Unhealthy Business

Big Pharma: Unhealthy for Patients, Economy, Science and Democracy

“As a MP in Nigeria, drug companies offered me houses in the U.K. and all the women I wanted if I would push through parliament drugs which had been banned in Europe. I refused because I was a Catholic but many accepted.” (In conversation with a former Nigerian MP while living in Bletchley, Milton Keynes, U.K. in 1989.) That was Nigeria in the seventies and eighties but is it different in Europe and America today? Is the pharmaceutical industry an unhealthy business?

In 2008 the Guardian published a damning report Adverse drug reactions cost NHS £2bn – an amount which has surely increased since then. This was compounded in 2014 by another article in the Guardian: NHS wastes over £2bn a year on unnecessary or expensive treatments: Leading medical body cites overtreatment and overdiagnosis as key problems, along with patients who demand treatment now (emphasis mine).

big pharma drug companies unhealthy economy health

Drug companies should display health warnings

Human nature being what it is, we can expect corruption at times, so headings like the following recent ones: Pharmaceutical firms paying members of panel which oversees NHS drug procurementTen senior officials on the Department of Health’s Pharmaceutical Market Support Group (UK) also act as consultants to drugs companies and in Ireland; procurement staff sacked in Dublin hospital may not be a surprise. While we may excuse some individuals, we expect better from companies working in an industry claiming to have the kudos of science behind them and the ethical responsibility of marketing potentially lethal drugs to innocent clients, while also extracting money under the guise of “caring” for them and being a “science”. We cannot excuse organised deceit where the cost is so high and where we expect businesses and leaders in positions of trust to act honourably.

Now six eminent doctors, including Sir Richard Thompson, the Queen’s physician and former president of the Royal College of Physicians, have had enough.¹ The Daily Mail has reported How Big Pharma greed is killing tens of thousands around the world: Patients are over-medicated and often given profitable drugs with ‘little proven benefits,’ leading doctors warn.

Among the many objections they raise in their lengthy attack on drug companies are the greed displayed by putting profits before patients and using “murky” practises to do so marketing “useless drugs patients don’t need”!

They called for a public enquiry into the way drug efficacy is obtained and revealed because “drugs are less effective than thought.” We are now at the point where we have an “epidemic of misinformed doctors and misinformed patients.” Patients are being over-treated and side-effects cause countless deaths world-wide, they – and others – claim.

One of the accusers, Dr Aseem Malhotra, a consultant cardiologist said drug companies are “gaming the system” by spending twice as much on marketing than they do on research.

One in three hospital admissions among the over 75s are the result of adverse drug reactions. Dr Malhotra is particularly concerned with the recent increase in prescriptions for statins. In 2014 NICE lowered the threshold for prescribing statins so more people would be prescribed them but six of the twelve members of the NICE panel received funding from drug companies – for “speeches or “advice”.

The full data, we are told, on statins and their side-effects has never been published. Likewise with Tamiflu, the anti-viral drug the NHS spent over a half billion pounds stockpiling for swine flu a few years ago. In 2014 a panel of scientists concluded it was no more effective than Paracetamol!

Other concerns the group of experts had were: biased research, biased reporting in medical journals and commercial conflicts of interest.

In the U.S. it is claimed one third of all healthcare activity brings no benefit at all! In 2009 Dr Marcia Angell, former editor of the New England Journal of Medicine, in a lecture said: “Of 667 new drugs approved by the FDA between 2000 and 2007, only 11% were innovative or better than previous drugs – about 75% were just copies of old drugs.” (It’s been observed that drug companies aren’t producing new drugs but instead are inventing new “diseases” for which they can use existing drugs.)

Psychiatry and Drug Deaths

Previous research, the group of doctors remind us, has linked psychiatric medication to thousands of deaths by suicide or due to induced drowsiness.

According to the FDA, side-effects have more than tripled in the last decade. There were 123,000 deaths in 2014 but this figure is likely to be a “gross underestimate.”!

Dr Peter Gotzsche, professor of research design and analysis at the University of Copenhagen and director of the Cochrane Collaboration, is quoted as saying: “Prescription drugs are the third commonest cause of death.” He says that in the U.S. Big Pharma activity fits the definition of “organised crime.”! (His books on the subject: Deadly Medicine and Organised Crime and Deadly Psychiatry and Organised Denial may be of interest)

Between 2007 and 2012 the majority of the ten largest drug companies were fined for misdemeanours such as  off-label prescribing, hiding data on side-effects and misrepresenting research results.

Polypharmacy, Over-prescribing and Over-diagnosing

As I’ve reported before on polypharmacy, over-prescribing and over-diagnosing, Dr James Le Fanu in his weekly column Doctor’s Diary in the Daily Telegraph is in agreement with Sir Richard and his fellow critics of Big Pharma. In An urgent crisis in the care of the elderly: less pills, longer life, (February 2016), Dr Le Fanu writes:

Less pills, longer life
There is considerably more to the recent headlines reporting rising mortality rates in the elderly than is immediately apparent. The experts have predictably blamed the rise (up 5.4 per cent last year, equivalent to an “extra” 37,000 deaths) on “an urgent crisis in the care of the elderly”. But this is unlikely, as the continuous upward trend over the past five years is strongly suggestive of a common underlying factor, the most obvious culprit being the current enthusiasm for over-treatment.

This might seem paradoxical as the ostensible purpose of drugs taken to lower blood pressure, sugar and cholesterol levels and so on is to prolong life, rather than shorten it. Their potential benefits, however, could be more than offset by the interactive cumulative side effects of taking (on average) half a dozen or more different medications.

This might sound alarmist, but as previously noted in this column, polypharmacy causes a well-defined syndrome in the elderly of tiredness, poor memory, depression and muscular aches and pains commonly, but wrongly, attributed to “getting old”. Further, the effects of reducing the number of drugs taken, or de-prescribing, is well documented to improve survival, halving the mortality rate compared to those who keep on taking the pills.

The difficulty now is that over-treatment has become so deeply embedded in current medical practice that those responsible cannot acknowledge their complicity in promoting it. The Norwegians aptly described this type of situation as “getting one’s foot stuck in the piano”, whereby the discordant noise caused by trying to disentangle it from the strings only draws attention to the seriousness of the problem.

Unhealthy Business

While critics of homeopathy complain about it being available on the NHS in the U.K., – at an annual cost of a mere £3million – it’s clear the biggest threat to science, a nation’s health and economy is the pharmaceutical industry, and when one considers how Big Pharma has funded governments (Tony Blair as Prime Minister refused to stop buying the BCG vaccine from Powderject even though Ireland had discovered Powderject’s labs were in a shambles and sought an alternative source in Norway. The owner of Powderject had made two donations of £50,000 to the Labour party. Have a browse here), it’s not unreasonable to conclude these companies are also a threat to democracy. The pharmaceutical industry is an unhealthy business.

Notes
1. In addition to Sir Richard, Dr Malhotra is backed by Professor John Ashton, president of the Faculty of Public Health; psychiatrist Dr JS Bamrah, chairman of the British Association of Physicians of Indian Origin; cardiologist Professor Rita Redberg, editor of medical journal JAMA Internal Medicine; and Professor James McCormack, a pharmaceutical scientist.

Image credit: Wiki Commons

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