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Massachusetts health care — wonky, with a healthy dose of reality

Years of drug industry lies warrant patient skepticism, not trust

Years of drug industry lies warrant patient skepticism, not trust

April 5, 2011

The drug industry’s poor track record toward patient concerns belies the rosy picture painted by last Monday’s Boston Globe report on last week’s MassBIO conference. The conference talked about "participatory medicine," empowering patients to participate with drug companies. Yet this approach will need to earn the trust of patient groups. Far from educating patients about risk or empowering them to direct research, the drug industry has withheld information about drug risks from the FDA, doctors and patients; minimized these risks in advertising; and overwhelmingly prioritized lucrative ‘me-too’ copycat drugs ahead of new drugs for rare diseases.

Drug industry: Add as Friend?
The drug industry’s record of suppressing internal studies that reveal dangerous side effects of several high-profit, blockbuster drugs is shocking. Just last summer, the New York Times reported that one of the biggest drugmakers, GlaxoSmithKline lied for 11 years to the public and FDA about the risks of their drug Avandia. Before this, drugmaker Merck lied for nearly as long about the increased risk of heart attacks caused by their block-buster drug Vioxx, which lead to an estimated 120,000 heart attacks, and 48,000 patients dying. Lilly lied to or withheld information from doctors about the risks and side effects of Zyprexa. The list goes on.

This systemic problem has lead FDA to propose far reaching transparency reforms that increase public access to studies and other safety data, allowing independent public health experts to assist FDA in evaluating drug safety and effectiveness on behalf of patients. Additional transparency reforms by the FDA would inform the public about drug approvals, including FDA’s denials when a manufacturer fails to show a drug is safe or effective. We support sharing of information on drug safety, development, and approvals with patients and the public, but industry must be made to do so universally -- and not just selectively when it assists their marketing needs.

Looking forward, industry can and has played a vital role in the development of new drugs. However, despite the industry’s significant annual investment in research, reportedly over $45 billion last year, few new drugs are on the way. Why? Because treatments for rare diseases are less important to the drug industry’s business model than coming up with the next blockbuster drug. These are too often only “me-too” drugs, or new versions of existing drugs with a large market, such as cholesterol and pain meds. For example, the top two selling drugs in the US for the last five years -- Lipitor and Nexium – are no more effective for most patients than generic alternatives that cost one-tenth their cost. But aggressive industry marketing to both doctors and patients has cost us and our health programs over $10 billion dollars a year on these drugs since 2004. Combined with runaway drug prices, these costs put pressure on insurers to stop covering other expensive but less widely used drugs.

Frustration with the financial rather than therapeutic priorities in new drug development has helped drive the NIH’s recent proposal to devote $700 million for commercializing new drug products. While this government funding is only a small fraction of the reported $45 billion that industry spends on research and development, the NIH is more accountable to focus drug development resources on patient needs, and not corporate profits.
-Wells Wilkinson, Pew Prescription Project