Who'd pay to run a trial if they didn't have an interest in the outcome?

A company running their own trial doesn't preclude other trials later on. Would you feel better if the African Union nations bucked up for a trial? Because they have a massive financial incentive too, though it's based on efficacy rather than sales.

Imo most trials should have two parts (1) do a blind bid so competitors can conduct trial (2) fund trial yourself as well. Hide names of both people conducting trial.

Keep results hidden and send both results to FDA for review. Publish both results after review. Only attach names of entities who conducted the trial at the end.

This enables for a full replication and evaluation without anyone knowing who did anything. And at the very least reduces risk of corruption.

Drug trials are already double-blind and highly regulated, particularly stage 3, so further controlling for the corruption you are suggesting doesn't seem necessary. If there is evidence (hard evidence not hearsay or conspiracy theories) of that sort of corruption, then I think what you suggest is a good improvement.

Without hard evidence, that's a great example of a conspiracy theory.

Do you have a more recent example than Vioxx in mind where your approach might have made enough of a difference to be worth the longer review process?

> It’s insane to me that we let people with massive financial incentives run their own trials.

The alternative is for some other organization to be on the hook for the HUGE costs a large scale trial. And then the incentives to not run useless expensive trials goes away.

> Consider your argument and opioids, where nearly 1000 people a week overdosed on at the peak?

What does that have to do, at all, with the process for getting medications approved?

These drugs were clearly being oversubscribed, intentionally and for profit, and people should have been sent to jail for this.

> Also consider "a scientist is as easy to buy as a politician".

What does this have to do with anything at all? This is why the FDA has fairly strict guidelines for approvals.

> Cigarette were considered to not cause cancer backed by science.

Cigarette's were never approved in a clinical trial.

> On top of that, the replication crisis in even chemistry and physics is seeing 30% of results can't be replicated.

Clinical trials are not "chemistry and physics" papers.

> The system is far more busted than people think.

I agree, but you are talking about a bunch of unrelated "systems", not clinical trials.

if 30% of chemistry and physics papers can't be replicated, and something more like 70% of sociology and phycology papers can't be replicated, do you think that clinic trials might have a less than 100% trustworthy due to the possible monetary gains from the company conducting them?

opioids went through clinical trials, no?

Opioids didn’t cause harm because they should have failed their clinical trials.

To add to your point, this erodes trust in science too. Public perception of complex topics is very, very important. People effectively have to "trust" science. When it's corrupted there are ripples of distrust sown through the populace. Vaccine deniers, climate deniers, etcetc - distrust is just one of the fuels that fan these flames.

The people sowing distrust ARE the vaccine deniers and climate deniers. People comparing vaccine trials to cigarettes, like the person you are agreeing with here, ARE the problem; they were not created by "corporate funded vaccine trials".

You don't think perverse incentivized trials/studies/etc do damage to public perception? I'm not well versed in this subject (or versed at all), but if anything i feel like i am the public we're speaking about. Pro science, but scared of bad faith science.

For example, my perception is that the push for pro-sugar doctrine "back in the day" has caused significant health problems and a distrust in the process.

Do you view this as not the case?

I have a Ph.D. in a hard science, so I guess I'm not totally unaware of how science works. Let's say, I have lived experience as to why 30% of physics and chemistry research can't be replicated.

Putting 100% faith and trust in a "corporate funded vaccine trials" is something I would suggest against given the potential monetary gains from those conducting it.

I've been part of teams that have put products through FDA clinical trials.

I can assure it was a somewhat different process than what ever process your "hard science Ph.D" requires for publishing papers.

They don't run their own trial. Hundreds of doctors and clinics sign up to run trials on the companies behalf.