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Thursday, October 18, 2012

Big Bad Pharma

Doctors generally want to do the best for their patients, but they can't know what that is if half of the data on clinical trials of drugs is missing and some of the rest is distorted.

New drugs are tested by the companies that make them, often in trials designed to make the drug look good, which are then written up and published in medical journals. Unless, that is, the company doesn't like the result of the trial (maybe it shows the drug not working or having severe side-effects), in which case this result might be hidden. The vital comparison may be made against a placebo or against unusually low or abnormally high doses of the drug – to ensure suitable conclusions as to efficacy and the severity of side-effects. It's no surprise that most published trials funded by drug companies show positive results.

 Companies pay doctors to extol the virtues of their drugs on the conference circuit (spelling out the sources of information they want doctors to use) and fund patient groups to lobby regulators to approve new drugs. Academic journals (I work for one, the BMJ) are sent research papers and comment pieces that may not always be written by the academics listed as the authors. If a journal does decide to publish a paper showing the benefits of a drug, it can be rewarded by the company which made it, who might buy up hundreds of thousands worth of reprints (glossy versions of the published paper) to distribute to doctors to encourage them to prescribe the drug.

Pharmaceutical companies are not charities. They exist to make and sell drugs and to make a profit for their shareholders.  Some companies spend much more on marketing than they do on research and development. In America 24.4% of the sales dollar is spent on promotion versus 13.4% on research and development. They inflate the cost of developing new drugs – Ben Goldacre cites companies claiming that it costs £550m to bring a new drug to the market but says others put it at a quarter of that cost.


http://www.guardian.co.uk/books/2012/oct/17/bad-pharma-ben-goldacre-review

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