Drugs firms 'creating ills for every pill'

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http://observer.guardian.co.uk/print/0,3858,5161925-102285,00.html

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Drugs firms 'creating ills for every pill'

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Expensive new medicines are oversold when cheaper therapies or

prevention would work better, say MPs

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Gaby Hinsliff, political editor

Sunday April 3, 2005

Observer

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The power of Britain's multi-billion-pound drugs industry has turned

this country into an over-medicalised society that believes in a pill

for every ill, a Commons inquiry will claim this week.

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The report will say that the billions of pounds poured into researching

and promoting new drugs have fuelled an over-emphasis on medicinal cures

at the expense of cheaper and better therapies, or simple prevention.

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The MPs heard evidence of 'disease-mongering' drugs firms effectively

inventing diseases for which they could then sell treatments, with

relatively normal behaviour - from mild depression to low female sex

drive - re-labelled as conditions for which drugs were supposedly

necessary.

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Lord Warner, the health minister responsible for medicines, admitted to

the inquiry: 'I have some concerns that sometimes we do, as a society,

wish to put labels on things which are just part and parcel of the human

condition.'

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The report from the Commons health select committee is also expected to

criticise the secretive process of licensing medicines in Britain,

following several safety scares in which so-called 'wonder drugs' have

turned out to have serious side effects.

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The common anti-depressant Seroxat was recently linked to an increased

risk of suicide in teenagers, while the widely prescribed arthritis drug

Vioxx was withdrawn last year over links to fatal heart attacks and

strokes.

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Labour's election manifesto is now expected to include a pledge to

overhaul the drug licensing regime. Expert members of the government's

medicines regulator will be banned from holding financial interests in

drug firms to avoid potential conflicts of interest.

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The seven-month inquiry follows complaints from patients' groups and

senior doctors that the interests of the industry are distorting health

care priorities.

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Prescriptions for Seroxat tripled after it was licensed for mild

depression, while The Observer revealed earlier this year that it was

being marketed to doctors as a treatment for ill-defined 'social anxiety

disorders'.

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Drug firms are banned from advertising directly to patients in Britain,

or offering bribes to doctors to prescribe a certain brand. However

campaigners say the industry has discovered ways of 'guerrilla'

promotion, including generously funding medical charities - which, the

inquiry heard, raises the risk of them becoming its 'unwitting foot

soldiers'.

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One mental health charity, Depression Alliance, receives almost 80 per

cent of its funding from drugs companies, while Arthritis Care received

money from Merck Sharp and Dohme, maker of Vioxx.

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Paul Flynn, the Labour MP who has campaigned to expose the influence of

the industry and gave evidence to the committee, said it deserved an

'absolute hammering' for its practices. 'The whole of society has been

conditioned to believe that we are dependent on medicines. I have had

arthritis all my life and I haven't taken anything for it - I believe in

exercise, swimming and walking.'

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The inquiry heard of drugs marketed to doctors in papers written for

medical journals ostensibly by independent experts which are, in fact,

ghostwritten by the firms, which pay academics to lend their names to

the reports.

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Dr Richard Horton, editor of leading journal, the Lancet, disclosed he

had been effectively offered bribes to publish papers showing drugs in a

favourable light. He said firms offered to buy 'hundreds of thousands of

reprints' - which could be worth up to half a million pounds to his

magazine - if their paper went in.

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However, a spokesman for the Association of the British Pharmaceutical

Industry denied fuelling dependence on drugs: 'I don't think we have

ever suggested that medicines are the only answer to health problems.

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'It is always down to the doctor to determine whether there is a real

medical condition. It is right we should be informing prescribers of

what medicines can be relevant.'

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When the solution becomes the problem

Reclassification of the cholesterol-lowering drug simvastatin as an

over-the-counter medicine for preventing heart disease is a classic

example of the pharmaceutical industry's worrying influence, experts

warned yesterday.

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The editor of The Drug and Therapeutic Bulletin , Dr Ike Iheanacho, said

long-term trials had not been carried out to test the drug's efficacy or

risks in those considered to be in moderate danger of having heart

problems. As people could be sold Zocor Heart-Pro, the drug by its brand

name, without detailed assessment of their health, there was also a

danger that those at high risk of having heart attacks were getting

inadequate treatment.

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'The absence of any long-term efficacy trails for Zocor Heart-Pro in the

target group means that people are, in effect, being used as guinea

pigs,' Iheanacho said.

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Another example is provided by the anti-depressant Seroxat. In November,

The Observer revealed that Seroxat's manufacturer GlaxoSmithKline (GSK)

was trying to market it as a cure for relatively mild forms of

depression, despite the fact that the the drug has been linked to

suicide. 'The thrust was to move sales beyond the $1 billion to the $2bn

mark by pushing it to people who were not clinically depressed,'

Professor David Healy told the select committee, while Richard Brook,

chief executive of Mind, the mental health charity, told the MPs that

the plan was 'all about developing

new conditions for that drug'.

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At the same time, other options are ignored. As The Observer pointed out

last week, Britain's GPs have largely ignored the advice of the Chief

Medical Office that many depressed patients should be prescribed

exercise programmes rather than pills.

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Robin McKie

Guardian Unlimited © Guardian Newspapers Limited 2005