An Advocate for Human Guinea Pigs
THE GRADUATE CENTER
Volunteers who participate in the early stages of clinical drug trials can make much more money than they would earn in minimum wage jobs, but being a human guinea pig is a dicey business.
"Phase 1 is the first step of drug trials and that's when the drugs are tested for toxicity," says Roberto Abadie, who examines the experience of paid research subjects in his recent book, The Professional Guinea Pig: Big Pharma and the Risky World of Human Subjects. In the trials, Abadie says, volunteers can be given "ten times the amount of what you would take if you were sick."
A visiting scholar with the health and sciences doctoral program at the Graduate Center, Abadie spent 18 months living in group houses and hostels in Philadelphia, a hotbed for clinical trials because of its proximity to pharmaceutical companies. He interviewed more than two dozen volunteers to find out what motivates them to sign up and how much they know about the risks involved.
"Some of these guys do 80 to 100 trials over a five-year period," says Abadie, who received his Ph.D. in anthropology from the Graduate Center in 2006. "They knew some trials are riskier than others. If the drug has never been on the market, they know the risks are higher."
The pharmaceutical industry began relying on paid volunteers in the mid-1970s, when Phase 1 trials on prisoners were banned in the U.S. Now research payments range from $1,200 for three or four days of the less intensive trials to $5,000 for three to four weeks of intensive trials, says Abadie. Most volunteers are indigent African Americans, Latinos and political activists who like to make money on a flexible schedule.
"It's a weird type of work," says Abadie, who is critical of pharmaceutical companies' aggressive recruiting techniques. "Because of the current economy, there are a lot of people who are desperate and they would do anything to try to get by."
Although subjects are carefully monitored during trials and adverse effects are rare, Abadie worries about drug interaction and long-term effects. "There's a 30-day period between drug trials; it's called a 'wash out period,' which means the drugs are no longer present in the blood and urine, but these drugs may stay in your liver," says Abadie.
Since volunteers pay taxes on their income from trials, he would like them to be recognized in a way that would bring them under the umbrella of federal labor laws.
Abadie also supports establishing a national registry of Phase 1 trial volunteers -- administered by the Food and Drug Administration -- that would prevent them from participating in too many trials and might help identify long-term adverse effects.
"We have to protect the volunteers who are helping the society," says Abadie. "The industry may not like it because they don't like oversight, and it may slow down the recruiting. I keep pushing for this idea because I care about the well-being of the guinea pigs."
-- Cathy Rainone