[Ip-health] Pharma Propaganda and Lies

[George M. Carter]

There ARE many good drug interventions out there...but the need to sell far
outweighs the need for Truth so that we have a genuine understanding of
risks, benefits and limitations.

The "patent" aspect of drug companies hurts in far too many ways for
immediate reform not to be essential. To wit:

1) Spinning, massaging and distorting of data that amplifies benefit
compared to generics where they are available, or downplays toxicities.

2) Limits access to data (and renders available data suspect).

3) Results in initial enthusiasm for drug discovery until the market
saturates...then efforts begin to wane as the opportunity for multi-billion
dollar blockbusters fade--except for higher cost interventions (e.g., T20).

4) Price gouging.

5) Genocide--where the industry intentionally and expertly blocks access to
lower prices or generics for developing nations (or for the poor in
developed nations), despite recognizing their actions cause enormous
suffering and death.

Berlin walls fall. World Trade Centers collapse.

The world can and does change...and the hegemony of lies and sleaze that
represent the pharmaceutical industry must end. The effects are disastrous
on a global scale and in breathtaking proportions.

More important to raise funds to murder Iraqis, I guess.
George M. Carter

****
Suicide Science - Dr. David Dunner: Paxil's Friendly Ghostwriter?
By Ric Giombetti
CounterPunch www.counterpunch.org April 8, 2002
Home: www.healthyskepticism.org

Dr. David Dunner of the University of Washington's Department of Psychiatry
admitted he "ghostwrote" an article that appeared in the March 1995 issue
of the journal European Neuropsychopharmacology (EN) on behalf of
pharmaceutical manufacturer SmithKline-Beecham (which has since merged with
GlaxoWellome to become Glaxo-Smith-Kline, or GSK).

Dunner had purportedly analyzed the data of clinical studies involving
GSK's antidepressant and anti-anxiety drug Paxil and concluded that it is
less likely to lead to suicidal thoughts than the older antidepressant
imipramine and placebo (sugar pill). Dunner never looked at any of the data
but he was still listed as an "author" of the article.

Meanwhile, Dr. David Healy of the University of Wales Department of
Psychological Medicine presented a different analysis of this same data
during the Paxil trial last year. The family of Wyoming resident Donald
Schell, 60, sued GSK in federal court after he shot his wife, daughter,
granddaughter and then himself to death in 1998 after two days on Paxil.
Healy testified on behalf of the plaintiffs. He argued GSK's internal
records demonstrated that there is a substantially increased suicide risk
for patients put on Paxil. The jury agreed with the plaintiff's position
that Paxil was primarily responsible for Schell's actions and awarded them
$6.4 million in June of last year. The judge in the case rejected GSK's
challenge of Healy's testimony and sent them packing to a federal appeals
court in Denver in August. A suicide warning has since been put on the
label for the drug, not here in the United States, but in Britain, where it
is known as Seroxat.

Where did Dunner's stunning admission of having ghostwritten such an
important article appear? In either of the local dailies the Seattle Times
or Post-Intelligencer? No, not even close. A Seattle resident would have to
purchase a ticket on the next British Airways flight from SeaTac to London
to meet the author of the article Dunner was quoted in: Sarah Boseley,
health editor of the Guardian. Boseley's February 7 article confirmed what
I have suspected all along about Dunner: He has little or nothing to do
with the actual research and writing behind many of the articles where his
name, D.L. Dunner, appears.

The current situation in peer-reviewed publication in academic and clinical
medical research is starting to resemble the Church's control over
publication of anything in, say, 1300. The pharmaceutical industry funds
most of the research into the crucial Phase III clinical trials that lead
to FDA approval for marketing drugs (the truth is most of the cost of
bringing a drug onto the market is put up by tax payers). This gives the
drug companies an enormous amount of influence over study design and, most
crucially, they typically retain control over study data as proprietary
information. The end result is that it's difficult to find a published
article in peer reviewed medical journals dealing with clinical drug
studies that weren't supported by funding from the drug's manufacturer.
Most medical journals are now dependent on pharmaceutical industry
advertising to stay in business. This didn't stop 13 prestigious journals,
including the Journal of the American Medical Association, New England
Journal of Medicine and Britain's Lancet, from publishing an editorial in
September of last year condemning the conditions put on researchers by the
drug companies as, "draconian for self-respecting scientists, but many have
accepted them because they know if they do not, the sponsor will find
someone who will." The aim of the journals was to implement editorial
policies to authenticate authorship of articles.

"The pharmaceutical companies usually retain the right to withhold the
information their researchers find that they don't want the public to see,"
said Keith Hoeller, community college instructor in psychology in Seattle
and editor of Review of Existential Psychiatry and Psychology (who also
brought the Boseley article to the author's attention). "These kinds of
contractual stipulations also provide researchers with incentives to find
the kind of results the drug companies are looking for in the studies they
fund."

"It would be a simple matter to say that the data is inherently
unscientific while it remains proprietary," said David Healy. "There is no
other branch of science in which the raw data remains inaccessible to
investigators generally and indeed essentially to the public." We can all
see what happened when the clinical data in the Paxil trials became a
scientific matter in a court case last year. This tells us that there may
be something to what many critics of the marketing of psychiatric drugs
during the '90s suspected all along: The public has been fed a self-serving
party line about the efficacy and safety of Paxil, Prozac, Zoloft, and all
of the other newer antidepressant drugs.

Actually Dunner is anything but friendly and approachable on the topics
being reviewed in this article. Dunner won't talk to me about what he knows
about the side effects of the newer antidepressant drugs and his conflicts
of interest with the pharmaceutical industry. I don't mind Healy's
willingness to discuss these matters with me. It's just that I help pay
Dunner's salary and help fund his department every time I pay Washington
state's regressive sales tax, not Healy's. None of this is a problem in the
area of financial conflict of interest though, as I have recently received
copies of Dunner's honoraria and conflict of interest records from the UW.

Here is a brief summary. Since July of 1997 and up until the end of last
year, Dunner made at least 80 requests for outside professional work for
compensation including 33 lectures sponsored by various pharmaceutical
companies, 14 for various universities and 11 on behalf of various
professional societies and other organizations. No exact dollar amount is
ever given on any of the records I have obtained. He also spends at least a
few days every year as a "reviewer" for various peer-reviewed academic
journals.

Dunner's record also includes eight statements of significant financial
interest. The most significant with regard to the Paxil clinical trial data
is a disclosure he made in 1998. The disclosure was made regarding an
application for a clinical trial dealing with Paxil in which Dunner would
serve as an investigator at his Center for Anxiety and Depression. His
Confidential Statement to the Vice Provost for Research states, "My
involvement with SmithKlineBeecham (the pre-Glaxo merger owner of Paxil)
involves being a member of the international advisory board related to
paroxetine (Paxil)." In other words, Dunner's name appeared in the EN
article not as an independent scientist but most likely as a part-time
employee of the manufacturer of Paxil. This conflict of interest is not
mentioned in the EN article.

Here is Dunner in his own word's in Boseley's Guardian article: "I don't
know who saw it (the Paxil clinical trial data). I did not. My role in the
paper was that the data were presented to us and we analyzed it and wrote
it up and wrote references." Dunner's co-author Stuart Montgomery, then of
St. Mary's hospital medical school in London, declined comment for the
Guardian article. His other co-author is Geoff Dunbar, a company employee
(Dunbar's status as a SmithKline employee was mention in the EN article).

Healy figures about half of all articles appearing in medical journals
today are ghostwritten jobs by pharmaceutical companies. What this tells us
is that we should regard much of what we read in the published medical
literature with a level of suspicion similar to that of a citizen of the
former Soviet Union reading Pravda. In other words, take with a grain of
salt any published article stating "studies show that drug X is a safer and
more effective treatment than drug Y and placebo."

The lack of candor most of the psychiatric profession and the
pharmaceutical industry has about these heavily marketed drugs has
potentially deadly consequences for the patients taking them. According to
Healy, "The evidence from across the board from all the companies producing
SSRI's (i.e. Prozac, Zoloft, Paxil, et al.) is that their drugs can make 1
in 20 of us agitated to the extent that we drop out of trials." Healy
figures that at least 250,000 people worldwide have attempted suicide
because of Prozac alone and 25,000 have succeeded. That sounds like a huge
number but if you put 50,000,000 people on the drug, at least 2,500,000
will become extremely agitated. If ten percent of that population attempts
suicide because of the extreme agitation, that gives you 250,000. If ten
percent of that population succeeds in carrying out their suicide attempt,
you end up with 25,000 dead bodies. Put another 100 million people on
Zoloft (comedian Phil Hartman's wife Brynn), Paxil, Luvox (Eric Harris at
Columbine) and the other more potent newer antidepressants and you have
might have another 50,000 dead bodies.

"The fact that (pharmaceutical) companies have chose to market them as
antidepressants rather than agents of agitation is a business decision
rather than a scientific matter," said Healy. Yes, business has been great
for the companies manufacturer these "antidepressant" drugs. The sales of
these drugs is now a $10 billion-per-year industry. However, the outcomes
for the patients put on these drugs have not necessarily been all that
great. The four dead members of the Schell family are testimony to this
fact. GSK's line in the Paxil trial that their drug didn't have enough time
to "help" Donald Schell follows no coherent logic. What GSK is saying is
that Schell needed to stay on the drug in his agitated state and his dose
possibly needed to be increased, a common occurrence in psychiatric
practice. Increase the patient's dose and you get an even more agitated
individual. You still end up with the deaths of three generations of
Schell's in Gillette, Wyoming on February 13, 1998 with Paxil as the
suspected culprit, no matter what kind of semantic games GSK wishes to
engage in with this case.

How much longer is David Dunner going to remain silent about the record of
harm these "antidepressant" drugs have caused? How many articles in
Dunner's publication record were ghostwritten? How much longer are the
Times and P-I going to quote Dunner as an unbiased expert on mental health
issues?
Rick Giombetti lives in Seattle. He can be reached at: rickjgio@speakeasy.net