Given the popularity of Tufts' Community Health program and the strong interest in Ex-College courses related to public health, pharmaceutical companies, and prescription drugs, it's not surprising that the spate of recent drug recalls has stirred up discussion in both academic and personal settings among Tufts students and faculty members.
According to Edith Balbach, Director of the University's community health program, there is a conflict of interest for companies like Merck & Co (see box) that are torn between optimizing their profits and ensuring the safety of their products. "We rely on these companies," she said. "We need the companies to be honest about research."
In Balbach's "Community Health and Drugs" course, students analyze the policies that govern the drug world, and the biological, political, cultural, and economic factors involved in the creation of these policies.
While the course focuses more on drugs with the potential for abuse, such as OxyContin, Balbach draws a parallel between the two drugs. "Multinational pharmaceutical companies make huge profits from both [VIOXX and OxyContin], and both call for a system to make sure that the drug is not harmful," she said.
One reform proposed by Keith Wilcoxen - who teaches the current Ex-College course "Discoveries, Drugs and Money: 100 Years of Pharmaceuticals" and is a senior research investigator at the Eisai Research Institute - involves prolonging the Food and Drug Administration's (FDA) participation in clinical trials for new medication.
Currently, the FDA oversees clinical trials only before the drug is put on the market. Once the drug is introduced, it is no longer the FDA's job to regulate it; it is solely the pharmaceutical company's responsibility to carry out thorough and accurate testing. Wilcoxen said that a neutral party such as the FDA might be a more effective supervisor of such testing.
According to Wilcoxen, carrying out effective clinical trials is extremely complex. "The trials are very expensive and time consuming and require the testing of thousands of patients, and even when companies test thousands of people for side effects, the medication will be used by millions once it is put on the market," he said.
"Moreso, as arthritis medication, VIOXX was taken mostly by elderly people, who are frailer by nature," he added. "Many [VIOXX-users] were over 70 years old; of course they were more prone to cardiovascular problems."
Although pharmaceutical companies are often put in compromising situations when recalling medication will be costly, both Balbach and Wilcoxen praised those companies for their important work creating life-saving medication.
"The pharmaceutical companies do good things for us - the drug discoveries are amazing," Balbach said. "The question is, how do we ensure whether [the companies] are serving the public interest?"
Wilcoxen believes that it's the patient's responsibility to educate him or herself about the medication they are taking. "We are a pill nation," he said. "It is our responsibility to educate ourselves."
Many Tufts students are taking steps to do just that. Freshmen Margaux Birdsall is careful to research her prescriptions before using them: "I usually ask my doctor if there are any side effects and if it contains any of the known things I'm allergic to," she said.
Freshman Laura McNulty takes things a step farther. "I go on the internet, do a Google, and then try to find a reputable source," she said, adding "not 'Joe's favorite medicines,' but a trustworthy site."
While a number of students are taking the initiative to learn about the risks involved with their medication, others rely on their doctors and other healthcare professionals to inform them of any potential side effects.
"If it's an antibiotic, I don't [research the prescription], but if it's a different type of inhaler, I go online, call my doctor, or ask my mom, who's a nurse," sophomore Nathaly Spilotros said.
"I ask my doctor, but I never research medication myself," freshman Sari Haime said.
For some students, learning about the problems with medications like VIOXX has had a lasting effect. "I might look more carefully into prescription drugs that I take in the future," said freshman Aaron Harris, who has never researched prescriptions in the past - said.
Even thoroughly researched medication may have potential risks attached. According to Wilcoxen, "potential medication users should keep in mind that no drug is 100 percent safe. But taking the initiative to research your prescription medication is an important step in lowering your risk of side effects."
