Medical Association to challange Pharma

Introduction: While nearly all those working in health care in a professional way are aware of the inroads made by corporations to serve their financial interest, only a few go public and are counted as critics. I am writing you because I am involved in the struggle to put patients first (see http://healthfully.org/rg--more on that below). I have an idea how to make a difference and want to share that idea with you. You are in a better position to challenge bad pharma. I have an idea of how to limit pharma’s ability to cause harm. Please take the time and consider what I purpose.

Organize: Doctors need an organization to challenge pharma’s influence upon the information, education, regulations, and the guideline systems; viz., to end the ways in which pharma frames our understanding of conditions and treatments. Since the 50s the AMA has become a lap-dog of pharma: it receives most of its funding from pharma. Not surprisingly only 15% of doctors belong to the AMA—and its dues is just $420.[1] While the BMA has a louder bark, and thus greater percentage of member (over 70%), it too is pharma friendly. Physicians (and the public) need a voice that challenges pharma. We need a Medical Science Association (MSA), a physicians’ association committed to pure medical science. Where the AMA and BMA fail, the MSA would act: act to write guidelines, to write medical textbooks, to publish medical journals and books, to expose the tobaccos science of bad pharma, to give continuing medical education classes (CME), and to lobby for changes. Taking into account that positive bias is the norm[2] for all published pharma funded trials, the MSA’s guidelines would require strong evidence when deviating from the standard practices during the golden (scientific) era of medicine.[3] MSA would lobby for a firewall between pharma funding and research. As a patients’ advocate, a broad-base movement would develop to repair the evidence base. MSA would support AllTrials and more. As part of its efforts it would lobby like AllTrials for the opening up of the data banks of the various national health services. Computer programs for comparative effectiveness research (CER) would tease out of their large data banks treatment evaluations from real-world patients (see Scientific American July 2011). Unlike WorstPill.org and Cochrane Collaboration, MSA isn’t trying to reach the largest audience of doctors; thus MSA would expose the widely accepted distortions generated by pharma. MSA would gather information on pharma’s KOLs (key opinion leaders) and make public this information. MSA would encourage members to take a pledge to be pharma free (like No Free Lunch). MSA would provide an office plaque for pharma-free members, and provide the public brochures and documentaries about the medical-industrial complex. This information would permit the public as a consumer to seek out members of MSA. Beside guidelines MSA would fund scientists to write position papers for the general public on the best treatments. We are all in it together: tobacco science is bad for everyone.

In the future: Once the data banks are opened for CER analysis, the way we practice medicine would change. MSA would issue guidelines, and thus provide a legal defense for deviating from the current dodgy guidelines. MSA would negotiate for improved working conditions and to limit the computerization of treatments by corporate hospitals and clinics. MSA as an organization could pressure legislatures to pass real fixes.[4] Only through an organization with extensive support by physicians and the public would there be sufficient pressure applied to the legislatures for it to pass effective reforms and inforce them.

Publishing house for medical science. There is a current need for a publisher of medical science. Too many worthy books go unpublished or are self-published. This year I bought 3 self-published books on the topic cardiovascular and the role of cholesterol.[5] Other works languish in foreign languages or obscure journals.[6] One such work is a French book on useless and dangerous drugs, which the Guardian has published a review and interviewed one author (at http://healthfully.org/rep/id7.html) Guide des 4000 Médicaments Utiles Inutiles ou Dangereux au Service des Malades et de Praticiens, Dr. Philippe Even director of the prestigious Necker Institute (other author by Dr. Bernard Debre depute de Paris). Possible you could contact its authors and use your influence to promote an English edition. There is a need for the publication and wide distribution of works that expose pharma’s tobacco science.

Production of documentaries: On YouTube are thousands of documentaries and lectures, many exposing the harm done by corporate medicine—see my page with links. With your wide readership you ought to be involved in the production of quality documentaries. Dr. Lustig’s lecture Sugar the Bitter Truth, (http://www.youtube.com/watch?v=dBnniua6-oM) UCTV has been downloaded 5,730,000 times by June. His documentary The Complete Skinny http://www.youtube.com/watch?v=moQZd1-BC0Y is for a wider audience. Prof. Angell had recorded her President’s lecture at University of Montana based on her book The Truth About Drug Companies http://www.youtube.com/watch?v=ZqKY6Gr6D3Q. Moreover you and associates could make documentaries to be played on LINK, FSTV, BBC, CBC, ABC and other alternatives to corporate stations. Wikileaks, Wikipharma: One last thought, a Wikileaks type website would open the closed doors of bad pharma. Possible someone in your university’s computer science department could set it up.

[1] CMAJ 2011, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3153537/ and http://www.citizen.org/documents/HL_201211.pdf. Their membership went from 278,000 in 2002 to 217,000 in 2011 a decline of 22%.

[2] Positive bias averaged 32% (range 11 to 69%) in a NEJM article, 2008. The study of neuroleptic drugs made a comparison of 74 journal articles to the raw data which was obtained by FOIA (Freedom of Information Act) from the FDA. See http://healthfully.org/index/id9.html, or http://content.nejm.org/cgi/content/short/358/3/252

[3] I have a website which in the last 5 years has taken a long-hard look at a number of treatments that deviate from the golden era, which ended in the 80’s, and found most of current treatments are worse than what came before. These finding I published at http://healthfully.org/rc/. Over and over again basic health science has been rewritten to promote the sales of patented drugs based on dodgy clinical trials. The blockbusters Vioxx & Tamiflu are blueprints for pharma.

[4] A lesson from history: Franklin D. Roosevelt believed the way to prevent a revolution and thus save the corporate system was to put money in the hands of those who are at the bottom of the economic pyramid. He believed in the Keynesian solution, thus a living wage was central in his program for economic recovery. Wages to factory workers had been cut 50%. In 1933 he had a meeting with the union leaders at the White House. In that meeting he told them of his proposed legislation to protect the union members’ right to organize. However he couldn’t pass the legislation without their help. At the end of the meet he said to them, “Make me pass the legislation”. Labor’s efforts through major strikes and mass demonstrations drove home the message that the masses were moving towards overturning the capitalist system. Over 1 million had voted in the 1932 election for socialist candidates. Radical change was needed to defuse the masses, so Congress passed the Wagner Act which protected the right to have union shops & strikes. With sufficient pressure from the public and physician, the legislatures would act to restore science & limit pharma’s power.

[5] The Great Cholesterol Con, 5^th Edition, 2012, by Anthony Colpo. Prof. Uffe Ravnskov, MD, PhD, Ignore the Awkward! How the Cholesterol Myths are Kept Alive, 2010—both are highly recommended. The Statin Damage Crisis, Dr. Duane Graveline.

[6] Peter Gotzsche in Deadly Medicine and Organized Crime, 2013, page 16-17, writes of such a situation where his important clinical trial found only a Danish publisher. Ben Goldacre in Bad Pharma writes of a case where an editor admits in writing that his rejection of a submission was because the drug manufacturer opposed its publication. More common is self-sensor by editors.