Marcia Angell, MD, THE TRUTH ABOUT THE DRUG COMPANIES

 
Post new topic   Reply to topic    msspeaks Forum Index -> BOOKS
View previous topic :: View next topic  
Author Message
agate
Site Admin


Joined: 17 May 2006
Posts: 5694
Location: Oregon

PostPosted: Fri Jun 05, 2009 2:59 pm    Post subject: Marcia Angell, MD, THE TRUTH ABOUT THE DRUG COMPANIES Reply with quote

I posted my review of this book on my books blog, and I'm just pasting it here:

Quote:
ANGELL, MARCIA, MD
THE TRUTH ABOUT THE DRUG COMPANIES: HOW THEY DECEIVE US, AND WHAT TO DO ABOUT IT (2004)

The author was the editor of the New England Journal of Medicine, following the editorship of Arnold Relman, MD, who happens to be Marcia Angell's lifetime partner and a frequent collaborator in other publications.

There isn't word about multiple sclerosis in this book but there is considerable discussion of Neurontin, which is often used for MS spasticity.
The author finds that Neurontin usage has been expanded for many off-label situations where it isn't effective.

This book argues that the pharmaceutical industry in the US has entirely too much money and power--and that it is involved in many questionable practices that are enhancing its money and power at a rapid rate, such as its heavy involvement in continuing medical education (CME) programs for doctors, in sponsoring medical conferences, and in providing free samples and other gifts to doctors routinely.

She points out that 32 percent of the sales revenue for the drug industry goes to "marketing and administration," while a much smaller percentage goes to research and development--and yet we US consumers are often told that the drug industry "must" be highly profitable because how else can the US be on the cutting edge in medical research?

She points out that the US is not a leader in medical research by mentioning that most truly innovative drugs in recent years have come from research outside the US. As for the efforts of the US drug industry, its major output nowadays is so-called "me-too" drugs, which are slightly modified copies of existing drugs that can be marketed as new drugs, thus enabling the industry to continue making a profit on a drug that has reached the end of its patent protection period.

The research that is done in connection with drug development is often flawed, Dr. Angell notes. For instance, for FDA approval a new drug needs only to be compared with placebo. The author makes a strong case for requiring that a new drug be compared with existing drugs (as well as with placebo).

She also would like to see more Phase IV studies done.

This book is full of good ideas and facts. Anybody concerned with the high cost of drugs in the US would be interested in it.
Back to top
View user's profile Send private message
agate
Site Admin


Joined: 17 May 2006
Posts: 5694
Location: Oregon

PostPosted: Tue Jul 21, 2009 1:03 pm    Post subject: An article by the same author on the same topic Reply with quote

From BMJ, February 3, 2009:

Quote:
doi:10.1136/bmj.b222
Cite this as: BMJ 2009;338:b222

Relationships with the drug industry: Keep at arm's length

Marcia Angell, senior lecturer in social medicine

1 Harvard Medical School, Boston, MA 02115

marcia_angell@hms.harvard.edu

...

I believe there should be no relationship between the drug industry and either prescribers or patients. Drug companies are investor owned businesses with a responsibility to maximise profits for their shareholders. That is quite different from the mission of the medical profession, which is to provide the best care possible for patients. I start with this simple fact, because it is so often obscured by the industry’s public relations. Drug companies are not confused on this score. Their major output now consists of "me-too" drugs for mild or ill defined conditions in essentially healthy people. This is because that market is big and more easily expanded than the market for innovative drugs for serious diseases.1

The purpose of drug companies’ contact with prescribers is nearly always to increase sales, and it usually involves payments of one form or another. These are often disguised as education—for example, sponsored continuing medical education, professional meetings, and conferences or dinner sessions to hear presentations about drugs. Companies provide meals, gifts, and subsidies of various sorts. But drug companies are not educational institutions. These activities are funded from their marketing budgets. Drug companies may, of course, provide accurate information to prescribers, but only if it serves their commercial interests. A growing body of evidence shows that they suppress or distort information that does not serve their interests.2 Prescribers are faced with the impossible task of sorting out good information from bias or misinformation.

The fact that drug companies pay prescribers to be "educated" underscores the true nature of the transaction. Students generally pay teachers, not the reverse. The real intent is to influence prescribing habits, through selection of the information provided and through the warm feelings induced by bribery. Prescribers join in the pretence that drug companies provide education because it is lucrative to do so. Even free samples are meant to hook doctors and patients on the newest, most expensive drugs, when older drugs—or no drug at all—might be better for the patient.


Education and information should be provided by health professionals

It is time the medical profession took full responsibility for educating prescribers about prescription drugs, instead of abdicating it to drug companies.3 Doctors should pay for their own continuing education, just as other professions do. Similarly, professional organisations should pay for their own meetings and publications, not go hat in hand to industry. Drug companies are not charities; they expect something for the tens of billions of dollars they invest in marketing. The evidence is that they get it, and that patients foot the bill in higher drug prices.

As with prescribers, the purpose of contact between drug companies and patients is to sell drugs. In the US, drug companies spend about $5bn (£4bn; 4bn in euros) yearly on direct-to-consumer advertising on television. The adverts are mostly for me-too drugs and are designed to convince viewers that one is better than another, despite the fact that these drugs are seldom compared in clinical trials at equivalent doses. Many seek to convince people that they have chronic disorders that require lifelong drug treatment. Thus heartburn is elevated to gastrointestinal reflux disease, with the implication that it needs to be treated to prevent serious complications. If people can be convinced they have a treatable medical condition, then it is an easy step to sell them drugs to treat it. Many doctors connive in this deception because it is easier to write a prescription than to counsel changes in diet or to offer reassurance. We need to stop accepting the fiction that marketing, whether to prescribers or patients, is good education.


Competing interests: None declared.
Provenance and peer review: Commissioned; not externally peer reviewed.


References

1. Angell M. The truth about the drug companies: how they deceive us and what to do about it. New York: Random House, 2004.

2. Turner EH, Matthews AM, Linardatos E, Tell RA, Rosenthal R. Selective publication of antidepressant trials and its influence on apparent efficacy. N Engl J Med 2008;358:252-60.

3. Relman AS. Industry support of medical education. JAMA 2008;300:1071-3.

Back to top
View user's profile Send private message
Display posts from previous:   
Post new topic   Reply to topic    msspeaks Forum Index -> BOOKS All times are GMT - 7 Hours
Page 1 of 1

 
Jump to:  
You can post new topics in this forum
You can reply to topics in this forum
You can edit your posts in this forum
You can delete your posts in this forum
You cannot vote in polls in this forum
Create your own free forum now!
Terms of Service Purchase Ad Removal Forum Archive Report Abuse