Background – page 3

Mind the gap

In 2006 I co-authored a book with nutritionist Patrick Holford called “Food is Better Medicine than Drugs”. A novel element for a book about health was that it told readers about some of the dangers that came with blockbuster drugs, information they might not normally hear about when deciding whether a drug or lifestyle approach was the best way to keep them healthy.

As well as describing sagas such as those involving SSRIs and Vioxx, it detailed some of the other techniques drug companies used to market their products more effectively, such giving senior doctors a generous fee to put their names to academic papers that had actually been “ghost written” by company employees.

How company-run trials were four times more likely to report favourable results than ones run by independent researchers. How even when there was good evidence that a non-drug treatment was more effective – such as cognitive behavioural therapy for insomnia – patients were far more likely to be treated with drugs.

What drove me to find out more about the shady side of the pharmaceutical industry was a simple journalistic imperative. You know there is a good story when there is a big gap between what a person or an organisation says they are doing and what is actually going on – paedophile priests, bent coppers or billionaires bashing benefit cheats while making extensive use of tax havens.

It’s the patients who feel the pain

Pharmaceutical drugs combined with modern medicine has obviously saved millions of lives and relieved a vast amount of suffering. I’m all in favour of drugs used appropriately. But as the what happened with SSRIs and Vioxx – let alone more recently with the diabetes drug Avandia  – shows that when it comes to marketing a drug, it is far too easy eliminate the negative and accentuate the positive.

The consequences – damaging side effects that were hidden from patients – are born by the patients not by the company executives. The analogy with the banking crash is clear – it’s not the bankers who are feeling the pain.

It wasn’t supposed to be like that. The system we have for checking that a new drug is effective and safe by running placebo controlled trials is known as evidence based medicine. It was supposed give doctors the information they need to balance risk and benefit when treating patients.

So what is to be done? Part of the answer takes us back to those boxes of SSRI trial data. The company claimed it owned all that information which was why only the occasional outsider like Healy got to see it but since then, despite the distortion this allows, little has changed.

This month (April 2012) a new scandal is brewing over the original data gathered during the testing of the flu drug Tamiflu (ref to come). There are serious doubts over the effectiveness of the drug but despite promises to make the data available for checking by other researchers – a basic scientific principle – access is still restricted. {Continues: Why am I here…}