chance,
Some doctors buy the Big Pharma marketing, but plenty of others don’t. My wife is a doctor and refuses to talk to drug reps.
Unfortunately the Republicans in Congress bought into Big Pharma’s lobbying and made it much easier to get drugs approved; Newt Gingrich called the FDA the #1 job killer in America. As a result we’ve had some widely publicized drug recalls.
That said, there is a problem here that is really unsolvable: Most of the time you only really need to test a drug in a few thousand patients to prove efficacy. But if a serious adverse event occurs in only one in ten thousand patients you will most likely never see it in the efficacy studies. And if you require efficacy studies to have thirty thousand patients rather than three thousand, far fewer drugs will be tested because they will be unaffordable. Big Pharma isn’t totally at fault here, and there is no conspiracy!