BIG PHARMA AND THE FAILURE OF EVIDENCE-BASED MEDICINE
"Pharmaceutical companies will inevitably continue to be the dominant influence in deciding what research is undertaken and conducting that research, publishing it and providing information to prescribers" House of Commons Health Committee. The Influence of the Pharmaceutical Industry. Fourth Report of the Session, 2004-2005, Volume I. March, 2005
"What’s not funny is that America is the most medicated nation on earth, with some 70 percent of Americans taking prescription drugs—yet we have worse health outcomes than other industrialized countries. Part of the problem may be the drugs themselves. As Slate’s devastating expose on the fraud in clinical drug trials shows us: We don’t know much about the drugs we prescribe. But as physicians, we have very little good information to go on. Even our most prestigious journals publish research based on falsified studies.... Pharmaceutical companies have more power than ever, and the American people are paying the price—too often with our lives." Dr. Daniela Drake from the February 21, 2015 article in the Daily Beast (Big Pharma Is America’s New Mafia)
As you can see, the statements above were written almost exactly a decade apart. Unfortunately, it seems that the old cliche is just as relevant today as it ever was --- the more things change, the more they stay the same. This is especially true with BIG PHARMA and the governmental agencies that "PROTECT" them. Their goal is to make money, and they don't care what they have to do or who they have to step on to accomplish said goal. When pressed, the editors of the the oldest and most prestigious medical journals on the planet will admit this. See if you can match the quote below with the editor who said it.
Not that it matters, but the correct answers are B, C, and A
If you want to see just how bad this problem was a decade or more ago, just take a look at the paper that was published in the May, 2005 issue of PLoS Medicine (Medical Journals Are an Extension of the Marketing Arm of Pharmaceutical Companies). This scathing expose by Dr. Smith, who was editor of the British Medical Journal, as well as the 25 or so other medical journals published under the umbrella of their name, is free online, and should be read by everyone. The faces turn red as Smith proceeds.
"The most conspicuous example of medical journals' dependence on the pharmaceutical industry is the substantial income from advertising, but this is, I suggest, the least corrupting form of dependence. The advertisements may often be misleading and the profits worth millions, but the advertisements are there for all to see and criticize. The much bigger problem lies with the original studies, particularly the clinical trials, published by journals. Far from discounting these, readers see randomized controlled trials as one of the highest forms of evidence. A large trial published in a major journal has the journal's stamp of approval, will be distributed around the world, and may well receive global media coverage, particularly if promoted simultaneously by press releases from both the journal and the expensive public-relations firm hired by the pharmaceutical company that sponsored the trial. For a drug company, a favorable trial is worth thousands of pages of advertising, which is why a company will sometimes spend upwards of a million dollars on reprints of the trial for worldwide distribution. The doctors receiving the reprints may not read them, but they will be impressed by the name of the journal from which they come. The quality of the journal will bless the quality of the drug."
Gulp! But this was written just over ten years ago. Surely things are different now? Surely they've changed? Surely this situation is under control? It would be nice to believe so, but they aren't, they haven't, and far from it. Despite all the talk, the studies, the meetings, the regulations, and the governmental oversight, this thing we erroneously refer to as EVIDENCE-BASED MEDICINE continues to disappoint.
Some of the highest-rated recent shows on television have been the programs where magicians pull back the proverbial curtains to reveal how the profession's tricks and illusions are actually done. One of the most interesting parts of this study is where Smith does the same --- he reveals a few of the ways that drug companies are able to prove anything they want to. I've dealt extensively with some of these, but below is some of his list.
Dr. Schierling completed four years of Kansas State University's five-year Nutrition / Exercise Physiology Program before deciding on a career in Chiropractic. He graduated from Logan Chiropractic College in 1991, and has run a busy clinic in Mountain View, Missouri ever since. He and his wife Amy have four children (three daughters and a son).