The New England Journal of Medicine reports this week that GSK has just been fined $3 billion, and that since 2009, drug companies have been fined $11 billion! Wow! Colossal sums, huh? However, it turns out these figures represent only about 10% of annual profits and should probably be considered as just the “cost of doing business” ie these fines won’t change behaviour.
Should we be worried about these crimes and misdemeanors? You bet. However, as Ben Goldacre points out in a Guardian published extract from his upcoming book, “Bad Pharma”, this is just the tip of the iceberg. Of more concern is routine distortion of the evidence base which is manipulated in a variety of ways by those who pay the piper – the drug companies. Read the Guardian article, then answer the following two questions…..
How confident are you that the drug companies act in your best interests?
How confident are you that “evidence based medicine” is based on objective, relevant scientific evidence?
Evidence-based medicine: as Mary Midgley reminds us, apart from anything else, one discipline of scientific thought is not enough:
“We need to stop treating ‘science’ as if it were a single monolithic entity, a solid kingdom embattled against rival kingdoms.” p32, The myths we live by.
Philosophy, ethics, history and humanities all link into the noble discipline of evidence-based science.
However the Pharmaceutical industry have shown themselves NOT to practice even ‘evidence-based’ research. Raw data is unseen – locked in bottom-drawers stacked full of negative results and where side-effects have too often been deliberately lost. Research papers are often Ghost-written with artful spin that politicians might envy. Marketing efforts have been enormous. Enormous. None of this seems to me to be the ‘evidence-base’ that so many today in my profession hold so high.
Overall medical EDUCATION has been led by the pharmaceutical industry and this is an entangled affair that has ‘guided’ (absolutely dominated) our ‘continuing professional development.’ New diseases have emerged mongered for a needy world. Again this is not objective science. This is not ‘evidence-base.’
However it is far too simple just to attack the market forces of the Pharmaceutical industry – forces that often put profit before care. The medical profession also has to get its act together – we need scientific pluralism that includes ethics, philosophy, medical humanities, epidemiology, sociology and the study of the history of our profession. These are necessary. Evidence-base research is a most necessary discipline but practiced alone it is simply not sufficient.
‘Evidence-base research is a most necessary discipline but practiced alone it is simply not sufficient’.
Peter , I agree with all you have written , particularly the above . I would add it (medicine) should not only include the subjects you describe but value them. I did a Medical Humanities course and it taught me a great deal and I learned to think and interact with people differently as a result.
Its countercultural to think that ones own chemistry set can be influenced by clinical encounters which are empowering and ‘educational’ . I think there is endemic medicalisation and over use of technology . I don’t have an answer but its more akin to sorting out many of the social and environmental issues —more local use of resources/knowledge and less frenetic activity.
Where do you practice?
[…] A post I wrote a couple of years back about GSK being fined $3 billion mentioned that between 2009 and 2012 drug companies had paid $11 billion in fines. ProPublica summaries some of the biggest fines from 2009 to 2014 here. […]