[xtraflossy]

The Major Role of Clinicians in the Discovery of Off-Label Drug Therapies
Posted 04/14/2006

Harold J. DeMonaco, M.S.; Ayfer Ali, B.A.; Eric von Hippel, Ph.D.

Abstract and Introduction
Abstract
Objective: To determine the role of clinicians in the discovery of off-label use of prescription drugs approved by the United States Food and Drug Administration (FDA).
Data Sources: Micromedex Healthcare Series was used to identify new uses of new molecular entities approved by the FDA in 1998, literature from January 1999-December 2003 was accessed through MEDLINE, and relevant patents were identified through the U.S. Patent and Trademark Office.
Data Synthesis and Main Finding: A survey of new therapeutic uses for new molecular entity drugs approved in 1998 was conducted for the subsequent 5 years of commercial availability. During that period, 143 new applications were identified in a computerized search of the literature for the 29 new drugs considered and approved in 1998. Literature and patent searches were conducted to identify the first report of each new application. Authors of the seminal articles were contacted through an electronic survey to determine whether they were in fact the originators of the new applications. If they were, examination of article content and author surveys were used to explore if each new application was discovered through clinical practice that was independent of pharmaceutical company or university research (field discovery) or if the discovery was made by or with the involvement of pharmaceutical company or university researchers (central discovery). Eighty-two (57%) of the 143 drug therapy innovations in our sample were discovered by practicing clinicians through field discovery.
Conclusion: To our knowledge, the major role of clinicians in the discovery of new, off-label drug therapies has not been previously documented or explored. We propose that this finding has important regulatory and health policy implications.
........http://www.medscape.com/viewarticle/529167

You know- Im not exactly sure how I feel about this. On one hand, it brings innovation and possible releife to patients. On the other,.. well,.. it seems no different then ME having another crazy idea, but I instead test my "hunch" out on (potentionaly unsuspecting) patients.
The difference in this "Field Discovery" is that the ones prescribing these "other" applications are doctors. There is SOME comfort in that,.. and the doc's can be sued if something doesnt work and kills somewone (good for the patient,.. well, the patients family,,sort of).
I am aware that at the core, ALL medicine comes from "field discovery",.. But while about half of these other uses came from a working relationship with the pharma company, the other half did not.

Since when did we ALL need to become doctors just to make sure the dictor were seeing is the right thing!!?

But if there is a drug that cures what ever I may have, but it's really prescribed something else, I'd be Happy that my Doc realized its "other" use.

Just wanted to post this, found it interesting. It's too hard to have a one sided viewpoint for me on this (actually, I cant remember the last time I had a one-sided viewpoint,... )