Duped into drug use

Patients are being deceived into taking drugs they do not need, that do not work and even put lives at risk, according to a scathing review of the influence big drug companies have on healthcare.

Drug companies ''masterfully influenced'' medicine, a review by Australian, British and US researchers has found.

The researchers described how the enormous profit involved in making and selling drugs gave the industry power to influence every stage of the health system.

''The benefits of drugs and other products are often exaggerated and their potential harms are downplayed,'' the research, published in the European Journal of Clinical Investigation, said.

A co-author of the paper, Emmanuel Stamatakis, of the University of Sydney's school of public health, said it was ''entirely illogical'' to rely on the pharmaceutical industry to fund medical research.

''The profits involved are just too large and the temptation to manipulate the evidence is difficult to resist, even when this may lead to the loss of lives,'' Dr Stamatakis said.

He cited anti-diabetic drugs, which he said increased the risk of heart problems and were prescribed despite interventions such as exercise being more effective.

One such drug, Rosiglitazone, is still prescribed in Australia despite being pulled from the European and New Zealand markets after thousands of lawsuits were filed against manufacturer GlaxoSmithKline. The company was accused of deliberately withholding evidence that the drug caused heart attacks.

Drug companies funded, designed and controlled a large portion of the most influential medical studies, researchers found after evaluating 600 clinical trials.

Trials funded by industry were four times more likely than those sponsored by not-for-profits to favour the sponsored drug.

Researchers also traced the influence of the drug companies to direct contact with doctors through their representatives, persuading doctors to prescribe drugs using flawed evidence of their effectiveness.

Doctors were showered with free trips to international drug conferences, fancy dinners, research grants and drug company shares. ''It is hardly surprising that clinical practice guidelines often are heavily focused on new costly interventions and only loosely follow the available evidence,'' reseachers wrote.

Medical writer and senior research fellow with Bond University, Ray Moynihan, said Australia was lagging behind other countries, including the US, in reining in unethical behaviour by drug companies. In the US, the Physician Payment Sunshine Act allows anyone to look up which doctors receive industry funding.

''I think transparency is key,'' Mr Moynihan said. ''The fact that you can go to a doctor and be prescribed a new drug without them telling you they've learnt all about that drug at an industry-funded event or a visit from a drug representative is outrageous.''

Brendan Shaw, chief executive of drug industry group Medicines Australia, said the industry made the medicines and vaccines people relied on.

''Industry engagement across the health sector is vital to patient outcomes and should be encouraged,'' Dr Shaw said. ''Absolutely this needs to be co-ordinated in an ethical and transparent way and the industry has a long track record of doing this.''

So why do Australian doctors accept drug company money?

''Prestige can be just as important as money,'' said Ken Harvey, who is part of the Medicines Australia Transparency Working Group.

''The pharmaceutical largesse takes Australian doctors all over the world on business-class airfares and puts them in five-star hotels,'' Dr Harvey said. ''That can be good in terms of engaging with peers but doctors should pay for that themselves. ''It becomes [a] seductive, symbiotic relationship.''

In June, the group will release its final recommendations on measures to improve transparency of payments between healthcare professionals and the drug industry.

Sources :

http://www.smh.com.au/national/health/duped-into-drug-use-20130406-2hdn4.html
  
Undue industry influences that distort healthcare research, strategy, expenditure and practice: a review