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How to Enroll in a Drug Study
There are several ways in which patients and their physicians
can learn of clinical trials in which they may want to take part.
Research subjects are frequently recruited through newspaper ads
placed by participating hospitals. Such ads explain what kind of
patients are wanted and how they can get further information about
the study. Specialists are likely to be aware of new experimental
drugs in their field of practice and know which of their colleagues
are carrying out clinical trials.
Patients who are thinking about participating in drug test- ing
should talk to their physicians, who may in turn con- tact a drug
company or teaching hospital for information. (FDA is not permitted
to release information about ongoing clinical studies unless the
drug sponsor agrees or the information is already public
knowledge.) Protecting the right and safety of people who
participate in drug testing is a major concern shared by drug
sponsors, clinical investigators and FDA. Each design, or protocol,
for a clinical trial has to ensure that no participant will be
subjected to unnecessary risk or be deprived of needed care merely
to find out if a new drug is effective. Once an investigational
drug has been shown to save patients lives or prevent their disease
from causing irreversible damage, patients in clinical trials
cannot be denied that therapy by being given a placebo. On the
other hand, once they're properly informed, patients may agree to
take part in placebo-controlled studies when their only risk would
be discomfort. (For more information about protecting research
subjects, see "Protecting 'Human Guinea Pigs"' in the December
1986-January 1987 FDA Cotisiitiier). Those contemplating enrolling
in a drug study should be aware of quackery disguised as legitimate
clinical research. How can a person tell whether he or she is
volunteering for bona fide medical research or is about to be
victimized by medical fraud'? A prudent first step would be to ask
your doctor about the investigator, the institution, and the drug.
If you decide to get in touch with the researchers, ask to see the
informed consent form. Insist on meeting with someone in authority
to explain the project to you in terms you can understand. Ask
questions, and if you are not completely satisfied with the
answers, don't agree to participate. Don't sign anything that
waives your rights if you are harmed in the course of the study. No
legitimate drug sponsor or investigator requires that. Be very
suspicious if you are asked to pay for an investigational drug. FDA
can allow drug sponsors to recover research and development costs
by selling investigational drugs, but only in the later stages of
clinical trials and only when it's understood that the sponsor
intends to bring the drug to market.
This is not the usual pattern. Ask to see evidence that FDA has
both approved the study and given approval of the investigational
drug to be sold. See if the drug used in the "clinical trial" is
being advertised as effective treatment for people who have the
disease. Such advertis- ing violates FDA regulations. If you become
aware of what appears to be health fraud masquerading as clinical
research, call the nearest FDA office. It's listed in the phone
book under U.S. Government. Not everyone may be willing to become a
clinical research subject. But, as an industry scientist pointed
out, participants in phase 2 and 3 clinical trials are very likely
to get excellent care at the hands of people who really know their
business. And they just might be involved in an important advance
in treatment for their disease."
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