s ‘All Trials’, Marketing Based Medicine, and the fight for clinical transparency | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists


From the desk of the editor

Welcome to the July 2014 homepage edition of i2P (Information to Pharmacists) E-Magazine.
At the commencement of 2014 i2P focused on the need for the entire profession of pharmacy and its associated industry supports to undergo a renewal and regeneration.
We are now half-way through this year and it is quite apparent that pharmacy leaders do not yet have a cohesive and clear sense of direction.
Maybe the new initiative by Woolworths to deliver clinical service through young pharmacists and nurses may sharpen their focus.
If not, community pharmacy can look forward to losing a substantial and profitable market share of the clinical services market.
Who would you blame when that happens?
But I have to admit there is some effort, even though the results are but meagre.
In this edition of i2P we focus on the need for research about community pharmacy, the lack of activity from practicing pharmacists and when some research is delivered, a disconnect appears in its interpretation and implementation.

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News Flash

Newsflash Updates for July 2014

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P. 
Access and click on the title links that are illustrated

Comments: 1

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Feature Contribution

Woolworths Pharmacy - Getting One Stage Closer

Neil Johnston

It started with “tablet” computers deployed on shelves inside the retailer Coles, specifically to provide information to consumers relating to pain management and the sale of strong analgesics.
This development was reported in i2P under the title Coles Pharmacy Expansion and the Arid PGA Landscape”
In that article we reported that qualified information was a missing link that had come out of Coles market research as the reason to why it had not succeeded in dominating the pain market.
Of course, Woolworths was working on the same problem at the same time and had come up with a better solution - real people with good information.

Comments: 5

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Intensive Exposition without crossing over with a supermarket

Fiona Sartoretto Verna AIAPP

Editor's Note: The understanding of a pharmacy's presentation through the research that goes into the design of fixtures and fittings that highlight displays, is a never-ending component of pharmacy marketing.
Over the past decade, Australian pharmacy shop presentations have fallen behind in standards of excellence.
It does not take rocket science - you just have to open your eyes.
Recently, our two major supermarkets, Woolworths and Coles, have entered into the field of drug and condition information provision - right into the heartland of Australian Pharmacy.

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The sure way to drive business away

Gerald Quigley

I attended the Pregnancy, Baby and Children’s Expo in Brisbane recently.
What an eye and ear opening event that was!
Young Mums, mature Mums, partners of all ages, grandparents and friends……...many asking about health issues and seeking reassurances that they were doing the right thing.

Comments: 1

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‘Marketing Based Medicine’ – how bad is it?

Baz Bardoe

It should be the scandal of the century.
It potentially affects the health of almost everyone.
Healthcare providers and consumers alike should be up in arms. But apart from coverage in a few credible news sources the problem of ‘Marketing Based Medicine,’ as psychiatrist Dr Peter Parry terms it, hasn’t as yet generated the kind of universal outrage one might expect.

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Community Pharmacy Research - Are You Involved?

Mark Coleman

Government funding is always scarce and restricted.
If you are ever going to be a recipient of government funds you will need to fortify any application with evidence.
From a government perspective, this minimises risk.
I must admit that while I see evidence of research projects being managed by the PGA, I rarely see community pharmacists individually and actively engaged in the type of research that would further their own aims and objectives (and survival).

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Organisational Amnesia and the Lack of a Curator Inhibits Cultural Progress

Neil Johnston

Most of us leave a tremendous impact on pharmacies we work for (as proprietors, managers, contractors or employees)—in ways we’re not even aware of.
But organisational memories are often all too short, and without a central way to record that impact and capture the knowledge and individual contributions, they become lost to time.
It is ironic that technology has provided us with phenomenal tools for communication and connection, but much of it has also sped up our work lives and made knowledge and memory at work much more ephemeral.

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Academics on the payroll: the advertising you don't see

Staff Writer

This article was first published in The Conversation and was written by Wendy Lipworth, University of Sydney and Ian Kerridge, University of Sydney
In the endless drive to get people’s attention, advertising is going ‘native’, creeping in to places formerly reserved for editorial content. In this Native Advertising series we find out what it looks like, if readers can tell the difference, and more importantly, whether they care.
i2P has republished the article as it supports our own independent and ongoing investigations on how drug companies are involved in marketing-based medicine rather than evidence-based medicine.

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I’ve been thinking about admitting wrong.

Mark Neuenschwander

Editor's Note: This is an early article by Mark Neuenschwander we have republished after the soul-searching surrounding a recent Australian dispensing error involving methotrexate.
Hmm. There’s more than one way you could take that, huh? Like Someday when I get around to it (I’m not sure) I may admit that I was wrong about something. Actually, I’ve been thinking about the concept of admitting wrong. So don’t get your hopes up. No juicy confessions this month except that I wish it were easier for me to admit when I have been wrong or made a mistake.
Brian Goldman, an ER physician from Toronto, is host of the award-winning White Coat, Black Art on CBC Radio and slated to deliver the keynote at The unSUMMIT for Bedside Barcoding in Anaheim this May. His TED lecture, entitled, “Doctors make mistakes. Can we talk about it?” had already been viewed by 386,072 others before I watched it last week.

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Dispensing errors – a ripple effect of damage

Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA

Most readers will be aware of recent publicity relating to dispensing errors and in particular to deaths caused by methotrexate being incorrectly packed in dose administration aids.
The Pharmacy Board of Australia (PBA), in its Communique of 13 June 2014, described a methotrexate packing error leading to the death of a patient and noted “extra vigilance is required to be exercised by pharmacists with these drugs”.
This same case was reported by A Current Affair (ACA) in its program on Friday 20 June

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Take a vacation from your vocation

Harvey Mackay

Have you ever had one of those days when all you could think was, “Gosh, do I need a vacation.”
Of course you have – because all work and no play aren’t good for anyone.
A vacation doesn’t have to be two weeks on a tropical island, or even a long weekend at the beach. 
A vacation just means taking a break from your everyday activities. 
A change of pace. 
It doesn’t matter where.
Everyone needs a vacation to rejuvenate mentally and physically. 
But did you also know that you can help boost our economy by taking some days off? 
Call it your personal stimulus package.

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Explainer: what is peer review?

Staff Writer

This article was first published in the Conversation. It caught our eye because "peer review" it is one of the standards for evidence-based medicines that has also been corrupted by global pharma.
The article is republished by i2P as part of its ongoing investigation into scientific fraud and was writtenby Andre Spicer, City University London and Thomas Roulet, University of Oxford
We’ve all heard the phrase “peer review” as giving credence to research and scholarly papers, but what does it actually mean?
How does it work?
Peer review is one of the gold standards of science. It’s a process where scientists (“peers”) evaluate the quality of other scientists' work. By doing this, they aim to ensure the work is rigorous, coherent, uses past research and adds to what we already knew.
Most scientific journals, conferences and grant applications have some sort of peer review system. In most cases it is “double blind” peer review. This means evaluators do not know the author(s), and the author(s) do not know the identity of the evaluators.
The intention behind this system is to ensure evaluation is not biased.
The more prestigious the journal, conference, or grant, the more demanding will be the review process, and the more likely the rejection. This prestige is why these papers tend to be more read and more cited.

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Dentists from the dark side?

Loretta Marron OAM BSc

While dining out with an elderly friend, I noticed that he kept his false tooth plate in his shirt pocket. He had recently had seven amalgam-filled teeth removed, because he believed that their toxins were making him sick; but his new plate was uncomfortable. He had been treated by an 'holistic dentist'. Claiming to offer a "safe and healthier alternative" to conventional dentistry, are they committed to our overall health and wellbeing or are they promoting unjustified fear, unnecessarily extracting teeth and wasting our money?

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Planning for Profit in 2015 – Your key to Business Success

Chris Foster

We are now entering a new financial year and it’s a great time to reflect on last year and highlight those things that went well and those that may have impacted negatively in the pursuit of your goals.
It's also a great to spend some time re-evaluating your personal and business short, medium and long term goals in the light of events over the last year.
The achievement of your goals will in many cases be dependent on setting and aspiring to specific financial targets. It's important that recognise that many of your personal goals will require you to generate sufficient business profits to fund those aspirations

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Attracting and Retaining Great People

Barry Urquhart

Welcome to the new financial year in Australia.
For many in business the past year has been described as a challenging period.
Adjectives are a key feature of the English language.  In the business lexicon their use can be, and often is evocative and stimulate creative images.  But they can also contribute to inexact, emotional perceptions.
Throughout the financial pages of newspapers and business magazines adjectives abound.
References to “hot” money draw attention and comment.  The recent wave of funds from Chinese investors, keen to remove their wealth from the jurisdiction and control of government regulations is creating a potential property bubble in Australia.

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Updating Your Values - Extending Your Culture

Neil Johnston

Pharmacy culture is dormant.
Being comprised of values, unless each value is continually addressed, updated or deleted, entire organisations can stagnate (or entire professions such as the pharmacy profession).
Good values offer a strong sense of security, knowing that if you operate within the boundaries of your values, you will succeed in your endeavours.

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Evidence-based medicine is broken. Why we need data and technology to fix it

Staff Writer

The following article is reprinted from The Conversation and forms up part of our library collection on evidence-based medicines.
At i2P we also believe that the current model of evidence is so fractured it will never be able to be repaired.
All that can happen is that health professionals should independently test and verify through their own investigations what evidence exists to prescribe a medicine of any potency.
Health professionals that have patients (such as pharmacists) are ideally placed to observe and record the efficacy for medicines.
All else should confine their criticisms to their evidence of the actual evidence published.
If there are holes in it then share that evidence with the rest of the world.
Otherwise, do not be in such a hurry to criticise professions that have good experience and judgement to make a good choice on behalf of their patients, simply because good evidence has not caught up with reality.

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Laropiprant is the Bad One; Niacin is/was/will always be the Good One

Staff Writer

Orthomolecular Medicine News Service, July 25, 2014
Laropiprant is the Bad One; Niacin is/was/will always be the Good One
by W. Todd Penberthy, PhD

(OMNS July 25, 2014) Niacin has been used for over 60 years in tens of thousands of patients with tremendously favorable therapeutic benefit (Carlson 2005).
In the first-person NY Times best seller, "8 Weeks to a Cure for Cholesterol," the author describes his journey from being a walking heart attack time bomb to a becoming a healthy individual.
He hails high-dose niacin as the one treatment that did more to correct his poor lipid profile than any other (Kowalski 2001).

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Culture Drive & Pharmacy Renewal

Neil Johnston

Deep within all of us we have a core set of values and beliefs that create the standards of behaviour that we align with when we set a particular direction in life.
Directions may change many times over a lifetime, but with life experiences and maturity values may increase in number or gain greater depth.
All of this is embraced under one word – “culture”.
When a business is born it will only develop if it has a sound culture, and the values that comprise that culture are initially inherent in the business founder.
A sound business culture equates to a successful business and that success is often expressed in the term “goodwill” which can be eventually translated to a dollar value.

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Pharmacy 2014 - Pharmacy Management Conference

Neil Johnston

The brave new world of health and wellness is not the enemy of Pharmacy, it is its champion.
Australian futurist, Morris Miselowski, one of the world's leading business visionaries, will present the Opening Keynote address on Pharmacy's Future in the new Health and Wellness Landscape at 2.00pm on Wednesday July 30.
Morris believes the key to better health care could already be in your pocket, with doctors soon set to prescribe iPhone apps, instead of pills.
Technology will revolutionise the health industry - a paradigm shift from healthcare to personal wellness.
Health and wellness applications on smartphones are already big news, and are dramatically changing the way we manage our personal health and everyday wellness.

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Generation and Application of Community Pharmacy Research

Neil Johnston

Editor’s Note: We have had a number of articles in this issue relating to pharmacy research.
The PGA has conducted a number of research initiatives over the years, including one recently reported in Pharmacy News that resulted from an analysis of the QCPP Patient Questionnaire.
Pharmacy Guild president, George Tambassis, appears to have authored the article following, and there also appears to be a disconnect between the survey report and its target audience illustrated by one of the respondent comments published.
I have asked Mark Coleman to follow through, elaborate and comment:

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‘All Trials’, Marketing Based Medicine, and the fight for clinical transparency

Baz Bardoe

articles by this author...

Baz Bardoe is a post graduate researcher, journalist and media analyst. He has qualifications in anthropology, marketing and business. His articles have appeared in 'Popular Science', 'Defence Today', 'Online Opinion' and many others. He is currently a military officer and hopes to commence PhD studies in 2014. He has an ongoing interest in issues relating to ethics and accountability. His views are from a personal perspective and do not purport to represent the views of the ADF in any capacity.

Editor's Note: i2P would like to introduce a new writer named Baz Bardoe, an experienced writer with an interesting background.
He joins our small group of writers looking at the ethics behind drug and other medical evidence that pharmacists rely on for their advice and recommendations to their patients.
Much of this evidence has been found to be fraudulent and will take decades to sort out.
This type of fraud also permeates other industries to the extent that information adverse to the interests of these industries (Big Pharma, Big Agriculture, Big Tobacco, Mainstream Media and Big Pesticide and Herbicide Manufacturers), is suppressed.
But they all seem to conspire using a similar methodology to the extent that human health is adversely affected through lack of information or publicising false information, or distributing misleading information.

It is fueled by greed which pays for corrupt lobbying activities to introduce legislation, which further supports and promotes these immoral/illegal activities.
It even overwhelms democratically elected governments in a subversive format such as a trade treaty.
Are you aware that Big Tobacco is currently trying to overcome recent Australian laws involving plain packaging for tobacco products utilising a back door treaty?
If Australia signs up to the current Trans-Pacific Partnership Agreement this will happen and the Australian government is then open to be sued by a corporation,for any internal legislation that impinges on the profits of Big Tobacco (and others).
If this activity is not stopped, all western economies (including Australia) will be faced with a tsunami of induced ill health. It is progressively happening in plain sight already and with pharmacists being the most accessible health professionals, we need to acknowledge the problem and then be part of the solution to stem the tide at both the political and informational levels to gate-keep on behalf of our patients.

Baz Bardoe's article, which was first published in Online Opinion 4/12/2013, follows:

“We don't have "evidence-based medicine" (EBM), rather we have "marketing-based medicine" (MBM).” – Dr Peter Parry

If you have ever used a pharmaceutical product, or if you are a healthcare provider, you need to read this article. At the end of it you may well be shocked into a major paradigm shift.

When most people use a pharmaceutical product, they assume that it has been independently tested, and found to be safe and effective before being released onto the marketplace. But the reality is very different. In some cases drug companies finance clinical trials and only selectively release data and reports that support their marketing goals. And many of the reports in medical journals which medical professionals rely upon to reach opinions about pharmaceutical products, are written by people with financial links to drug companies. In some cases reports are even being ‘ghost written’ by people employed by pharmaceutical companies. In short, medical literature and data is massively compromised by pharmaceutical marketing.

If this seems like some preposterous conspiracy theory then consider the work of Dr Peter Doshi and the independent Cochrane Collaboration which should give us pause for thought. “The current system……. is one in which the meager details of clinical trials published in medical journals, often by authors with financial ties to the companies whose drugs they are writing about, is insufficient to the point of being misleading”. (1)

And then there’s the even stronger position of epidemiologist Dr Ben Goldacre, as reported in The Guardian. "The decades-old industry practice of suppressing scientific evidence (and some independent researchers doing the same), leads Goldacre to declare that nothing we know about modern medicine should be assumed to be correct, and he makes the urgent case for forcing the release of all that pharma dark matter so scientists can re-run the numbers and work out what actually does work." (2)

Statements like this are sending shockwaves through the medical establishment, and with good reason. But as Goldacre indicates, it is an issue that has been brewing for a long time. Writing as editor of the prestigious medical journal ‘The Lancet' in 2002, Richard Horton stated that “a study of the interactions between authors of clinical practice guidelines and the pharmaceutical industry……… found serious omissions in declarations of conflicts of interest. Almost 90% of authors received research funding from or acted as consultants for a drug company. Over half had connections with companies whose drugs were being reviewed in the guideline, and the same proportion indicated that there was no formal procedure for reporting these interactions.” (3)  He also wrote in 2004 that “journals have devolved into information laundering operations for the pharmaceutical industry”. (4)

Clearly there is a problem. A very serious and shocking problem that goes to the core of which pharmaceutical products are safe and effective, and those which are not. And there is no doubt that consumers, policy makers and medical professionals alike have been consistently misled. Which brings me to the ‘All Trials’ initiative and Dr Peter Parry, a child and adolescent psychiatrist, and senior lecturer at the University of Queensland. All Trials is an initiative which began in the UK in January and is now attracting widespread support from the medical community there. Dr Parry is a staunch supporter and would like to see it gain traction here as well. He explains:

“The ‘All Trials’ campaign calls for all clinical trials to be registered on a regulated and enforced website and the methodology and results of the trials to be published on the website so that researchers and journals can be sure of the data and the context of the data. In other words to make medical science transparent. There is a lot of detail to pin down the process and make it enforceable because voluntary and semi-voluntary systems such as www.clinicaltrials.gov just aren't working. So the AllTrials website has a full explanation on their website if you follow the link "why this matters" and then "more information" (http://www.alltrials.net/all-trials/ ).”

Parry believes that the problem of pharmaceutical company influence on clinical data is pervasive and long standing.

“The problem has been bad for a long time. It has been getting a little better in recent years, but only a full overhaul of the system – in other words the "AllTrials" process – can truly rectify things. I am mainly aware of my own specialty of psychiatry. In the last 3 or 4 years there has been a shift in awareness within the profession. Previously there was a collective view that the few "radicals" who were complaining about the overly cosy relationship with Pharma had a point but were exaggerating. However now I think the collective view accepts that the outspoken members of our profession have had a valid and vital point – our whole "evidence-base" for our clinical, research and teaching practice has been compromised. To what extent compromised is hard to say – and that is precisely because of the lack of transparency with the data. Some research and guidelines could be based on fully accurate scientific data – but we cannot be sure what is and what is not. “

To an outsider this situation seems incredible and deeply shocking. It must have developed incrementally, but one wonders how it has been allowed to get to such a point?

“That is a good question”, says Parry. “Personally I haven't researched the literature on the sociology of medicine-pharma relationship to be able to give a detailed answer. However my gut feeling and discussions with colleagues over the years is that doctors may be clever guys and gals but we are realizing we are not marketing savvy. Even in a specialty like psychiatry, where you'd think we should be wise to the possibility of subconscious influence and the power of persuasion, there must have been a lot of naivety and also not enough guarding against having one's narcissism stroked in the past. Looking back, the level of advertising at conferences, the suave persuasiveness of the drug rep visits, using all the sophisticated psychology of marketing, seems outrageous – but surveys of doctors repeatedly showed that we thought we were above being persuaded and could remain rational, totally independent agents. In which case why did we even bother accepting all the marketing? Well, money has a lot to do with it.

But the overt marketing has been shown to be the lesser problem. The greater problem lies with what doctors always thought was the real science – the peer-reviewed articles published in the journals. It is interesting that Pharma have taken the increased restrictions on overt marketing with relative equanimity, but seem to have drawn a line in the sand over handing over the raw scientific data that the articles in medical journals are supposedly based upon.”

There now seems to be an impetus towards demanding change. All Trials has gained huge support in the UK. But given how pervasive the pharmaceutical companies influence has been on the medical edifice, one wonders what has prompted the more recent demands for transparency?

“I think the evidence simply became overwhelming that the academic medical literature has been severely compromised”, explains Parry. “Authors on articles in journals may not have had access to the raw data themselves, many it now seems were recruited late in the study and articles were "ghost-written" by undisclosed authors within or working for the pharmaceutical company. Authors usually signed commercial confidentiality agreements that restricted their rights to publish the data. I know a professor of psychiatry who was involved in half a dozen trials of an antipsychotic medication in a developing nation. He told me four of those trials were negative and the results never published, only the positive findings from the remaining two were published. He was appalled but legally could do nothing because of the confidentiality agreement he had signed. Behind the scenes these things got talked about and outrage gradually grew, too slowly to be sure, but thankfully it has reached a critical mass now.”

Parry suggests the independent Cochrane Collaboration has played a big part in the push for change, but even they have found investigating the thousands of articles that may be compromised a bit like “sifting through mud”. The literature is simply too “opaque”.

“The momentum has come from the UK, probably because of the Cochrane Collaboration's base there”, he says. “But also because of the strong stance taken by the British Medical Journal. The previous chief-editor of the BMJ, Richard Smith, after he finished his 25 years as editor wrote an article in the high-ranking PLoS Medicine journal titled "Medical Journals are an Extension of the Marketing Arm of Pharmaceutical Companies" (5). And the current chief-editor of the BMJ, Fiona Godlee, said to a British parliamentary committee in 2013 that ‘drug companies should not be allowed to evaluate their own products’. This leadership, coupled with the energy and drive of British medical epidemiologist, Ben Goldacre (6) seems to have super-charged the drive for change within the UK. The All Trials campaign  started in the UK in January 2013 and quickly got most of the British medical specialty colleges and other prominent medical academic organisations signed up as supporters. The question now is will the rest of the world follow? I am glad to see that the College I belong to, the RANZCP, is now looking at the AllTrials proposal. Hopefully we’ll soon follow the British RCPsych and sign on for this game changing reform of the academic medical base.”

Parry agrees with Goldacre’s view that if transparency can be achieved it will effectively rewrite the book on everything believed to be true in modern medicine.

“He is right”, he asserts.  “As I understand it, the AllTrials process would bring to light data and methodology from clinical trials going back years, as well as clean up the mess to provide an Evidence Based Medicine future rather than a Marketing Based Medicine one. As data comes to light about past clinical trials, then this may well shed light on current guidelines and clinical practices that need revising. Thus the implications are huge. AllTrials hopefully will mean we have a world of EBM and cost-effective medicine. There will be some red-faces, there is almost certainly a lot of fraudulent behaviour that may result in legal scrutiny. Many journal articles may need to be corrected or withdrawn and republished.”

He cites the example of an infamous article published on the drug Paroxetine in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP). The article was sponsored by Paroxetine's manufacturer SmithKlineBeecham, now known as GlaxoSmithKline (GSK) and is also known as "Study 329".  “The data and methodology of the clinical trial was released in a court case and shows that the published article markedly overstated the benefits of Paroxetine (strictly speaking it didn't differentiate from placebo) but was published as being "generally well tolerated and effective for depression in adolescents". The sales pitch in the company advertising went further stating Paroxetine ‘delivers remarkable efficacy and safety in adolescent depression’. Worse still, the article suppressed data on suicidal agitation and other "serious adverse events" of the adolescents on Paroxetine………….Enough is enough, things have to change. Thank goodness for AllTrials and I hope it works. In my opinion any health professional not supporting it needs to think again.”

Despite the importance of All Trials, Parry has been disappointed by the response in Australia to date.

“Almost none of the colleagues I've spoken to know about it, including across other specialties and general practice. I asked friends at a recent medical school reunion and they hadn't heard about AllTrials. However the Australian Medical Students Association signed up months ago, and good on them. Clearly they have an eye to the future! I'm hopeful though that the specialty colleges and the RACGP and our academic institutions such as the NH&MRC will follow their British counterparts soon.”

Every day people use pharmaceutical products in good faith, believing they are safe and effective. Medical professionals in turn condone products based upon what they believe to be Evidence Based Medicine, published in medical journals. This also has a direct bearing upon government health policies.

But if this turns out to be little more than the work of pharmaceutical PR professionals, consumers, medical professionals and policy makers are effectively playing a vast game of Russian Roulette. The Vioxx debacle, which saw a major pharmaceutical company withhold information from doctors and consumers for up to five years, and resulted in tens of thousands of deaths, is an extreme example of what can happen if we don’t get this right. But it may also be that billions of dollars are being wasted on products that don’t work as well as doctors and patients have been told they do; or symptoms may be worsened by some; or whole new medical problems may be being created by others. Right now we just don’t know.

It may be that we will have to rewrite a great deal of what we think we know about medicine. And if that is the case, we need to start right away. No one wants to look back and say “We should have acted sooner!”


Dr Parry was interviewed via email on 14/11/2013.

(1) Thomas, Katie (2013). Breaking the seal on drug research. New York Times. Here: http://www.nytimes.com/2013/06/30/business/breaking-the-seal-on-drug-research.html?ref=todayspaper&pagewanted=all&_r=1&

(2) Doctorow, Cory (2012). Why all pharmaceutical research should be made open access. The Guardian. Here: http://www.theguardian.com/technology/2012/nov/20/pharmaceutical-research-open-access

 (3) Horton, Richard. (2002) Just how tainted has medicine become? The Lancet, Volume 359, Issue 9313, Here:http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2802%2908198-9/fulltext

(4) Horton Richard (2004) The dawn of McScience. New York Review of Books. Here: http://www.nybooks.com/articles/archives/2004/mar/11/the-dawn-of-mcscience/

(5) Smith, Richard (2005). Medical Journals Are an Extension of the Marketing Arm of Pharmaceutical Companies. PLOS Medicine. Here:  http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0020138


(6) Ben Goldacre. Here: http://www.badscience.net/about-dr-ben-goldacre/




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