s ‘Marketing Based Medicine’ – how bad is it? | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists

Editorial

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
http://aca.ninemsn.com.au/article/8863098/prescription-drug-warning

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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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‘Marketing Based Medicine’ – how bad is it?

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.

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.

If you bought a new car and there was only a one in twelve chance that it would work properly, how would you feel?
And what if there was a one in three chance that it was downright dangerous?
Faced by these sorts of statistics, most consumers would be furious. And yet according to an article in the ‘Journal of Law, Medicine and Ethics’, entitled ‘Institutional Corruption of Pharmaceuticals and the Myth of Safe and Effective Drugs’ this may well be the state of affairs with pharmaceutical products.. The “…..proportion of new products with clinical advantages seems to have moved from about 1 in 8 down to 1 in 12, while the proportion with serious harms has gone up from 1 in 5 towards 1 in 3 ......"  (1)

Strangely a public outcry seems slow coming.

The problem largely emanates from a long term contamination of the medical evidence base by pharmaceutical marketing concerns, and incestuous relationships between drug companies, regulatory bodies, policy makers and media.
The problem has become so pronounced that it has sparked a revolution in the British medical establishment, and the formation of the ‘All Trials’ initiative.
Starting in January 2013 ‘All Trials’ is attempting to get to the bottom of what products and procedures actually do what they claim, and which do not.
A problem has been that pharmaceutical companies are not required to reveal all of their clinical data, so adverse findings are simply not making it into medical publications.
Another factor is the large percentage of clinical guidelines being written by people with links to drug companies – The Lancet revealed in 2002 that it may be as much as 90% of all guidelines that are now compromised in this manner.
By controlling the terms of reference drug companies have been able to skew the results. (2) 

But worse than this is the revelation that articles in medical journals are being ‘ghost written’ by people with financial links to drug companies, and that this has been largely hidden by non disclosure agreements.
In short massive fraud is involved leading epidemiologist Dr Ben Goldacre, a driving force behind ‘All Trials’, to declare that everything we know about modern medicine may well have to be re written. (3) 

Whilst it is one thing for pharmaceutical marketing to have infiltrated the medical journals that professionals and policy makers rely upon to make informed decisions, the rot goes far deeper.
The Huffington Post alleges that the Centre for Disease Control in America massively inflated flu morbidity figures, by including figures for other similar illnesses, then “….. unabashedly decided to create a mass market for the flu vaccine by enlisting the media into panicking the public.
An obedient and unquestioning media obliged by hyping the numbers, and 10 years later it is obliging still” (4)

And the flu jab itself is certainly not without its critics, most notably Dr Tom Jefferson of the Cochrane Collaboration, a global not-for-profit organisation of 14,000 academics who undertake rigorous assessments of medical procedures and products.
He states that the ‘flu vaccine showed “no effect on specific outcomes: laboratory-proven influenza, pneumonia, or deaths from pneumonia”. In other words, the ‘flu policy, while eminently agreeable, is unsupported by evidence that has been systematically collected, critically evaluated, and properly synthesized”.
The “ ‘trust us, we’re experts’ pose, ……. is only fit for underlings, not intelligent, responsible healthcare workers…..”. (5)

This isn’t America of course, but we are often influenced by their media and policy precedents.
And we have to question to what extent our policy makers and media are being influenced by material that has been contaminated by pharmaceutical marketing concerns.
The situation is bad enough to prompt psychiatrist Dr Peter Parry to proffer the term ‘Marketing Based Medicine’.
He suggests that we no longer have ‘Evidence Based Medicine’ at all, and the only way to repair the damage and restore credibility to pharmaceutical products is the adoption of the ‘All Trials’ initiative, or something like it, which will rigorously pursue independent testing. (6) 

Early in April this year the Cochrane Collaboration finally got the information they wanted from pharmaceutical giant Roche, concerning its product ‘Tamiflu’.
It had taken about five years and proven a frustrating experience.
What it revealed was that the British government had spent about half a billion pounds on a product that did little if anything to remediate the effects of flu.
“Putting the evidence together, it has found that Tamiflu has little or no impact on complications of flu infection, such as pneumonia”.
As Goldacre notes, it “….. is a scandal because the UK government spent £0.5bn stockpiling this drug in the hope that it would help prevent serious side-effects from flu infection. But the bigger scandal is that Roche broke no law by withholding vital information on how well its drug works. In fact, the methods and results of clinical trials on the drugs we use today are still routinely and legally being withheld from doctors, researchers and patients.
It is simple bad luck for Roche that Tamiflu became, arbitrarily, the poster child for the missing-data story”. 

Worse still is the fact that the Cochrane Collaboration believes that Tamiflu may have a number of side effects.
“Since percentages are hard to visualise, we can make those numbers more tangible by taking the figures from the Cochrane review, and applying them.
For example, if a million people take Tamiflu in a pandemic, 45,000 will experience vomiting, 31,000 will experience headache and 11,000 will have psychiatric side-effects.
Remember, though, that those figures all assume we are only giving Tamiflu to a million people: if things kick off, we have stockpiled enough for 80% of the population. That's quite a lot of vomit”. 

Goldacre contends that the whole episode illustrates the failures of regulation and transparency that permeate the pharmaceutical industry.
“This is a pivotal moment in the history of medicine. Trials transparency is finally on the agenda, and this may be our only opportunity to fix it in a decade. We cannot make informed decisions about which treatment is best while information about clinical trials is routinely and legally withheld from doctors, researchers, and patients. Anyone who stands in the way of transparency is exposing patients to avoidable harm. We need regulators, legislators, and professional bodies to demand full transparency. We need clear audit on what information is missing, and who is withholding it.” (7) 

But as an article in the Guardian reveals, “… the pharmaceutical industry has not been idle.
It has "mobilised" an army of patient groups to lobby against plans to force companies to publish secret documents on drugs trials.
Drug companies publish only a fraction of their results and keep much of the information to themselves, but regulators want to ban the practice.
If companies published all of their clinical trials data, independent scientists could re analyse their results and check companies' claims about the safety and efficacy of drugs." (8)
Clearly some pharmaceutical companies are opposed to such scrutiny, and one concern is that even if All Trials gains traction, they may find ways to circumvent it. 

Australian psychiatrist Dr Peter Parry, and Glen Spielmans, an American psychologist, researched over 400 internal pharmaceutical company documents that were released as a result of litigation against the pharmaceutical industry by States and Federal attorneys generals in the USA. 
These court cases resulted in some of the biggest criminal fines in legal history.
The documents revealed a systematic effort to bury or downplay negative data and maximise the positive spin on positive data for the manufacturers’ drugs by the time data entered the medical journals, conferences and other medical education events.
Spielmans and Parry published their research in the ‘Journal of Bioethical Inquiry’ (9) 

Parry agrees that without reliable data it remains very difficult to assess the efficacy and safety of pharmaceutical products. 

“As long as the raw research data can be concealed or spun – then the biggest problem remains.  Hence the need for the "AllTrials" campaign to be successful.  The British medical establishment is firmly behind the campaign. I’m hopeful our Australian and New Zealand psychiatry college, the RANZCP, will sign soon. The last communication I’ve seen on this is that our college is investigating the impact on our college journals. Journals can be vulnerable financially if AllTrials is implemented and less drug company sponsored studies are published because drug companies pay journals well for “reprints” of articles they use as handouts to doctors. I know several colleagues on our college journals' editorial boards and I am confident they would put ethics first.  But it does mean a new business model for some medical journals in the world, especially those that publish lots of drug company sponsored research.” 

“MBM has in my view been widespread and endemic and dreadfully corrupting”, states Parry. “ It has led in my field of psychiatry to an over-focus on medication and diminution of non-drug therapies.  It has led to spending on vastly more expensive on-patent medications which have minimal to no benefits over older off-patent medications.  Even where benefit of a new drug is significant, it is debatable about whether benefit equates with the cost – as the money could've gone to other non-drug interventions that may with older medication have worked better overall.  Academic careers have been built on close liaison with pharmaceutical companies, and other academic psychiatrists whose interest was on other aspects of psychiatry – have often been comparatively side-lined – this skews the whole ethos and discourse within the profession” (6)

Dr Lucija Tomijanovic is a senior post doctoral researcher in vaccine safety at the University of British Columbia.
She has co-authored papers with Professor Chris Shaw arguing that aluminium adjuvants can cause neurological harm in pediatric populations and states that  “…..a more rigorous evaluation of potential vaccine-related adverse health impacts in pediatric populations than what has been provided to date is urgently needed”.
She contends that “in spite of the widespread agreement that vaccines are largely safe and serious adverse complications are extremely rare, a close scrutiny of the scientific literature does not support this view”. (10)
Her work is taken seriously by the French government who heard a submission from her and other scientists in May. As a result the French are seeking the removal of aluminum adjuvants where possible; supporting research into the accumulation of aluminum in the brain, and will not promote any mass vaccination programs using vaccines with aluminum in them (11)
But what continues to underpin her work is the pursuit of compromises to good regulatory practice.
In an investigation of some thirty years of documents pertaining to the British  Department of Health and the Joint Committee on Vaccination and Immunisations, she concluded that the regulatory authorities and medical establishment often routinely under represented safety concerns.
She states that the documents appear to show that “…… the JCVI made continuous efforts to withhold critical data on severe adverse reactions and contraindications to vaccinations to both parents and health practitioners……The transcripts of the JCVI meetings also show that some of the Committee members had extensive ties to pharmaceutical companies and that the JCVI frequently co-operated with vaccine manufacturers on strategies aimed at boosting vaccine uptake.
Some of the meetings at which such controversial items were discussed were not intended to be publicly available, as the transcripts were only released later, through the Freedom of Information Act (FOI). These particular meetings are denoted in the transcripts as “commercial in confidence”, and reveal a clear and disturbing lack of transparency……”

She believes that there is an institutionalized bias towards over stating efficacy and minimizing harm, and this in turn is often uncritically reported by the media. (12)

Dr Peter Doshi is an assistant professor of pharmaceutical health services research at the University of Maryland School of Pharmacy, and associate editor of the BMJ. 
He has become something of a poster boy for the clinical transparency cause.
His background is in anthropology which gives him a skill-set that is extremely useful in this context. Anthropologists are trained to dispassionately observe, record and interpret.  For many medical professionals the idea that the edifice they base their expertise upon may be massively compromised is extremely confronting.
For Doshi it presents an investigative challenge.
Since 2009 he has worked with Dr Tom Jefferson on a Cochrane Collaboration

systematic review of neuraminidase inhibitors for influenza. 
This review has developed innovative methods for evaluating regulatory information including clinical study reports. 

“I think it is now time to start considering the data sharing movement empirically”, he states. “.Many companies have set out policies and are currently offering access to data.  It is time for independent investigators, guideline committees, and public health bodies not accustomed to using previously confidential clinical trial data to do so — and in doing so, report on their experiences so that we can learn what is working and what is not.” (13)

Which leaves us with an industry that has committed what the Cochrane Collaboration describes as a ‘laundry list of crimes’, not least being fraud, hiding drug safety information,  and collusion with regulators, policy makers and media. Since 1991 there have been some 239 legal settlements, totaling $30.2 billion. (5)

So what can consumers and concerned healthcare providers do?

Firstly it’s not all bad news. Dr Parry states: “The Australian College of Emergency Medicine recently signed the ‘AllTrials’ petition.
That is the first specialty college in Australia that I’m aware of to do so ….. the Australian Medical Students Association signed in 2013.” This is good news, particularly in regard to how the next generation of healthcare professionals will approach this issue.

But we need firm and decisive action from our policy makers, and we need it now.
Policy makers, regulators, media and healthcare providers need to be protected and insulated from pharmaceutical marketing.
The current situation where we are unable to definitively say which products work and which either don’t work or may be harmful, is a giant game of Russian Roulette, with the odds firmly stacked against patients.
Pharmaceutical companies that make good, effective products might see an opportunity to have their products independently validated, thus earning greater consumer trust.
As Goldacre states, an opportunity now exists to get this right, and we all need to lobby hard to ensure it happens.
The Cochrane Collaboration advises that we need to ‘immunise’ ourselves by ‘asking questions and questioning answers’. (5)

www.alltrials.net

(1) Light, Donald W and Lexchin, Joel and Darrow, Jonathan J (2013)  Institutional Corruption of Pharmaceuticals and the Myth of Safe and Effective Drugs - Journal of Law, Medicine and Ethics.. Here: http://www.pharmamyths.net/files/JLME-PROOFS__7-10-13.pdf

( 2) 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

(3) 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

(4) Solomon, Lawrence (2014). Don’t believe everything you read about flu deaths. The Huffington Post. Here: http://www.huffingtonpost.ca/lawrence-solomon/death-by-influenza_b_4661442.html

(5)  Cassels, Alan (2012) Eminence vs. evidence. Cochrane Collaboration. Here: http://www.cochrane.org/news/blog/eminence-vs-evidence 

(6) Dr Peter Parry via email (17/05/2014)

(7) Goldacre, Ben (2014).What the Tamiflu saga tells us about drug trials and big pharma. The Guardian.

Here:http://www.theguardian.com/business/2014/apr/10/tamiflu-saga-drug-trials-big-pharma?CMP=fb_gu

(8) Sample, Ian. (2013). Big  pharma mobilizing  patients in battle over drugs trials data. The Guardian. Here:

http://www.theguardian.com/business/2013/jul/21/big-pharma-secret-drugs-trials

(9) Parry, Peter and Spielmans, Glen (2009). From Evidence-based Medicine to Marketing-based Medicine: Evidence from Internal Industry Documents. Journal of Bioethical Inquiry

(10)Tomljenovic, Lucija and Shaw, Christopher (2012). Mechanisms of aluminum adjuvant toxicity and autoimmunity in pediatric populations. Lupus. Here:http://lup.sagepub.com/content/21/2/223

(11) Here: http://sanevax.org/france-debates-vaccinesafety/ 

(12) Tomljenovic, Lucija (2011) The vaccination policy and the Code of Practice of the

Joint Committee on Vaccination and Immunisation (JCVI): are they at odds?

Here: http://nsnbc.me/wp-content/uploads/2013/05/BSEM-2011.pdf 

(13) Dr Peter Doshi via email (20/05/2014)

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