Healthy Living

Doctors of Chiropractic advocate a basic formula for continuous good health: regular chiropractic adjustments, proper nutrition, adequate exercise, sufficient rest, quality relationships, a healthy mental attitude, and NO chemical interference.

Medical journals send strong warning to drug manufacturers

The following commentary was published in the September 22, 2001 issue of the St. Thomas Times Journal. Because the complete article is not available online, we have printed it in its entirety here:

The Canadian Press reported earlier this month that the editors of the world's leading medical journals have issued a strong warning to drug companies and researchers that are under contract to them.

Respected journals such as Britain 's Lancet, the New England Journal of Medicine, and the Canadian Medical Association Journal announced that they will no longer publish studies financed by pharmaceutical manufacturers unless those doing the research are given full academic independence by those drug companies.

The tough new policy of the medical journals is aimed at changing a research climate in which drug companies have been known to withhold negative data from study authors, ask academics to allow their names to be used on ghostwritten articles, or require them to sign contracts that would bar them from publishing without the drug companies' approval. Drug companies, to suppress negative findings, have used all of these measures.

The editor of Lancet said most articles submitted to that prestigious medical journal are deliberately slanted in favour of new drug products. Dr. Richard Horton said from London : We're just fed up with dealing with (the drug) industry in this way.

The new policy position of the medical journals is an attempt to wrestle power back from the drug companies, the main funders of new drug research who, in some cases, have become accustomed to calling the shots, according to Dr. Jeffrey Drazen, editor of the New England Journal of Medicine.

The purpose of this is to help the investigators be ... in a better position (to) get better contracts so in the long run ... patients and the physicians at the prescribing line are getting the whole story.

Those who follow such things will no doubt remember the case of Dr. Nancy Olivieri, the Toronto Hospital for Sick Children researcher who was sued by the drug firm Apotex when she revealed one of its drugs she was studying had serious side-effects.

The contract that Dr. Olivieri had signed prohibited her from publishing any data without the company's consent.

Whether she was right or wrong in the science she did, the contract was wrong. Apotex shouldn't have offered it to them (Olivieri and her colleague) and they shouldn't have signed it, said Dr. John Hoey, editor of the Canadian Medical Association Journal.

Articles based on incomplete or manipulated data, according to medical spokespersons, pose a serious public health risk. A couple of years ago, the Lancet published an article on Lotronex, a GlaxoSmithKline drug for sufferers of irritable bowel syndrome. The study was flawed, Dr. Horton said, but that wasn't caught by the journal's peer-reviewers and the favourable findings were published. The drug was later pulled off the market after it was linked to at least five deaths.

The anti-arthritis drug Celebrex, which took the market by storm when it was introduced two years ago, is a classic example of the problem. A study published last year showed Celebrex caused fewer stomach ulcers and other gastric problems than traditional anti-inflammatory drugs like Aspirin. Despite the fact Celebrex is considerably more expensive, sales hit record levels. (A 200mg capsule of Celebrex retails for $1.38 and two capsules per day is not an uncommon dosage!)

It was later discovered that Pharmacia, the manufacturers of Celebrex had given the author of the study comparative data for the first six months of the trial, but had not passed along data gathered after 12 and 18 months. The longer-term data suggested the benefits of Celebrex were modest at best, but the company defended withholding the data saying that so many patients withdrew from the later stages of the study that the numbers might have been skewed. (As one of those currently taking Celebrex, I was not aware, until doing research for this column, of this flawed study. You can bet I'll be asking my doctor about the advisability of my continuing on Celebrex.)

The editors of the medical journals claim, and I would certainly agree with them, that an independent arbitrator, not the manufacturer, should have made the call on the reliability and value of the shortened Celebrex study.

Make no mistake. The pharmaceutical industry is a huge business, spending an estimated $40 billion US each year in the research and development of new drugs. Getting a drug to market is a long and costly process

It is estimated that for every new drug that reaches the shelves in a pharmacy, the pharmaceutical manufacturer will have spent up to $600 million US. With that much money at stake, you can well imagine the pressure to achieve financial success for the product is extremely high.

-- Dawson Winchester , St. Thomas Times Journal