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Healthy Skepticism Library item: 17360

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Broadcast

McLeod S
Vioxx ruling raises questions over drug marketing
ABC Radio: The World Today 2010 Mar 5
http://www.abc.net.au/worldtoday/content/2010/s2837562.htm


Full text:

SHANE MCLEOD: Some believe the structure of the modern pharmaceutical industry means cases like Vioxx are inevitable.

Dr Peter Mansfield is a GP (general practitioner) who founded the group Healthy Skepticism that campaigns for changes to the way drugs are marketed.

He’s also a visiting research fellow at the University of Adelaide.

He joins me on the line now.

SHANE MCLEOD: Dr Mansfield how is it that companies invest millions of dollars in drugs like these and then can end up facing a court case like this?

PETER MANSFIELD: The problem is that the employees of pharmaceutical companies are human beings and when you put human beings together in a group you get group think. And so they end up believing their own spin and believing that their products are better than they really are.

SHANE MCLEOD: So how do you then change the industry? There’s obviously a lot of money to be made in drugs that treat chronic ailments like this and don’t the drug companies have to make money?

PETER MANSFIELD: Yes they do. They’re legally required to make money like any company and that’s fair enough.

How do we change things? There’s a beaut saying from a management consultant: If you put good people in a bad system the system wins. What we need to do is change the system.

At the moment the system rewards drug companies for doing the wrong thing. If they over-promote their drugs then they receive large amounts of money from the taxpayer via the Pharmaceutical Benefits Scheme.

And that’s large because of patent protection to give them big prices to give an incentive for research. So they control research. But Vioxx is an example of pharmaceutical companies not being good at research because of bias.

Taxpayers would be better off to put our money into research via mechanisms such as the NHMRC (National Health and Medical Research Council) rather than paying excessive prices for pharmaceuticals.

SHANE MCLEOD: So what lessons should the industry learn from this example?

PETER MANSFIELD: Well I think the lesson is that they are human like the rest of us and have a problem with bias. And so they’re just not a good group to do research if they’re being paid to do the wrong thing.

You know if they were to learn the lesson then they would be wanting to look at the same sort of reforms for the same reasons so that we can have a viable, profitable industry that’s paid to do the right thing rather than the wrong thing.

SHANE MCLEOD: I understand in this case the lawyers acting for the plaintiff are seeking about $150 million as a settlement. Do you think that is the type of money that would get rid of this as an issue?

PETER MANSFIELD: No because it, although it seems like a huge amount of money to ordinary people like you and me it’s a very small amount of money in the scale of their operations.

And if we’ve got an ongoing system that over time it seems that they’re going to make more money by over-promoting the drugs then that’s what they’re going to keep doing.

You know why should they change their corporate culture just because of one episode? That’s a small amount of money compared to what they actually made for the drug.

SHANE MCLEOD: What about the drug in this case – Vioxx? I mean there were some people who weren’t at such a big risk. Is it a drug that should still be available?

PETER MANSFIELD: Yeah it was taken off the market. And I would prefer that it was back on the market for those people who have a much higher risk of dying from stomach bleeding than from heart attacks.

But that’s a tiny market which the company is just not set up to look for. They wanted to be able to sell it for a much larger market because that’s what they’re rewarded to do. The blockbuster model of a drug that’s used by just about everybody.

SHANE MCLEOD: GP Dr Peter Mansfield thanks for your time.

Dr Mansfield, founded the group Healthy Skepticism. He’s also a visiting research fellow at the University of Adelaide.

 

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Cases of wilful misrepresentation are a rarity in medical advertising. For every advertisement in which nonexistent doctors are called on to testify or deliberately irrelevant references are bunched up in [fine print], you will find a hundred or more whose greatest offenses are unquestioning enthusiasm and the skill to communicate it.

The best defence the physician can muster against this kind of advertising is a healthy skepticism and a willingness, not always apparent in the past, to do his homework. He must cultivate a flair for spotting the logical loophole, the invalid clinical trial, the unreliable or meaningless testimonial, the unneeded improvement and the unlikely claim. Above all, he must develop greater resistance to the lure of the fashionable and the new.
- Pierre R. Garai (advertising executive) 1963