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Comments: 289 +- Science: Medical Papers By Ghostwriters Pushed Hormone Therapy on Thursday August 06 2009, @04:50PM
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krou writes "The New York Times reports on newly released court documents that show how pharmaceutical company Wyeth paid a medical communications firm to use ghost writers in drafting and publishing 26 papers between 1998 and 2005 backing the usage of hormone replacement therapy in women. The articles appeared in 18 journals, such as The American Journal of Obstetrics and Gynecology and The International Journal of Cardiology. The papers 'emphasized the benefits and de-emphasized the risks of taking hormones to protect against maladies like aging skin, heart disease and dementia,' and the apparent 'medical consensus benefited Wyeth ... as sales of its hormone drugs, called Premarin and Prempro, soared to nearly $2 billion in 2001.' The apparent consensus crumbled after a federal study in 2002 'found that menopausal women who took certain hormones had an increased risk of invasive breast cancer, heart disease and stroke.'"
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Here come the Lawyers (Score:3, Insightful)
Re:Here come the Lawyers (Score:5, Insightful)
Good! This is one of those cases where the pharmaceutical companies should be held accountable over and above the slap on the wrist the FDA will give them - if that.
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Re: (Score:3, Interesting)
Agreed. I think say, fining them two hundred times their gross worth and imprisoning their board of directors and corporate officers until every penny has been paid off ought to do the trick.
Re:Here come the Lawyers (Score:5, Insightful)
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Re:Here come the Lawyers (Score:4, Interesting)
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Re:Here come the Lawyers (Score:5, Insightful)
I respectfully disagree; I think corporate death penalty is the appropriate route to go.
All assets of the company are seized by the government, all patents are made public domain, liquid assets (cash and similar instruments) are distributed amongst the victims, the rest is auctioned off to pay for court costs.
Then, the former shareholders of the company can sue the board of directors and anybody else who no longer has corporate immunity, for causing all of their investment to go away because the company committed crimes against humanity.
This would put every single company on notice: You exist to serve the people; you are allowed to eck out a profit insofar that you do not commit crimes against us. Companies are only people on paper, and I have no compunctions about putting them to death for crimes against the people they are supposed to serve.
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Re:Here come the Lawyers (Score:5, Insightful)
I disagree with the idea of fining the perpetrators.
These are white collar RICO Act violations involving fraud by mail and conspiracies that cross state lines. The individuals involved should be identified by the FBI and charged by the US Attorney General. Each one of them has conspired to defraud healthcare providers and bona fide researchers, in a manner that has caused the deaths of some USA citizens and placed many more at high risk of cancer or other diseases.
There is no way in hell that the USA is going to get decent health care, no matter what Congress does, until these kinds of white collar crimes in the healthcare industry are addressed for what they are: felonies that indirectly cause death and suffering to the general public.
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Re:Here come the Lawyers (Score:5, Insightful)
I'd like to see murder or similar charges placed against the people involved. If I did anything that indirectly caused the death of any single individual, I doubt anyone would have any problems with charging me with some sort of death related crime. Why are these jackholes immune? Corporate officers gave orders and directions and approval for these acts that ultimately resulted in the deaths of people. Had they not done so, they would not be responsible.
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Re: (Score:3, Insightful)
They are immune because they are insanely wealthy and big time political donars/bribers.
Re: (Score:3, Insightful)
...and take their own "medicines".
What... would be the point? (Score:5, Interesting)
Except that nobody is really being held accountable, unless you're talking about SERIOUS jail time for the officers and forfeiture of profit + interest (at credit card rate no less.) Let's be honest here, the worse that can be expected is that FDA will slap some fine on the companies, and the companies will just happily pass the cost onto its paying customers (you and I.) There is NO ACCOUNTABILITY.
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Re: (Score:3, Insightful)
Why fine the company? The science was very probably accurate;
of course they left out that the content glorified the reduction of trivial symptoms and the consideration of potentially fatal side effects were beyond the scope of the paper
Re:Here come the Lawyers (Score:5, Insightful)
This is one of those cases where the pharmaceutical companies should be held accountable over and above the slap on the wrist the FDA will give them...
Then there are insurance companies hauling bus loads of loud, fat people to public meetings on health care. Industry busy trying to undermine public discussion and fudge research results. Big oil has been doing the same thing only a lot longer. When I was doing research for DoE they were paying for research later used to undermine the conservation programs put in place in the wake of the '74 oil embargo. And it worked. Between the push by the oil companies and the Saudis increasing production, DoE's direction on oil policy was changing rapidly by '82. Less than 10 years after lines at the gas pump people were buying vehicles the size of a Bangladesh apartment.
There's a fine line between engaging in freedom of speech and manipulation. Actually, it's not all that fine. At some point we're going to need to take a hard look at whether the artificial person that is a corporation has the same right to free speech as an individual. Unless you're fabulously wealthy, corporations have a major advantage in getting their free speech packaged and delivered to market. Then there are efforts, like this one, of deliberate deception. Where are the consequences? Why aren't there stunning, quarterly number tanking, breath-taking fines for this kind of behavior? If one of us got caught doing something similar, we could face fraud charges.
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Re:Here come the Lawyers (Score:5, Insightful)
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Re:Here come the Lawyers (Score:4, Insightful)
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Re:Here come the Lawyers (Score:4, Informative)
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Re:Here come the Lawyers (Score:5, Interesting)
That's true, but journals' reputations still do depend on a perception that the studies they publish are generally high-quality and honest. So I could see a case for these journals suing Wyeth for the damage to their reputations that these papers have caused.
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Re:Here come the Lawyers (Score:4, Informative)
Last time they pimped for Merck, now Wyeth. If anyone needs to be punished, it's Elsevier.
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Re:Here come the Lawyers (Score:5, Insightful)
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Re:I agree. (Score:5, Insightful)
It's not "fuck the investors over" - it is "ensure that the pressure is towards behaving ethically". With anything like decent risk management, you shouldn't have more than some low, single digit percentage in this anyway; investors often lose all their investment when a company goes bankrupt.
I'm also somewhat disturbed that you feel that what you should be thinking about after you find you've invested in murdering people is "What's going to happen to my money?"
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Re:Here come the Lawyers (Score:5, Interesting)
Defrauded. Falsified. Lied. But what does that even mean anymore?
The reality is our society is so mired in exaggeration, misrepresentations, doublespeak, non-denial denials, irrelevant conclusions, marketing lies, cover your ass language and general bullshit that we, as a culture, have probably lost the ability or even the inclination to discriminate truth and lies.
And by discriminate, I don't mean being able to tell one from the other. I mean we have actually lost much of our capacity to actually care whether anyone is telling the truth or lying to us. Truthfulness is no longer rewarded. Indeed it is often punished. Falsehood is conversely rarely, if at all punished and is most often rewarded. This is the culture we live in, so why should people recognize any intrinsic ethic in telling the truth or unethical in lying? Even organizations that are supposed to deal in disclosing the truth are widely recognized and accepted to be mostly peddling lies.
Did Wyeth actually lie? Do you think you would be able to "prove" in a court of law that a single thing they paid to have printed was in fact a lie, rather than a simple massaging of data or a case of being liberal with the truth. The latter won't be enough to secure a conviction as well the Wyeth layers know. And besides, who care if people lie anyway.
Companies don't have honor or morals or ethics. If they break their word, even on a signed contract, no one is going to come after them. There's not going to be a permanent black mark on their reputations. With the world the size it is, the same holds true for people as well. Sure, some of us might get indignant about it all, but most people will never even hear about it, and most of those that do will forget about it by the next morning.
This is the society we, as democracies, have chosen for ourselves. The fruits of our decision should come as no surprise to anyone.
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Re: (Score:3, Insightful)
I have mod points, but I want to answer this one because there is no +1 Unvarnished Truth option.
I'm sad now.
Re:Here come the Lawyers (Score:4, Insightful)
I do hope they win money from Wyeth. Heck, I don't even mind Wyeth pushing their agenda in the literature, if the science is good it should stand on its own. But being evasive and publishing with a hidden financial agenda is not cool, especially when lives are at stake.
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Re: (Score:3, Interesting)
Surely the doctors who put their names on the papers are the ones who should both be sued and also have their reputations for research completely trashed.
Who ya gonna call? (Score:3, Funny)
When there's something weird
In your study results
Who you gonna call?
Ghostwriters!
Wyeth isn't alone (Score:5, Insightful)
Re: (Score:3, Insightful)
This is precisely why in science, real science, we have the scientific method which requires that experiments/studies etc. be repeatable. All it would take is for these fraudulent claims to be tested and it is over for the fools who tried to usurp the system.
Re:Wyeth isn't alone (Score:5, Insightful)
Unless the people retesting are the same ones who submitted it in the first place (either via ghost writers, sham corporations, etc). Then it becomes like artificial sweeteners, where you have a mountain of evidence stating that it is safe (from the corporations, or people funded by the industry) and some research stating that it isn't safe, and the end result is people are confused and no one knows what to really believe.
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Re:Wyeth isn't alone (Score:4, Informative)
It's not that the notepads and pens they handed out to doctors cost too much, it's that the trade group representing drug companies voluntarily agreed to stop the practice. [nytimes.com]
And not only has ghostwriting been around forever, but the drug companies have long hired well-respected doctors as consultants (at high rates), or paid for them to give lectures (again, at high rates). These well-respected doctors (called 'Key Opinion Leaders') have considerable influence within their specialty.
Disclosure: I arrange for doctors to work as consultants for drug companies.
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Re:Wyeth isn't alone (Score:5, Interesting)
No, the reason they dropped the pens / pencils / paper AND the cruises to the Bahamas AND the free golf AND the fancy dinners wasn't cost. The costs were cheap compared to the benefits they wrought. They stopped them because of the noise and bad press (and the belated 'ethics' whitepaper by the AMA and other trade groups).
The ghost writing and the funding of spurious research is / was one step removed from this in the public's eye. Now the heat is one here and big Pharma will paper over this issue and continue some other way of pushing their agenda. Look to lobbying for the next big push. If you take away an individual doctor's role in deciding which drug or treatment to prescribe and bump it up to a committee or better yet, a legislator, then you can pay a K Street firm a couple of times per year and not worry about having an army of drug reps running around.
Big Pharma has it's strategy mapped out for any possible occasion. They're smart, cunning and have been playing this game for a long time. Resistance is futile....
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Perhaps now people will isten? (Score:3, Insightful)
Yeah right...
This happens when you trust people who make money when you don't feel well. When will people learn that doctors do not profit from you being healthy? Neither do pharmaceutical companies. Taking medicine in the belief that whoever gave it to you wanted you to feel better is very naive.
It's stuff like this, and many personal experiences, that make me so cynical toward doctors. It's a sad state of things, but there you have it.
Re: (Score:3, Insightful)
Your an idiot.
I know quite a few doctors, and all of them want to see their patients get healthy. It's not like they don't have enough business.
What does a Doctor gain by prescribing you a treatment that isn't needed?
I am of course tlkaing about science based medicine, Natural path, homeopaths, acupuncturist and others of there ilk are a different matter. They charge of treatments that do no damn good.
Defensive Medicine (Score:3, Insightful)
What does a Doctor gain by prescribing you a treatment that isn't needed?
Defensive Medicine (CYA for doctors) [wikipedia.org]
Re:Perhaps now people will isten? (Score:4, Insightful)
This happens when you trust people who make money when you don't feel well. When will people learn that doctors do not profit from you being healthy? Neither do pharmaceutical companies. Taking medicine in the belief that whoever gave it to you wanted you to feel better is very naive.
Yeah, that's why my doctor has encouraged me to eat better and exercise so that I don't have to take anti-cholesterol or blood pressure medication.
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Re: (Score:3, Insightful)
Not curing disease, not curing underlying causes... but maintenance treatment of symptoms, and underlying causes of those symptoms.
This isn't star trek, you can't take out a magical pill out of your pocket that makes a woman grow a new kidney. Hell, you we most of the time can't even make drugs to cure simple symptoms without causing horrible side effects. Don't blame pharmaceutical companies for the simple fact that science doesn't understand most of what's going on.
The job of the pharmaceutical companies isn't to choose the best treatment plan for patients, that's what doctors are for. Quite often that treatment plan involves things
Ugh (Score:5, Insightful)
The list (Score:5, Insightful)
I wonder if there's a list pharmaceutical company CEOs distribute to their immediate families...
Dear Mom, here's a list of medications made by pfeiser that I wouldn't take, even if my doctor recommended them.
Your loving son, Jeff.
That would be a great read on wikileaks.
I am a physician (Score:5, Insightful)
And I can tell you frankly that the medical profession is split in two. There are people who are in it for the human aspect - usually the doctors. Then there's the people who are in it for the money: The pharmaceutical companies.
This is not surprising, coming off another recent study done by (and now we learn that it was paid for) and published in a magazine owned by a subsidiary of Merck.
Just the fact that these companies are allowed to advertise on TV directly to patients is disgusting. But ask your doctor if XYZ is right for you, because you don't need it at all, or there's probably some cheaper similar drug whose patent has expired and costs 1/4 the price, but if you waste your doctor's time enough he'll write the prescription just to get you out of his office with a smile on your face. After all if he says "NO", you might not come back.
Just the fact that an HIV patient will literally die bankrupt, at $1000+ per month for the meds. Unless you're very rich, you won't be able to keep THAT up for very long, and when you run out of money - so sorry, we can recommend a hospice for you.
Pharmaceutical companies scream about billions of dollars in research, yet they can afford all that printed material for doctors, 5 star hotels for doctors for "seminars", pens, calculators, TV air time, etc. Yet some companies still make money with Aspirin - yes the name belongs to Bayer, but anyone can make and sell acetyl-salicylic acid - the patent expired years ago.
No, big pharma loves the protections patent law gives them, and if they can completely distort the market and throw actual science out of the window WHO CARES so long as it increases sales.
That's why we have Cochrane studies, where we DOCTORS look back at what we're doing and seeing if it REALLY IS effective. A new study from my country published by a close friend of mine suggests that having your blood pressure at 140/90mmHg gives NO INCREASED RISK of heart disease or stroke. But studies paid for by big pharma INSIST (and they've convinced the American Heart Association) that your blood pressure has to be UNDER 120/80. In fact, they want TEENAGERS to start taking blood pressure medication. Hey, at $100-200 per patient per month, SO WOULD I. But we know full well where the unethical branch of the medical sciences is...
The above comment is my opinion as a 3rd world physician, since I have to watch people die because they can't afford the few medications that DO work as advertised (and are thus even MORE expensive).
Re:I am a physician (Score:5, Insightful)
I am a physician, and my mother has hypertension. Damn straight I'm going to medicate her. I'm giving her a diuretic and an ACE inhibitor. $4 per drug per month, for a total of $96 per year. Just like I prescribe to my patients. Treating hypertension prevents strokes. It's not one study. It's dozens of studies, over decades of statistics. A since study may have a P value of .95, stating that it is statistically significant. That means that there's a 1 in 20 chance that it is just plain wrong. I'm banking on the decades of data. Wake me up when the UKPDS changes their recommendations to not treat hypertension.
The fact of the matter is, my patients are as cost conscious as I am, since they know what it's like to pay for trade name drugs when the generic equivalents are covered by the insurance companies. They love that after a first visit with me they can cut there monthly bills by $100 or more. They tell their friends, and I get more patients.
Big Pharma has screwed the medical industry. Us doctors (as a group) are doing it, too, as are the trial lawyers.
And the general public, who feels that docs should be sued into oblivion for the littles mistakes. You know what? Mistakes happen. Deal with it. If you would rather docs retire early rather than pay ridiculously high malpractice premiums, so be it.
My wife required a high risk OB during her last pregnancy. Pretty hard to find in our state, since the malpractice for obstetricians is ridiculously high here.
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+1, and don't forget the plain economic stupidity (Score:3, Interesting)
I wish there was more study and awareness of the economic idiocy and need for regulation to resolve it, too.
In the UK, the NHS (national health service) cannot afford to treat everyone with certain life-saving drugs because those drugs are too expensive, so they don't, or do so only for a few people.
The drug companies lobby the NHS to include those drugs, and the NHS refuses because the money is better spent on cheaper treatments for more people. Some newspapers and some people side with the drug companies
Re: (Score:3, Interesting)
Where does that leave the HMOs from the USA?
I don't practice in the USA so it wouldn't be appropriate for me to make a detailed post about that. However I know a lot of professionals who have quit for just that reason - they don't enjoy being told how to practice medicine by an accountant.
From my perspective, working in a country that has both a mandatory (ie, it gets docked from your paycheck every month) health care system BUT ALSO offers private medicine for th
Re:I am a physician (Score:5, Informative)
From one doc to another, stop using atenolol. :-) Atenolol is not a particularly good beta blocker. It's advertised as a QD drug, but really should be given BID. In addition, it is renally cleared.
I can't count the number of times the following happened: Patient's renal clearance decreases transiently for some reason. The atenolol buildy up in the system and causes hypotension and bradycardia, causing a further drop in renal clearance. And the cycle continues until the patient ends up in the ER in complete heart block and renal failure or dead.
Use metoprolol ER (generic equivalent to toprol xl) or carvedilol. Both generic and with proven cardioprotective effects.
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Suggested Remedy (Score:4, Insightful)
Beyond any direct fines or other remedies, just halve the patent times on all their patents across the board for each infraction. Sixteen years of protection left on Xyliklopper? Now it's eight.
I've taken a cue from my own mother (Score:4, Interesting)
Who had these drugs pushed at her with a great deal of pressure to take them. She finally said, "I'm almost seventy, for chrissake. I'm SUPPOSED to be old. She also clued me in as to how these drugs are harvested or manufactured or whatever you would call it. They're extracted from the urine of pregnant mares. In order to do that, the horses are made pregnant. Then they are confined to their stalls, 24/7, so that the urine can be collected. They're never allowed outside, never allowed even to move around in the stalls--just made to stand there without a break for their rather lengthy gestation terms. When the foals are born, they are taken away from the mothers immediately and are often slaughtered. That kind of confinement would be torture for any animal--it is doubly so for a horse which needs to be able to move about and use its legs.
A few wrinkles in the fullness of time were much preferable to her, and so they will be to me.
Re: (Score:3, Insightful)
This isn't consensus.
It's people signing of on biased meta-studies.
No, the people screaming the loudest don't have the most to gain from global warming.
Re: (Score:3, Insightful)
You could say the opposing side has a lot to gain from AGW not being true. After all, the cost of reducing carbon emissions is significant to those who produce the most CO2. The difference between AGW and this nonsense is that *climatologists would have to be wrong [climate models and ice cores etc.] *physicists would have to be wrong [infared absorbsion spectrum of CO2] etc. In short, there would need to be a massive conspiracy of thousands of scientists all in on it.
Re:"Scientific Consensus" (Score:5, Insightful)
It's odd that the anti-climate change crowd will essentially assert that climatologists are part of some even cabal to destroy the economy, and yet essentially are siding with a group of multinational corporations whose vested interest is in keeping everyone vomiting as much CO2 into the atmosphere for as long as possible.
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Re: (Score:3, Informative)
On April 29, 2008, environmental journalist Richard Littlemore revealed that a list of "500 Scientists with Documented Doubts of Man-Made Global Warming Scares"[26] distributed by the Heartland Institute included at least 45 scientists who neither knew of their inclusion as "coauthors" of the article, nor agreed with its contents.[27] Many of the scientists asked the Heartland Institute to remove their names from the list.
From here [wikipedia.org].
Re: (Score:3, Informative)
Philadelphia Inquirer [philly.com],
UPI [upi.com] (Two quotes: "Ghostwriters paid by U.S. pharmaceutical giant Wyeth worked on dozens of articles published in medical journals under doctors' names, court documents indicate." and "A Wyeth spokesman said the ghostwritten articles were scientifically sound and subject to peer review by the journals that published them.")
NYT [nytimes.com]
Re: (Score:3, Interesting)
But the law should, and should make the *criminal* and *civil* penalties so utterly destructive to any business that they don't dare do it. I'm talking life imprisonment, seizure of assets, massive awards for those injured, and so forth. I mean, basically make such behavior a recipe for extinction of the company, utter destruction of share value, imprisonment of researchers who colluded, seizures of every asset of every member of the board, every officer of the company, and so forth.