Healthy Skepticism Library item: 314

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Laurance J.
Firms become more aggressive as productivity crisis takes its toll
Independent.co.uk 2004 Apr 23

Full text:

The noose is tightening on the pharmaceutical industry. It has delivered many new drugs in the past 50 years, which have saved millions of lives and transformed the outlook for millions of others, but its power and influence is now a cause of growing disquiet.

It has consistently been one of the most profitable industries, is truly global and has great political power, especially in the United States. But it faces a productivity crisis. It was once producing three new chemical entities each year; that number is now down to 0.3. So companies have had to market their products still harder and “invent” new diseases to treat.

Researching and developing new drugs is extremely costly. A major drug trial may cost millions of pounds and companies have become adept at ensuring they deliver the right results. It is not a matter of dishonesty but of being clever – in setting the trial up, finding the right people to run it and write it up and the right place to publish it.

Richard Smith, editor of the British Medical Journal , said: “Drug companies very rarely get the results they don’t want.”

In cancer, heart disease, mental health and other fields, the companies have delivered trials that have boosted sales of their products. But the research has been subsequently questioned.

A British Medical Journal study found that new cancer drugs are expensive, but deliver few benefits over existing ones. Vast sums have been spent researching, developing and promoting new heart drugs called Ace inhibitors and calcium channel blockers. But an independent study, published in the Journal of the American Medical Association , showed they were no better than the cheapest, oldest diuretic drugs.

About 10,000 prescriptions a day are written for acne drugs, but there is no solid evidence that one is better than another.

The drug companies’ failure to provide all necessary data to enable the institute to issue safe and reliable guidance to doctors needs urgent attention. But the companies’ reluctance to run trials comparing rival products “head to head” must also be addressed.

Dr Smith said that public funding must be provided to run more trials comparing treatments, in the interests of the NHS, even if the cost runs into seven figures. “To spend that amount of money to answer a fundamental question about which drug to prescribe has got to be better value for money than to go on prescribing these drugs for years and years without knowing what is best.”