Even under high magnification, new drug benefits are vanishing
By the end of the 20th century, modern medicine was fending off 190,000 deaths a year from otherwise fatal heart conditions. Funding poured into cardiovascular research, more than doubling from $3.8b in 1995 to $8.4b in 2005. Now from this richly oxygenated drug pipeline, two new heart drugs have emerged. Massive clinical trials depict, at IMAX scale, medicines that seem better, faster, stronger. But it still takes squinting to see the improvements. And even tests in tens of thousands of people aren’t large enough to show that the new drugs actually save lives.
Once, life-saving effects were visible to the naked eye. In the 1980s, a clinical trial of 17,000 people demonstrated unequivocally that aspirin prevented hundreds of deaths. After a heart attack, aspirin cuts the subsequent risk of death, stroke or heart attack by 2.0% . Improving on aspirin took nearly a decade and a trial of over 19,000 people for the faint effects of a new drug, Plavix, to surface. Plavix surpassed aspirin by a hard to see, Braille-like bump of 0.5%. But the benefits of Plavix and aspirin, taken together, are additive. After Plavix gained FDA approval in 1997, it won for drug-maker Sanofi-Aventis the second largest pharmaceutical franchise in the world.