Speaking of evil scum . . .

We can always whip up an evil scum post by taking a look over at the pharmaceutical industry. Two pieces in the new BMJ (I think you'll just get the first 150 words or something but the Blog Oversight Organization requires that I provide links) skim the scum for us.

First, Medtronic corporation, a name you will find familiar should you be a totebagger. The Senate finance committee has found that they paid -- get this, it's not a typo or an extra zero -- hundreds of millions of dollars to doctors to pretend to be the authors of articles they drafted, edited and approved praising its product InFuse. Senator Max Baucus says, "Medical journal articles should convey an accurate picture of the risks and benefits of drugs and medical devices, but patients are at serious risk when companies distort the facts the way Medtronic has." Indeed. The editors of Spine Journal weigh in: "If surgeons had known that the lead authors of the 13 original studies on InFuse had received payments ranging from $1.7 million to $64 million [sic!] from Medtronic and that its marketing employees were co-authors and co-editors, would they have been as eager to use InFuse on their patients?"

That's all well and good but BMJ fails to name the names of those "physicians." They are all cruising along with high powered appointments and continuing to publish.

Along a somewhat different pathway of scummery, BMJ editor Fiona Godlee writes an open letter to Roche board member John Bell, "regius professor of medicine at Oxford University." Since it's open, presumably she doesn't mind if I quote it at length.

Dear John

I am writing to you in your capacity as a member of the board of Roche. As you may be aware, the BMJ has been working with the Cochrane Collaboration in its efforts to get Roche to release the raw data on the effects of oseltamivir (Tamiflu) so that Cochrane can properly fulfil the UK government’s commission for a systematic review of neuraminidase inhibitors based on clinical study reports.

To remind you of the background to this, in 2009 the BMJ published the updated Cochrane review of neuraminidase inhibitors in healthy adults.1 This took the view that, since eight of the 10 randomised controlled trials on which effectiveness claims were based were never published and because the only two that had been published were funded by Roche and authored by Roche employees and external experts paid by Roche, the evidence could not be relied on. The BMJ also published an article summarising the Cochrane team’s efforts to obtain the data from these randomised controlled trials and a feature investigation exploring the underlying issues.2 3

After these articles were published, we and the Cochrane Collaboration received public assurances from Roche that the data from these 10 trials would be made available to physicians and scientists.4 Although some further data have been released to the Cochrane reviewers, the data that were promised (“full study reports”) have not been made available. . . .

The Cochrane reviewers now know that there are at least 123 trials of oseltamivir and that most (60%) of the patient data from Roche’s phase III completed treatment trials remain unpublished. We have concerns on a number of fronts: the likely overstating of effectiveness and the apparent under-reporting of potentially serious adverse effects. Meanwhile, oseltamivir has just been added to the World Health Organization’s List of Essential Medicines, alongside aspirin and β blockers.

On behalf of the Cochrane collaborators and public health decision makers around the world, I ask Roche to honour its publicly stated promise to make available the full clinical study reports. In order for the Cochrane collaborators to properly analyse these data they will need individual patient data in electronic format.

Oseltamivir has been a great commercial success for Roche. Billions of pounds of public money have been spent on it, and yet the evidence on its effectiveness and safety remains hidden from appropriate and necessary independent scrutiny. I am appealing to you, as an internationally respected scientist and clinician and a leader of clinical research in the United Kingdom, to bring your influence to bear on your colleagues on Roche’s board. As company directors, responsibility for Roche’s behaviour rests with you, as individuals and collectively. In refusing to release these data of enormous public interest, you put Roche outside the circle of responsible pharmaceutical companies. Releasing the data would do a great deal to restore confidence in the company and its board of directors.

As you may recall, during the Great Flu Pandemic Hoax of three years back, the World Health Organization and many national governments paid megabucks to stockpile the stuff. That's your money. It's you who got ripped off.

Personal note: I'm still without electrical power but I think of it as a kind of penance. My neighborhood wasn't burned to the ground or washed into the ocean, my children didn't disappear into the raging waters, I didn't lose my business and I'm not freezing or starving. I'm blogging from work where I can also take a shower and get a good meal. Not so for millions of people.