Where do we go from here?

So, where do we go from here?

My thanks to Charles Medawar of Social Audit for this summing up:

In the immediate future, there is potential for progress on three main fronts – none politically attractive, though all central to the future health and reputation of pharmaceutical medicine.

First, we need urgently to examine the meaning of personal responsibility in corporate settings: specifically, the General Medical Council (GMC) should now investigate and rule on the conduct of Dr Alastair Benbow. Both would in some way be on trial. The GMC is a professional court with feudal if honourable traditions, with still some way to catch up with the climate of the late 20th century. As for Dr. Benbow, he seemed so sincere in his advocacy for the drug, so replete with reassurance, that his position must now be clarified. Did he critically review the relevant scientific evidence before making these claims? Was he a leader in some cynical process, or kept well ignorant and brilliantly coached in his denials? The latter seems much more probable, but we need to know for sure. Are these horrible and damaging drug disasters driven by knaves, fools, or victims – or some, none or all of the above? The GMC must now rise to the occasion: we need some definitive view.

Secondly, what of the proposed prosecution of GlaxoSmithKline by the UK authorities (led by the Medicines and Healthcare products Regulatory Agency)? In the USA, civil actions will progress later this year, seeking to link the now damning factual evidence with tragic human consequences. But in Britain, are we now due for a replay of Prime Minister Blair’s recent decision to abort the bribery investigation into British Aerospace (BAE), on the grounds of national interest and security? What is the MHRA up to? Their last word (7 April 2006) was this: “The conduct of the investigation required the Enforcement Division of the MHRA to consider over a million pages of scientific and other documentation which comprised the factual background to the case. A team of medics and scientists from across the MHRA assisted with this. The process of considering documents is now completed and documents are only reviewed now if they come to light as new evidence. Potential witnesses from inside the MHRA have been interviewed and notes have been taken from them, from which statements will be drafted. These statements seek to convert the findings of the review of the scientific and regulatory documentation in to evidence suitable for the conduct of a criminal trial, if appropriate … once the criminal investigation has been concluded a file will be forwarded to prosecuting lawyers within the legal department of the Department of Health. They will apply the Code for Crown Prosecutors to decide whether or not there will be a prosecution.”

Thirdly, we urgently need some proper enquiry into the conduct and effectiveness of the UK drug regulators themselves – the Medicines and Healthcare products Regulatory Agency (MHRA) – in line with the 2005 recommendations of the Parliamentary Health Committee, in its report on ‘The Influence of the Pharmaceutical Industry’. The evidence from this and earlier Panorama programmes hugely underlines the importance of this main recommendation: “During this long inquiry we became aware of serious weaknesses in the MHRA. Worryingly, in both its written and oral evidence the Agency seemed oblivious to the critical views of outsiders and unable to accept that it had any obvious shortcomings, except those that could be remedied by more transparency. The Agency’s attitude to its public health responsibilities suggested some complacency and a lack of requisite competency, reducing our confidence in its ability to undertake the reforms needed to earn and deserve public trust. Nor did we conclude that the MHRA provides the discipline and leadership that this powerful industry needs. We recommend that there be an independent review of the MHRA …”

Oh yes – and we also go to the High Court taking Glaxo with us.

The good Dr Keller – 2

More on Dr Keller below (from Prozac Backlash by Joseph Glenmullen MD, page 373). I’m sure Keller made an impression on all of you who watched the last Panorama programme. Start here if you missed my first post about him.

An example of a strong drug proponent who advocates chronic maintenance administration of antidepressant medication is Dr. Martin Keller, professor and chairman of the department of psychiatry at Brown University. Keller has published numerous research articles, many of them coauthored with other psychopharmacologists who take a similar position on the treatment of depression.

Appearing in prestigious medical and psychiatric journals, Keller’s articles have the appearance of impartial academic publications. Yet, as described in Chapter 5, the October 8, 1999, Boston Globe revealed that “Keller earned a total of $842,000 last year [1998], according to financial records, and more than half of his income came .. from pharmaceutical companies whose drugs he touted in medical journals and at conferences.”

For example, while publishing articles specifically endorsing Zoloft for the chronic treatment of depression, Keller received $218,000 in 1998 alone from Zoloft’s manufacturer, Pfizer. “At the same time,” continued the Boston Globe, “Keller was receiving millions of dollars in funding from the National Institute of Mental Health for research on depression and ways to treat it.”

The Boston Globe said Keller cited his NIMH-funded research on depression in an article in which he made claims on behalf of drugs like Zoloft.

No conflicts of interest here then, I’m sure you’ll agree…

Glaxo puts pressure on MPs in a bid to avoid criticism

One of Paul Flynn’s Early Day Motions laid down yesterday has made me stop and think, it was EDM 767 – CONDUCT OF GLAXOSMITHKLINE 30.01.2007. It reads:

“That this House questions the propriety and courtesy of the action of GlaxoSmithKline (GSK) in writing to hon. Members with constituency interests in GSK urging them to oppose Motions for Early Day (EDMs) critical of their conduct, then denying originators of the EDMs details of the content of their messages when requested.”

Now if I understand this correctly, what has happened is that Glaxo has, at some point in the recent past, has written blanket letters to MPs with constituency interests in GSK urging them to oppose any EDMs that might be critical of Glaxo. Read that again – that’s any EDMs critical of them.

On what grounds exactly? Where’s the logical argument? Where are the facts for and against? The details of the individual case don’t seem to matter – the message is simple – Glaxo does not expect to be criticised…

As Glaxo has not shown Paul Flynn details of the content of these messages, it is up to us to guess at what they might have said to the MPs they wrote to. How do you imagine a large employer like Glaxo might ‘lean on’ an MP to get him or her to do what is expected of them – Bribes? Bullying? Threats? Promises?

Remember that there can be no logical argument or statement of fact, because these letters were written BEFORE Glaxo had read the detail of any EDMs that might be critical.

Until we get to see the content of one of these messages all we can do is keep on guessing about what was said…

GlaxoSmithKline – nice people to do business with?

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