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Drug Company Disguised Advertising As Science

ananyo writes "A former pharmaceutical company employee has blown the whistle on drug promotion disguised as science. Drug companies occasionally conduct post-marketing studies to collect data on the safety and efficacy of drugs in the real world, after they've been approved by the U.S. Food and Drug Administration. 'However,' writes the anonymous author in an editorial in the British Medical Journal (subscription required), 'some of the [post-marketing] studies I worked on were not designed to determine the overall risk:benefit balance of the drug in the general population. They were designed to support and disseminate a marketing message.' According to the whistleblower, the results of these studies were often dubious. 'We occasionally resorted to "playing" with the data that had originally failed to show the expected result,' he says. 'This was done by altering the statistical method until any statistical significance was found.' He adds that the company sometimes omitted negative results and played down harmful side effects. Nature says it was unable to work out who the writer was but they likely worked on diabetes and the studies criticized were from the Denmark-based pharmaceutical company Novo Nordisk."

47 of 172 comments (clear)

  1. zzzz by MickyTheIdiot · · Score: 4, Insightful

    Perhaps if big Pharma was actually honest that would merit a story.

    SOP.

    1. Re:zzzz by ohnocitizen · · Score: 4, Insightful

      It is worth a story for the following reasons: 1. Our attention span is incredibly short. 2. No one would claim a serial killer's latest crime wasn't a story for the mere reason it was expected. 3. Our attention span is incredibly short.

    2. Re:zzzz by MickyTheIdiot · · Score: 2

      huh? I wasn't paying attention.

    3. Re:zzzz by ColdWetDog · · Score: 4, Informative

      The vast majority of the time it is.

      You have been brainwashed by anti medical science FUD.

      Not when it comes to Big Pharma. They are impressively consistent. About the only thing they've done of late is to get more subtle.

      Even with all of the rules and regulations foisted on them to be more ethical, they will skirt the law and ethics are hard as they can. 'Unrestricted' educational grants to seminars who have speakers who get money from the very same company who inevitably have a positive spin for the drug or device the company is marketing. Yes, the spins are getting more nuanced - in the past they were just openly blatant about it, now they will discuss some positive data, a dribble of controversy and then come up with a positive recommendation.

      And don't even get me started on Direct-to-Consumer Advertising.......

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    4. Re:zzzz by ColdWetDog · · Score: 3, Funny

      tl;dr

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    5. Re:zzzz by Stem_Cell_Brad · · Score: 5, Insightful

      I do not wish to defend the whole Division in Big Pharma companies set up to perpetuate bullshit. This is harmful and infuriating. But, do not throw out the baby with the bathwater. You know what actually makes Big Pharma A LOT of money - drugs that work. Anyone who has taken an antibiotic or Viagra will probably agree. So, the lying bullshit is not the only thing Big Pharma does. Please do not simply condemn medical research and call it all a fraud because of the influence of business/advertising on pharmaceutical companies.

    6. Re:zzzz by omnichad · · Score: 3, Interesting

      Direct to consumer advertising isn't all bad. Especially since some doctors are wooed so easily. At least for the critical-thinking consumer, it's been a plus. There's an awareness that there's never been before. Knowing that there is a possible chemical fix to a problem, knowing the side-effects even if they are stated very quickly, and knowing the competition. A doctor who's been compromised by unethical marketing is not going to tell you all the risks, side effects, or even generic alternatives. Having foreknowledge of common pharmaceuticals has helped me greatly in doing my own basic research before I take medicine for anything.

    7. Re:zzzz by Reverand+Dave · · Score: 4, Insightful

      The advertising/business influence are the parts of big pharma that are so corrupt. Those are the wings that claim they need so much money for R&D but then consistently have advertising budgets and executive compensation that is 2-3x their R&D Budgets. They are also the wings that fight so hard to keep a profitable drugs like viagra or prilosec out of the hands of generic manufacturers so they can be affordable when people really need them. They are also the wings that fight to have their congress critters go after foreign manufacturers for trying to make affordable AIDS drugs for the people that really need it and really can't pay for it. Yes, big pharma does do some good, but it's not like their altruistic in their motives. The scientists that actually do the research might be, but not the parts of the company that make it big pharma to begin with.

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      I got here through a series of tubes
    8. Re:zzzz by FingerDemon · · Score: 3, Insightful

      If some are condemning their research as fraud, they bring it on themselves by including marketing expenses in their research budgets in order to justify higher prices for consumers in the countries (like the U.S.) where they can get away with it. News reports I have seen in the past few years indicate they are making record profits. That certainly isn't because they have come up with much better antibiotics. It is because they advertise heavily until people bug their doctors for a prescription. That said, there are certainly wonderful advances and I'm sure good and decent scientists working for all the right reasons in those firms. I just doubt sincerely that they are in control.

      --

      "Contrarily the lookaside buffer might not be the panacea... "
    9. Re:zzzz by Stem_Cell_Brad · · Score: 4, Insightful

      Agreed. I don't know, but I am guessing that big pharma was not always like this, i.e evilly pimping weak drugs for their profits. It certainly does not need to be like this. Congress critters need to grow a pair and enact laws that make the advertising/business bullshit division of big pharma not very profitable. I'm sure that could be done while helping the companies better deal with financial risks of research.

    10. Re:zzzz by Luckyo · · Score: 4, Insightful

      The problem is that a lot of drugs that work TOO WELL do not in fact make money. Take a look at vaccines for example. You need one shot every ten years for most standard vaccines. They have extremely high success chance. And they're not making any meaningful money, because they are simply not needed that often.

      On the other hand, psychotropic drugs that are designed to combat depression? Shitty success rate in comparison, but profit leaders.

    11. Re:zzzz by ColdWetDog · · Score: 2

      Oh, there are parts of "Big Pharma" that are 'good guys'. People who believe in the mission of making good pharmaceutical products to help people. And there certainly is a bit of hyperbole here (surprise!) on Slashdot. Not everything is an evil conspiracy and the drug companies are not holding back 'cures' in order to milk the system. Remember not to ascribe to malice what is best explained by incompetence - human biology, as I suspect you know from your nic - is hard. Very hard.

      But, Big Pharma has an amply documented dark side. Because drug development is hard, it is much easier to manipulate the market and get higher returns through the whiles of advertising and marketing and manipulation of the patent and other legal systems. Big Pharma has taken this to new heights over the past couple of decades and shows no evidence of changing it's ways.

      Yes, legal pressure is the only thing that is going to get any substantive changes done, but don't hold your breath.

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    12. Re:zzzz by Kalriath · · Score: 2

      Viagra is an accident. They were trying to make heart pills. In fact, I'd say easily quite a few of these "drugs that work" are actually drugs that didn't work, but just so happened to do something else as a useful side effect. And as it happens, a lot of the drugs that work are actually the result of university or other publicly funded medical research organisations.

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  2. Big Surprise by redrew89 · · Score: 4, Insightful

    Pharmacutical companies, especially in the US, are constantly making dubious claims, and marketing products that, occasionally, provide more suffering in the form of side-effects, than the disease they are designed to treat. It's generally accepted that these companies are genuinely apathetic to the medical issues, and simply do anything they can to maximize profit. Next, you'll be telling me that the firearms industry deliberately pressures governments into military action.

    1. Re:Big Surprise by Cosgrach · · Score: 2

      I have to agree on this. It has been my experience that they really don't give two shits about actually curing anything - a great many (if not most) of the drugs that are made simply treat they symptoms and not the root cause. Just why is this? PROFIT! Actually curing anything leads to lower profits in the future. They must keep the investors happy you know.

      The best way to good health is to eat good foods in reasonable portions, exercise, and keep the weight off. Limiting exposure to harmful chemicals (in food and your everyday life) also goes a long way in reducing the risk of cancer type ailments.

      --
      Why is it that most of the people that I encounter seem to have been shat from the Sphincter of Mediocrity?
    2. Re:Big Surprise by ldobehardcore · · Score: 5, Informative

      Just look at the latest generation of psoriasis drugs. Their lists of severe side effects is a mile long, and to me seem just as bad or possibly even worse than the disease they treat. Do you want your whole immune system knocked out to treat mild to moderate psoriasis. I enjoy not having to constantly worry about pneumonia TB and systemic fungal infections.

      --
      Hectice, baby, Mercator says hello to you
    3. Re:Big Surprise by shentino · · Score: 3, Insightful

      Just because it's the status quo doesn't make it right.

      Apathy is what allows this crap to continue.

    4. Re:Big Surprise by arth1 · · Score: 4, Informative

      The Pharmaceutical companies don't strap you into a seat and toss pills down your throat all will-nilly.

      On the contrary, I think this is exactly what they did by pushing the PREP and MSEHPA acts.
      Whether the politicians do it "for the greater good" or not doesn't change that it's the Pharmaceutical companies that sponsor it, because enforced medication whether needed or not means more money for them.

    5. Re:Big Surprise by omnichad · · Score: 2

      Or like Ambien - a sleep aid - can lead to sleep-driving.

    6. Re:Big Surprise by mosb1000 · · Score: 2

      Aside from antibiotics and anti viral medications (which scare the shit out of me, honestly), all drugs treat only symptoms. You ether keep taking them until you get better due to some other natural process, or you keep taking them for the rest of your life, unless you want your symptoms to return. And what's worse, they pretty much all have harmful side-effects. I cringe when I see older people taking handfuls of drugs three times a day. How could all that possibly be necessary? Wouldn't it be better just to suffer through whatever symptoms they have?

    7. Re:Big Surprise by TimFenn · · Score: 2

      You should check out some of the latest biologic-based treatments for psoriasis that are "in the pipeline:" http://dx.doi.org/10.1038/nm0512-638

      Biologics typically have the benefit of being very specific against their target with few - if any - side effects. The downside is usually the cost/method of treatment, but thats another story...

      --
      CAPS LOCK IS THE CRUISE CONTROL OF AWESOMNESS
    8. Re:Big Surprise by Kozar_The_Malignant · · Score: 4, Informative

      >How could all that possibly be necessary?

      They're old. Stuff starts going wrong.

      >Wouldn't it be better just to suffer through whatever symptoms they have?

      No. Suffering through the symptoms of diabetes, hypertension, atrial fibrillation pretty much sucks and also leads to earlier death than otherwise.

      --
      Some mornings it's hardly worth chewing through the restraints to get out of bed.
    9. Re:Big Surprise by Obfuscant · · Score: 3, Interesting

      Their lists of severe side effects is a mile long, and to me seem just as bad or possibly even worse than the disease they treat.

      That's a value judgement better left to the suffer of psoriasis, don't you think? Those side effects don't appear in every user, they appear in some fraction. What do you do if one of the side effects appears when you use the drug? Tell your doctor and get off it. That's exactly what happened when I was put on a blood pressure med. (Or a cholesterol one, I don't remember which.) One potential side effect was a cough, which I got. Told Doc, switched drugs, cough gone, new drug working.

      One potential side effect of the blood pressure med is feeling light headed when standing suddenly. Ok, I can deal with that. I used to have low blood pressure so I know how to minimize that. Now I have reasonable pressure and less chance of stroke or blowing a kidney. I'll take the side effect over either of those problems any day.

      Do you want your whole immune system knocked out to treat mild to moderate psoriasis.

      I don't have psoriasis, so I can't know how bad it is or how much I would risk to get rid of the problem. Do you?

      I enjoy not having to constantly worry about pneumonia TB and systemic fungal infections.

      So do I. I also enjoy not having psoriasis.

      Life is made up of risks. Some are worth taking. Some aren't. You choose one way. Someone else may choose another. And when they choose another, they may wind up not having the side effect that you seem so worried about. It's hard to know what someone else is going through and know if they should risk a 1% chance of a side effect to get relief from their medical problem. You are probably aware that every major surgical procedure has a potential side effect of death from anesthesia issues, don't you? Should all major surgery for everyone be stopped because you don't think the risk is worth it?

  3. Everyone does this by Anonymous Coward · · Score: 4, Insightful

    This was done by altering the statistical method until any statistical significance was found

    I'm convinced that backing into a conclusion by playing with analysis is the raison d'être of most white collar work in the Western world. Using 'risk' models to rationalize market positions enables arbitrary use of capital by so-called banks. Economic and climate analysis pretty much boil down to teasing out curves that fit the preconceived policies of various statists.

    Not surprising that multi-billion dollar drug companies.leverage the same tools. Monkey see monkey do.

    1. Re:Everyone does this by dkleinsc · · Score: 3, Insightful

      George Carlin said it best:

      Cuz ya do know folks, Ya do know, livng in this country you know, that every time you're exposed to advertising you realize once again that America's leading industry, America's most profitable business is still the manufacturing, packaging, distribution, and marketing of BULLSHIT. High quality, Grade A, Prime cut, Pure American BULLSHIT.

      And the sad part is, Most people seem indoctorinated to believe that bullshit only comes from certain places, certain sources. Advertising, politics, salesmen, not true. Bullshit is everywhere, bullshit is rampant. Parents are full of shit, teachers are full of shit, clergymen are full of shit, and law enforcment people are full of shit, this entire country is completely full of shit, and always has been, from the Declaration of Independance, to the Constitution, to the Star Spangled Banner, it's really nothing more than one BIG steaming pile of red white and blue all Americian BULLSHIT.

      --
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    2. Re:Everyone does this by boristdog · · Score: 3, Insightful

      This was done by altering the statistical method until any statistical significance was found

      I'm convinced that backing into a conclusion by playing with analysis is the raison d'être of most white collar work in the Western world.

      I thought that's how we were taught to do labs back in all my science classes.

    3. Re:Everyone does this by MickyTheIdiot · · Score: 4, Insightful

      Because the only healthy response to our world right now is to laugh at it.

    4. Re:Everyone does this by Anonymous Coward · · Score: 2, Funny

      I am one sick bastard.

      Big Pharma probably has a drug for you.

    5. Re:Everyone does this by Obfuscant · · Score: 2
      This.

      I recall one time hearing Carlin's rant about disease. He took a really sick shot at eating disorders. It was almost as if he completely ignored mental disorders as a cause of physical problems. No, it wasn't almost, he deliberately ignored them. He was busy telling anorexics to "just eat" and bulemics to stop, and that their body dysmorphic issues were all due to their poor decision making abilities. It was their fault and they should just suck it up and stop being whatever they were.

      That one rant said more about George Carlin than anything else I've ever heard. I'm in full agreement. His "bullshit" meter is reading his own bile, not what's around him.

  4. I work in drug marketing by Anonymous Coward · · Score: 5, Informative

    I work in drug marketing, (software dev at an ad agency) and all I can say is that my pot dealer is more ethical than a typical multinational drug company.

    If it's not illegal, they will do it. If you don't want drug companies to do something, make it illegal. Libertarian nonsense won't fix this problem any more than it helps deal with other problems.

    Drug companies have lawyers, and always seek to obey the law (and sometimes fail). They don't care about ethics. They care about the law, and perception. Their purpose is to maximize shareholder value, not do good for the world.

    As for me... yes I sold out.. no I don't care. It's a cold world.

    1. Re:I work in drug marketing by MickyTheIdiot · · Score: 2

      I really appreciate your comment, but I cringe at the "maximize shareholder value" meme.

      The top 1% of the country owns WAY more than 50% of the stocks. The biggest shareholders are the CEO/executive class themselves. When you say "maximize shareholder value" it implies that they are doing it for "everyone" (or the 401k, normal investor, index fund investor) and I think the it's misleading. At the end of the day they are doing it for themselves and its just another selfish motive.

      We also treat the "shareholder value" meme as if it was handed down by Moses on stone tablets, too. It's a legal construct and is based on legal precedence. If we actually had the political will we could add requirements to corporate charters that gave them more responsibility. At one point in the past (pre railroad barons) they were actually there!

  5. Get some perspective, Slashdot! by TimHunter · · Score: 4, Funny

    So, some international drug companies are lying about science just to make a profit while callously risking millions of people's heath as a consequence? What's that to me?

    Do you really expect me get upset about this when Apple's new MacBook Pro is expensive and impossible to repair? It's APPLE, for cryin' out loud.

    I think /. needs to get some perspective!

  6. Duh by Hatta · · Score: 4, Insightful

    This is what happens in for-profit research. And for that matter, if you need results to get the next grant, then you're effectively doing for-profit research. The whole practice of science, private and public is essentially profit driven. Until we start rewarding scientists for negative results as well as we do positive results, we're going to see a lot of faulty positive data published. This is why most major published results in cancer science can't be replicated, for instance.

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  7. Not the first time they're in the heat by bergelin · · Score: 4, Informative

    They marketed a drug called Victoza before recieving authorization to market it several times, and "making claims and comparisons that were misleading, disguising promotional material and failing to provide information which reflected available evidence".

  8. Lies, damned lies, and statistics by amoeba1911 · · Score: 3, Insightful

    The whole point of the field of statistics is to keep changing your models until you find one that shows the result you want. Why else do you think there are more than a dozen different normalization tests?

    1. Re:Lies, damned lies, and statistics by neurophil12 · · Score: 2, Insightful

      It's hard to tell when someone is just expressing a cynical sentiment and when someone is being completely serious. I do take issue though when people suggest that statistics are lies, largely because I think many people get to thinking that all statistics are meaningless. Statistics are meaningful when properly applied. Statistics are complicated and there are many models because the world is complicated. Different tests are better in different situations, depending on for instance how much you want to trade off power (the likelihood of detecting a real effect) for precision (avoiding false positives), whether you have a large or small sample size, or whether you think there might be interactions between variables. Now it might be the case that someone isn't sure which test to use. Assuming they can't figure out the answer, they can run multiple tests, but if they do then they should control for that by adjusting the p-values of each test accordingly. Ultimately though scientists are human, and they will have competing interests to be honest and to cheat. The key is the process, including forms of peer review, and hopefully some day a venue for publishing negative results, such that there is less pressure to cheat. Profit will always push the needle the other direction though.

  9. Ask your doctor by NoNonAlphaCharsHere · · Score: 2

    Hypoxia(TM) may cause explosive crap fits, genital warts, palm hair, excessive body odor, bleeding eyes, hairy facial moles, incontinence, ulcers, an increased risk of tuberculosis, agonizing headaches, crippling gastro-intestinal pain, rigid joints, slurred speech, massive hair and eyebrow loss, spousal abuse, certain forms of cancer, slow agonizing death, hunchback and hives.

    Ask your doctor if Hypoxia(TM) is right for you!!

  10. Common in mass media -- not just Big Pharma by Brewster+Jennings · · Score: 4, Interesting
    I worked as a news producer in medium and large DMAs (Designated Market Areas -- usually, a single city and its suburbs) for ten years, and was the field producer for a health segment with a local physician.

    Every week, we'd get news stories based on "studies": coffee is good for you, bananas are good for you, aspirin is good for, etc.

    The coffee study was invariably done by retailers or growers of coffee, the same for bananas, aspirin, etc. The problem about medicine and pharmacology (or science in general, for that matter) is that you almost never get a zero-one phenomenon, and correlation does not necessarily equal causation. These ambiguities present a very large 'gray area' for the people doing these studies, unfortunately.

    Add to that the fact the groups comissioning the research are going to censor out anything negative about their products, and you get an extremely unreliable information product. Trust me when I say that the husk of what remains of modern traditional journalism has neither the time, the resources, nor the inclination.

    The only solution I see to this problem is for users to keep the same jaded cynicism that they should probably have for any media product, or to advocate better government regulation to separate real research from junk science.

  11. Re:Sounds like Climate Scientists by NoNonAlphaCharsHere · · Score: 2

    Sounds exactly like what denialists do in order to ignore obvious man-made tipping of the environment in order to preserve the status quo.

  12. Let's Look at Those Two Relationships by eldavojohn · · Score: 4, Interesting

    I work in drug marketing, (software dev at an ad agency) and all I can say is that my pot dealer is more ethical than a typical multinational drug company.

    Well let's take a look at the relationships you propose here. Your drug dealer is a single entity, probably not making a ton of money. I mean, he's making money but he in turn pays it to the supplier and then X middle men back to whoever is growing it. It's probably not as much as a software developer. Even if he is making a lot of money, he depends on you to not rat him out to the cops. So if he starts busting your balls or raising prices and you feel like he's unfair you can just turn him over to the cops and face little or no repercussions. So he will probably be friendly, courteous and -- assuming he doesn't mix business with pleasure -- have his shit together enough to accommodate your emergency needs. He/She is the interface to your whole pot experience and has reason to make sure personally that you are a very happy camper.

    Let's look at a multinational drug company. They have infinite resources, they have infinite lawyers, they will sue you on a whim, they will sue you if voice concern. They are faceless, they never meet you, they actually abuse a broken system to interface with you (HMOs and prescriptions). They operate "within the law" (like you said if it isn't illegal they'll do it) so you have no leverage on them if your relationship goes sour. In fact, if your relationship goes sour your goose is pretty much cooked. Oh, and if you manage to threaten their infinite capital, they have ways of generating more of it. When they fight amongst themselves, people die. That's how powerful they are ... when someone wants to license a patented drug in India and Pfizer wants $200 per dosage and that means that Indian patients can't get the super expensive research compounds, people die. And when an Indian firm just makes a generic version of it, they've basically painted a target on their back for international IP laws. When something does go wrong that they are indeed liable for, you are clumped into a class action lawsuit with no voice ... you have the option to opt out of the class action lawsuit (which I think are opt in by default) but to do so would mean going toe to toe with your personal resources and lawyers against their infinite sums of both. Tell me, what incentive do they have to even give a shit about you? And you, Anonymous Coward, you are doubly F'd in the A because you work for one, so that's just more leverage they hold over your head.

    And I'm supposed to be surprised that your pot dealer is more ethical and humane than big pharma? He'd have to develop some pretty complicated drugs and then go on a rampage of carnage and bloodshed and looting to come close.

    As for me... yes I sold out.. no I don't care. It's a cold world.

    Listen, from various points of view, everyone has sold out. You live in a capitalistic society and in your employment respect you cannot hold yourself to higher standards than that unless you're okay with living on the street. And nobody should blame you for putting good food in your mouth and living in the best place you can afford. Capitalism's the name of the game and if you don't play it right, you get screwed over. So just suck it up and embrace it, I have. Might make us hypocrites but it doesn't invalidate our logic.

    --
    My work here is dung.
    1. Re:Let's Look at Those Two Relationships by shentino · · Score: 3, Insightful

      You can't play the game unless you're rich enough to begin with to buy politicians off.

      Because the moment you step on the field you are a target and the elite have the referees on their own payroll.

  13. Drug Dealers by ThatsNotPudding · · Score: 2

    They're all the same.

  14. Proof by ThatsNotPudding · · Score: 2

    Look no farther than the dearth of actual, fucking, take once and done *CURES*. Oh, but plenty of life-long maintenance drugs for profit lock-in, yessiree bob.

  15. just FYI, diabetes is cured now by catmistake · · Score: 2

    unable to work out who the writer was but they likely worked on diabetes

    I realize that insulin is a huge cash cow for Big Pharma in the US, but hopefully they are not so brazen as to actively lobby the FDA to attempt to prevent the cure (discovered 6 years ago) from reaching the millions suffering from this disease. Suspiciously, I haven't seen any major US news outlets reporting on this interesting and insanely good news for those that suffer from the disease.

    1. Re:just FYI, diabetes is cured now by dorpus · · Score: 2

      Any number of scientists have claimed miracle cures in the past. The work will need to be replicated to establish credibility.

      Additionally, mice are a poor model organism for studying obesity. Their fat metabolism is quite different from humans. They have given false hopes before to a "cure" for obesity via leptin.

  16. Re:This is pretty much known anyway by ColdWetDog · · Score: 2

    Although it's nice to have this backing it up. I'm a med student and 10% of our course is dedicated to analysis of clinical trials, and the statistical tricks drug reps use to dupe you into prescribing their new drugs.

    Protip: Learn your statistics well (and your English gooder). If you have a passably advanced knowledge you can 1) understand the lies and damned lies 2) have lots of fun twisting the drug rep at conferences and meetings. Always fine quality entertainment after a night up on call.....

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    Faster! Faster! Faster would be better!
  17. Re:Sounds like Climate Scientists by geekoid · · Score: 2

    Except Climate scientists have evidence, predictions, and data.

    Please take you trolling elsewhere.

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