Re: “Therapeutics Initiative is out of mainstream,” comment, March 5.
I read this inaccurate comment with dismay. The Therapeutics Initiative is an initiative of a group of scientists at the University of British Columbia that evaluates the efficacy and safety of new and older drugs being considered for inclusion in the B.C. Pharmacare system.
It uses the best evidence to make decisions; e.g., evidence based on careful therapeutic trials in which efficacy and safety of new drugs were evaluated using double-blind, placebo-controlled trials. These trials eliminate observer and patient bias. It also uses, when available, assembled data from multiple trials that have been carried out to the high standards required.
Dr. David Miller quotes the Common Drug Review as recommending that the drug, which he likes, be listed with “other similar drugs” for treatment of chronic obstructive pulmonary disease. Good evidence of safety and efficacy is not required for this listing. He claims that an equal number of serious adverse events in the treatment and placebo arms of a trial mean that the drug is safe. Any new drug should have fewer serious adverse events than a previous standard drug to be considered an advance.
I have a small amount of COPD from when I smoked. However, I am now 91 years old and have exercised all my life, swimming and other exercises. A Victoria physician noted that I had COPD and prescribed an agent with atropine-like qualities. All it did was make my life miserable by causing persistent cough. I quit both the drug and the physician.
Dr. Edwin E. Daniel
Professor emeritus in pharmacology
University of Alberta
Victoria
