Carton of Retrovir (zidovudine, AZT), comprising 40 capsules, 250mg, in foil push-out sheets, from The Wellcome Foundation Ltd, London, England, 1992-3
How can doctors and pharmaceutical companies balance the need of patients for new treatments with the risks from unproven new medicines? In the case of thalidomide, the price paid for poor drug testing was very high. But can the opposite also be true? Could the clear benefits of a drug outweigh any potential for harm? You might wonder what is so special about the little blue box of pills pictured here. “Retrovir” is a brand name for AZT (azidothymidine) – the first drug that prolonged the lives of those with AIDS.
In 1986, when the drug was tested in America against a placebo, its benefits effects were quickly apparent. But if you were a participant in such a trial, clearly receiving an ineffective placebo while others were getting visibly better, would you put up with it? No, neither did the patients. Activist groups protested against any delays in approving this drug that was clearly working. This was the first time that patients had such a strong impact. Retrovir was also a very expensive product, but further protests succeeded in lowering of the cost so that more patients could benefit. ‘Buyers’ clubs’ were even organised to allow poorer patients access to the life-saving drugs.
AZT remained the only drug available for some time, and activists blamed its manufacturer for lobbying against approval of other competing drugs. Once more, their protests accelerated the approval of supplementary drugs that helped patients survive for longer. So you see this small blue box not only represents the first ray of hope for people with AIDS. It also marks a turning point, when desperate patients stood up against pharmaceutical companies and demanded a say in the drug development process.