Thursday, April 21, 2011

Flu Warning: Beware the Drug Companies!/ NY Review of Books

This long piece meanders from the H1N1 pandemic and the billions spent to save us from a flu much less malign than usual, to the marketing of Tamiflu (a dangerous drug for influenza whose efficacy may be zero) to the problems with industry control of research on all drugs in our pharmacopeiea.  The points may be familiar to readers of this blog.  But the issues are crucial to resolve if we are to regain trust in our medications and our medical litreature.  By Helen Epstein:
... On June 11, 2009, Margaret Chan, the director-general of the WHO, announced that a “pandemic emergency”—or worldwide epidemic—of H1N1 influenza was officially underway. Governments around the world placed immediate orders for anti-flu drugs and vaccines worth hundreds of millions of dollars, as a new stock index, *RXFLU, tracked company profits. According to J.P. Morgan, up to $10 billion was spent globally on “influenza preparedness” in 2009, including over $4 billion by the US alone.6

The predicted dire emergency did not occur. In the 2009–2010 “influenza season” about 18,000 people died from the disease worldwide, fewer than in previous years, and the vast majority of victims had serious underlying conditions such as cancer, lung disease, AIDS, or severe obesity, which can impair breathing.7 Since one influenza strain usually dominates all others during a typical flu season, H1N1 may actually have saved lives by displacing more aggressive viruses. The WHO maintains that its decisions were based on the best available evidence, but last year European governments, stuck with hundreds of millions of euros’ worth of unused medicines and vaccines, began asking questions.
In March 2010, a Council of Europe report8 concluded that the H1N1 virus was known to be mild well before the WHO issued the pandemic “declaration” and expressed concern about the influence of powerful pharmaceutical companies over decision-making at the agency. A draft of the WHO’s response was released in March 2011.9 It calls for more “transparency” but concludes that “no critic of WHO has produced any direct evidence of commercial influence on decision-making.” Unfortunately, the response does not account for the billions of dollars lost in the panic or for the lives that may have been put at risk by the agency’s hasty medical recommendations...

GlaxoSmithKline’s diabetes drug Avandia was linked to thousands of heart attacks, and earlier in the decade, the company’s antidepressant Paxil was discovered to exacerbate the risk of suicide in young people. Merck’s painkiller Vioxx was also linked to thousands of heart disease deaths. In each case, the scientific literature gave little hint of these dangers. The companies have agreed to pay settlements in class action lawsuits amounting to far less than the profits the drugs earned on the market.54 These precedents could be creating incentives for reduced vigilance concerning the side effects of prescription drugs in general....
Forcing drug companies to make all their original data available to all independent researchers would achieve much the same thing, and cost absolutely nothing. Legislators and the public should demand both of these reforms without delay.

No comments: