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

 

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

Cashing in on swine flu

Swine flu is to be avoided – unless you own shares in the pharmaceutical industry that is. The world’s second biggest drug company GlaxoSmithKline is expected to reap around £3 billion by January from sales of its swine flu vaccine and its anti-viral drug Relenza.

Aware of the widespread hostility to its exploitation of disease to make ever fatter profits, GSK recently went to great lengths to put a nice face on its operations. Andrew Witty, its new chief executive, has announced announced a new strategy whereby the company “would help the poor”. Medical charities have pointed out, however, that lowering prices would undercut companies that produce generic drugs, thereby leaving the poorer countries still at the mercy of Big Pharma.

The swine flu pandemic is an example of not just how the pharmaceuticals cash in on disease but why profit-centred research and production actually makes it impossible to tackle diseases in a systematic way. This is demonstrated by two US scientists, Christopher Walsh and Michael Fischbach, writing in the Scientific American magazine.

They point to the challenges in discovering cures for the new “super bugs” which have arisen in recent years. Not only swine flu, but the lethal MRSA are bugs which have emerged from a combination of modern medical treatments and the evolutionary process of bacterium. Like MRSA, the “hospital bug” which caused 19,000 deaths in the US in 2007 alone, the H1N1 strain, which causes swine flu, does not respond to antibiotic treatment.

Walsh and Fischbach say that “modern medicine is losing the war against disease-causing bacteria that were once considered vanquished, and new approaches to discovering and creating antibiotics are needed to turn the tide.” They add:

Unfortunately, all the antibiotics sold today are blunt instruments; they not only kill the pathogens that cause infections, they also kill the helpful bacterial mutualists that inhabit our gut. In some cases this eradication of a patients gut micro flora clears the way for a different strain of bacteria, such as clostridium difficile, to multiply and cause a new, ‘secondary’ infection, that can sometimes be more dangerous than the first.

A new strategy of developing “narrow spectrum” drugs that target the pathogen more accurately and leaving other bacteria intact is needed, they say. But the financial incentive for Big Pharma is missing because such drugs would have limited applications and require rapid diagnostics, they “might be economically unattractive to drug companies”.

Walsh and Fischbach explain that the urgent need to discover new antibiotic classes is a complex process requiring novel discovery strategies. There was a “golden age” of antibiotic discovery from the 1930s-1960s, but such discoveries ground to a halt. One reason, they claim, were the small profit margins in antibiotic research, “compared with so-called lifestyle drugs” as well as the challenge of finding brand new antibiotic classes.

The spread of pandemics like swine flu is seen by many as the result of the over-use of antibiotics in factory farming as well as in medical treatment in general. The blunt instrument approach, in which millions become unpaid and unconscious guinea pigs, yields bigger profits than the innovative strategy and precise targeting that is urgently needed.

The outbreak of swine flu has led to a race between the drug giants, GSK and rival Hoffmann-LaRoche, which is earning vast profits on its drug Tamiflu. During the bird flu epidemic of 2005, the US government purchased $2 billon worth of Tamiflu doses. Some 50 million doses of were prescribed for it before and during the bird flu epidemic. Dangerous side effects were noted amongst Japanese teenagers. The antiviral was developed by a company whose chairman was gung-ho Bush ally Donald Rumsfeld, by the way.

Corinna Lotz
AWTW secretary