How do you get an independent opinion? The European Parliament has refused to ratify the accounts of the European Medicines Agency on the grounds that they haven't been reassured that those that advise the body on the licensing of drugs are free of potentially corrupting influence from those who stand to benefit from the award of a license - in other words the pharmaceutical companies.
Where are the experts who might do this review who have not received the largess of the pharmaceutical companies? Despite strenuous efforts by national governments to restrict payouts by Big Pharma to individual doctors, most experts have received some money from the pharmaceutical industry, but was it corrupting? Funding for research and CME often comes from the industry and certainly, in the past, this has been lavish. I can remember a trip to Monte Carlo that I spoke at where there was a massive influx of European hematologists flown in by Roche to listen to me (among many others).
I must say that I was not impressed by the entertainment that was laid on (an excerpt from the musical Chess) which I walked out on and I would certainly rather have been at home (Monte Carlo is very seedy and not a patch on Bournemouth). Generally, I have done any teaching because I enjoyed teaching rather than for any financial reward from the pharmaceutical industry. However, I have received the cost of going to educational meetings from the Industry. But don't you think that this should have been provided by my employer? After all, surely the University expects its professors to keep up to date and this is much more easily done by attendance of meetings like ASH, IWCLL and EHA.
The truth is that national governments have skimped their funding of research and secondary education, expecting industry to make a contribution. All well and good, so they should, but funds need to be transferred in a non-corrupting way.
I have on three occasions given evidence to a NICE committee. On one occasion one of the assessors accused one of the doctors giving evidence of being in the pay of the pharmaceutical company. The doctor reacted abruptly, "Either withdraw that accusation or I will sue you for slander. I have witnesses." The accusation was withdrawn with poor-grace. It does show that the adjudicators are extremely skeptical of medical evidence. I have also given evidence in Medico-legal cases on behalf of the plaintiff. I am paid for my work, but I give an honest opinion for the court. My responsibility is to the court not the plaintiff.
On the other hand the criticism is a bit rich coming from members of the European Parliament. A more corrupt body it would be hard to envisage.
In another news item a parliamentary committee has criticized the peer-review system. Peer-review has been called slow, expensive, biased, open to abuse, innovation-stifling and bad at detecting fraud. It may be all of these things as well as open to corruption, but no peer-review is worse. Most peer reviewing is honest though it is usually not paid for and often resented as a chore. However, authors accept that if they want their work published it has to be peer-reviewed and accept that their reviewing other people's work is a tit-for-tat for having their own work refereed.
6 comments:
Doc,
What good reason is there for assuming that a govt agency is more honest than a profit making company? My experience with govt suggests that those who work for or are funded by govt are, as a group, much worse liars than private businesses that stand to lose a lot by hurting their customers.
Consider the global warming issue, for example. I believe it will come to be known as the biggest scientific fraud in history, financed almost completely by govt money.
Over and over, I've read that govt funded research is permeated by fraud, this often by publicly emoployed researchers themselves.
In a free market, no one is forcing me to accept anyone's decisions, and fraud is actionable both civilly and criminally.
I wonder how many people have died waiting on govt approval of drugs and other treatments. I've read that prior to the Aids epidemic, it took the FDA 17 years to approve a new drug and that Aids activists had to fight to get that down to 10 years.
What possibe justification is there for anyone telling me that
I can't rely on my own judgment where my life and health are concerned?
My experience in my profession has been that the best qualified lawyers went into private practice. Govt jobs were mostly for failures. And it looks to me like the same gas been true in other fields. I can tell many stories. Many govt employees are just bums.
There is a reason capitalistic nations have been the most productive and socialistic nations like China and Russia have been moving toward market economies.
Doc,
What good reason is there for assuming that a govt agency is more honest than a profit making company? My experience with govt suggests that those who work for or are funded by govt are, as a group, much worse liars than private businesses that stand to lose a lot by hurting their customers.
Consider the global warming issue, for example. I believe it will come to be known as the biggest scientific fraud in history, financed almost completely by govt money.
Over and over, I've read that govt funded research is permeated by fraud, this often by publicly emoployed researchers themselves.
In a free market, no one is forcing me to accept anyone's decisions, and fraud is actionable both civilly and criminally.
I wonder how many people have died waiting on govt approval of drugs and other treatments. I've read that prior to the Aids epidemic, it took the FDA 17 years to approve a new drug and that Aids activists had to fight to get that down to 10 years.
What possibe justification is there for anyone telling me that
I can't rely on my own judgment where my life and health are concerned?
My experience in my profession has been that the best qualified lawyers went into private practice. Govt jobs were mostly for failures. And it looks to me like the same gas been true in other fields. I can tell many stories. Many govt employees are just bums.
There is a reason capitalistic nations have been the most productive and socialistic nations like China and Russia have been moving toward market economies.
Any profit making company is bound to act in its own interest; it would be betraying its own shareholders otherwise. What needs to be done is to ensure that the opinion it gives is in the interest of those who are paying for the opinion.
There is always an interest. Unpaid advisers usually have their own which may well be undeclared.
Is it in the best interests of a profit making company to kill its customers? I think not.
Historically, govt's and those using them for their own purposes have a far higher body count.
One can make a good argument for the claim that Rachel Carson has turned out to be the worst mass murderer in history.
I can defend myself against privately instigated fraud, but the govt has a legal monopoly on the use of force.
The tobacco companies are good examples of profit making companies killing their own customers. At first they didn't know they were doing it, then they didn't want to believe they were doing it, then they figured they could get enough new customers to replace them since it takes an awfully long time to kill the exisating ones.
I agree with you about Rachel Carson.
Thank you for the insights. I hope we in the US can learn from the British experience.
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