pharma_lecture

pharma_lecture - Pharma Lecture Would it be ok for me to...

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Pharma Lecture Would it be ok for me to take $500 from Shering-Plough to begin lecture with plug for Clarinex? Are Ray etc – the crack dealers in Bourgois’ In Search of Respect any worse than Pharmaceutical industry? All pushers & interesting overlap in techniques (cheap introductory offers to get hooked) Marcia Angell wrote polemic, and I’m sure we’d find nice people work for Pfizer etc… But… Angell (former editor, New England Journal of Medicine) shows… 1) Clinical Trials a) Rigged through all sorts of tricks : (i) compare new drugs with placebos, not real rivals (ii) compare v rigged dose of rival
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(iii) use partial data – cf Celebrex 6 months instead of full year of data they had VIOXX the same (iv) Use young subjects with few side effects new drugs may actually be worse than old cheaper ones – as with diuretics for hypertension b) Clinical trials not really run by doctors anymore Doctors often paid bounty on subjects they recruit – so incentive to cut corners CROs (Contract Research Organizations) subcontract to doctors & control study design, analysis etc See Le Carre’s The Constant Gardener on CROs Often written up by drug Companies & doctors paid to sign, edit Adriana Petryna studies CROs Looking at techniques for manipulation Many find subjects in Ukraine & E. Europe – drug trials have become kind of surrogate health care
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Go there for lax regulations What owed to these subjects once trials over? “professional Guinea pigs” c) Contract clauses to prevent publication Betty Dong (UCSF) & synthroid (hyperthyroidism) Boots invoked confidentiality clause to prevent her from phblishing her finding that synthroid no more effective than cheaper generic Nancy Olivieri, L1 & Apotex – similar situation See Rachel Schuchman, The Drug Trial Scientific authority invoked in drug studies, but actual practice of science being hollowed out d) Only convenient trials declared medical journals now asking for trials to be registered at outset, so can’t be hidden
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2) FDA a) Underfunded to look at drug ads, safety issues b) Reliance on user fees from drug companies to review clinical trial data. (New since mid-90s). Is Angell right that “he who pays the piper…”?
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pharma_lecture - Pharma Lecture Would it be ok for me to...

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