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| Aug 12, 2008 | |
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Paid to be lab rats
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| Thousands here are believed to be involved in drug trials | |
| By Liaw Wy-Cin & Shobana Kesava | |
| FOR 10 days, Mr Gilbert Tan was holed up in an air-conditioned hospital room, working on his university project.
The 27-year-old had free Internet access and could also watch videos, play games, read, chat with friends - or just sleep. His end of the bargain involved eating at appointed times and popping a pill at 9am every day. For his time and trouble in the three 10-day periods over two months, he was paid $5,000. He was among 14 healthy volunteers testing drug company's Pfizer's new anti-HIV drug for the first time. These human tests, known as clinical trials, must be run before any drug or vaccine gets the go-ahead to be put on the market. Typically conducted in three phases, the trials involve healthy individuals, followed by patients of the disease the drug is designed to treat. The trials test how safe and effective a drug is and the doses in which it should be manufactured. Mr Tan, for instance, was in Phase I, aimed at determining the safety of the drug in healthy individuals. The number of clinical trials in Singapore has been on a steady rise in the last 10 years. About 500 trials are ongoing, said the Health Sciences Authority, the body that approves the running of clinical trials and the marketing of drugs here. The number of new trials started in the Republic each year has been on the rise - from 99 in 1998 to 253 last year. In the first six months of this year alone, curtains went up on 133. At least nine global drug firms are testing a few hundred drugs and vaccines in Singapore, for illnesses ranging from heart disease and gastro-intestinal disorders to diabetes and cancer. Cancer drugs made up the largest proportion of new trials conducted last year - about one in four. And by the looks of what is happening in scientific research here, all these numbers can only head north. With the decade-old push for biomedical sciences starting to bear fruit in laboratories, drugs have reached the testing stage. Official figures are not available, but the number of people involved in clinical trials here is estimated to run into the tens of thousands. Their reasons for signing up for drug trials vary: Among the healthy, it could mean an additional source of income or a getaway to study for an examination. Some participants do it for altruistic reasons. They may have lost loved ones to an illness and so want to be able to help future patients, said Dr Goh Boon Cher, who sits on a review board with the National Healthcare Group, a major cluster of public medical institutions here. For drug trial participants who are already ill, the trial may be a last-ditch attempt to prolong their lives. Madam Nora Smah Md Eunos, 43, who was dying of colorectal cancer in 2004, is certain that an experimental drug she tried bought her 12 cancer-free months. Patients on trials are covered for their time as well as medical and transport expenses, a sum that ranges from $20 to $160 a day or visit. Drug trials are usually run in partnership between hospital doctors and drug companies or research organisations. Recruitment is done through newspaper advertisements about once or twice a month, by word of mouth or by inviting former participants to take part again. Doctors interviewed said response rates vary with the nature of the trial and the relationship between the doctor running the trial and the patient. The more promising the drug is, the more people want to take part in its trial; and the greater the trust a patient has in his doctor, the more likely he is to sign up for a trial. Still, there are risks involved. People in drug trials have died or developed serious side effects or complications in the United States and Europe. So far, though, the trials here have not seen any serious fallout. The more common side effects include rashes, fever and diarrhoea, said doctors interviewed. Strict guidelines are in place to protect patients and these, together with Singapore's efficiency, are factors making the Republic attractive as a trial venue. Large drug firms are also looking this way as it is important to get patient data on Asian diseases and drugs for Asian patients. Professor John Wong, one of the founders of the Cancer Therapeutics Research Group, said that in 1997, when the group was set up, pharmaceutical companies were not terribly interested in Asia. Now, however, with China and India advancing and doing well, treatments for cancer will be in demand. The centre, which is doing clinical trials for cancer drugs, found a few years ago that the two-drug cocktail of docetaxel and carboplatin was more toxic for Chinese than for Caucasians. It was one of the first studies to show that ethnicity mattered in lung cancer treatment. Singapore's ethnic mix is thus a pull for drug companies wanting to gather data on how their drugs work across ethnic groups, said doctors. Professor Soo Khee Chee, assistant chief executive of research and education at SingHealth, another public health group here, said: 'Singapore's population reflects half the population of the world.' | |
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