Exposing drug industry funding of UK patient organisations

Drug firms ‘could shape the profiles of patient organisations through heavy investment’ even if they don’t have a say in their content of campaigns or research

Big pharma poured £57m into UK patient charities which could influence NHS drug decision makers, Bath University researchers’ analysis finds, the independent reports Read University of Bath blog.

Key messages

  • From 2012 to 2016 the drug industry donated over £57m (€65m; $73m) to UK patient organisations, with the annual sum more than doubling over the period
  • The funding benefited a small number of organisations and activities related to research and public involvement
  • The industry gave priority to commercially high profile conditions
  • Industry payment disclosures had limited transparency

We’ve been banging the drum about transparency of payment to doctors for years – we’ve even put a moratorium on financial conflicts of interest in the authors of any of our education articles. Not because we think that all doctors who receive money from industry are being influenced to push their agenda – but because we have no way of telling when that’s happening…

At the same time, and rightly, patient groups are becoming more involved in setting things like research priorities, and in guideline development – and we’re campaigning to increase that involvement. but as that involvement increases, it’s also important to make sure that potential industry influence is made transparent.

Piotr Ozieranski, is an assistant professor at the Department of Social and Policy Sciences at the University of Bath and one of the authors of a new analysis which attempts to build a picture of industry funding of UK patient groups.

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Reforming disease definitions : a new primary care led, people-centred approach

Drug Companies Shouldn’t Help Decide Who Is Sick, 2019

Abstract

Expanding disease definitions are causing more and more previously healthy people to be labelled as diseased, contributing to the problem of overdiagnosis and related overtreatment. Often the specialist guideline panels which expand definitions have close ties to industry and do not investigate the harms of defining more people as sick. Responding to growing calls to address these problems, an international group of leading researchers and clinicians is proposing a new way to set diagnostic thresholds and mark the boundaries of condition definitions, to try to tackle a key driver of overdiagnosis and overtreatment. The group proposes new evidence-informed principles, with new process and new people constituting new multi-disciplinary panels, free from financial conflicts of interest. Image wikimedia.

Conclusion

Developing a framework for this long-term reform and facilitating a global collaboration to enact it will involve proactive and reactive efforts that we hope will drive a cultural shift and a practical change in how diseases are defined. Research teams will continue to quantify estimates of overdiagnosis arising from current disease definitions, informing priorities for action. Actions include the constitution of new panels, with new processes and new people, to review and revise existing definitions. Concurrently, primary care organisations will become more reactive to expansions in definitions seen as increasing the risk of overdiagnosis, such as the controversial 2017 hypertension widening, explicitly rejected by the American Academy of Family Physicians, and other groups, and the rejection of the expanded definition of gestational diabetes by the Royal Australian College of General Practitioners. An international meeting to review progress on our proposal and develop more detailed strategies for change will take place at the December 2019 Preventing Overdiagnosis conference in Sydney

There are important limitations, uncertainties and caveats to note as we propose this ambitious reform of disease definitions, which will provoke opposition from those whose markets are directly threatened.

  1. First, we write as a group working across a multitude of influential national and international organisations, but we do not in this instance represent them.
  2. Second, our backgrounds and thinking are largely medical, and there is clearly opportunity for this initiative to be informed by evidence, experience and theories outside medicine, including, for example, from philosophy.
  3. Third, addressing the problem of expanding disease definitions is but one of many potential solutions to overdiagnosis, and much important work is underway already to try and wind back the harms of too much medicine, safely and fairly, such as calls to action within our associations, creation of new medical curricula, scientific discussion at national and international meetings and new information materials for the public.
  4. Fourth, given the novel nature of this proposal, there is not yet a mature evidence-base to support it.
  5. Fifth, there is clear synergy between this proposal and the calls for reform of clinical practice guidelines, which has not been explored in this analysis.
  6. And finally, we acknowledge moves to expand definitions, to detect and treat people earlier, are often driven by the best of intentions, and we see great merit in identifying those who will benefit from a medical label and subsequent care.

However, notwithstanding the good intentions driving a bad system, the human person can no longer be treated as an ever-expanding marketplace of diseases, benefiting professional and commercial interests while bringing great harm to those unnecessarily diagnosed.

Angell on Big Pharma

Some more truth about the pharmaceutical companies

Do pharmaceutical companies corrupt academic research and the clinical trial process ? You bet.

Dr Marcia Angell of Harvard Medical School and the author of The Truth About the Drug Companies talks with EconTalk host Russ Roberts about the impact of pharmaceutical companies on academic research, clinical trials and the political process. Angell argues that the large pharmaceutical companies produce little or no innovation and use their political power to exploit consumers and taxpayers. Reference.

Les laboratoires pharmaceutiques font-ils la course au profit, au mépris de la santé des citoyens ?

Les labos sont-ils aux mains de “Big Pharma” ?

Questions à Boris Hauray, chargé de recherche Inserm à l’Institut de recherche interdisciplinaire sur les enjeux sociaux, juin 2019.

  • Les laboratoires sont-ils aux mains du Big Pharma ?
  • Est-ce qu’il existe une entente secrète entre les laboratoires ?
  • D’où vient cette idée de la toute-puissance de cette industrie ?
  • Entre professionnels de santé et industrie, y a-t-il forcément conflits d’intérêts ?
  • Le monde médical est-il plus transparent aujourd’hui ?
  • L’industrie cache-t-elle des remèdes pour vendre de nouveaux traitements ?
  • Cette industrie fait-elle du lobbying contre les médecins douces ?

Référence : questions au cœur des Idées Claires, programme hebdomadaire produit par France Culture et Franceinfo destiné à lutter contre les désordres de l’information, des fake news aux idées reçues.

Carey Gillam on Monsanto Lawsuit

The legal picture and the bigger picture, MARCH 29, 2019

How much power will we grant profit-driven corporations to determine not just what we’re exposed to, but what we’re permitted to know about it ?

Carey Gillam, longtime journalist, is currently research director at the group US Right to Know, and author of the book Whitewash: The Story of a Weedkiller, Cancer and the Corruption of Science.

Reference.

Un monde sans pesticides

Quelles alternatives pour une agriculture sans pesticides ?

  • France Culture, De cause à effets, le magazine de l’environnement par Aurélie Luneau.
  • Avec François Veillerette, Ecologiste miltant, Marie-Hélène Jeuffroy, Directrice de Recherches à l’INRA et Jean-Bernard Lozier, Agriculteur.

Références : LeMonde et iTunes, 27/01/2019.

La puissance déroutante de l’effet nocebo

Des troubles imaginaires ? Absolument pas !

À l’inverse de l’effet placebo qui soulage, l’effet nocebo provoque des symptômes désagréables. Cet effet est lié à l’image du médicament : présenté négativement ou redouté par le patient, son efficacité sera altérée et ses effets indésirables augmentés.

Référence, Mardi 15 janvier 2019par Dominique Dupagne, SANTÉ POLÉMIQUE. iTunes.

Ces lobbies qui influencent et manipulent notre vie quotidienne

Stéphane Horel, décortique les stratégies perverses des lobbies qui mettent en péril notre démocratie

Qu’il s’agisse de notre santé ou d’alimentation, les lobbies maintiennent parfois sur le marché des produits nocifs pour nous et profitable pour leur porte-monnaie.

Stéphane Horel publie une enquête dont le titre fait froid dans le dos : “Lobbytomie” aux éditions La Découverte. Au fil de 400 pages, elle décrit comment les lobbys sont devenus des acteurs incontournables de la vie démocratique en dépit d’une quelconque légitimité électorale.

Can environmental health research help communities impacted by fracking ?

Fracking and Health: Ask an Expert, with Dr. Gregory Howard, 2018

Dr. Gregory Howard, environmental public health scientist and consultant, describes various types of health studies, focusing on what a community should consider before beginning a study.

Dr. Gregory Howard explains how study design is influenced by the goals and needs of the community and the decision makers they are trying to reach, and discusses challenges of doing such research.

  • Oil & Gas Program, Fracking and Health: Ask an Expert Podcasts.

Can noise from fracking operations affect your health ?

Fracking and Health: Ask an Expert, with Dr. Michael McCawley, 2018

Dr. Michael McCawley is Clinical Associate Professor at West Virginia University.

Dr. Michael McCawley discusses the adverse health effects associated with stress from environmental noise exposure and how factors contributing to noise levels might not be effectively addressed through mitigation measures or setbacks.

Abstract

Modern oil and gas development frequently occurs in close proximity to human populations and increased levels of ambient noise have been documented throughout some phases of development. Numerous studies have evaluated air and water quality degradation and human exposure pathways, but few have evaluated potential health risks and impacts from environmental noise exposure. We reviewed the scientific literature on environmental noise exposure to determine the potential concerns, if any, that noise from oil and gas development activities present to public health. Data on noise levels associated with oil and gas development are limited, but measurements can be evaluated amidst the large body of epidemiology assessing the non-auditory effects of environmental noise exposure and established public health guidelines for community noise. There are a large number of noise dependent and subjective factors that make the determination of a dose response relationship between noise and health outcomes difficult. However, the literature indicates that oil and gas activities produce noise at levels that may increase the risk of adverse health outcomes, including annoyance, sleep disturbance, and cardiovascular disease. More studies that investigate the relationships between noise exposure and human health risks from unconventional oil and gas development are warranted. Finally, policies and mitigation techniques that limit human exposure to noise from oil and gas operations should be considered to reduce health risks.