Author: Julian Todd
What NEED does this meet?
The international public, as well as NHS organizations, are remorselessly targetted for the sale of inappropriate pharmaceuticals at inflated prices. The corporations work within a system of legalized monopoly and hide important information. We need a presentation of the facts drawn from different sources that can be used as the first line of defence. It would also point out what information we do not know, suggesting the questions that investigators should be looking into.
What is the APPROACH?
Very helpfully, new pharmaceuticals are given new invented unique names, so it is very easy for software to tag them, and track their appearance in the news media, and watch as the companies post their propaganda onto places like wikipedia and build their marketing campaigns. It is well documented and utterly predictable that the money is available to promote a drug that is in patent against one that is out of patent, even when it is undeniably more dangerous and less effective.
We need an automatically updated chart like publicwhip that scrapes the patent and trademark databases, and lists who owns them, on what date the patent expires (**very important), links to all news publications citing the drug in chronological order, cost of drug per patient, cost of manufacture (**usually a blank, drug companies refuse to divulge this, or blatantly lie about it — see the case of AIDS drugs that Cipro began to manufacture), names of the doctors who have conducted the drugs trials, list of similar drugs, evidence of who invented the drug (**often the drug company just buys it in from a taxpayer supported university, and then pretends that they spent 500m pounds on it).
What are the BENEFITS to people?
It will expose the big picture of this this market commodity in one page. Those who are using particular named drugs, have been prescribed particular named drugs, have been virally marketed at to ask their doctor for a particular named drugs, will have a source that’s slightly more structured than just typing the name of it into google, and getting a pile of links, none of which includes price or patent expiration data. This would be easy to make it possible to inform oneself on the pattern a sudden set of negative publicity against a drug (after years of good publicity) that is shortly to go out of patent in order to convert people to the next patented drug — which will be more expensive but might not be better.
What is the COMPETITION?
Public Citizen runs the worstpills.org site. This proposal is a simpler across various sources of information.
What BUDGETS & LOGISTICS are required?
The software may have wide applications, across products outside medicine. We need to scrape trademark and patent data into a single table, and scan across all of bbcnews sites or online paper news sites for a chronological list for each known unique name. This on its own is better than the google shambolics.
The other data, such as prices and manufacturing costs, could be lifted from the wikipedia, if people include the data there in slightly structured and scrapable form. ie, rather than make our own wiki, use the one that’s there already to gather and host the data.
One day I hope people in these companies may start to leak info about the manufacturing and research costs on actual particular instances, so we can have an informed public debate about these matters, not just layers and layers of excuses and faked expenses from the most profitable companies in the world.
As a Primary Care Trust pharmacist, I recognise the concerns raised here and applaud them. However, while the proposal itself is helpful, it can only play a small part in assessing the appropriateness of new drugs.
The structures in place for paying for drug research and development – either directly or indirectly – are very complex, and unless this includes an objective for huge research bills funded directly by the tax-payer (and development costs are so great that the UK tax-payer is unlikely to be able to match the sort of funds spent on research by multi-national companies), there has to be a commercial interest for development to be carried out. The Universities are not adequately funded, so it has to be through drug companies, and in one way it is very efficient because only successful drugs will show a return. Equally, there is so much mistrust, suspicion and ignorance that an amount of â??marketingâ?? is required to get a drug used.
Therefore we have national organisations such as NICE, and local networks of Pharmaceutical Advisors in each PCT that work with GP surgeries to dispel myths and give rational balance to marketing messages. Patients may well be led by â??viral marketingâ?? to ask for a particular drug, but it is the role of the doctor to explain when that drug is not suitable or appropriate, and for the Pharmaceutical Advisors to provide the support and information to doctors. It is an unseen and unacknowledged role that works well.
I see. Perhaps if we knew the data, we might be able to tell whether the above story above was or not. The allegations are quite startling. The cited research costs are hugely inflated. 4/5ths of development money is spent on “me-too” drugs which don’t give patients any better treatment. And companies fight to keep drugs on the list long after it should have been obvious that they are dangerous.
Perhaps total financial disclosure of every part of their companies as well as a complete ban on “marketing” of products might be a way to ensure that their business in some way serves the public interest.
If you want to put it in terms of money, the UK tax payer is already footing the bill for the whole ridiculous package, a part of which (and we don’t know how much or how little) is the “huge research bill”. Obviously it would be much cheaper to fund it directly, and no voter would be against doing so.
Please take my word for it that the “huge research bill” is indeed monstrously huge. Average time to market for a drug these days is between 7 and 12 years across the industry – although in the current climate it’s correct to say that more acquisition’s happening – e.g. venture capitalists setting up small firms for a single candidate drug, and then hawking it around the pharma companies.
Speaking as someone who works for big pharma, and designs electronic data capture systems for use in Phase 1 Clinical Trials, I can also assure you that big pharma is living in *fear* of the FDA, GxP, MHRA and SoX legislation that binds us and (rightly) ensures attention to detail and massively expensive design and build costs for IT systems, and similarly frightening levels of documentation, proof and detail in R&D. Aspirin, were it discovered today, wouldn’t get approval from the FDA due to QT prolongation, for heaven’s sake…
I’m working from an IT perspective here but have strong links across the business of a large pharma company and despite scary scare stories to the contrary have never come across any behaviour that warrants the cynicism implied in the posts above.
Note that I *don’t* have exposure to sales and marketing, though – although I will say that spend on S&M is approx 2x R&D costs across the industry. The situation in the US is a little odd with respect to TV advertising of named prescription drugs, I grant you.
But then I would say all this, wouldn’t I?
It’s also worth noting that in recent years there has been a major drive to encourage pharma companies to put this information in the public domain themselves: it’s all there in standardised electronic format for submission to the FDA et al, and submission data does and is in the public domain in a large number of cases.
Similarly, FDA info re adverse events etc are also readily available online currently.
Oh, and the “public citizen” stuff is bollocks.
For a more informed, but still fairly cynical (but entertaining) look at the drug industry, have a look at pharmagossip on blogspot…
So, does this mean that you’d be in favour of a project like this because it would explode what you assert is bollocks put out by Public Citizen? The allegations are widely believed and credible. The numbers speak for themselves: AstraZeneca profits 25% of sales, reported R&D 15% of sales. No other sector of the economy makes this much money, except for illegal drug dealing. Then there are the indisputable cases of me-too drugs such as Nexium, brought to you by the Sharks Fin Project, http://www.newyorker.com/critics/atlarge/?041025crat_atlarge
The FDA itself has been practically funded by the industry since the law was changed in 1994. That puts it on par with the Press Complaints Commission. I am sure there are reams of accountability and documentation involved in the system, but it can be accused as a facade and a device to control the market if bad expensive drugs are being used by people, in favour of good cheap ones that are already available.
As the idea that Aspirin would not meet FDA approval if it were introduced now, I can find no statement of this allegation outside of neo-liberal publications. It looks like a fiction invented during the Vioxx case during the battle to withdraw it from the market, when people were claiming that it was safer than aspirin, and they needed to assert this lie as a logical consequence.
Scientists continue to press the well informed case for a restructuring of drug classifications [broken link removed Aug 2013 – see http://web.archive.org/web/20080411110439/http://www.unregisterednews.com/content/view/109/51/%5D