Big Pharma: Research iz us

There are multiple interesting themes in the Andrew Scully review of David Healy’s book Mania, but the theme I want to emphasize here is the Pharmaceutical industry’s corrosive influence on the research world.

Except from the Times Literary Supplement article “The Madness of Big Pharma”

“Statistical significance has a very different meaning from clinical significance, of course, though it is a distinction the marketing departments do their best to obscure. Besides, Healy argues, by far the largest source of improvement in the clinical trials of these drugs is attributable to the placebo effect, the drugs themselves contributing but small marginal increments to this effect, and at the cost of major side effects. In fact, “in any sample of ten patients, with drugs like the mood stabilizers, the clinical trial data suggest one responds to the drug while nine do not”.

Yet even were one to accept this sobering line of argument, one would have missed a still larger set of problems associated with chemical “cures”. For Healy goes on to describe how Big Pharma has captured almost total control over the research process, to say nothing of buying up academic experts and turning them into marketing shills. It is drug companies that assemble, pay for and manage large-scale clinical trials. They own the data, and they use and manipulate them for their own purposes, suppressing damaging information wholesale, massaging outcomes and manufacturing new “diseases” whose primary function is to serve as marketing vehicles for new varieties of psychotropic pills. With an ever-expanding array of problems being medicalized and added to psychiatry’s Diagnostic and Statistical Manual, “diseases have all but become commodities and are as subject to fashions as other commodities, with the main determinant of the fashion cycle being the patent life of a drug”. Big Pharma controls the trials, and controls the reporting of the trial results. In consequence, instead of serving as a check on therapeutic enthusiasms, “RCTs have become the primary marketing tools of pharmaceutical companies. They are the fuel that powers bandwagons, helped by the fact that company trials in which the drug fails to beat the placebo commonly do not see the light of day”.

Except when there are lawsuits. Class action lawsuits in the United States, with their elaborate pre-trial discovery process, have done something to bring unsavoury drug company practices into the light of day, and to bring forth some of the suppressed data. Increased risk of suicide, of diabetes and other metabolic disorders, of massive weight gain, of the reduction of life expectancy, and the existence of an array of trials where drugs had no discernible therapeutic effect – these are just some of the findings belatedly beginning to surface. And then there is the buying up of academic talent – payments in the hundreds of thousands of dollars, even the millions, to “opinion leaders” to promote off-label uses of a whole spectrum of pills – consultation fees, free trips to desirable locales, to say nothing of the increased flow of research dollars to particular laboratories that reliably report the findings their commercial masters are seeking. Futilely, universities and academic journals have put in place requirements that researchers disclose the financial interests that might contaminate their findings, only to find such rules flouted, with minimal consequences for the offenders.”….. for much more:


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