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CMAJ - March 21, 2000JAMC - le 21 mars 2000

Drug testing a growth industry in Salt Lake City

CMAJ 2000;162:854

Do your cheeks hurt when touched? Do you have osteoarthritis of the knee? Does overexposure to the sun cause you to get cold sores? Private research firms regularly use newspaper ads in Salt Lake City to solicit individuals with these types of ailments to serve as paid subjects in drug-research studies.

Until the mid-1980s, clinical trials like these were usually done by researchers at university medical centres, but the managed-care industry put pressure on US drug companies to cut costs. Now studies to evaluate the safety and effectiveness of new drugs are more likely to be done by private companies or by doctors doing the work as a sideline to their private practices.

Faster and cheaper private studies have helped American drug companies to introduce more than 300 new drugs in the past decade, says Dr. Ralph Karler, a pharmacology professor at the University of Utah. In Salt Lake City, at least 15 organizations — including private companies, doctors, clinics and hospitals — use newspaper and broadcast ads to recruit volunteers. No figures are available for the number of tests conducted or the number of volunteers involved annually. "The drug companies are grinding out drugs at an incredible rate and they need them tested," says Karler. "It's very lucrative and it's very easy."

On a recent Sunday, Intermountain Clinical Research advertised in the Salt Lake Tribune for subjects with atopic dermatitis, cold sores, sinusitis and osteoarthritis of the knee. Two- to 4-year-old children with asthma were also sought.

Amy Burgess, the patient recruiter at Intermountain Clinical Research, says volunteers are paid US$200 up to $700, depending on the time required . Some ads also promise physical examinations and medication at no cost. However, many subjects receive an inactive placebo, since crossover formats are not regularly used, adds Burgess.

Utah residents are considered good subjects because they are in better health and use less alcohol than residents of other states. About 70% of the state's population are Mormons, and adherents don't smoke, or drink alcohol or coffee. But that also means Utahans are not a representative group, adds Karler.

"We could say that the simpler the lifestyle of the population, the fewer interactions you're likely to get. However, that's not real life. It'd be like testing drugs only in men and not females, or in blacks but not whites."

However, Karler says studies may be easier to conduct in Utah, where subjects are likely to be more compliant. "I think this population is easier to handle than a population in Chicago or Boston. People take their medicine and they show up. Things probably run a lot more smoothly here than in a big city where you get a lot of [study] dropouts." — Janet Brooks, Salt Lake City

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