Pills, pills, pills

The FDA today asked Pfizer to take its painkiller Bextra off the market as a result of its ongoing investigation of Cox-2 inhibitor drugs. Bextra, Celebrex, and Vioxx have all been investigated by regulators for increasing risks of heart attack, gastrointestinal problems, and skin rashes. Dr. Steven K. Galson, acting director of the FDA's Center for Drug Evaluation and Research, said,

Today's actions protect and advance the health of millions of Americans who rely on these drugs every day.

Now, I am not normally a defender of big pharma, but Dr. Galson's comment contain the elements of the obvious and powerful counterargument: millions of Americans rely on these painkilling and anti-inflammatory drugs to live functional lives. This is not aspartame or ephedrine; Bextra is an important drug that improves the quality of life for millions. It's terrible that a small number of people suffer debilitating or fatal side effects, but many, many more are alleviated of suffering.

Jonas Salk's vaccine for polio caused 149 cases of the disease the year it was licensed (1955), leading to 10 deaths. Yet I think there is little doubt that the effect of that vaccine has been immensely beneficial, as the polio rate in the United States dropped 90% in the three years after it became available, and since the 1970s the infection rate has been less than one in a million. Would today's FDA have recommended Salk take his vaccine off the market?

The doctors who prescribe our drugs take an oath to do no harm, but the FDA shouldn't handcuff them to the point they can do no good.