The Top Five Ways that Pharma Affects You

Salon.com recently published a piece:
http://www.salon.com/2014/01/25/5_evil_ways_the_multi_billion_dollar_drug_industry_is_in_bed_with_your_doctor_partner/
--that cuts to the chase in the ways that the media can either bring us up to date or else pull the wool farther over our eyes.

The main thrust of the piece is a review of the five most common ways that the pharmaceutical industry manipulates physicians and keeps things favorable to their own goals--which means, replacing what's true with what's valuable. The five ways are no surprise to anyone, but as we increasingly get into the thick of the swamp, it's valuable to be reminded of the big picture every so often:

• Spying on prescribing
• Easy CME access for shilling docs
• Ghostwriting
• Speakers' bureaus
• Clinical trials (how the enterprise is conducted so that who pays the piper calls the tune, when at least 70 percent of the piper is paid by Pharma)

It's valuable at times to recollect certain aspects of the big picture. Take ghostwriting. The main features of the extent of medical ghostwriting, how as many as half the stories in med journals on some sensitive topics might be ghostwritten, have been out for at least 10 years. What has happened? About zilch. Everyone agrees that ghostwriting is an especially egregious offense, and so far as I can tell, it goes on just about as before. Ditto for most of the other sins.

In another smart move:
http://blogs.bmj.com/bmj/2014/05/30/jane-feinmann-is-the-current-system-of-publishing-clinical-trials-fit-for-purpose/
--the BMJ ran a study of the current state of the publication of clinical trials. Not surprisingly, there was disagreement over most issues. But at least there was finally a sense that something was starting and that the end results might be useful.

We're getting out toward a decade from the publication of the first wave of studies that started to shed light on the real implications of Pharma's rigid control over the system. What's changed? To a large extent, nothing.