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to Think About
|A recent report
in The Guardian newspaper illustrates just how far ethics in business
is being eroded. It points out that doctors and psychiatrists are being
misled as to the efficacy and possible side-effects of some new medicines.
The following is taken from a small Irish monthly publication called ALIVE
in which it picks up on a report from The Guardian that exposes
scams by drug companies.
"Psychiatrists and doctors are being seriously misled about the usefulness and the possible side-effects of new medicines, because of a dangerous scam by scientists and leading psychiatrists. The doctors depend on articles in journals and on conference lectures for independent and critical information on the latest drugs. But now The Guardian has revealed that much of what the medics read and hear is secretly written by the drugs companies themselves.
Scientists and top psychiatrists are paid large sums of money to put their name to articles written by company employees, which then appear in medical journals, or are given as lectures at conferences sponsored by the companies. "Senior doctors, inevitably very busy, have become willing to 'author' papers written by drug companies," said The Guardian's Health Editor, Sarah Boseley (7th Feb 2002).
In some cases, it alleges, the 'authors' have not even seen the raw data they are 'writing' about, but depend on limited information supplied by the industry. Exposing the scandal, the newspaper noted that the problem "has become widespread in such areas of medicine as cardiology and psychiatry, where drugs play a major role in treatment".
Last year The New England Journal of Medicine could find "very few research psychiatrists who did not have financial ties to drug companies that make anti-depressants." The ties included expensive gifts or trips, royalties on the drug, or shares in the company. Said one well-known British psychiatirst to a colleague, "What day is it? I'm working out what drug I'm supporting today."
Even the prestigious journals are publishing the dubious articles. Dr. David Healy, who gained exceptional access to company archives said: "It may well be that 50% of the articles on drugs in the major journals across all areas of medicine are not written in a way that the average person in the street expects them to be authored."
As a result of the racket, doctors' confidence, even in genuine papers, is eroded; they no longer know what or who to believe. Much of the problem arises from the increasing dependence of researchers and their departments in the drugs industry. The companies provide huge funding for researh, so they decide who receives the money, what studies are conducted, and how they are presented in the professional journals.
But the influence of the companies is not limited to articles and authors. Even the journals, in many cases, have become dependent on the massive advertising provided by the companies, which limits their independence. The ties between industry and researchers have become so big a problem that the World Health Organisation is worried about them. A top WHO official has warned of the grave danger to research "if clinical trials become a commercial venture in which self-interest overrules public interest, and desire overrules science."
Revelation of the scam comes at a time when UK research is raising serious questions about anti-depressants, suggesting that they may be only 10% more effective than placebos (fake pills). According to the US survey, cooperative British psychiatrists get about $2000 plus airfares and gotel accommodation for speaking at sponsored conferences. But payments to some American psychiatrists run as high as $10,000.
Research shows that prescriptions for anti-depressants have shot up in Britain from 9 million in 1991 to 22 million in 2000. And the cost of the drugs has risen from £54 million to £310 million.
But a consumer watchdog believes that patients are being given inadequate and misleading advice about the value and safety of what they are taking. The latest edition of Health Which? says patients are not fully informed about the usefulness of the drugs, and the possiblity of addiction or of an increased risk of suicidal behaviour. The magazine refers to a study carried out by Dr. Joanna Moncrieff, a senior lecturer in psychiatry at London University. She found that patients who were given anti-depressants were only 10% more likely to respond than those given placebos.
"More people are being put on these medicines on the basis of evidence far less solid than generally portrayed", said the psychiatrist. Sue Freeman, managing director of Health Which?, pointed out that "anti-depressants do help in some cases". But, she added, "current advice from the Royal College of Psychiatrists and other sources is potentially misleading patients."
As a former nurse I have personal experience of the huge amounts of money spent by drug companies to promote new drugs. My area of care was with the terminally ill and as Home Care Manager I attended two such conferences. We were accommodated in one of Ireland's most exclusive golfing resorts hotels and wined and dined for a full weekend. In all there were about 200 of us made up of doctors and nurses. The cost of this type of promotion is absorbrd into the cost of the drugs to the consumer - the patient or governments providing national health care. Is it any wonder that Third World Nations cannot afford medicines, when we in the First World spend such immoral amounts on promotion to those who can afford to 'pay, thus bumping up the cost of the medicines!
Apart from the financial gains, look at the dangers of the above practices. How can we be sure that proper trials and testing have been undertaken? We rely on the 'experts' to say that they have found evidence to support or to deny the claims of the drugs companies as to the value of their medicines, but if the 'experts' are lining their own pockets unethically, then the doubts increase.
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