Richard Horton, the Editor-in-Chief of the Lancet, once observed:
The history of medicine is littered with wonderful early results which over a period of time turn out to be not so wonderful – or in fact even adverse… there are a whole string of recent examples where preliminary data led to a lot of excitement and caused changes in clinical practice and then eventually we realised they had done more harm than good. Why is it we never learn these lessons?
The pharmaceutical industry makes drugs for medical purposes. The industry campaigns hard for stronger patents throughout the world, though many economists are highly critical of patents in medicine. In some cases, patented drugs sell for thousands of times as much as they would cost if there were no patents. The industry illustrates some of the worst aspects of corporate power, corporate crimes, and ‘free lunches’ (or rents) that enrich executives and shareholders.
Social Costs, Private Profits
The early stages of drug research and development are often funded publicly, with universities and governments throughout the world paying much of the costs. Corporations often become involved only after early tests show promise. As one commentator pointed out:
The whole ecosystem in which innovation is housed – patents, copyright, finance, universities, research, knowledge transfer, ownership rules, regulation to ensure common standards – is co-created between the public and the private.
However, the companies that receive the patents keep the profits. Once they have a patent for a drug, companies can charge whatever will maximise their profits. In other words, whatever richer people can afford to pay. In an extreme case, a drug called Cerezyme cost over $200,000 for a year’s treatment, even though almost all of the development had been funded publicly. Healthcare systems in rich countries end up rationing drugs because of their cost.
Under these circumstances, allowing private companies to keep all of the profits from patented drugs, the development of which has been largely publicly funded, makes no sense. It is an example of how the economy is rigged to transfer immense wealth into the hands of executives and shareholders of big companies, whilst causing harm to others.
To make matters worse, it’s estimated that up to a third a of new drugs are no more effective than existing drugs. The Canadian government published a review of the 61 drugs patented in Canada in 2018. It concluded that only one was what is called a breakthrough, and 56 provided little or no improvement compared with existing medicines.
The U.S. National Institute of Health (NIH) carried out a large study published in 2002 to see if existing drugs for high blood pressure worked. Some of the drugs were among the world’s biggest sellers, yet the study found that old-fashioned diuretics worked as well or better than anything else. The diuretics cost $37 per year. The other drugs tested cost $230-$715 dollars per year, yet doctors were mostly prescribing the more expensive drugs.
Huge amounts of money have been spent on diabetes drugs, such as Avandia, that turned out to be ineffective. When they were first introduced, they were initially promoted as life-saving. The flu drug, Tamiflu, had minimal value, but massive stockpiles were purchased against H1N1 influenza in 2009 due to misleading research data and corporate lobbying. The manufacturer, Roche, withheld data to mislead everyone. This should be considered a serious crime, but is not actually illegal.
Fraud and Deception are Widespread
If a drug is really effective, it requires no marketing. Proper scientific studies demonstrate the benefits, and doctors and healthcare networks all over the world will use it. However, because most drugs are not very effective, companies need to spend huge amounts ‘persuading’ doctors to prescribe them. This includes gifts, holidays and other inducements (a euphemism for bribes). Many doctors are happy to go along with this. In some countries there is also a great deal of more general advertising. In total, more is spent on marketing than on research. This marketing is ultimately paid for by the people who buy the drugs, making them much more expensive.
Many new drugs are copycat drugs. In other words, variations of existing drugs. Good examples are Cialis and Levitra, which are variations of Viagra. The companies have an oligopoly, so they can control prices. Huge sums are spent on marketing these copycat drugs, but if they did not exist, nobody would miss them.
All big pharmaceutical companies have been convicted of selling harmful, sometimes fatal drugs. The industry has been fined over $50 billion during the last twenty years. In 2012, the pharmaceutical company Glaxo Smith Kline (GSK) was fined £3 billion in the U.S. for mis-selling drugs; for fraud, bribery and overcharging; for paying lavish inducements to doctors; for covering up negative research evidence; and for making false claims about medicines. GSK has also been fined in India, South Africa and the UK. Although these figures sound large, they are not enough to deter the companies from continuing to commit these crimes. The sales of a single drug can be worth many times these amounts, so as far as the companies are concerned, crime pays. No individual is prosecuted for criminal offences. In 1997 some pharmaceutical companies were fined for operating a global price-fixing cartel. One author has gone so far as to say that the official definition of organised crime closely describes the activities of the drug companies.
The industry has a long history of exaggerating the benefits of its drugs, understating the downsides and hiding negative results. A recent study showed that in the real world, medicines tend to be four times more harmful than the manufacturers claim. Adverse effects hospitalise a quarter of a million people in the U.K. and 2 million in the U.S. each year. There were 55,000 deaths from the pain-relief drug Vioxx, but the data were withheld by the manufacturer, Merck. Large numbers of heart attacks, strokes and deaths were caused by the diabetes drug, Avandia. One expert commentator stated that:
Until more meaningful penalties and the prospect of jail time for company heads who are responsible for such activity become commonplace, companies will continue defrauding the Government and putting patients’ lives in danger.
Numerous studies have found that when corporations foot the bill, research is more likely to come up with results that support new drugs. In other words, there is now overwhelming evidence that drug companies manipulate the research. Companies test their own medicines, so testing is cleverly designed to emphasise benefits and understate harms. Negative trials have not always been published. They can get away with this because of inadequate regulation.
The pharmaceutical industry spends more than any other industry on lobbying the U.S. Government, spending $280 million in 2018. The purpose of this is to keep regulation of the industry favourable to its interests. The U.S. regulator is called the Food and Drug Administration (FDA). It is underfunded, has shown little interest in safety and has no ongoing, long-term safety analysis. It also has serious conflicts of interest, with many staff connected to the industry. The former FDA chief went to work for the drug company, Pfizer. Many former members of the U.S. Congress have taken jobs as lobbyists for the pharmaceutical industry.
Astonishingly, the regulatory situation in Britain is even worse. The U.K. regulator (MHRA) has not successfully prosecuted a single firm, and the fines total just £73,300. The regulator boasted in 2012 of having given 467 warnings and 151 cautions, but these have no effect. Laws and regulations are not enforced, and conflicts of interest exist throughout the whole drug approval system.
All of these factors have been at work during Covid. There is increasing concern that the World Health Organisation (WHO) has been captured by pharmaceutical interests. There is also evidence that university research has been manipulated by funders. The profit motive in the hands of companies with immense power seems to corrupt everything it touches. The injections that are labelled ‘vaccines’ are described by governments and manufacturers as ‘safe and effective’, yet the evidence shows that the claimed effectiveness has been hugely exaggerated, the short term harms have been greater than claimed and the long term harms remain unknown. Governments have paid huge amounts to private companies, such as Pfizer, for these experimental drugs, giving shareholders and executives a free lunch beyond their wildest dreams. They have indemnified the companies against liability for any harms from the drugs, diminishing their incentive to ensure they are safe.
Within the pharmaceutical system, the focus on corporate profit, rather than medical need, tends to push in the wrong direction, creating perverse incentives. In other words, profit-seeking companies will always try to claim that their medicines are more effective and less harmful than is actually the case, and they can earn more profits by committing bribery and fraud. The pharmaceutical industry is a glaring example of an industry that is ‘not fit for purpose’. It fails the populations of both rich and poor countries.
Possible Solutions?
I should stress that in discussing solutions I have no strong ideological bias towards markets or state. All successful economies have been combinations of the two. The main goal with the pharmaceutical system should be to eliminate financial motives to manipulate drug trials and minimise the expenditure on marketing. This might require an organisation that is not profit-orientated being responsible for the large-scale testing of possible medicines. This would have to be much more transparent than existing research carried out by private companies. Pharmaceuticals might be one area where the elimination of patents would benefit society, so there would be no overpriced medicines or windfall profits. (I’ll write an article about more general problems with patents in the future.) All successful drugs, developed mainly via public means, would be available to every country to make as cheaply as possible. Private companies could still participate in other aspects of the process, such as early research or manufacturing drugs.
There have been debates for generations about whether the system should be partly nationalised and these have resurfaced recently. Proponents suggest that this could provide the same medicines for a fraction of the cost. There would be no financial incentive to commit fraud or bribery, no copycat drugs, no expensive marketing, no lobbying, no legal battles over patents and no depriving poor countries of medicines. But would there be perverse political and bureaucratic incentives in their place, to appear successful and hide failure? Would public bodies do a better job of developing the drugs we need?
If you have any thoughts on the best way to reform the pharmaceutical industry, let us know.
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Wow! I agree with something that Dominic Cummings said!
Backstabbing, lying bastard that he is.
Diversity = Less White People. ——-Whiteness is ofcourse the Original Sin if you listen to the silly Liberal Progressives and, the social justice warriors and the wokerati, that want to apologise to everyone that isn’t white for every thing a white person ever whispered into his wife’s ear. And heaven forbid if a statue of the disgusting man is not promptly chucked into a river. ——–I sit here and my grandfather had to sit in a bomb shelter under his house and my uncle was torpedoed by U boats in the Atlantic twice and was rescued from the sea. The Nazi’s killed many millions and put them in concentration camps, but guess what. I don’t hate GERMANS. The Germans that live today had nothing to do with war.
The problem with Germany as shown these last three years is that they seem to be reverting to 1930’s type.
And I suppose London was a peace rally?…yeah, right
I am not sure what you mean. So I won’t pass comment at this point.
I must admit I haven’t looked but how diverse is the enquiry team? Could the same (about important facts falling through the cracks) be said about them too I wonder?
‘Lack of diversity’ wasn’t a problem for Anders Tegnell.
Again, the inquiry failed to ask what Lee Cain thought would have changed if the PM had had brown people to advise him? Would the decision have been quicker, more intense lockdown? If so, what is his reasoning that that would be a good thing?
Sunak is brown, and he now claims to be anti-lockdown. He’s the wrong sort of brown I suppose.
I’m utterly amazed that we managed to win the second world war with the lack of diversity we had in the War Cabinet at the time. Mind you, the latest RBL donation campaign leaflet seems to think it was the Indian, Caribbean and Gurkha soldiers that won it – so maybe Lee has a point.
We didn’t win the Second World War.
We failed to achieve the objective for which we ostensibly went to war.
We gained no territory or riches. We didn’t lose as many people as in WW1, but the economic effects were far worse, and WW1 didn’t involve the destruction of our countryside. We were far less free after the war than before.
We avoided defeat because of the RCN.
Well, that was just a trailer! No doubt you’ve been watching the Dominic hearing recently – he’s back on after lunch from 13:45. I’m not commenting on it, except that it was absorbing. Tells its own story.
A shame he missed his coveted Churchill moment by not following Sweden.
And as most on here realise, he will be thrown under the bus.
https://www.globalresearch.ca/march-9-2022-biden-signed-death-warrant-american-freedom-digital-takeover-financial-system/5838305
The digital takeover of the financial system in the USA via an Executive Order so this country won’t be far behind.
Really I could decide if they were stupid or evil, Lee Cain is more stupid than evil I’d say. Cummins too really comes across as a gullible thicko with an anger management problem.
He took the opportunity of criticising many of his colleagues as well, rather than admitting his errors. However, he did demonstrate how incompetent the Gov was, in particularly inside No. 10. When it comes to being gullible, he was one of the ones who was like that, being gullible to the academic “experts” on the topic. It demonstrates that this place is a worthwhile cause, rather than paying too much attention to what the bureaucrats might try to do again.
Isn’t stupid evil? Stupids carry out actions they know will be to the detriment of others, but for no tangible gain to themselves. Therefore they do things just for the immiseration of others, that being their joy.
That’s evil.
This term diversity I think people misunderstand what it really means. You can read the real meaning if you refer to corporate business strategies. It is essentially an obvious point, that the bigger the pool you have to draw on the more likely you are to secure talent, hence Indian and Chinese maths graduates etc. There is no suggestion in this strategy that ‘diversity’ is inherently good or even good within a larger social perspective. It is important to read what it actually happening rather then the window dressing.
Well no, not really. Diversity means you need people conversant with a particular area of expertise: so in business you want specialists in marketing, sales, accounting, legal, regulatory, production around the table.
It is to be hoped the best talent was hired in the first place and that has nothing to do with race.
With respect to this issue, diversity would mean specialists in virology, epidemiology, infection/contagion control, critical care, immunology… for example, and not political advisors, psychological warfare specialists.
Lee Cain has one of those faces I would KEEP punching.
Why does he always look grubby?
Well it appears that he has the faintest of five o’clock shadow (bum fluff?), but you can just picture him in a dirty mac offering sweets to kids too.
Honestly the whole thing is a schtick and not a particularly sophisticated one.
Quite. Respiratory viruses and the disease they cause, follow long known trajectories. In fact that is true for all known pathogens and the diseases they cause. Millions of words have been written on the subject, umpteen hours of research.
The UK Common Cold Research Unit spent 50 years researching respiratory viruses and trying to find vaccines/cures (unsuccessfully) then closed when there was nothing more to do.
They cannot even use incompetence as an excuse. So something else – it’s clear.
It is a mixture of wanting to feel safe and wanting to belong and do the same thing that everyone else is doing. Nothing wrong with that impulse in certain times. I would say that we are bringing more people to our side.But you shouldn’t wish for total immediate enlightenment. Can you imagine what it would be like if everyone got it at once. It is unstable now the best we can hope for is a gradual release.
Listening to Cain and Cummings it is evident that they really were in a bit of a panic, losing their s### over apperntly rising ‘cases’ and could have done with a dose of humility about their own grasp of the situation.
It’s difficult to reason with an idiot totally convinced of their own competence (is that the Dunning-Kruger thing we keep hearing about?)
They would have benefited from a chat with Planet Normal’s ‘George’ or John Iaonnidis for some perspective. Everything is someone else’s fault but the biggest gem for me today was that of the Potemkin meetings: ministers strutting into Downing St for meetings whose outcome was already settled. (Just like this Inquiry!)
But if you look at the stats, the number of ‘cases’ – aka positive PCR tests was very low in February, March, April, actually starting to decline in March.
Deaths peaked in the first week in March, declining thereafter into April, virtually gone by May as were positive tests.
Infection to death is on average 21 to 28 days, therefore if deaths peaked first week of March, infections peaked first week of February.
Respiratory virus epidemics follow a known, distinct trajectory with period of low level activity, sudden exponential rise, peak, then steady decline – called a Gompertz Curve.
The death curve could be time shifted approx one month back, to indicate early infections started in December 2019, rose exponentially in January 2020, peaked in early February and declined thereafter through March.
With all the alleged experts and over a century of acquired knowledge and experience from around the World with respect to respiratory viruses and their spread, it is quite impossible they did not know – via their advisors – this.
I refuse to believe the cover story – novel virus, we panicked, didn’t know what to do, diversity of views.
When they can smuggle a befuddled cretin like Biden into the White House, what chance has the rest of the world got. After 2 weeks I concluded that that they were trashing the economy for the flu. Any one with a modicum of intelligence could see that. But the idle millions lapped it up.
It actually was less serious than ‘flu. ‘Flu is often serious and fatal in the young, particularly babies and infants. The risk from CoVid for the young was approaching zero.
CoVid was only a high risk for end of life individuals with existing medical conditions.
So presumably he has some sort of evidence that countries with a more “diverse” decision-making panel (presumably in black countries, more diverse means less black and more white – or is white universally bad, and black countries should in fact strive for less diversity?) did “better” during covid?
I don’t think he was using the modern perversion of the word ‘diversity’
Any manager worth his salt cavasses a diversity of views in order to make the best informed decision.
I don’t see how there can be a diversity of views if there are not present a diversity of individuals.