The Drugs Don’t Work

How the Medical-Industrial Complex Systematically Suppresses Negative Studies – Published on naked capitalism (first on The Guardian), by Yves Smith, September 23, 2012.

We’ve written a lot about the scientism of mainstream economics, both here and in ECONNED, and how these trappings have let the discipline continue to have a special seat at the policy table despite ample evidence of its failure. As bad as this is, it pales in comparison to the overt corruption of science at work in the drug arena. Although this issue comes to light from time to time, often in the context of litigation, the lay public is largely ignorant of how systematic and pervasive the efforts are to undermine good research practice in order to foist more, expensive, and sometimes dangerous drugs onto patients.  

Ben Goldacre, a British doctor and science writer, provides a short overview of one of the worst scams practiced by Big Pharma: that of suppressing negative research, in a new piece at the Guardian (hat tip John l). This is the overview:

Drugs are tested by the people who manufacture them, in poorly designed trials, on hopelessly small numbers of weird, unrepresentative patients, and analysed using techniques that are flawed by design, in such a way that they exaggerate the benefits of treatments. Unsurprisingly, these trials tend to produce results that favour the manufacturer. When trials throw up results that companies don’t like, they are perfectly entitled to hide them from doctors and patients, so we only ever see a distorted picture of any drug’s true effects. Regulators see most of the trial data, but only from early on in a drug’s life, and even then they don’t give this data to doctors or patients, or even to other parts of government. This distorted evidence is then communicated and applied in a distorted fashion.

In their 40 years of practice after leaving medical school, doctors hear about what works ad hoc, from sales reps, colleagues and journals. But those colleagues can be in the pay of drug companies – often undisclosed – and the journals are, too. And so are the patient groups. And finally, academic papers, which everyone thinks of as objective, are often covertly planned and written by people who work directly for the companies, without disclosure. Sometimes whole academic journals are owned outright by one drug company. Aside from all this, for several of the most important and enduring problems in medicine, we have no idea what the best treatment is, because it’s not in anyone’s financial interest to conduct any trials at all … //

… So get this: doctors that revealed not the content of any of the work they did, but some of the key features of the research contracts, were harassed, with the clear intent of getting them fired and damaging their reputations.

Goldacre also has a long discussion of “off label” uses of drugs, and GlaxoSmithKline presented studies that showed paroxetine, an anti-depressant, was effective in children, even though if you included the studies they hid, you would have to conclude that its efficacy was not proven. And because this was an off label use, GSK didn’t have to report about the side effects, namely, increased risk of suicide. Goldacre writes:

How is it possible that our systems for getting data from companies are so poor, they can simply withhold vitally important information showing that a drug is not only ineffective, but actively dangerous? Because the regulations contain ridiculous loopholes, and it’s dismal to see how GSK cheerfully exploited them: when the investigation was published in 2008, it concluded that what the company had done – withholding important data about safety and effectiveness that doctors and patients clearly needed to see – was plainly unethical, and put children around the world at risk; but our laws are so weak that GSK could not be charged with any crime.

Again, please read the entire article and circulate it widely. The way to start to attack this is to demand more transparency, say by requiring any drug company that gets NIH funding to make all its drug research contracts and studies public. A credible threat is the only way to force this miscreant industry to begin to behave responsibly.
(full text).

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