Two alternative drugs are available to prevent blood clots from develo

Question

Two alternative drugs are available to prevent blood clots from developing after a heart attack. According to two major studies, drug Y does this no more effectively than the more expensive drug Z, but drug Z is either no more or only slightly more effective than drug Y. Drug Z’s manufacturer, which has engaged in questionable marketing practices such as offering stock options to doctors who participate in clinical trials of drug Z, does not contest the results of the studies but claims that they do not reveal drug Z’s advantages. However, since drug Z does not clearly treat the problem more effectively than drug Y, there is no established medical reason for doctors to use drug Z rather than drug Y on their heart-attack victims.

Which one of the following principles, if established, would most help to justify a doctor’s decision to use drug Z rather than drug Y when treating a patient?

(A) Only patients to whom the cost of an expensive treatment will not be a financial hardship should receive that treatment rather than a less expensive alternative one.

(B) Doctors who are willing to assist in research on the relative effectiveness of drugs by participating in clinical trials deserve fair remuneration for that participation.

(C) The decision to use a particular drug when treating a patient should not be influenced by the marketing practices employed by the company manufacturing that drug.

(D) A drug company’s criticism of studies of its product that do not report favorably on that product is unavoidably biased and therefore invalid.

(E) Where alternative treatments exist and there is a chance that one is more effective than the other, the possibly more effective one should be employed, regardless of cost.

J2S2019 · Answer

IMO the correct answer is E

(A) Only patients to whom the cost of an expensive treatment will not be a financial hardship should receive that treatment rather than a less expensive alternative one -  Out of context

(B) Doctors who are willing to assist in research on the relative effectiveness of drugs by participating in clinical trials deserve fair remuneration for that participation -  Out of context

(C) The decision to use a particular drug when treating a patient should not be influenced by the marketing practices employed by the company manufacturing that drug -  this answer choice is doing nothing but making the conclusion less reliable - Incorrect

(D) A drug company’s criticism of studies of its product that do not report favorably on that product is unavoidably biased and therefore invalid -  Out of context

(E) Where alternative treatments exist and there is a chance that one is more effective than the other, the possibly more effective one should be employed, regardless of cost -  This correctly identifies the reason why a doc should prescribe drug Z rather than drug Y - as there is a probability that Drug Z is having a chance of being more effective, a doctor should use this drug regardless of the cost.

David nguyen · Answer

Two alternative drugs are available to prevent blood clots from developing after a heart attack. According to two major studies, drug Y does this no more effectively than the more expensive drug Z, but drug Z is either no more or only slightly more effective than drug Y. Drug Z’s manufacturer, which has engaged in questionable marketing practices such as offering stock options to doctors who participate in clinical trials of drug Z, does not contest the results of the studies but claims that they do not reveal drug Z’s advantages. However, since drug Z does not clearly treat the problem more effectively than drug Y, there is no established medical reason for doctors to use drug Z rather than drug Y on their heart-attack victims.

Which one of the following principles, if established, would most help to justify a doctor’s decision to use drug Z rather than drug Y when treating a patient?

Conclusion: There is no "MEDICAL REASON" for doctors to use drug Z > drug Y. 
We need to defend doctor's decision that there is a medical reason.

A talks about cost. Out.
 
B talks about doctor's benefits. Out.
 
C talks about the effect of marketing. Out.
 
D talks about unfairness. It does not give the medical reason. Out.
 
"However, since drug Z does not clearly treat the problem more effectively than drug Y" 
"but drug Z is either no more or only slightly more effective than drug Y"
=> Z is slightly more effective than Y, maybe 0.00001%. But as long as it is more effective, it should be used. D is the answer.

Ksmew · Answer

Why B is wrong? we are asked to strengthen Doctor's decision to prescribe drug Z, which B answers directly. Whereas E is a generic statement.... Pls explain

deveshj21 · Answer

eakabuah   mira93 @nighblade354
Was stuck between option A and E.According to you what would be the best reason to eliminate option A?

Harsh9676 · Answer

Hi  Ksmew

Just read the choice again with more thought on the highlighted word:

(B) Doctors who are willing to assist in research on the relative effectiveness of drugs by participating in clinical trials  deserve  fair remuneration for that participation.

Option B is an opinion and we actually don't know whether Stock Options that the doctors are receiving are fair enough already. In addition, we also don't know whether the money spent on Drug Z would go to the doctors.

Please give kudos, if you like my explanation.

Harsh9676 · Answer

Hi  deveshj21

The question asks in general and choice A restricts the scope.

Question: Which one of the following principles, if established, would most help to justify a doctor’s decision to use drug Z rather than drug Y when treating  a patient ?

Choice A : (A)  Only patients to whom the cost of an expensive treatment will not be a financial hardship should receive that treatment rather than a less expensive alternative one.

Hope this helps.

achloes · Answer

nightblade354

How can A be eliminated? Since drug Y and drug Z are comparable in terms of efficacy, shouldn't the decision then be based on the cost, which is the distinguishing factor?

Thanks in advance!

nightblade354 · Answer

Two alternative drugs are available to prevent blood clots from developing after a heart attack. According to two major studies, drug Y does this no more effectively than the more expensive drug Z, but drug Z is either no more or only slightly more effective than drug Y. Drug Z’s manufacturer, which has engaged in questionable marketing practices such as offering stock options to doctors who participate in clinical trials of drug Z, does not contest the results of the studies but claims that they do not reveal drug Z’s advantages. However, since drug Z does not clearly treat the problem more effectively than drug Y, there is no established medical reason for doctors to use drug Z rather than drug Y on their heart-attack victims.

Breakdown:

Y: Costs $ and efficacy is 90% (just using round numbers to make visualization easier)

Z: Costs $$ and efficacy is 90% - 92%

A justify question is asking you to say "OK, here is your problem and here is the outcome we want. Find the information in the middle to bridge the gap and make it work". With this model, per the below, we need to justify Z over Y. Well, if we are going to justify it (which means adding a principle or premise) we need to say that cost doesn't matter and that we are going with the best medicine period. This is the only way to justify the claim given the information we have. Best medicine wins is what we are looking for as a principle.

Which one of the following principles, if established, would most help to justify a doctor’s decision to use drug Z rather than drug Y when treating a patient?

(A) Only patients to whom the cost of an expensive treatment will not be a financial hardship should receive that treatment rather than a less expensive alternative one. --  WRONG! We are told here that only patients who can afford the drug should get it. Well, we are choosing Z over Y, so we don't care who can afford it. Our only goal is to say that the best medicine is given to people. Financial hardships don't matter when we're only caring about efficacy.

(E) Where alternative treatments exist and there is a chance that one is more effective than the other, the possibly more effective one should be employed, regardless of cost. --  PERFECT! Parse this out as I did above. If an alternative treatment exists (Y Vs. Z), and there is a chance it is better (Z has at worst equal, if not better, outcomes) then we should choose it regardless of cost. Word for word how we justify Z over Y given the information. Z might be better, but costs way more. How do we justify using it? By saying cost doesn't matter.

achloes , did this help?

unraveled · Answer

Two alternative drugs are available to prevent blood clots from developing after a heart attack. According to two major studies, drug Y does this no more effectively than the more expensive drug Z, but drug Z is either no more or only slightly more effective than drug Y. Drug Z’s manufacturer, which has engaged in questionable marketing practices such as offering stock options to doctors who participate in clinical trials of drug Z, does not contest the results of the studies but claims that they do not reveal drug Z’s advantages. However, since drug Z does not clearly treat the problem more effectively than drug Y, there is no established medical reason for doctors to use drug Z rather than drug Y on their heart-attack victims.

Which one of the following principles, if established, would most help to justify a doctor’s decision to use drug Z rather than drug Y when treating a patient?

(A) Only patients to whom the cost of an expensive treatment will not be a financial hardship should receive that treatment rather than a less expensive alternative one. - WRONG. 2nd best but it focusses on cost aspect instead of reason why doctor must use Z over Y. And that too for specific cases only. So, the reasoning offered goes in either direction depending on the situation.

(B)  Doctors  who are willing to assist in research on the relative effectiveness of drugs by participating in clinical trials  deserve fair remuneration for that participation . - WRONG. Bland and irrelevant.

(C) The decision to use a particular drug when treating a patient should  not be influenced by the marketing practices  employed by the company manufacturing that drug. - WRONG. Morally correct but does not matter. In fact, this goes against Doctor using Z.

(D) A  drug company’s criticism  of studies of its product that do not report favorably on that product is  unavoidably biased and therefore invalid . - WRONG. Irrelevant. Doctor must use Z and that reason in not identifiable here.

(E) Where alternative treatments exist and there is a chance that one is more effective than the other, the  possibly more effective one should be employed, regardless of cost . - CORRECT. Cost not playing a role here.

Answer E.

Two alternative drugs are available to prevent blood clots from develo

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Two alternative drugs are available to prevent blood clots from develo

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