Article Source: http://felixjtapia.org/blog
Trade Traffic or illness is the translation given to
'disease mongering', the term used to describe the manipulation made some pharmaceutical companies to extend the terms of a disease, ie generate fictitious ailments, in order to sell a product. Researchers
, published an article in British Medical Journal 'Selling sickness: the pharmaceutical industry and disease mongering' which showed how pharmaceutical companies were inventing a supposed female sexual dysfunction, to boost sales of certain drugs. All marketing perverse process disturbingly affecting citizens. Click here to go to the original article
Buy diseases to the letter. And remedies
Laboratories define new diseases in looking for more market niches - companies behind cooked to create reports needs
Sampedro
COUNTRY - Society - 09/10/2008
Raloxifene (Evista, Lilly) reduces to 75 % risk of fracture in postmenopausal women. The Ropinirole (Requip, Glaxo) relieves restless leg syndrome, which affects 20% of the population, and methylphenidate (Ritalin, Novartis) relieves hyperactivity, suffered by 8% of children. Proliferation of female sexual dysfunction, bipolar disorder grows, intensifies the osteopenia.
All this is truth. But not the whole truth, because the statistics are angled, although technically correct, look at the problem from an artful perspective. And the key to the emerging debate on the "traffic of disease (disease mongering ).
"Trafficking of disease" is a highly charged, and it is on purpose. Has been promoted by Australian journalist Ray Moynihan
, who now works at the School of Public Health Medicine of the University of Newcastle (Australia). And he wants to denounce the "sale of diseases by expanding the boundaries of the pathological, to open markets for those who sell and administer treatments "(PLoS Medicine, May 2008). Although the term
disease mongering has been misappropriated by the movement antipsychiatric and the sect of Scientology, the debate is serious and has reached the technical literature. And those responsible for public health. The Madrid Health Ministry, for example, demanded last year firms Lilly and Procter & Gamble to soften the promotion of their drugs (Evista and Actonel) to prevent fractures.
"In Europe, pharmaceutical companies are already marketing their drugs to prevent fractures in women with osteopenia [slight deficit of bone] and other conditions, according to his calculations, affecting almost half of postmenopausal women, "said the doctor Pablo Alonso, Department of Clinical Epidemiology and Health Public Hospital de Sant Pau. Alonso is the author of a study of disease mongering and osteopenia published this year by the British Medical Journal
. His conclusion is that "have exaggerated the risks of osteopenia and have been undervalued drug side effects." Refers to four active ingredients: raloxifene, alendronate, risedronate and strontium ranelate. These drugs have proven effective in preventing fractures in women with osteoporosis. The question is whether to extend them to the much more common osteopenia. The industry support for it in four scientific papers published in recent years, which opened this article: Raloxifene reduces fractures by 75% for osteopenia. " It seems a compelling argument. But the statistics are skewed. Mathematician John Allen Paulos
explains this type of bias in his book A Mathematician Reads the Newspaper, is a pollutant chemical plant near , and one study concluded that the risk of a rare type of cancer has doubled in the neighborhood. Naturally, everyone takes off from there.
But they should, because this cancer is so rare (say affects 0.0003% of the general population) that the doubling of their risk (up to 0.0006%) is negligible. For women with osteopenia, the risk of fracture is so low that a further reduction of 75% is irrelevant: it would medicate 270 women for three years just to avoid a split, according to Alonso and his colleagues calculated. But there's more. Possible side effects ranelate-cause diarrhea, and there are doubts about the cardiovascular and neurological consequences, not mentioned at any time. Nor raloxifene, although it increases the risk of venous thrombosis and heart attacks. Neither the gastrointestinal consequences of alendronate. Lastly, work on the Lilly drug is signed by three employees of Lilly, the Merck drug was not only funded by Merck, but three of its authors acknowledge conflicts of interest, that of the drug that distributes Spain Procter & Gamble include two experts from Procter & Gamble, and Servier laboratory of the drug bears the signature of three consultants to Servier, which also funded the study.
Even the definition of osteopenia is under the spotlight of traffic experts diseases. The criterion is based on bone mineral density. If it is much lower than normal (2.5 standard deviations below the mean), osteoporosis is diagnosed. If not so much (between 1.0 and 2.5 standard deviations below the mean), osteopenia is diagnosed.
Indeed, these criteria were published in 1994 by a small group of study associated with the World Health Organization (WHO), and are not intended as a guideline for diagnosis, the authors themselves branded as "somewhat arbitrary" - merely a help to standardize epidemiological studies. Alonso also stressed that the WHO team had funding Rorer Labs, Sandoz and SmithKline Beecham.
The vagueness of the diagnostic criteria is a common theme in the discussion of traffic conditions. Researchers
Lisa Schwartz and Steven Woloshin
, Dartmouth University, say that the incidence of restless leg syndrome "has been exaggerated to open markets for new drugs." Evidence presented in the first international congress dedicated to traffic conditions, held two years ago in Newcastle, Australia.
At the same meeting, the University psychiatrist Leonore Tiefer of New York documented the role of the pharmaceutical industry "the creation of a new condition called female sexual dysfunction." And another psychiatrist, David Haley, University of Cardiff, certified "the increasing promotion of bipolar disorder, and drugs to treat it." The discussion becomes more delicate when it affects some types of cancer. For example, the English government last year authorized the marketing of the vaccine against human papillomavirus to prevent cervical cancer, and proposed to the regions for inclusion in the immunization schedule of the National Health System (NHS .) Germany, United Kingdom, Belgium, France and Denmark had already taken similar steps. Vice President Maria Teresa Fernandez de la Vega explained that cervical cancer is the second most common cancer among women and causes 280,000 deaths per year worldwide. In Spain emerge each year 2,100 new cases.
Most experts endorse the decision, but not all. The NHS "has not taken the most rational decision," a group of six researchers led by Carlos Alvarez-Dardet, professor of public health at the University of Alicante and editor of the Journal of Epidemiology and Community Health.
These experts estimate the cost minimum as 125 million per year (each vaccine costs 465 euros). And estimates that "when they start to prevent the first cases of cancer within 30 years, the NHS will have spent 4,000 million. Prevent a single death will cost eight million euros then. " Each year die from this cancer in Spain 600 women, a rate of two deaths per 100,000 women of risk. With a drug proven effective, economic arguments can be secondary, but this is not the case papillomavirus vaccine, according to these specialists in public health. Cervical cancer usually takes decades to develop, and the oldest phase III clinical trial began four years ago. "The vaccine has been promoted as an effective tool in preventing cervical cancer," say, "but that scientific evidence does not yet exist."
This virus, however, causes a sexually transmitted infection most common. Usually subside within two years, but if they persist can evolve to cancer in 20 or 30 years. There are over 100 strains of the virus, but licensed vaccines (Gardasil, Merck, and Cervarix, GSK) caution against that cause 70% of cases of cervical cancer.
A team of researchers directed by Teresa Ruiz Cantero, public health department of the University of Alicante, has studied the communication strategies of laboratories, focusing on medicines for menopause and erectile dysfunction.
Again, a common strategy is to "expand the range of indications" by "the extent of disease from minimal symptoms to severe illness. Now drugs are consumed by healthy populations outside the initial indications. " According
Ruiz Cantero, have issued messages such as "more than half of men over 40 have erection problems," that are "a clear manipulation, some biased and simplistic messages that increase the perception that the problem is very prevalent, almost epidemic."
These experts point out that the WHO's objective is to make a rational use of medicines, and not be met if the industry raises the prevalence, or does not include all information in drug advertising. WHO, by the way, also speaks of "seeking truth" in medicine.
"support should be a concert of English universities to regulate the use of his name in marketing campaigns by pharmaceutical companies," says Ruiz Cantero. "And to impose transparency on the financing of university research." Also patients' associations should disseminate what companies the fund.
The website could help, but is full of drug information disseminated by their own manufacturers. Ruiz Cantero believes that the Ministry of Health is to lead information on the Internet. "So other institutional web pages should regularly update their information." The study's findings have been published by the Institute for Women.
The director of the International Federation of Pharmaceutical Manufacturers, Harvey Bale, defended last year, before a meeting of 100 countries, consumers, the industry's ability to promote their medicines in an ethical manner. But only after admitting some "examples of sobrepromoción capital."
The British pharmaceutical employer has published a leaflet for journalists he admitted that the number of diseases is growing, but argues that companies are responsible not defined. For its part, Glaxo denied that the promotion of its drug for restless legs syndrome is a disease trafficking case.
"Part of the problem," says Moynihan, "is the industry spends on promotion about 25% of net sales, almost double the investigation. " Marketing strategies, according to this expert, includes commercials on television about "drugs for lifestyle, public awareness campaigns on emerging diseases and the" financing of patient associations and physicians. "
Pfizer manipulated Neurontin data
In the early nineties, Pfizer manipulated the publication of trials of its drug Neurontin, according to a judicial investigation has revealed in the courts of Boston, collected The New York Sunday Times. Neurontin is an epilepsy drug, and the goal of the multinational was extended to other indications such as neuropathic pain resulting from diabetes. This helped the Neurontin to exceed 2,000 million euros in annual sales.
experts who have reviewed for the judge thousands of company documents, including emails from your managers, showing that Pfizer deliberately delayed the publication of several studies that went wrong-which found no evidence that Neurontin serve for neuropathic pain, and manipulated others to display the data itself in a more desirable for business purposes. The lawsuit was filed by consumer groups, insurance companies and unions in Boston. Pfizer asked to return them billions of dollars for Neurontin prescriptions, and accuse the company of "misrepresenting the benefits of the drug under false pretenses."
Pfizer denies the charge and ensures that the data presented in an "objective, accurate, balanced and complete."
is "a publication strategy that aims to convince physicians of Neurontin's effectiveness and to misrepresent or suppress negative findings," said Kay Dickersin, School of Public Health Johns Hopkins University. Bias that occurs in more than half of the articles on testing, published in September by PLoS.
In 2000, the principal investigator of one of the negative studies, the British
John Reckless, the company threatened to publish on his own if he did it. In September of that year, an officer of the firm wrote in a letter: "Dr. Reckless is eager to publish, but this will have several ramifications. I think we can limit the disadvantages of delaying the publication of that study as much as possible. " The work was not published until 2003, by which time the results appeared combined with two other studies, and the three together indicated that Neurontin was indeed useful against neuropathic pain. In another exchange of emails, a manager of marketing for the company and a professional writer discussed how to decorate results for presentation at a conference. Traffic
diseases Image Credit: Anthony Flores
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