still more reasons you can’t trust big pharma

MORE REASONS YOU CAN’T TRUST BIG PHARMA

Evidence Based Medicine

Payoffs. Tit for tat. Quid pro quo. You scratch my back, I scratch yours.  Whatever you want to call these “arrangements” (in many cases they are not direct cash payments), they cannot be considered anything less than outright BRIBES.  And even though the problem is increasingly being brought to the public eye, it’s actually getting worse instead of better.  One of the ways this is happening is via our medical media.

A chief reason for a free media is for them to be able to report on government vice.  In other words, we have Freedom of the Press so that media outlets can tell common citizens about instances of governmental corruption without fearing for their lives (just don’t mention this to Seth Rich’s family).  Similarly, we have many medical media outlets whose job is to report on what’s new in the scientific, medical, and pharmaceutical industries.  In many cases, although not always, this pertains to reporting on new research or medical “breakthroughs”.  Many of you may not be aware of the recent fallout () surrounding this topic.

MEDICAL MEDIA OUTLETS ARE TAKING MONEY FROM BIG PHARMA hand-over-fist and then trying to suggest that it doesn’t cloud their judgment or affect the stories they print. Furthermore, practicing physicians are doing the same thing.  Only since it’s illegal for industry to offer doctors cash-for-prescribing, one of the more common ways to work around this pesky little problem is to do just what our politicians have done — give short little talks (“speeches“) for payments that could only be described as exorbitant (a great and hilarious example of this can be found HERE).  We see the very same outcomes happening in the results of studies that have been done on the docs who create the “GUIDELINES” that everyone else in their profession is forced to follow.   When studies are actually done on this those who create said guidelines, they show that these guidelines are bought and paid for.

Not quite two decades ago, the editor of the New England Journal of Medicine showed the world how big this problem is by asking a question via the title of an editorial; Is Academic Medicine for Sale?  Few people would know who she is if DR. MARCIA ANGELL had not answered her own question so brutally.  But it’s obvious few got her memo.  Just one short month ago today, Peer Journal Preprints (Industry Payments to Physician Journal Editors) had this to say about the sad state of affairs of journal editors who, like Angell, happen to be physicians.  Pay attention to these cherry-picked results.

“In 35 journals 333 of 447 ‘top tier’ editors met inclusion criteria as US-based physician-editors. Of these, 212 (63.7%) received any industry-associated payments in the study period. In an average year during the study period, 141 (42.3%) of physician-editors received any payments directed to themselves (rather than their institutions).  A substantial minority of physician-editors receive direct payments from industry within any given year. More robust and specific editor financial conflict of interest declarations may be appropriate given the extent of editors’ influences on the medical literature.”

So, while not everyone was on the take, there were two editors who collected more than 1 million dollars each in this study.  But the fun doesn’t stop there.  One week later the British Medical Journal published a study called Payments by US Pharmaceutical and Medical Device Manufacturers to US Medical Journal Editors: A Retrospective Observational Study.  Five researchers from the University of Toronto, concluded that the problem may be even worse.

“Our finding that editors of high impact journals (in specialties such as cardiology, gastroenterology, and endocrinology) receive larger payments than the typical practicing physician of the same specialty should raise questions. It is well recognized that pharmaceutical and medical device makers target physician ‘thought leaders’ for lucrative consulting and advisory roles. The rationale for such a strategy is that these leaders can influence both their physician peers and trainees to boost sales of products. Our finding suggests that, not surprisingly, editors at influential journals are attractive to industry; indeed, the same traits that make an individual attractive to an influential journal as a candidate for an editorial role would likely make that individual attractive to industry.  We found that industry payments to journal editors are common and can be substantial. Moreover, many journals lack clear and transparent editorial conflicts of interest policies and disclosures. Journal editors should reconsider their conflict of interest policies and the impact that editor relations with industry may have on public trust in the research enterprise.”

When it comes to medical research, it is being financially conflicted at every turn of the crank.  What do I mean?  For instance, these journals are full of advertisements — in many cases for the very drugs or devices whose studies are being published.  And then there’s the issue of reprints.  Drug manufactures frequently request large numbers of study-reprints, paying top dollar for them (most studies are not free, more on that shortly).  These reprints are then used by the pharmaceutical company to promote their product by essentially saying, “hey, look how good our new medication turned out in this ‘peer-reviewed’ study.”  A couple of questions.

Why, if most of this research is being done in public facilities and universities (or in private facilities using public dollars) do you — the American taxpayer — have to pay for the results of these studies?  Spend any real amount of time on PubMed like I do, and you quickly realize that while most study’s abstracts are free, the actual studies usually are not (I would guess that this number is about 10-15%).  The cost of obtaining these studies in their entirety is anywhere from $4.00 for a half day digital “rental,” on up to several hundred dollars ($199.00 is a very common price for a study).  Thus, when Big Pharma tells a certain journal that it needs “X” number of reprints of a certain study (think in terms of the “speeches” discussed earlier) the financial windfall for said journal could be substantial.  And unfortunately, it is apparent that there are far too few editors of far too few journals who aren’t so comfortable and cozy as to willingly bite the hand that is feeding them. 

Lastly, I just loved the Orwellian term from one of the quotes above, “THOUGHT LEADERS“.  Speaking of thought leaders, are you aware of the #1 way Big Pharma’s thought leaders continually manipulate the research so that it always seems to come out in their favor?  Can anyone say INVISIBLE & ABANDONED STUDIES?  Although I have written about this phenomenon extensively (see link), the problem of not reporting negative findings has gotten so bad that believe it or not, a major medical institution (The European College of Neuropsychopharmacology) is now offering a prize of 10,000 Euros for the best paper showing negative results.  In an article called World’s First ‘Negative Findings’ Science Prize Aims to Tackle Publication Bias, ZME Science says of this problem…

“Unpublished negative scientific results can lead some research groups on unnecessary false tracks. Simply put, if you’d know there’s a good chance the research will come up blank before starting, you might choose not to engage and use limited resources in some other project.  Unpublished data is effectively a waste of valuable real and human capital, particularly in the face of the reproducibility challenge. According to a recent study, irreproducible biomedical research costs the US economy alone $28 billion each year. Over 50% of published biomedical data cannot be reproduced, as startling as that may sound.”

And there it is folks, not only is industry burying their negative results; of the results that are published, a significant percentage cannot be reproduced — many experts believe this number to be over 50% (HERE).  Even though I love looking at medical research, this post shows why it all needs to be taken with a grain of salt, which is doubly true for those still touting EVIDENCE-BASED MEDICINE as the pinnacle of truth and virtue.  The problem is, I just showed you THE OTHER DAY in my piece on Metals in Vaccines that science isn’t doing what it claims to be able to do simply because it can’t — it’s not capable (HERE).  For those of you interested in why, just follow some of the links.  And for those of you interested in addressing potential underlying causes of you chronic health conditions or chronic pain, be sure and read THIS SHORT POST.

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