Pharmaceutical companies are not the only culprits here. Physicians involved in clinical research, by choice or economic circumstance, are sometimes forced to distort the message. Of course, drug development does not happen in a vacuum. There are overseeing agencies that mandate certain standards be met. This may reflect the changing world of drug approval and one cannot help but wonder if accelerated approval is undergoing the maturation and tempering long overdue.
Time tells all.
In addition, the emergence of metabolic and morphologic changes that appear to be associated with the use of the therapies have created concerns about the long-term feasibility of keeping people on combination therapy. To address this burgeoning problem the pharmaceutical industry and clinicians have embarked on a furious effort to simplify dosing and find a way to ameliorate the side effects. Drugs with fewer known metabolic and morphologic side effects are being substituted for drugs known to have more of these side effects. While all this tweaking of regimens may make some incremental difference in the success of these regimens, it seems unlikely that over a long period of time it will make a difference in the overall success rate. Thinking outside the box.