [[Chemistry:Efficacy|efficacy]] claims,
* [[Social:Disease mongering|creating new diseases]],
* encouraging unapproved uses.

== Impact ==
This is the reason why organizations like "Worst Pill, Best Pill" <ref>{{cite web|url=http://www.worstpills.org/ |title=Worst Pill, Best Pill. Public Citizen's Health Research Group |publisher=Worstpills.org |date= |accessdate=2014-02-17}}</ref> recommend not to use/prescribe new medications before being in the market for at least ten years (except in the case of important new drugs that treat previously unsolved problems).

Agencies of drugs, committee of ethics and organizations of patients' safety should consider: 
* Requiring that clinical trials run long enough to pick up evidence of side effects and record all adverse reactions, including in subjects who drop out.<ref name=pmid10328077>{{cite journal |doi=10.1001/jama.281.18.1753 |pmid=10328077 |title=The Safety of New Medicines |journal=JAMA |volume=281 |issue=18 |pages=1753–4 |year=1999 |last1=Wood |first1=Alastair J. J }}</ref>
* Paying companies more for new drugs in proportion to how much better they are for patients than existing drugs, and marketing according to the value of the new drugs (ratio of benefits to harms and marketing).<ref>{{cite web|url=http://english.prescrire.org/en/81/168/46799/0/NewsDetails.aspx |title=Astellas' lawsuit against Prescrire: French court rules that Prescrire did not "denigrate" Protopic° (tacrolimus). Prescrire. 2 March 2011 |publisher=English.prescrire.org |date=2011-03-02 |accessdate=2014-02-17}}</ref>
* Considering that market could be a force against the best use of medications.<ref>[http://www.actasanitaria.com/el-mirador-de-juan-gervas-garum/ Gérvas J. Garum. Acta Sanitaria. 07/03/2011.]</ref>

== See also ==
{{col div}}
* {{annotated link|Social:Disease mongering}}
* {{annotated link|Medicine:Health policy}}
* {{annotated link|Philosophy:Inverse care law}}
* {{annotated link|Medicine:Medicalization}}
* {{annotated link|Patient safety}}
* {{annotated link|Medicine:Pharmaceutical industry}}
* {{annotated link|Medicine:Pharmaceutical marketing}}
* {{annotated link|Medicine:Quaternary prevention}}
* {{annotated link|Medicine:Medical science liaison}}
{{colend}}

== References ==
{{reflist}}

== Bibliography ==
* [http://www.pharmamyths.net Light DW (Editor). The Risks of Prescription Drugs. New York: Columbia University Press; 2010.] 
* [https://web.archive.org/web/20101225093331/http://www.jameslindlibrary.org/pdf/testing-treatments.pdf Evans I, Thornton H, Chalmers I. Testing Treatments: Better Research for Better Healthcare. London: Pinter & Martin Ltd; 2010.]

== External links ==
* [http://www.pharmamyths.net/_the_inverse_benefit_law__105485.htm Donald W. Light]
* [http://www.equipocesca.org Equipo CESCA]
* [http://www.healthyskepticism.org/global/ Healthy Skepticism]
* [http://www.worstpills.org Worst Pills, Best Pills]
* [http://www.psn.es Better Healthcare]

[[Category:Adages]]

{{Sourceattribution|Inverse benefit law}}