From Research Fortnight, 27 February 2013.
The organisation that represents British pharmacologists has remained largely silent over the problems of both big pharma and alternative medicine. It’s time for that to change, says David Colquhoun.
Over the past few years a courageous group of writers, researchers and activists has worked to expose the truth about the medicines we are sold, be they conventional or alternative.
Thanks, above all, to Ben Goldacre’s books and articles, more people than ever know that the big drug companies have been concealing evidence of the harm their products do, or the good they fail to do. On the other hand, thanks to a small army of bloggers, the preposterous claims made by peddlers of quack remedies are less likely to go unchallenged.
Big pharma is in trouble. Many of its products have been revealed to provide only marginal benefits, and some things that seemed useful, such as SSRI antidepressants, have been shown to be next to useless once hidden trials were revealed. Roche continues to conceal the full data on Tamiflu. And industrial money has corrupted university research, with companies withholding data from collaborators in academia, and putting researchers’ names on ghostwritten papers that they have not seen.
Between 2009 and 2012, fines of at least $10 billion were imposed on some of the most eminent companies, including Lilly, Pfizer, AstraZeneca, Merck and Abbott. The biggest single fine of all, $3bn, imposed in July 2012, went to a British company, GlaxoSmithKline.
And yet, the organisation that represents pharmacologists in this country, the British Pharmacological Society, has remained silent throughout.
In fact, last year the BPS, without consulting its members, signed an agreement with the Association of the British Pharmaceutical Industry on collaboration between healthcare professionals and the pharmaceutical industry. Much of the medical establishment also signed. Two of this document’s most objectionable clauses are that “Industry plays a valid and important role in the provision of medical education” and “Medical representatives can be a useful resource for healthcare professionals”.
It is naive to think that industry personnel can teach clinical pharmacology without bias in favour of their own company’s products. Such clinical “education” has long been part of pharma’s marketing strategy; most of the doctors I know and respect refuse to see reps altogether. The BPS has many members who teach pharmacology—are they really so inadequate?
At least some of the pharmaceutical industry’s products work. But pharmacologists should also be concerned about the quackery industry, worth about one tenth of the pharmaceutical industry at $60bn a year. Virtually none of its products work.
You would think that the BPS would take a view on the claims made for medicines, but apparently not. For almost a decade, it has maintained a near-total silence on problems such as the labelling of homeopathic and herbal remedies and the teaching of alternative medicine in universities.
Perhaps this is not surprising, given the equally supine nature of the government agency that oversees the pharmaceutical industry, the Medicines and Healthcare Products Regulatory Agency. Rather than being merely useless, the MHRA has been actively unhelpful. It has allowed misleading labels to be put on herbal potions, and nodded through surreal labels on homeopathic treatments that give advice on what to do in case of an overdose. It has stood by while pharmacists sell homeopathic ‘vaccines’ for whooping cough and meningitis. If children die of meningitis after buying such quackery, the MHRA should be held responsible.
It’s difficult to see what makes the BPS so reluctant to speak out against the MHRA. But members of the MHRA’s senior staff are BPS members and the society’s president, Philip Routledge, is a past chairman of the MHRA Herbal Medicines Advisory Committee.
Negotiating the relationship between science, industry and government requires skill. But that is no excuse for the BPS’s collusion in failures of both honesty and reason.
The BPS must show that it is on the side of the whistleblower. It should speak in favour of academics and industry collaborating on drug development, but make it clear that industry must have no say in how, or whether, results are published. And it must get behind AllTrials, the campaign for transparency in the reporting of clinical trial data.*
I have been a member of the BPS all my working life. I now find myself asking if I can remain a member of an organisation that has done so little to defend honest scientific behaviour.
*The print version of this piece stated that the British Pharmacological Society had not signed the AllTrials petition. In fact, the society signed on 20 February 2013.
David Colquhoun is professor of pharmacology at University College London. A version of this article with references appears on his blog.
In the 13 March edition of Research Fortnight, Humphrey Rang, president elect of the British Pharmacological Society, responds to this article.