Healthy Skepticism Library item: 8282

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Publication type: news

Tripp R.
Funding for obesity research centre questioned
The Kingston Whig-Standard 2007 Jan 27
http://www.thewhig.com/webapp/sitepages/archives.asp

Full text:

Saturday, January 27, 2007 – 00:00
Local News – By Rob Tripp
Whig-Standard Staff Writer
Bringing researchers, public health officials and civic leaders together to battle bulging waistlines with education seems a good idea.
“There’s no question that there’s a major obesity epidemic out there,” says Dr. Arya Sharma, who holds a chair in obesity research at McMaster University in Hamilton.
It’s estimated that 300 million people worldwide are obese. Eighteen million Canadians are obese, according to Health Canada, and they drain $4.3 billion annually from the health-care system.
They also constitute a vast potential market for anti-obesity drugs.
Queen’s researcher Robert Ross says his newly created Centre for Obesity Research and Education, of which he is director, will stage workshops, lectures and send guest speakers out into the community. As well, it will translate dense scientific studies into plain language.
But an expert on health policy at York University says consumers should be wary since a global drug company that stands to earn billions of dollars with a new weight-loss miracle pill is the sole source of the centre’s funding.
“It’s going to be part of the campaign that they’re using to drive the sales of this product,” said Dr. Joel Lexchin, an emergency physician and associate chair of the school of health policy and management at York.
Drug company Sanofi-aventis pledged roughly $400,000 to the centre over three years through an unrestricted educational grant, Ross said. Although other funding is being sought, it is the only money paying for the centre’s startup.
“We have no accountability [to them],” he said. “We make no reports. We have no advice to give them or them us.
“They do not sit on our council. They no not advise us on any issue.”
Ross said he’s proud to have the financial support.
“Is there any obligation on the part of [the centre] to fulfil a Sanofi-aventis driven mandate as the consequence of the funding … received?” Ross said. “That’s a categorical no.”
Also, the agency’s direction will be set by two bodies comprised of scientists, community leaders like the medical officer of health, bureaucrats in local government, and nurses.
Sanofi-aventis is seeking approval in Canada and the U.S. to sell rimonabant, a new prescription drug to treat obesity, diabetes and smoking.
Sharma, who doesn’t have a problem with the drug-company connection, acknowledges the firm, among the top five biggest drug makers in the world, has an interest in promoting understanding of obesity as a serious health problem.
“They have an interest in that because of course they have a drug to treat that condition and so by increasing public awareness that obesity is in fact a health problem, they, in the end, do hope that is going to drive their market,” said Sharma, who receives funding from several drug companies, including Sanofi-aventis.
Ross said he is involved as an investigator on three international clinical trials of rimonabant, funded by Sanofi-aventis.
A publicly traded company based in France, Sanofi-aventis had total sales of C$41 billion in 2005, according to the firm’s annual report.
Lexchin has spent roughly 20 years studying the connection between the pharmaceutical industry and researchers. In 2003, an article by Lexchin published in the British Medical Journal showed that in almost all cases, drug companyfunded research was heavily biased in favour of the products of the drug makers.
More than a dozen additional studies published in medical journals since came to the same conclusion.
Lexchin said drug companies spend, by his estimate, roughly $2 billion a year on marketing in Canada, compared to roughly $1.2 billion per year spent developing new medicines.
Education is marketing, he said.
“The idea behind these things is that if you increase awareness of a disease and you’ve got a product for that disease, you’re going to benefit, whether or not the information that’s disseminated mentions your particular product by name,” said Lexchin.
Ross said it is “blatantly false” to suggest that the centre is on a mission to drive people to doctor’s offices.
The new obesity centre has provisional approval from Queen’s principal Karen Hitchcock but still requires final approval from the university’s senior governing body, the senate.
“We have nothing to do with policy,” Ross said. “We are not setting agendas. We’re not lobbyists.”
Ross, a professor in the university’s school of kinesiology and health studies, said the firm is simply being a good corporate citizen because it recognizes the problem.
Lexchin said drug companies can be good corporate citizens.
“But the bottom line is that they’re in the business to make money,” he said. “Sanofi and all the other drug companies are not in the business of giving away money.”
It’s estimated that Sanofi-aventis could reap more than $5 billion annually from sales in the U.S. alone of its new drug.
Rimonabant is approved for sale in Europe. Health Canada will not comment on its review of the drug.
According to Sanofi-aventis, rimonabant is being sold in nine countries, where users have reported weight loss. Sideeffects include depression, anxiety and nausea.
The firm says money given to Ross has nothing to do with the marketing of rimonabant.
“This has absolutely nothing to do with that,” said Sylvain Clermont, a spokesman for the company at its Canadian head office in Laval, Que.
Clermont said Sanofi-aventis is involved in many prevention and education initiatives.
The company gives $100,000 to an education program in Quebec promoting exercise, gives $65,000 a year to a program in Ontario that trains students in CPR, and spends, according to Clermont, $85 million yearly in Canada on research and development.
“We are a health-care company that has interests in not only selling drugs,” he said.
Clermont said that initiatives the company funds are primarily in areas where it sells drugs, particularly cardiovascular disease, diabetes and oncology.
“It’s our responsibility as a corporate citizen to support these kinds of programs,” he said.
Clermont could not say if Sanofi-aventis is currently funding any clinical trials or other work at Queen’s University.
The company has given money to a researcher connected to the new obesity centre, Jean-Pierre Despres, who sits on one of two bodies that will guide the centre’s activities.
Despres, an obesity researcher at the Universite Laval, has been involved in clinical trials of rimonabant funded by Sanofi-aventis.
He was the guest speaker this week at a kickoff public lecture for the centre where he was billed as a “world leader in obesity research.”
Despres has been touting the potential of rimonabant for nearly three years.
In 2004, he presented the results of a clinical trial at a conference in New Orleans sponsored by the American College of Cardiology.
He praised the substance as the first drug with the potential to treat metabolic syndrome, a condition in which a person with too much abdominal fat has abnormal blood fat levels, high blood pressure and high blood sugar.
It is rimonabant’s apparent ability to help control all these problems that has earned it praise as a potential wonder drug.
Studies – mostly funded by Sanofi-aventis – show that it controls diabetes, raises good cholesterol levels, and tells the brain to stop craving food and cigarettes.
It does this by blocking certain chemicals in the brain that cause cravings and it controls other organs that control blood fats and insulin.
“Once it’s approved here in Canada, they’ll be launching a heavy promotional campaign aimed at doctors,” said Lexchin.
Dorothyanne Brown, a nurse at the North Kingston Community Health Centre, was recruited to sit on a community council advising the obesity centre. She has concerns about its ties to a drug company.
“It’s a devil we dance with every day when you’re working in health care and it’s extremely difficult to avoid being part of that dance,” Brown said. “It concerns me because a lot of best practices are determined by research that is conducted under the auspices of drug companies that have a drug that becomes part of the best practice.”
Brown said pharmaceutical companies provide a valuable service.
“I also know that they are salespeople who are interested in promoting their medication so that is another reason why I’m on the council,” she said. “I don’t want things led that way because, as I said, it’s not appropriate and obesity is multi-factorial thing and just treating things with medication is not the way to do stuff.”
Dr. Ian Gemmill, the region’s medical officer of health, also sits on an advisory body to the centre.
He sees obesity as the next major public health battle, after smoking. The public health agency is working on a major public education campaign that might launch late this year. He is not concerned about the drug company connection to the Queen’s centre.
“In many cases when unrestricted educational grants are provided by the private sector, I don’t have a problem with that,” he said.
He’s confident the organization will heed to conflict of interest guidelines.
Sharma hopes the new centre fills a void, educating health professionals about the complexity of obesity and its treatment.
Today, most physicians and dieticians don’t know how to treat the problem, he said.
“They all know it’s bad and they all know that one needs to do something about it, but very often the advice that they give you in terms of obesity management are actually quite useless or are completely unrealistic,” he said.
Sharma believes that the money invested by drug companies is an important and vital part of modern medicine.
Without it, he said, we wouldn’t have 90 per cent of the medicines in use today.
“There’s no question they’re in it to make money,” he said. “That does not automatically mean that the drugs that they produce are useless or bad or produce problems.”
rtripp@thewhig.com