Big Pharma makes you sick

The fact that the UK government alone wasted £473m on a drug for flu that works no better than paracetamol is an expensive example of how Big Pharma can actually harm your health at the taxpayer’s expense rather than improve it.

A lack of expertise at government level, corporate secrecy and media scaremongering combined to induce panic-buying of the drug Tamiflu by the state from 2006 onwards. At the time, some were predicting that a pandemic of bird flu could kill up to 750,000 people in Britain.

The drug was widely prescribed during the swine flu outbreak in 2009. Tamiflu was stocked by 96 countries and got on to the World Health Organisation’s list of essential medicines. Manufacturer Roche were laughing all the way to the bank. Last year the world’s third largest drugs company with revenues last year of over $52 billion.

At most, a dozen pharmaceutical corporations control the research, manufacture and sales of drugs. Naturally, they keep their drug trials secret and secure. Some are tested on unsuspecting, desperate people in developing countries.

Scientists at the Cochrane Collaboration had to fight long and hard to get their hands on the Roche research data. In November 2012, a researcher suggested that European governments sue Roche and that doctors and others boycott the company’s products until it published all its data on oseltamivir (Tamiflu).

Finally, have wrenched the data out of the reluctant Roche, the Cochrane Foundation scientists now say that the drug did not prevent the spread of flu or reduce dangerous complications, and only slightly helped symptoms. As to the claim that Tamiflu could slow the spread of the disease to give time for a vaccine to be developed, the report's authors said "the case for this is simply unproven" and "there is no credible way these drugs could prevent a pandemic".

Worse than that, Tamiflu could have actually made people sicker. Carl Heneghan, Professor of Evidence-Based Medicine at the University of Oxford and one of the report's authors, told the BBC: "I think the whole £500m has not benefited human health in any way and we may have harmed people. The system that exists for producing evidence on drugs is so flawed and open to misuse that the public has been misled."

Oseltamivir was first produced towards the end of the last century and had little success at first. So Roche’s public relations team went to work to stoke media interest and create political pressure to buy the drug.  The corporation’s PR adviser Edelman worked with the company to create “a hybrid network of twelve local public relations agencies to take advantage of flu as a breaking news story and launch Tamiflu in the top 100 local markets when flu was in the area”.

In September 2009, the BMJ reported that doctors were raising concerns about side-effects and that it was clear that Tamiflu could not contain a local outbreak within a defined area. The report added: “Yet orders continue to grow. In the UK, oseltamivir has practically become an over the counter drug, with one distinction: it is handed out free after callers provide a simple description of their flu symptoms by telephone, bypassing the need to see a doctor.”

The Tamiflu scandal is just one of many that beset the industry. For example, Big Pharma – the handful of corporations that control the global industry – haven’t produced a new range of antibiotics for 20 years because there’s little profit in selling this type of drug.

During that time, the over-prescription of antibiotics by health practitioners and their intensive use in livestock farming to make meat cheaper has spawned new bacterial strains that are immune to existing drugs. Others have become so difficult to treat that they kill some 25,000 Europeans yearly.

In 2013, the top 10 pharmaceuticals had astronomical revenues totalling over $300 billion. Much of it comes from drugs we don’t need and from denying developing countries the right to sell generic equivalents at lower prices.

When it comes to holding on to patents to enforce monopolies, Big Pharma has an appalling record. Dylan Gray’s film “Fire In the Blood” documents how the corporations and governments blocked access to low-cost AIDS drugs – causing millions of unnecessary deaths.

He says: “At the industry's behest, governments in the US and Europe use a dizzying variety of trade mechanisms, threats of sanctions and so on to curtail supplies of affordable medicine in the global south. The potential impact of these measures in human terms is nothing less than cataclysmic.”

There are solutions we could pursue if the profit motive was not the main driver. First, over-prescribing has to stop. Doctors have to put patients first instead and abandon the quick-fix approach as well as misplaced loyalties to drug firms.

Secondly, we should note that  84% of worldwide funding for drug discovery research comes from government and public sources, against just 12% from drug companies. Apparently, researchers have already discovered new antibiotics but haven’t got the funds to develop them. So the science is there. However, the technology and capacity to turn knowledge into products is in the hands of Big Pharma.

This is a cash rich industry – the top 20 corporations have an estimated $150 billion in resources – that is now more interested in protecting patents than developing new drugs against common diseases, or in persuading people to buy “lifestyle” drugs they don’t really need. Big Pharma has an unhealthy grip on society’s collective throats that requires a strong dose of revolutionary medicine to loosen.

Paul Feldman
Communications editor

 

Profiting from the sick and disabled

Disabled people and their supporters taking part in today’s nationwide action against the company enforcing government benefit cuts have asked doctors and nurses organisations to end their relationship with Atos Healthcare.

The global corporation which operates in over 40 countries was brought in by the New Labour government and was then awarded a £300 million three-year contract extension by the ConDems, with clear instructions to reduce claimant numbers.

A new benefit, employment support allowance (ESA), has replaced incapacity benefit and every claimant is being assessed by Atos. Thousands have been disqualified from claiming ESA by Atos staff.

The government claims that figures show that the "vast majority" of claimants for ESA are fit for work. But four out of 10 of those who appealed against the decision by Atos to deny them benefits are successful on appeal, a process that costs the taxpayer £50m a year.

The open letter says: “Since 1995, when medical assessments for incapacity benefit were privatised and taken out of public services, standards have steadily declined. But Atos has brought this to a new low. While none of the work tests deserve to be called a ‘medical’ as they have no basis in patient welfare, since Atos started carrying out the ESA tests in 2008, there has been a dramatic increase in the number of people with severe illness and disability being assessed as fit for work and denied benefits.”

Campaigners told the British Medical Journal and Royal College of Nursing: "We are outraged that Atos is profiting from denying those of us who are sick or disabled, the benefits we need to survive and maintain our level of health.”

The letter adds: “A Channel 4 News report in 27 July 2011 acknowledged what thousands have been saying: it interviewed the heartbroken partner of a critically ill man whom Atos denied his entitlement on grounds that he was ‘fit for work’ – he died less than three months later. How many more people have died following such cruel and callous treatment?”

In August, the it was reported that 12 Atos doctors are under investigation by the General Medical Council for improper conduct. The Royal College of Psychiatrists and many others have strongly criticised the devastating effect the Atos exam and cuts have had on patients.

GP Margaret McCartney, writing in the British Medical Journal, has questioned the ethics of doctors performing assessments without access to patients’ medical records, and the lack of specialist knowledge of physiotherapists and general nurses employed by Atos.

Earlier this year, Atos, whose staff assess around 11,000 benefit claimants a week, was severely criticised by Parliament’s work and pensions select committee after it found that many people had "not received the level of service from Atos which they can reasonably expect".

The open letter insists that doctors’ and nurses’ ethics are being “corrupted” by Atos’ offers of higher salaries and daytime reduced work hours, adding: “Claimants rightly fear that most Atos assessors are uncaring and prejudiced – they work to targets which have nothing to do with patients’ individual health needs or with the realities of the job market which sick and disabled people are being thrown into.

“The stress of the Atos examinations has hastened deaths and caused a number of people to commit suicide. For many others, it is exacerbating their already fragile health condition.” Atos has taken action to shut down websites which have attacked the company.

The Labour government introduced work capability assessments in 2008 when it replaced incapacity benefit and income support for new claimants with ESA. The Coalition government has accelerated the changes – with the support of Labour, naturally.

Paul Feldman

Communications editor

The disaster that is the 'war on drugs'

When the outgoing president of the Royal College of Physicians (RCP), Sir Ian Gilmore, calls for an end to the state’s prohibition of drug use, acknowledging that the policy has failed abysmally, you can guess what the official reaction will be.

So no prizes for those who thought that a spokesperson for the Home Office would say: "Drugs such as heroin, cocaine and cannabis are extremely harmful and can cause misery to communities across the country. The government does not believe that decriminalisation is the right approach.” That’s been the line for 40 years since doctors were banned from prescribing heroin to patients under laws passed by the Labour government of 1966-70.

Farewell emails are more often than not best forgotten. But Sir Ian’s missive to the 25,000 members of the august RCP certainly wasn’t. He told them: “I personally back the chairman of the UK Bar Council, Nicholas Green QC, when he calls for drug laws to be reconsidered with a view to decriminalising illicit drugs use. This could drastically reduce crime and improve health."

He endorsed a recent article in the British Medical Journal by Stephen Rolles, from the think tank Transform Drug Policy Foundation. This demonstrated in a comprehensive and conclusive way that the policy of prohibition had harmed public health, encouraged organised crime and fuelled corruption. It’s a conclusion reached by many official reports, including one by the Police Foundation as long ago as 1999.

And as last night’s Channel 4’s brilliant, eye-opening documentary, Birth of a narco-state, by Angus Macqueen, revealed, prohibition carried into foreign policy by the US and Britain has had a disastrous effect on Afghanistan. Attempts to prevent poor farmers growing poppies has helped create a state dominated by the drugs mafia at the very highest levels. Naturally, the Taleban also uses heroin smuggling to fund its cause. As a result, half of Afghanistan’s gross domestic product is from the drugs trade and bribery of state officials. About 90% of heroin on Britain’s streets is Afghan, smuggled into the country through Iran and Turkey.

Globalisation has created an international, large-scale business in drugs, which operates like any other industry. The market is highly competitive, which ensures that prices remain low and within reach of most sections in society. Between a third and a half of theft and burglary is estimated to be drug-related. The illegal drug market is estimated to be worth between £4bn and £6.6bn a year. As a report by the Royal Society of Arts acknowledged: “There is no reason to think that the illegal drugs business and its accompanying market can simply be closed down. Certainly all efforts so far to close them down have been dismal and often expensive failures.”

The sharp rise in the use of drugs in society is undoubtedly connected to increased levels of alienation produced by the intense, consumer-oriented society. The market economy depends to a greater extent on low-wage, flexible labour and destroys more skilled jobs than it creates. Many working-class communities are deprived of job opportunities that are both sustainable and meaningful. These deep structural inequalities are, of course, insoluble as far as capitalism is concerned.

In his BMJ article, Rolles calls for regulation in place of prohibition and says it would be far cheaper than the ever increasing resources currently directed into efforts to control supply. But a huge state apparatus has grown up around the “war on drugs”, both domestic and military. Its perpetuation serves to sustain a draconian control over sections of society, especially young people, to the point where it has become self-justifying. Getting off the drugs merry-go-round and abandoning prohibition, will require a real dose of democracy that takes us beyond the present state of affairs.

Paul Feldman
AWTW communications editor

Big Pharma is not good for your health

Swine flu is big business for pharmaceuticals like Roche, the manufacturer of the antiviral drug Tamiflu and the other giant corporations now producing vaccines to sell to desperate governments. Whether the products actually work is another matter and getting the trial data is nigh on impossible.

Big Pharma is effectively a secret society that owes its gigantic profits to the National Health Service in Britain and its equivalent in other countries. Take Roche and Tamiflu. Doctors say that are unable to assess how effective the anti-flu drug is because the company will not release evidence obtained from trials.

In fact, an independent review published by the British Medical Journal (BMJ) has found no evidence that Tamiflu can prevent healthy people with flu from suffering complications such as pneumonia. Although the drug may cut a day or so off the illness, it is impossible to say without access to Roche’s data. "Governments around the world have spent billions of pounds on a drug that the scientific community now finds itself unable to judge," said Dr Fiona Godlee, editor of the BMJ. Sales of Tamiflu have netted Roche sales of £1.6bn this year alone. The British government has stockpiled enough for half the population.

A second review was carried out at Birmingham University by Professor Nick Freemantle and Dr Melanie Calvert. Freemantle said he was surprised to see such a widespread use of Tamiflu and added: “But I suppose that once you've gone and bought lots of doses, then it's a bit like the situation with gun control in the US. If you have a gun in the house, it is much easier to use it. But it does not mean it's the right thing to do."

But it’s not just Roche who are cashing in. Other Big Pharma corporations are doing nicely out of producing vaccines directed at the H1N1 swine flu virus. Swiss pharmaceutical giant Novartis has opened a large-scale, cell-culture manufacturing plant in America – backed by $487 million in federal funding. The plant will be able to produce 50 million doses of seasonal flu vaccine and 150 million doses of pandemic vaccine.

One of the reasons that vaccines are back in fashion is that patents are running out on the industry’s core prescription drug business. Some $135 billion in prescription drug sales will lose patent protection in the next five years, and there's little in drug companies' pipelines to replace those sales, according to health industry analysts like Alan Sheppard of consultants IMS.

Big Pharma’s claim that it is a socially responsible industry that has to make huge profits to fund research into new drugs that are then made available to the public belongs in the realm of fantasy. For example, a study by two York University researchers last year estimates the US pharmaceutical industry spends almost twice as much on promotion as it does on research and development, contrary to the industry's claim. The study found that the industry spent 24.4% of the sales dollar on promotion, versus 13.4% for research and development, as a percentage of US domestic sales.

Big Pharma is a cash rich industry – the top 20 corporations have an estimated $150 billion in resources – that is now more interested in protecting patents than developing new drugs against common diseases, or in persuading people to buy “lifestyle” drugs they don’t really need. Scientists say that little new has come out of the industry over the last decade. Meanwhile, universities are starved of resources and money devoted to research has fallen in real terms. Big Pharma has an unhealthy grip on society’s collective throats that requires a strong dose of revolutionary medicine to loosen.

Paul Feldman
Communications editor