Freakonomics Radio

269. Bad Medicine, Part 2: (Drug) Trials and Tribulations

Dec 8, 2016
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ANECDOTE

Thalidomide Tragedy And A Heroic FDA Hold

  • The drug thalidomide was marketed as safe but caused thousands of fetal deaths and severe birth defects.
  • Francis Oldham Kelsey at the FDA blocked its US approval and was later hailed as a hero.
INSIGHT

Excluding Women Created Knowledge Gaps

  • After thalidomide, the FDA broadly excluded women of childbearing potential from early trials to avoid fetal harms.
  • That exclusion created a knowledge gap about drug effects in women for decades.
ANECDOTE

DES And Long-Delayed Harms To Offspring

  • DES and thalidomide were prescribed to pregnant women and later shown to cause cancers and birth defects years later.
  • These tragedies led the FDA in 1977 to recommend excluding most premenopausal women from early trials.
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