Drug companies and charities accused of conflict of interest. UK

[Guest guest]

http://www.whale.to/a/char.html

 

Drug companies and charities accused of conflict of interest

 

July 2002

Investigation: pharmaceutical giants pump millions into charities ... who

in turn campaign to get the firm's drugs prescribed

By Sarah-Kate Templeton, Health Editor

 

 

 

The latest campaign by Arthritis Care appears to be a straight- forward

battle by a charity to ensure the most effective drugs for the patients it

represents. It features a survey carried out by Arthritis Care which found

that only one in three GPs is prescribing a new type of arthritis drug

called COX-2 inhibitors which, according to the charity, are not associated

with the stomach complications caused by the older form of the drug. In

getting the message across that arthritis patients are losing out on the

most effective treatments, the charity also warns that 2000 patients die a

year as a result of gastrointestinal complications brought on by the older

medicines.

 

But the message becomes less clear cut when it emerges that the Arthritis

Care campaign is partly funded by Pharmacia and Pfizer, the companies which

manufacture the new COX-2 inhibitor drug celecoxib which costs up to 10

times more than the drugs it would be replacing.

 

There are also claims that the initial results of a trial, funded by

Pharmacia and showing that its new drug is safer than the cheaper ones,

were misrepresented.

 

The Arthritis Care study, published in September 2000 in the Journal Of The

American Medical Association , stated that COX-2 inhibitors were associated

with a lower incidence of complications than traditional anti-inflammatory

drugs. But by August 2001 letters published in the same journal drew

attention to the fact that complete information about the trial, available

to the United States Food and Drug Administration , contradicted these

conclusions. The authors had claimed that celecoxib was safer than older

drugs, with less gastrointestinal bleeding.

 

However, only six months of data was recorded in the paper. When results

for the entire 12-month period of the trial were analysed, critics claimed

the side effects were shown to be similar to those of older drugs.

 

But by this time the findings published in the original article were widely

distributed and believed. An editorial in the British Medical Journal

records that a total of 169 articles reported the initial results and this

coincided with the sales of the drug increasing from $2623 million (£1752m)

in 2000 to $3114m (£2080m) in 2001.

 

In July 2001, following the positive paper published in the Journal Of The

American Medical Association, the government's drug rationing body the

National Institute of Clinical Excellence (NICE) issued guidelines

recommending the drug for specific 'at risk' categories of patients. Armed

with these guidelines, Arthritis Care launched a campaign for wider

prescription of COX-2 inhibitors.

 

The campaign was funded by Pharmacia and Pfizer, who make the new COX-2

inhibitor drug. Both companies are listed on the Arthritis Care website as

donors, but exactly how much they donate is kept secret.

 

Dr Simon Maxwell, senior lecturer in clinical pharmacology and therapeutics

at the University of Edinburgh and a doctor at the city's Western General

Hospital, is deeply concerned about the conflict of interest.

 

'The data that was presented was skewed in favour of COX-2 inhibitors. I,

as someone who spends a lot of time looking at drugs, would say that these

are an advance -- they have benefits for some patients -- but the extent of

that advance has been over-hyped. The interest is in the fact that these

drugs cost about 10 times more than what they are replacing. What they are

replacing are among the most commonly prescribed drugs, and so it is easy

to work out the maths of what this would do to drugs bills. To insist that

all GPs prescribe these new drugs in preference to the older drugs is a

nonsense.'

 

Maxwell believes that when medical charities and patient groups campaign in

favour of a new drug, they should declare their interests.

 

'The pharmaceutical industry do this because they realise that the people

who can really have the strong political message are the patient groups

themselves.

 

'It is great to get patient groups' opinions but the pharmaceutical

industry knows that this is the lobby that has the power with the

government and with health professionals.

 

'This causes great concern. As a doctor involved in new drugs, I have to

declare all of my interests when I state an opinion about a drug. If I

travelled anywhere funded by the pharmaceutical industry then, quite

rightly, I would need to declare that. So, if these patient bodies state

their opinions, and they are perfectly entitled to do that, they should

make the same declaration that they have an interest in this.'

 

An investigation by the Sunday Herald has discovered that many of the

country's leading charities fail to make public details of the funding they

receive from pharmaceutical companies.

 

In the last financial year Diabetes UK received around £1m in funding from

the pharmaceutical industry. Around 7.5% of the charity's income consists

of such donations -- this is roughly the same amount as is raised by

community fund-raising. Although a page of the charity's annual report is

dedicated to community fund-raising activities, including the £300,000

raised by the charity's presence at the London Marathon, funding from the

pharmaceutical industry is not mentioned at all in the public document.

 

Last year, Diabetes UK received funding from 11 pharmaceutical companies

manufacturing diabetes drugs. A spokeswoman for the charity said: 'We don't

publish exact figures as often donors prefer us not to.'

 

Eight major pharmaceutical firms selling asthma medication are listed on

the National Asthma Campaign website as donating at least £10,000 a year

for three years. For this the companies are granted 'elite corporate gold

membership'.

 

Describing the rewards of 'gold membership' the website states: 'This is

the solid foundation upon which a long-term partnership, beneficial to both

parties, is then built. The scheme is targeted predominantly at companies

with a commercial interest in asthma. It enables them to raise their

profile in the asthma/health care market, and increase their understanding

of the needs of people with asthma through close contact with key staff

within the National Asthma Campaign.'

 

The National Asthma Campaign received £185,000 in the last financial year

from the pharmaceutical industry. Inhaler manufacturers Allen & Hanburys

donated £60,000. Another pharmaceutical company donated £40,000 towards

setting up a helpline.

 

Every year, the Patients Association, a national health watchdog standing

up for patients' rights, receives over £100,000 from the pharmaceutical

industry and health care companies. Pharmaceutical giants such as Pfizer,

GlaxoSmithKline and Pharmacia pay £5000 each to become platinum members of

the group's donation scheme. Donations from the pharmaceutical industry

contribute up to 20% of the group's income.

 

But Mike Stone, director of the Patients Association, insists the group is

open about its links. 'We as an organisation get funding from

pharmaceutical companies. There are a number of companies and we are quite

open about it -- in no way would we let them influence policy.

 

'We are a national organisation and for an organisation our size this is

just a percentage of our income -- about 15% to 20%.'

 

Some medical charities are now becoming increasingly aware of the potential

conflict of interest. In their most recent accounts the MS Society made a

point of listing exactly how much it receives from the pharmaceutical

industry. The charity lists all donations over £500, including one for

£22,000 from Biomedical Research Ltd and another for £13,000 from Schering

Health Care which makes the expensive multiple sclerosis drug beta

interferon for which the charity campaigned to make more widely available.

 

The accounts state: 'The society is aware of public interest in the

financial relationship between medical charities and the pharmaceutical

industry.'

 

Similarly, Alzheimer Scotland has a strict policy to protect the charity's

activities from being influenced by the pharmaceutical industry.

 

Chief executive Jim Jackson said: 'We are aware that this is a sensitive

issue but we feel that we have got clear policies to protect the integrity

of the charity. We are aware of the narrow line that we have got to draw.

 

'On the one hand we are desperate to generate as much income as possible so

that we can do as much as possible for people with dementia and their

carers, but we are careful not to endorse particular products.'

 

Arthritis Care last night defended taking cash from Pharmacia and Pfizer to

fund its COX-2 drug campaign. Kieran Kettleton, director of communication

for the charity, said: 'NICE actively contacted Arthritis Care and said we

need you to promote our new guidelines to people with arthritis because it

is important to get the message to people with arthritis, particularly

those with gastrointestinal complications.

 

'We are a charity and money to do this does not come from anywhere. We

received a grant from Pharmacia and Pfizer for this campaign but we said

that the campaign would not mention any product and Pharmacia and Pfizer

make just one of the five COX-2 drugs available.'

 

Kettleton would not reveal exactly how much Pharmacia and Pfizer paid for

the campaign.

 

'They have agreed to contribute towards the costs and the campaign has not

finished yet. It is an expensive campaign,' he said.

 

Arthritis Care dismissed the study which found that the new, more expensive

COX-2 drugs were no better than older medicines. He said many other studies

found them to be an advance on the other drugs on offer.

 

Diabetes UK pointed out that it has a policy on the 'ethics of working

relationships' and a spokeswoman for the National Asthma Campaign said that

donations from the pharmaceutical industry form only 1.7% of the charity's

income.

 

Richard Ley, spokesman for the Association of the British Pharmaceutical

Industry, pointed out that the Long Term Medical Alliance, an umbrella body

for voluntary organisations for people with long-term illness, has

guidelines advising that charities should make public where funding comes

from.

 

'These organisations perform a valuable function and clearly they need

funding. In many cases the pharmaceutical industry is happy to do what it

can to help. This funding is without strings attached and it is always up

to the patient groups how they spend the money. It must be an equal

partnership with both sides benefiting.'

 

*********

http://www.sundayherald.com/25738

Drug firms' magic money circle

 

 

 

 

By Sarah-Kate Templeton, Health Editor

 

 

 

Medical charities which campaign for expensive new drugs receive millions

of pounds of funding from the pharmaceutical industry, a Sunday Herald

investigation can reveal.

One charity, Arthritis Care, has admitted that the pharmaceutical giants

Pharmacia and Pfizer fund their latest campaign, which calls for the wider

prescription of a new class of drug which they make called COX-2

inhibitors. But the charity refuses to say how much cash it received.

 

Health experts say the benefits of the expensive new drug have been

exaggerated. Results of a trial, funded by Pharmacia, showing the new drug

is safer than those they would replace, have been disputed in medical

journals.

 

Another charity, Diabetes UK, has admitted that last year it received about

£1 million from the industry while the national health watchdog, the

Patients Association, receives up to 20% of its funding from pharmaceutical

companies.

 

But funding from the industry to charities is often kept secret. Now t he

extent of the funding has prompted leading medical experts to call for all

sums to be made public.

 

Dr Simon Maxwell, senior lecturer in clinical pharmacology and therapeutics

at Edinburgh University and a doctor at the city's Western General

Hospital, said: 'The pharmaceutical industry do this because they realise

that the people who can really have the strong political message are the

patient groups.

 

' The pharmaceutical industry knows that this is the lobby that has the

power with the government and health professionals.

 

'This causes great concern. As a doctor involved in new drugs I have to

declare all of my interests when I state an opinion about a drug. If I

travelled anywhere funded by the pharmaceutical industry then, quite

rightly, I would need to declare that. So, if these patient bodies state

their opinions, and they are perfectly entitled to do that, they should

make the same declaration that they have an interest in this.'

 

Professor Warlow, professor of medical neurology in the department of

clinical neurosciences at Edinburgh University, added: 'Medical charities

are an increasingly important source of advice and information for patients

and, if a company can influence that advice, then of course it may try to

do so.

 

'I have no idea how much all this actually does influence charity and

medical advice, but presumably the more money that is provided, the more

the advice could be changed.

 

'That is why I, and others, are keen to see exactly how much money is

involved in research grants, consultancy fees, and 'educational' meetings.'

 

 

 

 

 

 

Gettingwell- / Vitamins, Herbs, Aminos, etc.

 

To , e-mail to: Gettingwell-

Or, go to our group site: Gettingwell

 

 

 

 

Mail Plus - Powerful. Affordable. Sign up now