Do you think customer service has gotten better since companies began outsourcing their call centers to other countries?

Well, me neither.

Now imagine what that same approach would do to medical research. Except you don’t have to imagine it at all – because this is our frightening new reality.

In fact, as of November 2007, a third of all clinical trials were being conducted overseas, in many cases in Third World countries, according to a report in the New England Journal of Medicine. At the same time, fewer clinical trials are being carried out in the United States and Western Europe.

These developing countries are of course less expensive to work in. A top-flight medical center in India charges between $1,500 and $2,000 per case report, a tenth of what even a second-tier institution here in the United States would demand.

But it’s not just cheaper. No, saving money is just a side benefit of moving these studies abroad. The real reason Big Pharma likes working in developing nations is so they don’t have to deal with that pesky FDA oversight so much. Researchers in many other countries can often carry out clinical trials with little to no review at all.

In fact, Big Pharma may have pushed our friends in India just a little too far. The authorities there are investigating the death of a baby involved in a vaccine trial. A baby! The poor child had a preexisting cardiac disorder, according to reports, and never should have been part of the study to begin with.

Still, in many cases researchers seem to work outside of the system. The authors of the report found one study in which 670 researchers in developing countries were asked if local or national health officials had reviewed their work. Nearly half said they did not.

Do you really think Big Pharma hasn’t noticed that?

The FDA is often shortsighted and narrow-minded, but even their imperfect oversight is far better than none at all.

I’ve spent much of my adult life reading and studying the results of clinical trials. And believe me, it ain’t easy.

There’s an art to reading medical reports, because there’s always a devil or two hiding in the details. Some are poorly designed, and in those cases the problems leap right off the page. But in other cases, researchers with dubious motives intentionally try to misrepresent their conclusions and manipulate data.

They’ve been doing that for years with studies based in the United States and Europe, where there is some oversight and scrutiny.

Just imagine what they’re doing now behind your back.