Doom and Gloom Again

The pharmaceutical industry, like oil companies and arms manufacturers, isn’t viewed highly in the public imagination. And for good reason. There is growing awareness of an inherent conflict of interest in the testing of drugs by the companies that manufacture them — like Pfizer, Merck and Eli Lilly — and a steady stream of tales from journalists, researchers and doctors of deliberately dodgy trials, buried unfavorable results, and purchased academic journals.

Yet the greatest crime of the world’s major private pharmaceutical companies is not what they do, but what they don’t do.

Antibiotics revolutionized healthcare. In the ongoing war against bugs and infection, these companies have abandoned their posts at the most critical time: when the enemy is mounting its most ferocious attack in generations. As these firms continue to shirk their duties — effectively abandoning antibiotic research for some 30 years now — senior public health officials are warning that the world could soon return to the pre-antibiotic era, a miserable, fearful time that few people alive now remember. We have forgotten how common and deadly infectious disease once was. We’ve taken antibiotics for granted, but we can hardly blame ourselves for such complacency.

The director of the US Centers for Disease Control and Prevention, Thomas Frieden, warned authorities of their “limited window of opportunity” to deal with the “nightmare” presented by the rise of a family of bacteria highly resistant to what are often our last line of antibiotic defense: the suite of drugs known as carbapenems. A few months earlier, the UK’s chief medical officer, Sally Davies, used similar language to describe a future “apocalyptic scenario” in 20 years’ time, when people will be dying from infections that are currently understood to be trivial, “because we have run out of antibiotics.” Davies described how the phenomenon “poses a catastrophic threat” to humanity akin to that of climate change and imagined a scenario in the coming decades in which “we will find ourselves in a health system not dissimilar to the early 19th Century,” where any one of us could go to the hospital for minor surgery and die from an ordinary infection that can no longer be treated. Major interventions like organ transplants, chemotherapy, hip replacements and care for premature babies will become impossible.

What did the pre-antibiotic era look like? There was 30% mortality from pneumonia. Mortality from appendicitis or a ruptured bowel was at 100%. Before Alexander Fleming’s serendipitous discovery of the first antibiotic penicillin, hospitals were filled with people who had contracted blood poisoning through cuts and scratches. These scratches often developed into life-threatening infections. Using amputation or surgery as common medical responses for scraping out infected areas is not pleasant or preferred, but these were the only options for the doctors.

Reports in medical journals, charity organization analyses, government studies, and the pharmaceutical sector’s own assessments attribute the dangerous threat to insufficient market incentive - lack of profit. Unlike drugs that millions of people have to take for the rest of their lives to target chronic illnesses such as heart disease — drugs that suppress symptoms but do not cure — antibiotics are usually taken for a few weeks or months at most. This makes antibiotics unfavorable for capitalism.

The Infectious Diseases Society of America in 2008 put it: “[Antibiotics] are less desirable to drug companies and venture capitalists because they are more successful than other drugs.” It is long-term therapy — not cures — that drives interest in drug development, the paper concluded.

Only four of the global Big Pharma 12 are engaged in antibiotic research. Capitalism encourages these firms to cherry-pick the products that make the most money for their shareholders, such as Viagra.  A common criticism from the Left of these companies has been that their profit-seeking hurts the poor of the developed and developing world, who can’t afford their drugs. This is true as far as it goes, but doesn’t tackle the scale of this problem. It is the capitalist command to accumulate profit that  pharmaceutical companies must obey that is the major threat to public health and needs to be done away with entirely.

See full article here

No Profit - No research - No Cures

Resistant to existing antibiotics, superbug-related infections worldwide result in thousands of deaths each year—an estimated 99,000 in the U.S. MRSA kills an estimated 19,000 people every year in the U.S., compared with the 17,000 who die from AIDS, according to the Centers for Disease Control.


"We are in a crisis situation," said Dr. Cesar Arias, an associate professor of infectious diseases at the University of Texas Health Science Center. "The World Health Organization says this is one of the top three health threats to the world in this century, and I can't argue with that," said Arias, who has researched and written extensively on superbugs.

Dr. G. Richard Olds, dean of the school of medicine at the University of California-Riverside, explains "Pharmaceutical companies like to push drugs in advertising to make money, and a patient often thinks if a doctor doesn't prescribe antibiotics he's a bad doctor," Olds said. "But the medical profession has to be precise when it comes to handing out drugs—we have to use them appropriately and for the right reasons,"

So the the world scientists are being mobilised to tackle the problem...ummm...no. Quite the opposite.

"We have a clear case of too many antibiotics being used and not enough new ones in the system to fight these bacteria," according to Alan Christianson, a specialist in naturopathic medicine. "We haven't had any new antibiotics in the pipeline over the past 10 years, and it takes time to get one in, so we're way behind the curve on this."
 The large drugmakers Johnson & Johnson and AstraZeneca have said publicly that they have reduced or stopped research funding for new antibiotics, citing the costs. Developing more expensive drugs, such as one for HIV, is better for returns.

"These firms want to know that they will make an antibiotic that will work economically, and there is no guarantee," Christianson said. "There's a lot of trial and error to find the right one. There's really no money in antibiotics."

Patents or Patients

When HIV/Aids took hold around the world and antiretroviral (ARV) drugs became available from 1987, the  drug treatments required then cost $15,000 a year, which very clearly limited their use to well-insured or relatively rich western patients. Prices for AZT3 officially started at $25 per pill in South Africa. Although HIV/Aids was the scourge of Africa in the 1980s, its management ad treatment was initially completely out of reach of  those hit by "slim" disease as it was then known as locallywho were just expected to go away and die. And millions, denied medication, did die. An estimated 10 million people perished between 1996 and 2003 thanks to denial of drugs by Big Pharma. And all the while the medicines were just sitting there ... out of the financial reach of the inflicted. Big Pharma was quite happy to see millions of deaths in order to keep patent law - and its profits.

 Thanks to India's 1970 patent law, drugs could be made to the highest technical standards (a fact often denied by a propaganda campaign of the western drugs companies) .The Pfizer patent for fluconazole (used for treating Aids-related fungal infections) in South Africa was deliberately broken by importing it from India. The price per capsule in South Africa stood at $40, while in Asia it was 5 cents. With Africa hosting two-thirds of the world’s HIV/Aids cases, this kind of action made an impact politically. In 2000, Yusuf Hamied’s Cipla generic pharmaceuticals company agreed to produce  a three-ARV combination that would cost patients $1 a day - at $350 a year this was less than a 40th of the cost demanded by western drugs companies.

Big Pharma's argues the expense of its products is due to development costs: in fact, marketing budgets in drugs companies are very much higher than those for research and development, which averages a risory 1.3% of expenditure across top pharmaceutical companies. In fact, 84% of research and development worldwide is carried out by government and public bodies, whereas pharmaceutical companies contribute only 12% and account for only three out of every 10 new drugs invented.

 The Executive Director of the Joint UN Programme on HIV/AIDS, Michel Sidibé, said “It is outrageous that in 2013, when we have all the tools we need to beat this epidemic, 1.7 million people still die each year because they cannot access treatment.”

Now with India’s government adopted the WTO’s Trade-Related Intellectual Property Rights (Trips) patent regulations it may well be all over for generic medicines. The pharmaceutical companies will be able to continue to grossly overprice its drugs. People are going to die needlessly once again.

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

Failing to report

Roche, one of the world's biggest drug companies, is at the centre of an investigation after failing to report that people died while taking their medication. Roche, which made profits of £6.3 billion in 2010, has a legal duty to examine every suspected side effect and report them to regulators around the world so that potential safety concerns can be investigated. This means that each side effect reported to the patient support call centre should have been immediately sent to the safety team to be assessed. These must then be sent to regulators – within 15 days for the most serious reactions – even if no link between the drug and the reaction be proved.

15,000 people died while taking its medicines. Roche also failed to pass on a further 65,000 reports of suspected side effects that were recorded by patient.

http://www.dailymail.co.uk/news/article-2170317/Roche-investigation-UK-watchdogs-80-000-adverse-reactions.html

Sugaring the pill ?

The vice-president of a diabetes charity has been called on to sever ties with the group because he also acts as a lobbyist for a drugs giant. Sir Michael Hirst is both a figurehead for Diabetes UK and an adviser to Denmark-based Novo Nordisk, a firm that is planning to withdraw a vital form of insulin from the UK.Novo Nordisk plans to remove Mixtard 30 as a treatment, which some diabetics have used for more than 10 years. Doctors believe the move could cause problems for sufferers and the NHS.

Hirst, a one-time Tory MP, is a former chair of Diabetes UK and now acts as the charity's vice-president. At the same time, he is chair of Edinburgh-based Pagoda PR, which represents Novo Nordisk.Hirst is “retained to act for a number of health-related clients, including Roche Diagnostics and Novo Nordisk”. Services include public affairs advice and parliamentary lobbying.

Tristan Stewart-Robertson, a writer and type-1 diabetic, said: “The withdrawal of this form of insulin highlights the problem of having only two companies worldwide that produce insulin. With only two firms controlling the patent, you really need a patients’ rights group that is 100% on the diabetics’ side."

When Novo Nordisk withdrew another insulin treatment, Actrapid in 2005 Hirst said: “...product rationalisation is a common fact of life.”

Drug Pushers

Which? surveyed 200 doctorsDrug companies are bombarding GPs with promotional materials and inducements . GPs received four visits per month on average from drug reps.
They also received five promotional mailings about new drugs a week, and inducements to attend conferences.

25% of the GPs questioned had been sponsored to attend a conference, seminar or training event in the UK in the last 12 months and 5% had been sponsored to attend an event abroad. In just one month, one GP was offered nine conference places and 13 meals, and received nine visits from drug reps, 10 letters, 21 leaflets, two patient information booklets and one training DVD. This amounted to 22 companies contacting her about 31 drugs.

Yet doctors still report a lack of information from independent sources and just only 7% trusted the information they received from drug firms.

Lets not make any bones about it - those in the pharmaceutical industry are in business to make profits and to compete with their commercial rivals .Drug companies will waste resources with duplication of effort for the marketing of their own particular product and leave doctors and other health workers no wiser when the information they receive proves so partisan .