An interesting observation made by Jill Fisher in her article Ready-to-Recruit or Ready to Consent is the attempted shift in marketing bracket made by the CRO’s. The author notes that currently the Phase I of clinical testing tends to be dominated by low-income men, whereas Phase II and III is mainly composed of subjects without health insurance and particularly white women. It seems clear given the examples of television commercials promoting clinical testing, that the CRO’s are attempting to evolve their image in order to attract more middle class participants to the trials. The likely reason for this is that the main consumers of the pharmaceuticals will in all likelihood be affluent middle and upper class individuals, and so for this reason the best way to confirm their efficacy is to test them on the people who will be using them.
However I believe this attempt is unlikely to succeed because it stands in contrast to the conclusions the author comes to regarding the reasons people involve themselves in clinical testing. Fisher essentially concludes by stating that the majority of subjects involve themselves in the study because they do not have access to the necessary health insurance which would allow them standard treatment, they are excited about the prospect of access to medicine because they are uneducated about the nature of clinical testing, or they simply do it exclusively for the money. All of these are reasons which are unlikely to correspond to the situations of middle class individuals. For this reason it is almost inevitable that the new drugs will be clinically tested on the exact kinds of individuals who will not be using them, a fact which I can see having some affect on the eventual success of the drug in question.
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