Wednesday, October 3, 2012

(Opinion) Pharmaceutical Industry Controversy: You Can’t Trust Your Medicine

The truth is out about medically prescribed drugs. If you were hoping that the drugs prescribed to help cure your illnesses by your doctors were thoroughly and transparently tested by responsible and unbiased professionals, then I am afraid you will be disappointed. The good news is that you can still trust your local doctor as much as you did before. Your physicians are not acting maliciously towards you at all. The bad news is that the legal framework of the pharmaceutical industry appears to be specifically constructed to allow the pharmaceutical industry to put drugs into the marketplace regardless of their effectiveness and regardless of their potential negative side effects.

Okay, so let’s talk this through. Medical professionals will tell you that very few if any medical drugs are perfect and that drugs have varying degrees of success with different people and even drugs that are extremely helpful can have negative side effects. However, there is a very basic expectation that when you are prescribed medicine, it will be have been proven that that medicine can have some sort of positive effect on your health, and that the doctor prescribing you that medicine will have enough information to decide whether the benefits outweigh the side effects of the drug they are prescribing.

This article will contest that the recent controversies surrounding the pharmaceutical industry show that not only is this basic expectation not being met, but that legal and systematic processes are insuring that it isn’t. Recent findings paint a picture of an industry that prioritises its own financial gain over any concern for health or even a basic sense of morality.

Ben Goldacre recently published some absolutely incredible data in his recent book that demonstrates the pharmaceutical industry actively deceiving physicians and the general population. Reboxetine is marketed as an antidepressant used to treat clinical depression, panic disorder and ADHD. If you read up on the drug it will show you a convincing list of seemingly well-designed tests with positive results. The drug is reported as performing better in trials both against a placebo and other antidepressants.

 However, in October 2010 the full picture of Reboxetine was finally revealed by a group of researchers. Seven trials had been conducted with only one showing positive results, but the company elected to publish the only positive results. It should be made clear at this point that there is no legal requirement for all trial results to be revealed. However, once the other six trials were brought to light, they showed a shocking tale of deceit. In all six trials it was shown that Reboxetine was no better than a dummy sugar pill. 

The trials showed 507 patients benefitted more from Reboxetine over other drugs with all of those results being published. A further 1,657 patients worth of data clearly demonstrated without question that Reboxetine was no better than other drugs. It seems that the current structures allow the pharmaceutical industry to actively discount three quarters of the data from their trials.Even more worrying is that Reboxetine actually displayed several negative side effects on certain trial subjects. This was not reported because the trials were simply discounted. Officially, they were never conducted.
 An even more horrific example is the case of paroxetine in children. Paroxetine is another anti-depressant drug. GlaxoSmithKline conducted trials of the drug on children with no benefits shown. The company decided not to reveal this information and internal documents actually revealed a deliberate cover up of the trial results to protect the company’s interests. During that time 32,000 prescriptions were given to children by doctors believing the pharmaceutical industry’s claim that the drug worked. 

Not only did GSK withhold the fact that the drugs were ineffective, but they also withheld much more serious information about its side effects. A legal loophole meant that GSK did not have to inform the regulator of the side effects on children from Parexotine. Parexotine’s safety data was not revealed to the regulator because the drug doesn’t have specific market authorisation for use on children. The side effect that wasn’t reported was that Parexotine increased the risk of suicide in children.

 GSK were not legally obligated to report the findings of their safety tests. The pharmaceutical industry, an industry responsible for producing medicine, prioritised their reputation and financial gain over the health and safety of children; children whose doctors had judged needed to be treated with anti-depressants. It might be worth dwelling on that point. Children who needed treatment for issues like depression and panic disorder were prescribed a drug that not only wouldn’t help them, but could increase the risk of their committing suicide, and there were people who knew this, people who could have prevented it.

There are no mysteries surrounding the people who are perpetrating these travesties. In 2010, academics in Toronto and Harvard researched a huge range of drug trials and found that 85% of industry funded drug trials turned up positive results, while government funded trials produced a success rate of just 50%. This is far too large of a gulf to be anything besides manipulation. Besides the fact that researchers are free to bury any negative results and at times academics and researchers are even contractually obliged to maintain secrecy, there are also other ways in which these trials can be manipulated. Researchers can watch results as they come in, intervene at any point and even test their drug against other drugs that they know do not work. This isn’t the way in which science or medicine production is supposed to work.

The pharmaceutical industry can only be trusted to act in its own financial interest. This is a fact about businesses that is generally accepted in society, but there has always been an implicit assumption that the production of medical drugs was regulated and designed to ensure the health and safety of the patients that will eventually be prescribed them. Private industry cannot even be trusted to inform doctors of an extremely harmful side effect for a drug being prescribed to children. The case of the pharmaceutical industry would seem to be yet another argument against the privatisation of NHS services. The consequences for allowing market and capital to take priority over social responsibility can be truly catastrophic. 

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