April 3rd 2005

   Drugs firms 'creating ills for every pill

   Expensive new medicines are oversold when cheaper therapies or prevention would work better, say MPs

   Gaby Hinsliff, political editor
   Sunday April 3, 2005
   The Observer

   The power of Britain's multi-billion-pound drugs industry has turned this country into an over-medicalised society that believes in a pill for every ill, a Commons inquiry will claim this week.
   The report will say that the billions of pounds poured into researching and promoting new drugs have fuelled an over-emphasis on medicinal cures at the expense of cheaper and better therapies, or simple prevention.
   The MPs heard evidence of 'disease-mongering' drugs firms effectively inventing diseases for which they could then sell treatments, with relatively normal behaviour - from mild depression to low female sex drive - re-labelled as conditions for which drugs were supposedly necessary.
   Lord Warner, the health minister responsible for medicines, admitted to the inquiry: 'I have some concerns that sometimes we do, as a society, wish to put labels on things which are just part and parcel of the human condition.'
   The report from the Commons health select committee is also expected to criticise the secretive process of licensing medicines in Britain, following several safety scares in which so-called 'wonder drugs' have turned out to have serious side effects.
   The common anti-depressant Seroxat was recently linked to an increased risk of suicide in teenagers, while the widely prescribed arthritis drug Vioxx was withdrawn last year over links to fatal heart attacks and strokes.
   Labour's election manifesto is now expected to include a pledge to overhaul the drug licensing regime. Expert members of the government's medicines regulator will be banned from holding financial interests in drug firms to avoid potential conflicts of interest.
   The seven-month inquiry follows complaints from patients' groups and senior doctors that the interests of the industry are distorting health care priorities.
   Prescriptions for Seroxat tripled after it was licensed for mild depression, while The Observer revealed earlier this year that it was being marketed to doctors as a treatment for ill-defined 'social anxiety disorders'.
   Drug firms are banned from advertising directly to patients in Britain, or offering bribes to doctors to prescribe a certain brand. However campaigners say the industry has discovered ways of 'guerrilla' promotion, including generously funding medical charities - which, the inquiry heard, raises the risk of them becoming its 'unwitting foot soldiers'.
   One mental health charity, Depression Alliance, receives almost 80 per cent of its funding from drugs companies, while Arthritis Care received money from Merck Sharp and Dohme, maker of Vioxx.
   Paul Flynn, the Labour MP who has campaigned to expose the influence of the industry and gave evidence to the committee, said it deserved an 'absolute hammering' for its practices. 'The whole of society has been conditioned to believe that we are dependent on medicines. I have had arthritis all my life and I haven't taken anything for it - I believe in exercise, swimming and walking.'
   The inquiry heard of drugs marketed to doctors in papers written for medical journals ostensibly by independent experts which are, in fact, ghostwritten by the firms, which pay academics to lend their names to the reports.
   Dr Richard Horton, editor of leading journal, the Lancet, disclosed he had been effectively offered bribes to publish papers showing drugs in a favourable light. He said firms offered to buy 'hundreds of thousands of reprints' - which could be worth up to half a million pounds to his magazine - if their paper went in.
   However, a spokesman for the Association of the British Pharmaceutical Industry denied fuelling dependence on drugs: 'I don't think we have ever suggested that medicines are the only answer to health problems.
   'It is always down to the doctor to determine whether there is a real medical condition. It is right we should be informing prescribers of what medicines can be relevant.'

  When the solution becomes the problem

   Reclassification of the cholesterol-lowering drug simvastatin as an over-the-counter medicine for preventing heart disease is a classic example of the pharmaceutical industry's worrying influence, experts warned yesterday.
   The editor of The Drug and Therapeutic Bulletin , Dr Ike Iheanacho, said long-term trials had not been carried out to test the drug's efficacy or risks in those considered to be in moderate danger of having heart problems. As people could be sold Zocor Heart-Pro, the drug by its brand name, without detailed assessment of their health, there was also a danger that those at high risk of having heart attacks were getting inadequate treatment.
   'The absence of any long-term efficacy trails for Zocor Heart-Pro in the target group means that people are, in effect, being used as guinea pigs,' Iheanacho said.
   Another example is provided by the anti-depressant Seroxat. In November, The Observer revealed that Seroxat's manufacturer GlaxoSmithKline (GSK) was trying to market it as a cure for relatively mild forms of depression, despite the fact that the the drug has been linked to suicide. 'The thrust was to move sales beyond the $1 billion to the $2bn mark by pushing it to people who were not clinically depressed,' Professor David Healy told the select committee, while Richard Brook, chief executive of Mind, the mental health charity, told the MPs that the plan was 'all about developing new conditions for that drug'.
   At the same time, other options are ignored. As The Observer pointed out last week, Britain's GPs have largely ignored the advice of the Chief Medical Office that many depressed patients should be prescribed exercise programmes rather than pills.

   Robin McKie

  

  

  

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