Thursday, 10 March 2016

Lively times for the pharmaceutical industry

Today's blog is from our chairman Robin Daly who is backing the Dying for a Cure campaign to urge the UK Government to implement measures to tackle the conflicts of interest between profits and public health in cancer care.

February was a ‘lively’ month in the pharmaceutical sector. GSK attracted yet another £37m fine for illegal practices on 12th February. Although a record-breaker in itself, as the largest fine ever to be handed to a drugs company by a UK competition regulator, for size, it pales into insignificance by their own standards, since they set the pharmaceuticals bar at the current record level of $3bn in 2012.1 Fines of a few million like this can be seen as simply a reasonable marketing cost, merely serving to uphold the seemingly true adage, in this field at any rate, that ’crime pays’. This time they got caught out for buying the inactivity of smaller companies that would otherwise have weighed in with cheap generic alternatives to a GSK blockbuster, once their patent had expired. By paying out £50m, they managed to ‘suppress’ any competition and keep the gravy-train rolling a bit longer.2 Seroxat sales in one year in the UK alone were £90m. How a fine of a mere £37m is proportionate for this, I fail to understand. 

But far more difficult to grasp is the manner in which criminal misdeeds that led not only to undeserved profits but also to enormous suffering and the deaths of thousands - as has been the case in many high-profile cases - could lead solely to affordable fines and not to the prosecution of a single executive for manslaughter, let alone crimes against humanity. Furthermore, when ordinary mortals are convicted of repeating a serious crime they are treated more severely than the first time. Pharmaceutical giants however, seem to manage to arrive in court with a clean slate time and time again - they just pay the fine and then it’s business as usual, whilst others pay the real price.

If you suspect I’m using some sensationalist hyperbole here, then let me suggest some bedtime reading. The author of Deadly Medicines and Organised Crime - How Big Pharma Has Corrupted Healthcare3 is not some drop-out conspiracy theorist, but a founding member of the world’s most respected systematic reviews body, the Cochrane Collaboration. The language Peter Gotzsche uses goes far beyond mine in its outright accusations laid at the door of ‘big pharma’. And true to his background, Gotzsche backs it all up with over 800 references.

Ministers launch urgent inquiry into NHS officials' second jobs at drugs firms

Next up, comes another downer for the pharmaceuticals: on 16th February the Telegraph announced that a FOI request had revealed that ‘more than 130 NHS officials involved in assessing which drugs are given to patients are also acting as paid consultants to pharmaceutical companies’.5  Alistair Burt, the health minister, was so ‘shocked’ by this totally unexpected ‘revelation’ that he responded “These are very serious allegations – an urgent investigation is under way and action will be taken against any NHS staff attempting to influence purchasing decisions in return for payment, gifts or hospitality.’

Anyone with even a cursory understanding of the history of modern medicine will probably, like me, have found his response laughable, as it is well know that ’twas ever thus. The revolving door between posts in the regulatory bodies and in drug corporations (notice how the Telegraph reports that the CCG’s defend the covert relationship with industry, rather than the public  - this has traditionally been the part regulatory bodies play, as Gotzsche makes plain3) , as well as the myriad ways in which the pharmaceuticals seek to influence the course of medicine towards ever greater profits, have long been well documented. Way back in the last century, Ralph Moss did sterling work in this area in books such as The Cancer Industry.6  Peter Gotzsche’s heavyweight broadside3 is simply the latest in a long line of attempts to awake us to the criminality of medicine. That said, it is by far the most comprehensive and hardest hitting to date, in my opinion.

And then along comes a ray of sunshine to break through the murky pharma dealings,  the sort of news pharmaceutical corporations will do pretty much anything for (it seems) - AstraZeneca got ‘breakthrough status’ for its new immunotherapy drug.4 Durvalumab uses ‘the body's own defence system to attack tumours’ which sounds like a very smart idea. But hold on a minute… haven’t we heard that idea somewhere before? Haven’t ‘quack’ doctors and nutritionists been banging on about this for decades? Ah, but this is different - here we are talking about a proper drug as opposed to all that ‘natural medicine’. How do we know it’s a ‘proper drug’ ? Because, unlike ‘natural medicines’, real drugs - to even begin to get taken seriously - have to be unnatural, patentable and potentially profitable, bringing us to the current nonsensical scenario where all conventional medicines are, by definition, toxic. ‘Proper drugs’ all have proper side-effects. And breakthrough status does nothing to ameliorate Durvalumab’s situation in this respect. But the benefit it does certainly bestow is a fast track to profits, the raison d’ĂȘtre of the pharmaceutical industry. So an amazing day for AstraZeneca and probably a mixed blessing for some future cancer patients.

Pharmaceutical firms paying members of panel which oversees NHS drug procurement

And then, just when things were beginning to look a little brighter, on the 18th, the Telegraph printed yet further ‘revelations’ that ‘more than one in three members of the government panel overseeing the NHSs procurement of medicines across Britain has been carrying out paid work for drugs companies.’7 It looks as though Alistair Burt has his work cut out looking sufficiently shocked and being seen to respond decisively to this onslaught of unexpected ‘news’ - not to mention countering accusations of naivety concerning the basic workings of the organisation he purports to lead.

Does all this mean I think that drugs are just a complete con? Absolutely not. In a perfect world, all medicines would be natural and non-toxic, but medicine is far from a perfect science, and no-one has all the answers. This is never more true than in cancer. At this point, people with cancer need all the resources they can get, whether natural or otherwise. But above all they need trustworthy resources, and such has been the corruptive force of greed in the development of medicine, that the only trustworthy drugs tend to be those with a track record. This is a tragic state of affairs. Despite being pretty cynical about Alistair Burt’s apparent ‘shock’ and about drug ‘breakthroughs’, it is genuinely heartening to see at least the beginnings of a general understanding and disapproval of the biggest racket in history, and the fact that many of our health professionals are, and have always been complicit in this; and it is also good to see the drugs industry finally acknowledging that our best defence against cancer has always been our own innate immune defences.

Probably the most astonishing aspect of all this is the continuing ability of these businesses to trade with impunity and to retain some sort of respectability, despite having their dirty washing very publicly laundered with regularity, and despite such a powerful voice within medicine as Gotzsche’s spelling it out so bluntly.3 GSK’s best attempt at cleaning up its act following the $3bn monster fine in 2012 has included investigations over bribery in Poland, the United Arab Emirates, Lebanon, Jordan, Syria, Iraq and Romania, not to mention another record-breaking $490m fine for bribery in China.7

The ‘moral’ of the story is, I suppose, that money can buy an awful lot of things, especially if you have enough. And the pharmaceutical industry certainly has more than enough. As for morals…

Dying for a Cure Campaign - Overhaul Cancer Drug Development

It seems that there may now be a unique opportunity to finally tackle these sorts of conflicts of interest within the pharmaceutical industry.  In September 2015, the Parliamentary Assembly of the Council of Europe concluded that conflicts of interest between profits and public health within the pharmaceutical industry have led to a lack of new drugs of real therapeutic benefit in recent years and shocking levels of profiteering. It voted overwhelmingly (94%) in favour of a Resolution to tackle the issue.

One man who lost his wife to ovarian cancer last year, has taken the initiative to set up a formal campaign to urge the UK Government to act on this resolution and implement measures to tackle the conflicts of interest between profits and public health.  The campaign is called Dying for a Cure and is linked to a petition on, urging the UK Government to overhaul cancer drug development.  If like me, you want to see things change, please make your voice heard by supporting this campaign.

Read more from Robin here

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