Drug Companies - A conflict of interest?

TheyKnowMyIP

Seems like the Pharma industry is coming under severe scrutiny now: http://www.irishtimes.com/newspaper/health/2011/0920/1224304402832.html

Do you place unmitigated trust in these companies to look out for your health 100%? Why are drugs with questionable track records being pushed to the public? Are we being potentially swindled where possible if the information in this article is anything to go by?

cosmicfart

Bolivia has the best coke, period.

chin_grin

cosmicfart wrote: »

Bolivia has the best coke, period.

Can or bottle? :pac:

Biggins

TheyKnowMyIP wrote: »

Seems like the Pharma industry is coming under severe scrutiny now: http://www.irishtimes.com/newspaper/health/2011/0920/1224304402832.html

Do you place unmitigated trust in these companies to look out for your health 100%? Why are drugs with questionable track records being pushed to the public? Are we being potentially swindled where possible if the information in this article is anything to go by?

What do you think or are you just looking for opinion pieces for your report or thesis?

Seachmall

Surely they get their research from independent, peer reviewed publications, not Pharma funded or distributed ones?

jimdeans

I'll give you my opinion, as the partner of a doctor and as someone who runs a small medical virology research lab.

Drug companies are the lowest of the low. They make great stuff, but they will try and push their meds for stuff that it doesn't work on. They'll use dodgy stats to convince doctors that their drug is better than the competitors, even though it's not.

I don't know how they sleep at night. They try to give my partner all kinds of gifts if she'll come to their talks about their newest drug. She won't take anything from them and sticks to peer reviewed journals for her info. Most of my medic friends are the same, but some aren't. They all say the same thing: "The advertising doesn't influence me".

I personally think drug companies should only be allowed publish their research in independent journals, and should be allowed zero interaction with medical staff.

Sauve

I work in the frontline of this industry and I wouldn't say companies are 'swindling' patients.
However, drug companies do attempt to push their products on GPs' and pharmacies, with HUGE bonus deals and incentives.
The difference is that doctors and pharmacists are there for the wellbeing of the patient, not the drug company, and although these bonuses and deals are appealing, I have never come across a patient who was given an appropriate medication/treatment for the cause of profit.
The drug companies who sell these products are there to sell. They're businesses.
Pharmacists and doctors work ethically, with patient safety at the fore.

TheyKnowMyIP

Biggins wrote: »

What do you think or are you just looking for opinion pieces for your report or thesis?

I believe the research trials should be far removed from the pharms and carried out ethically like any other field of study. Ethics seems to be lost on these companies. This isn't a small issue granted. We're talking about lives here. A friend of mine is still paying back a loan for Avastin, despite the drug being almost useless if recent medical tests are anything to go by:o

A little honestly would go a long way I guess.

TheyKnowMyIP

Sauvignon82 wrote: »

Pharmacists and doctors work ethically, with patient safety at the fore.

Not trying to discredit Medical Professionals. Their job is by far the most challenging I reckon. It's that their hands are tied. Drug Research authenticity isn't something a GP or even a specialist should have to deal with. Rigour is key.

AnamGlas

If they're professionals, they aren't going to jeapordise their careers.

jimdeans

TheyKnowMyIP wrote: »

I believe the research trials should be far removed from the pharms and carried out ethically like any other field of study. Ethics seems to be lost on these companies. This isn't a small issue granted. We're talking about lives here. A friend of mine is still paying back a loan for Avastin, despite the drug being almost useless if recent medical tests are anything to go by:o

A little honestly would go a long way I guess.

in some parts of the world, university research departments will carry out the trial and data collection for the drug companies. The drug companies still do the data analysis and spin the results as they please. But there's usually an agreement that the data will definitely get published in a journal, which will help with publication bias. But it's still open to a lot of shenanigans.

TheyKnowMyIP

jimdeans wrote: »

in some parts of the world, university research departments will carry out the trial and data collection for the drug companies. The drug companies still do the data analysis and spin the results as they please. But there's usually an agreement that the data will definitely get published in a journal, which will help with publication bias. But it's still open to a lot of shenanigans.

Interesting. I was under the assumption that Industry Research is generally more thorough. How wrong I was.

TheyKnowMyIP

AnamGlas wrote: »

If they're professionals, they aren't going to jeapordise their careers.

Ain't that simple I am afraid:pac:

Might head to that Lecture. Sounds bloodly interesting. Education is key.

opinion guy

Seachmall wrote: »

Surely they get their research from independent, peer reviewed publications, not Pharma funded or distributed ones?

AHAAHAAAAHHAHAHHAHAHAAHA........


no wait...I'm not done yet....


AHAHAHAHAHAAAAHAHAHHAAHAHAHAHAHAHA


Thanks for that Seachmall:)


Latest dodgyness I heard of is drug companies scouring the smaller studies on a drug as by the laws of statistics one will eventually show the result you want. They find that study and promote it to promote their drug and ignore the 19 other ones that say the exact opposite

jimdeans

TheyKnowMyIP wrote: »

Interesting. I was under the assumption that Industry Research is generally more thorough. How wrong I was.

Industry has the big money. And if they're onto a winner and want to show it works, then they have the resources to do that in a very convincing way.

The problem is that their loyalty is to their shareholders, not the patient. I genuinely don't know how their reps sleep at night. But they will say all kinds of stuff to get a doctor to prescribe their drug.

All research has the potential to be conflicted. A big mistake people make is that if it's in a peer reviewed journal, it's true. There's lots of rubbish out there. And the skill is in deciding what's rubbish and what isn't.

jimdeans

opinion guy wrote: »

Latest dodgyness I heard of is drug companies scouring the smaller studies on a drug as by the laws of statistics one will eventually show the result you want. They find that study and promote it to promote their drug and ignore the 19 other ones that say the exact opposite

An old trick. See my reference to publication bias above.

Sauve

And that skill (hopefully) is where the docs and pharmacists come in when prescribing and dispensing the stuff.
I know the pharmacist who owns our place spends a lot of time reading up and researching everything that comes through the door.
And we're not fooled by the shiny posters and stats that the reps push on us.
I'd like to hope that this is the norm....

pragmatic1

No one should trust anything 100%. However, the IMB and the EMEA provide a valuable service by monitoring drug efficacy and safety. I'm also very glad that pharmaceutical companies are around so I dont have to rely on faith healers and medicine men when I'm sick. Sometimes we're just ****ing spoilt in the west.

jimdeans

Sauvignon82 wrote: »

And that skill (hopefully) is where the docs and pharmacists come in when prescribing and dispensing the stuff.
I know the pharmacist who owns our place spends a lot of time reading up and researching everything that comes through the door.
And we're not fooled by the shiny posters and stats that the reps push on us.
I'd like to hope that this is the norm....

Exactly. But you'd like to think they wouldn't have to go trawling through papers for skewed data, on top of everything else they have to do.

The shiny posters and the stats receive mega bucks (and I mean billions) because they work. Even with people who think they're not influenced.

opinion guy

jimdeans wrote: »

An old trick. See my reference to publication bias above.

True....but the twist I heard was they were deliberatly running lots of small studies to get a positive result....then publish that and just don't publish the negative ones at all. even more evil

Sauve

jimdeans wrote: »

Exactly. But you'd like to think they wouldn't have to go trawling through papers for skewed data, on top of everything else they have to do.

The shiny posters and the stats receive mega bucks (and I mean billions) because they work. Even with people who think they're not influenced.

Yeah I see your point there.
Marketing is marketing at the end of the day and even the most astute are liable to be influenced.
Although being aware of it is probably half the battle...
I suppose the best we can do is keep the ethics in place.

jimdeans

Sauvignon82 wrote: »

Yeah I see your point there.
Marketing is marketing at the end of the day and even the most astute are liable to be influenced.
Although being aware of it is probably half the battle...
I suppose the best we can do is keep the ethics in place.

it's just a shame that guys like you, run off your feet in a pharmacy, have to worry about the drug companies trying to mislead u, on top of everything else you have to be doing.

ILikeBananas

Seachmall wrote: »

Surely they get their research from independent, peer reviewed publications, not Pharma funded or distributed ones?

Very little testing of pharmaceuticals gets done by independent bodies. It's a hugely expensive process and so the only people who can afford to do it are.....the pharmaceutical companies themselves!

The pharmaceutical companies commission the studies and then use their statisticians to portray the results in the best possible light.

Ben GoldAcre write extensively about this in his excellent book "Bad Science"

opinion guy

Well thats the unfortunate truth of it really - the pharma companies are the only ones who can afford to do the important studies. We need them. We just need to keep them on a tight leash

TheyKnowMyIP

Interesting when you read about the guy complaining about his drug prescription and their propoganda. In the case of Mental Health, would it not be better to pump this money into places like Pieta House? They seem far more deserving of the money if that documentary on the telly a few days ago is anything to go by. Mental Health should not be trivialised to some farcical nonsense. Anybody can suffer.

It's shocking what they get away with, especially when it comes to cancer treatment:mad: Research first, profit second in order of precedence. When you push to market too quickly, quality is obviously going to suffer, No?

opinion guy

TheyKnowMyIP wrote: »

It's shocking what they get away with, especially when it comes to cancer treatment:mad: Research first, profit second in order of precedence. When you push to market too quickly, quality is obviously going to suffer, No?

Well to play devils advocate for a minute - no profits, no new drugs.
Tbh I think that the real issue is that once a drug is licensed the assumption of patients, and to some extent doctors, is that it must be safe. In reality their is post marketing surveillance etc and weird side effects only emerge over a few years. However there is this insistence in promoting the image of medicine and drugs as infallable.

Take the narcolespy swine flu thingy (I'm right now assuming this is a real thing - I don't know enough about it tbh). That vaccine was brought to market so quick out of necessity - but with that there are inevitably risks. Howver the line at the time was - oh yeah perfectly safe.

People then see these stories of narcolepsy and this then damages credibility and next thing people start refusing vaccines next time around when they realise authorities can't back up their claims of safety.

There needs to be alot more honesty and public education about how the whole process works I feel.

TheyKnowMyIP

opinion guy wrote: »

There needs to be alot more honesty and public education about how the whole process works I feel.

True. Hopefully something will come of this. Higher quality testing and less of the misinformation will only benefit everybody excluding the drug company shareholders, who aren't exactly driven by absolute honesty.

entropi

ILikeBananas wrote: »

The pharmaceutical companies commission the studies and then use their statisticians to portray the results in the best possible light.

This.

What is needed, but wont actually happen, is for independant, non biased research. Then blind trials and data analysis performed, and then published. If it gets published, industry cannot cover their asses with data that would otherwise make them look better than they are.

mackg

Master of Nothing wrote: »

This.

What is needed, but wont actually happen, is for independant, non biased research. Then blind trials and data analysis performed, and then published. If it gets published, industry cannot cover their asses with data that would otherwise make them look better than they are.

Who is going to pay for this?

entropi

mackg wrote: »

Who is going to pay for this?

Fcuked if I know, maybe some wealthy philantropist? :pac:

The sad thing is, that industry will always have the cash and resources behind them to fund their own, slightly skewed to their side, research. While genuine and non biased research will haardly get to see the light of day.

Plus, cures dont sell, drugs do...it'll continue onwards, day after day.

ed2hands

A most interesting article on drug trials:

http://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-medical-science/8269/

mackg

Pharmaceutical companies are obviously out to make money just like any other business, if anyone thinks that a sales rep for anything is a good source of unbiased info they are an idiot. As Jim said his wife consults medical journals for her info, if this is not what your doctor does you have a crap doctor and need to seek out a new one.

Pharma companies spend astronomical amounts of money on research most of which goes on developing drugs that don not even make it to clinical trials, drugs that do make it clinical trials are subject to stringent tests checking for both negative side effects and the positive effect(s) the drug is designed for.

No amount of skewed statistics are going to generate the sales that a good fit for purpose product will. The only place buying a GP would be of benefit is to prescribe off patent brand name drugs instead of cheaper generic drugs, here the drugs are identical so the cost is the only difference.

Not every drug works in every situation, if a drug does not work for you, you should return to your doctor and your dose should be increased or you should be reassessed and an alternative treatment be prescribed.

In the end your health depends more on you choosing a good doctor who will look out for your interests than anything else.

EDIT: Obviously if someone is prescribing stuff that won't work because they have been bribed than they should be stripped of their licence to practice medicine and probably given a jail sentence.

Edit:

A most interesting article on drug trials:

http://www.theatlantic.com/magazine/...-science/8269/

Very interesting indeed, could do without the arse licking though

opinion guy

mackg wrote: »

Pharmaceutical companies are obviously out to make money just like any other business, if anyone thinks that a sales rep for anything is a good source of unbiased info they are an idiot. As Jim said his wife consults medical journals for her info, if this is not what your doctor does you have a crap doctor and need to seek out a new one.

Thats a nice idea, but think about it for a minute. If a doctor were to read up the science behind everything he prescribes what time would he have left to see patients ? This in our already overrun system where doctors are doing 80 to 100 hours a week on a regular basis. Whilst I agree with you in principle, in practice it just isn't practical - which means there should be expert bodies reviewing these things etc.

Pharma companies spend astronomical amounts of money on research most of which goes on developing drugs that don not even make it to clinical trials, drugs that do make it clinical trials are subject to stringent tests checking for both negative side effects and the positive effect(s) the drug is designed for.

No amount of skewed statistics are going to generate the sales that a good fit for purpose product will. The only place buying a GP would be of benefit is to prescribe off patent brand name drugs instead of cheaper generic drugs, here the drugs are identical so the cost is the only difference.

Not every drug works in every situation, if a drug does not work for you, you should return to your doctor and your dose should be increased or you should be reassessed and an alternative treatment be prescribed.

In the end your health depends more on you choosing a good doctor who will look out for your interests than anything else.

EDIT: Obviously if someone is prescribing stuff that won't work because they have been bribed than they should be stripped of their licence to practice medicine and probably given a jail sentence.

Edit:

Very interesting indeed, could do without the arse licking though

One point you are missing here is that genetics plays a big factor in alot of this stuff. There was a big fuss a few years back when a guy high up in the pharma industry said publicly that x% of drugs don't work - he meant on account of genetic variablity.

http://www.independent.co.uk/news/science/glaxo-chief-our-drugs-do-not-work-on-most-patients-575942.html

opinion guy

ed2hands wrote: »

A most interesting article on drug trials:

http://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-medical-science/8269/

Just read this great article

Jimoslimos

You should take a read of 'Bad Science' by Ben Goldacre, amongst many other things, he deals with the tricks and downright dishonesty used by big pharma to bury poor trial data, circumvent independent review and push their products onto the public.

And if you think its bad here and the EU try the US where you have the same companies advertising anti-depressants for dogs (in order to treat seperation anxiety) in a thinly-veiled brand-recognition exercise.

TheyKnowMyIP

ed2hands wrote: »

A most interesting article on drug trials:

http://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-medical-science/8269/

Thank you for posting that article. A real eye opener I have to say. Seems like this widespread misrepresentation of fact is a far larger problem than most Scientists are willing to admit:

"Even when the evidence shows that a particular research idea is wrong, if you have thousands of scientists who have invested their careers in it, they’ll continue to publish papers on it,” he says. “It’s like an epidemic, in the sense that they’re infected with these wrong ideas, and they’re spreading it to other researchers through journals."

Hard Science like Physics, Mathematics etc appear to be the only areas not suffering from a vast misrepresentation of fact(s)/fraud. You can't really fudge the numbers there too often, can you?

Jimoslimos

TheyKnowMyIP wrote: »

Thank you for posting that article. A real eye opener I have to say. Seems like this widespread misrepresentation of fact is a far larger problem than most Scientists are willing to admit:

OK, generalisation much? I don't believe there is widespread misrepresentation of facts among the scientific community - certainly poor methodology when it comes to research. Scientists aren't infallible, all-knowing gods, but normal people with all the associated flaws. That's why we (should) openly publish our findings in a clear and easily reproduced fashion for our peers to review.

Where I think major problems lie is where data goes unpublished. Take for instance initial research and papers on a promising new drug show promising results, subsequent larger-scale follow up trials show little to no benefit - common for this data never to be published and the project to be quietly shelved - where I would argue THIS is probably every bit as important.

TheyKnowMyIP

Jimoslimos wrote: »

OK, generalisation much? I don't believe there is widespread misrepresentation of facts among the scientific community - certainly poor methodology when it comes to research. Scientists aren't infallible, all-knowing gods, but normal people with all the associated flaws. That's why we (should) openly publish our findings in a clear and easily reproduced fashion for our peers to review.

Where I think major problems lie is where data goes unpublished. Take for instance initial research and papers on a promising new drug show promising results, subsequent larger-scale follow up trials show little to no benefit - common for this data never to be published and the project to be quietly shelved - where I would argue THIS is probably every bit as important.

While I do agree mostly, research methodology errors are unintentional at best. Much of the criticism is aimed towards the drug/psychiatry industry. The cat is literally out of the bag now with the upcoming DSM revision for instance. You can't fully say these Academic Journals(which are industry funded) aren't intentionally publishing false research.

Fraud and unintentional mistakes are two entirely different concepts. The unpublished studies are possibly suppressed due to lack of patent ownership? I mean they are hardly going to praise a drug for which they cannot obtain a patent for. Conflict of interest abound I guess.

TheyKnowMyIP

mackg wrote: »

Who is going to pay for this?

Teflon Bertie. Hurr hurr

hatrickpatrick

Drugs companies have an incentive not to cure chronic problems permanently, but instead to make people reliant on a particular product. It is for that reason that I will never, ever trust them.

For instance: Sure codeine is a good headache repellant. But do you think it's PURELY a coincidence that once you get hooked on it, lack of it CAUSES headaches?

You think they didn't know about that side effect before they marketed it? You think they weren't deliberately using that as a way to get people hooked on their products?

Sound cynical? It is. But from a purely business point of view, it makes a whole lot of sense.

--Kaiser--

Pharmaceutical companies are some of the evilest of evil corporations

smk89

hatrickpatrick wrote: »

Drugs companies have an incentive not to cure chronic problems permanently, but instead to make people reliant on a particular product. It is for that reason that I will never, ever trust them.

For instance: Sure codeine is a good headache repellant. But do you think it's PURELY a coincidence that once you get hooked on it, lack of it CAUSES headaches?

You think they didn't know about that side effect before they marketed it? You think they weren't deliberately using that as a way to get people hooked on their products?

Sound cynical? It is. But from a purely business point of view, it makes a whole lot of sense.

Not that I mean to argue in the favour of drug companies but its unfair to blame them for causing drug addiction in codeine. The body causes that by getting used to the drug and expecting it regularly. It happens with pretty much all drugs.

TheyKnowMyIP

--Kaiser-- wrote: »

Pharmaceutical companies are some of the evilest of evil corporations

Tell that to the medical professionals prescribing the drugs. Charging extortionate prices for knowingly dangerous dud drugs(at least in the case of anti depressants) should result in loss of a medical licence and a custodial jail sentance:mad:

It's wrong to paint every professional Doctor out there under the same light, but it's impossible to overlook the number shifting at this point. It's nice to see the poll results reflect some sort of logical response to an insane situation.

TheyKnowMyIP

opinion guy wrote: »

People then see these stories of narcolepsy and this then damages credibility and next thing people start refusing vaccines next time around when they realise authorities can't back up their claims of safety

Isn't Narcolepsy a real brain disease though? Neurologists deal with Narcolepsy as a brain disease just like Parkinsons, autism etc.

There is an empirical basis right there imo. The vast majority of "mental disorders" come across as just labels to me. Biological Psychiatry is flawed.

opinion guy

TheyKnowMyIP wrote: »

Isn't Narcolepsy a real brain disease though? Neurologists deal with Narcolepsy as a brain disease just like Parkinsons, autism etc.

There is an empirical basis right there imo. The vast majority of "mental disorders" come across as just labels to me. Biological Psychiatry is flawed.

Yes its a real thing. I didn't say it wasn't ?

There have been reports of narcolepsy occurring in people who got the swine flu vac - thats what I was referring to. I have no idea whether its legit or not.

amacachi

opinion guy wrote: »

Yes its a real thing. I didn't say it wasn't ?

There have been reports of narcolepsy occurring in people who got the swine flu vac - thats what I was referring to. I have no idea whether its legit or not.

Think they've got a class-action lawsuit started. It would be interesting to find out how many people it affected and what the baseline rate for new cases of narcolepsy is though.

jimdeans

amacachi wrote: »

Think they've got a class-action lawsuit started. It would be interesting to find out how many people it affected and what the baseline rate for new cases of narcolepsy is though.

Who are people gonig to sue?

Pandemics (well, viral pandemics, I don't know about anything that's not a virus :P ) are a special situation legally. And the governments of most coutries will provide the indemnity if something goes wrong with a pandemic vaccine. So the govt will speed up the regulatory process for the vaccine, and will basically take the flack if the vaccine causes problems.

I was in the UK during the pandemic, so not sure if the Irish govt did that at the time. But the pharma companies were not going to bother making the vaccine if they weren't indemified externally, to the best of my knowledge.

amacachi

jimdeans wrote: »

Who are people gonig to sue?

Pandemics (well, viral pandemics, I don't know about anything that's not a virus :P ) are a special situation legally. And the governments of most coutries will provide the indemnity if something goes wrong with a pandemic vaccine. So the govt will speed up the regulatory process for the vaccine, and will basically take the flack if the vaccine causes problems.

I was in the UK during the pandemic, so not sure if the Irish govt did that at the time. But the pharma companies were not going to bother making the vaccine if they weren't indemified externally, to the best of my knowledge.

Fairly sure it was a voluntary thing so they should be able to go ahead and sue the manufacturers.

TheyKnowMyIP

amacachi wrote: »

Fairly sure it was a voluntary thing so they should be able to go ahead and sue the manufacturers.

Not if the risks are cleared stated on the packs. Otherwise, it's a possibility alright. What is more disturbing, is that these drugs are prescribed under the assumption that a chemical imbalance exists, whereas medical science has proven this assumption to be totally wrong.