6 ms·

Drugmakers undermine medical journals and skew medical research

68 points by gruseom 15y ago

michaelpinto 15y ago
There's been a great deal of talk about the need for open medical journals — it's s small movement but I hope it really takes off. Not only would you be able to get much more info, but it could be free — which can open that info up to wider and even non-professional audience.
- marciovm123 15y ago
  This is something I'm actively working on. There's a lot of entrenched interests blocking this kind of innovation, but several disruptive forces at work (like massive iPad adoption amongst physicians) are enabling interesting approaches.
  - michaelpinto 15y ago
    I think if there was grant money or funding it would help things a great deal.
TheBiv 15y ago
Remember, this is mainly pushed by those living by the profit in the public markets and not by individual scientists. I don't believe that this group needs this caveat, but having worked in two research labs, I know that some people do have the belief that it is "liberal scientists" deliberately misleading the public.
- fleitz 15y ago
  Accidental misleading is somehow better? There's a lot of funding from the public trough and a lot of funding from the private trough, to say that one corrupts less is to misunderstand economics. The private companies have pens, trinkets and buffets, the public companies have the school system, the army, the justice system, FDA, IRS, CIA, FBI, DEA, ATF and the police. If I wanted to mislead and force my will upon doctors I'd certainly take the latter over the former.
  - gruseom 15y ago
    The private companies have pens, trinkets and buffets They have far more than that, which is the whole point of the article.
    - anamax 15y ago
      > They have far more than that, which is the whole point of the article. Anyone who thinks that money is the only, or even most influential, source of corruption doesn't know much about people. People will commit the most horrendous atrocities in the name of "doing good", and that's not the only thing that is far more effective than money.
      - rhizome 15y ago
        Nobody is saying that money is the only or most-influential source of corruption.
        anamax 15y ago
        They're saying that things will get better if money's role is reduced. That necessarily increases the relative influence of other things. In particular, they're arguing for public money. How many of you look at most govt officials and say "I want that person running my life."?
        rhizome 15y ago
        Right. Reducing the influence of one (of many) component will reduce the whole thing. It's not a zero-sum game where influence incontrovertibly remains constant with the various factors increasing in response to others' decrease. Influencers will try to maintain a given level of benefit for their efforts, of course, but that doesn't mean that reducing money's role won't have an overall effect at all. This is what you seem to be arguing.
      - leot 15y ago
        This can be compared to the basic distinction between precision and bias. While noisy and variegated individual biases pitted against each other in good-faith debate can have low "precision", the more pernicious problem is bias, which is what emerges where there is a consistent organizing influence pushing people in a particular direction. Indeed, it's amazing that the same people who tout most strongly the power of the invisible hand immediately believe that there are other things "far more effective" when the hand's unchecked subtle and consistent influence has negative consequences. Lastly, the stories of horrendous atrocities caused by misguided-do-gooders are the exceptions that prove the rule -- throughout history, truly horrendous has been the cascade of constant repeated atrocities big and small perpetrated worldwide by people acting in their own (perhaps shortsighted) self-interest at others' expense.
- WalterBright 15y ago
  The Lysenko affair in the old Soviet Union shows that scientific fallacies can be strongly promoted for reasons unrelated to profit.
crag 15y ago
This is nothing new. The same has been going on in drug trials for years. The trials are paid for by the company making the drug. With FDA and (sometimes) NIH oversight of course. But the FDA is terribly under funded. And the NIH is already a tool for the pharm industry. And if a company's drug gets into trouble, a few calls to a few of our elected officials takes care of the little fact right quick. We only hear about it when people die. Remember Vioxx?
- ramanujan 15y ago
  The FDA is not underfunded. Its budget has more than doubled from 2006 to 2011: http://articles.latimes.com/2010/feb/11/nation/la-na-fda-budget11-2010feb11 http://articles.latimes.com/2010/feb/11/nation/la-na-fda-bud... When a business fails, its budget is cut as customers leave it in droves for other businesses. But when the FDA fails, the idea is to throw more money at it, to increase the budget of a failure. The problem is that the FDA is a monopoly. When it fails, which happens routinely, people should be able to look to alternate reviewers -- like the European or Japanese regulatory bodies. That doesn't happen right now.
  - ori_b 15y ago
    What alternative do you propose to prevent drug companies from marketing unsafe or ineffective drugs? Yes, things could be improved, but taking apart the FDA isn't, IMO, a solution.
  - archgoon 15y ago
    >The FDA is not underfunded. Its budget has more than doubled from 2006 to 2011: How much does it need to do its job? Has the amount of work stayed constant between 2006-2011? Was it properly funded in 2006?
    - fleitz 15y ago
      It needs zero because the market will provide these services. Or if it doesn't it would be clear that consumers didn't want these services.
ssdsa 15y ago
Are there any other non-native speakers who thought of drug lords when reading the headline?
za 15y ago
"The vast majority of drugs - more than 90 per cent - only work in 30 or 50 per cent of the people," Dr Roses said. "I wouldn't say that most drugs don't work. I would say that most drugs work in 30 to 50 per cent of people. Drugs out there on the market work, but they don't work in everybody." -- Allen Roses, worldwide vice-president of genetics at GlaxoSmithKline 2003 http://www.independent.co.uk/news/science/glaxo-chief-our-drugs-do-not-work-on-most-patients-575942.html http://www.independent.co.uk/news/science/glaxo-chief-our-dr...
- gruseom 15y ago
  That's misleading. Many of the most profitable pharmaceuticals (e.g. SSRIs, as Irving Kirsch devastatingly established - see http://news.ycombinator.com/item?id=2622912 http://news.ycombinator.com/item?id=2622912) are known not to work anywhere near that well, if "work" means significance beyond placebo. There is even powerful evidence against the claim that they work at all.
billswift 15y ago
Derek Lowe provides an excellent commentary on the article, both what it gets right and what it gets wrong. http://pipeline.corante.com/archives/2011/06/07/even_worse_than_reality.php http://pipeline.corante.com/archives/2011/06/07/even_worse_t...

68 points by gruseom 15y ago

There's been a great deal of talk about the need for open medical journals — it's s small movement but I hope it really takes off. Not only would you be able to get much more info, but it could be free — which can open that info up to wider and even non-professional audience.

marciovm123 15y ago
This is something I'm actively working on. There's a lot of entrenched interests blocking this kind of innovation, but several disruptive forces at work (like massive iPad adoption amongst physicians) are enabling interesting approaches.
- michaelpinto 15y ago
  I think if there was grant money or funding it would help things a great deal.

TheBiv 15y ago

Remember, this is mainly pushed by those living by the profit in the public markets and not by individual scientists. I don't believe that this group needs this caveat, but having worked in two research labs, I know that some people do have the belief that it is "liberal scientists" deliberately misleading the public.

fleitz 15y ago
Accidental misleading is somehow better? There's a lot of funding from the public trough and a lot of funding from the private trough, to say that one corrupts less is to misunderstand economics. The private companies have pens, trinkets and buffets, the public companies have the school system, the army, the justice system, FDA, IRS, CIA, FBI, DEA, ATF and the police. If I wanted to mislead and force my will upon doctors I'd certainly take the latter over the former.
- gruseom 15y ago
  The private companies have pens, trinkets and buffets They have far more than that, which is the whole point of the article.
  - anamax 15y ago
    > They have far more than that, which is the whole point of the article. Anyone who thinks that money is the only, or even most influential, source of corruption doesn't know much about people. People will commit the most horrendous atrocities in the name of "doing good", and that's not the only thing that is far more effective than money.
    - rhizome 15y ago
      Nobody is saying that money is the only or most-influential source of corruption.
      - anamax 15y ago
        They're saying that things will get better if money's role is reduced. That necessarily increases the relative influence of other things. In particular, they're arguing for public money. How many of you look at most govt officials and say "I want that person running my life."?
        rhizome 15y ago
        Right. Reducing the influence of one (of many) component will reduce the whole thing. It's not a zero-sum game where influence incontrovertibly remains constant with the various factors increasing in response to others' decrease. Influencers will try to maintain a given level of benefit for their efforts, of course, but that doesn't mean that reducing money's role won't have an overall effect at all. This is what you seem to be arguing.
    - leot 15y ago
      This can be compared to the basic distinction between precision and bias. While noisy and variegated individual biases pitted against each other in good-faith debate can have low "precision", the more pernicious problem is bias, which is what emerges where there is a consistent organizing influence pushing people in a particular direction. Indeed, it's amazing that the same people who tout most strongly the power of the invisible hand immediately believe that there are other things "far more effective" when the hand's unchecked subtle and consistent influence has negative consequences. Lastly, the stories of horrendous atrocities caused by misguided-do-gooders are the exceptions that prove the rule -- throughout history, truly horrendous has been the cascade of constant repeated atrocities big and small perpetrated worldwide by people acting in their own (perhaps shortsighted) self-interest at others' expense.
WalterBright 15y ago
The Lysenko affair in the old Soviet Union shows that scientific fallacies can be strongly promoted for reasons unrelated to profit.

crag 15y ago

This is nothing new. The same has been going on in drug trials for years. The trials are paid for by the company making the drug. With FDA and (sometimes) NIH oversight of course. But the FDA is terribly under funded. And the NIH is already a tool for the pharm industry. And if a company's drug gets into trouble, a few calls to a few of our elected officials takes care of the little fact right quick. We only hear about it when people die. Remember Vioxx?

ramanujan 15y ago
The FDA is not underfunded. Its budget has more than doubled from 2006 to 2011: http://articles.latimes.com/2010/feb/11/nation/la-na-fda-budget11-2010feb11 http://articles.latimes.com/2010/feb/11/nation/la-na-fda-bud... When a business fails, its budget is cut as customers leave it in droves for other businesses. But when the FDA fails, the idea is to throw more money at it, to increase the budget of a failure. The problem is that the FDA is a monopoly. When it fails, which happens routinely, people should be able to look to alternate reviewers -- like the European or Japanese regulatory bodies. That doesn't happen right now.
- ori_b 15y ago
  What alternative do you propose to prevent drug companies from marketing unsafe or ineffective drugs? Yes, things could be improved, but taking apart the FDA isn't, IMO, a solution.
- archgoon 15y ago
  >The FDA is not underfunded. Its budget has more than doubled from 2006 to 2011: How much does it need to do its job? Has the amount of work stayed constant between 2006-2011? Was it properly funded in 2006?
  - fleitz 15y ago
    It needs zero because the market will provide these services. Or if it doesn't it would be clear that consumers didn't want these services.

ssdsa 15y ago

Are there any other non-native speakers who thought of drug lords when reading the headline?

za 15y ago

"The vast majority of drugs - more than 90 per cent - only work in 30 or 50 per cent of the people," Dr Roses said. "I wouldn't say that most drugs don't work. I would say that most drugs work in 30 to 50 per cent of people. Drugs out there on the market work, but they don't work in everybody." -- Allen Roses, worldwide vice-president of genetics at GlaxoSmithKline 2003 http://www.independent.co.uk/news/science/glaxo-chief-our-drugs-do-not-work-on-most-patients-575942.html http://www.independent.co.uk/news/science/glaxo-chief-our-dr...

gruseom 15y ago
That's misleading. Many of the most profitable pharmaceuticals (e.g. SSRIs, as Irving Kirsch devastatingly established - see http://news.ycombinator.com/item?id=2622912 http://news.ycombinator.com/item?id=2622912) are known not to work anywhere near that well, if "work" means significance beyond placebo. There is even powerful evidence against the claim that they work at all.

billswift 15y ago

Derek Lowe provides an excellent commentary on the article, both what it gets right and what it gets wrong. http://pipeline.corante.com/archives/2011/06/07/even_worse_than_reality.php http://pipeline.corante.com/archives/2011/06/07/even_worse_t...