I’m currently reading Ben Goldacre’s ‘Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients‘. It would be fair to say that this is a book that can change the way you think about medicine and the medical world. I am only a third of the way through but it has already provided so many insights into how the industry works, cataloging both the damages that have been wrought, and what can be essentially fixed with fairly minimal fuss. In particular the book deals with the suppression of negative and missing data, that is not published or made accessible to regulatory bodies, hospitals or doctors, ie pretty much everyone in the realm of medicine.
This is particularly interesting in the case of National Institute for Health and Clinical Excellence (NICE), the UK body that help to regulate and provide decisions on which medicines best benefit patients in the UK. Even this body does not have access to companies and researchers, who are legally allowed to hide, not publish and prevent governmental bodies from accessing valuable research (Goldacre: 28). All in the name of profit and exploitation.
Legal battles with drug companies for access to information can lead to years of legal wrangling. The European Medicines Agency, a EU wide body that approves and regulates drugs for use throughout the Union, has also been known to block researcher access to study reports on drugs due to ‘commercial interest’, even in the view of a systematic review to uncover which drugs are most effective treatments for certain life-saving conditions (Goldacre: 71).
This book is an essential yet disturbing read on how drug companies work, and how they influence bodies across the board.
In some good news India’s Supreme Court has stopped Novartis patenting a cancer drug that is desperately needed. This gives the Indian drug companies the opportunity to make generic copies of the cancer drug to give to patients at a price that they can afford. The comments from Novartis are, largely, disgusting, with threats to pull out of the India market altogether. Ah, the price of profit is a body dropping dead it seems- well done Novartis.
Yesterday was April the 1st, a high time for jokes and japes of all characters. Yet the British government have seen that day as a choice day to enact deep structural changes to the NHS, as well as the partitioning and selling off of certain parts of the NHS to private contractors, with a specific clause for buyers not to favour the NHS options when considering equipment and staff. This can only end in one way- to benefit the big pharma and private companies, and not to help patients. Unbelievably the Health Secretary Jeremy Hunt recently dropped the clause that put the rights of patients first to be formally enshrined at the heart of the NHS, this was a Central Recommendation of the Mid Staffordshire inquiry.
This is a fundamental step towards watering down the value and accessibility of the NHS. In particular this is a step away from seeing patients as a person to fix and to heal, to seeing patients as moneybags. This will have dire effects on individuals with rare diseases, where the treatment is costly and specialist. I worry for the future of the NHS, an institution that has cared for me in my direst hours, after intense surgery and massive blood loss, caring for my broken bones and helping me to heal once again.
The ‘Missing Data’ section of the above book got me thinking about how science is applied and researched in other disciplines, especially in my own realm of human osteology and archaeology. The meta-analyses and systematic reviews in particular could be a useful approach to identifying and classification of disease in palaeopathology, with regards and relation to the clinical medical data. I bet there is some interesting results in the way bioarchaeologists and osteologists present their data.