“The measures reflect a growing body of research about discrepancies between journal articles and the full results of the studies behind them. Journal editors are also responding to the escalating debate in Washington on ensuring drug side effects are properly disclosed. In the wake of the withdrawal of Merck & Co.’s painkiller Vioxx over cardiovascular side effects, some legislators are calling for tougher safety scrutiny of drugs on the market.
The JAMA study last year said articles often cherry-picked strong results to report, even if those results were in a different area than the study was designed to test. Typically scientists set up clinical trials to answer one or two primary questions — for example, whether a drug reduces the risk of a heart attack and stroke. These are called the primary outcomes. The JAMA study found that 62% of trials had at least one primary outcome that was changed, added or omitted.”
(Source: the Wall Street Journal )
UPDATE 3/25/07: We have removed our spoof image of JAMA’s cover because some of our readers have alerted us that, upon closer inspection, the thumbnail of the JAMA issue, which depicts a cartoon examination scene, contains nudity. This was a complete, unintentional oops on our part! No offense was intended. (Though we have to wonder…why on earth is JAMA putting these sorts of depictions in their cover art in the first place?)
It’s no surprise anymore that the major medical journals are plastered with pharmaceutical advertisements – after all, when was the last time you visited a doctor’s office that wasn’t drowning in pharmaceutical marketing widgets? Nor is it a surprise that the very studies in medical journals (not the advertisements) are deceptively skewed in Big Pharma’s favor about two-thirds of the time.
I would think physicians and researchers would be appalled by the replete corruption. But when your own federal government spends more time telling you that vitamins are deadly – because a handful of terminally ill patients weren’t able to stave off inevitable death with a dose of knowingly worthless synthetic E – than it does being concerned about 60,000+ deaths  from one drug alone, is it any wonder? That’s a lot of people – that’s more than many entire cities!
For decent people, it’s just a natural inclination to trust authorities claiming to be both knowledgeable and ethical. After all, that’s what we’re paying them for. The problem is, the pharmaceutical companies are paying them more – to the tune of 19 billion dollars . I have no doubt that many people working in the pharmaceutical industry are there with the best of intentions. I am not against drugs necessary to improve and save lives, of which there are many successes.
But I do have a problem with an overly-lenient and largely voluntary drug approval process  that is a mockery of ethical standards. Because we trust journals and doctors so implicitly, we forget that, like any business, pharmaceuticals are in it for the money. It’s just business. Sometimes, the business creates good; but increasingly, it doesn’t, and the guardians of public health – the FDA, peer-reviewed journals, physicians – are, at best, manipulated, and at worst, corrupt.
Can you imagine if 60,000 people died from, say, anything but a federally-approved pharmaceutical? Say, echinacea. Grape juice. Ketchup. Anything – imagine the outcry.
I wish this were a conspiracy theory. I wish this were a minor problem. I wish people could say, “There goes Sisson with his indignant ranting again.”
But the facts are clear:
– Pharmaceutical studies are deceptive at least 62% of the time ,
– The FDA, through a combination of voluntary adherence protocols and a poorly-designed approval process  that rushes drugs through and fails to adequately follow up, inherently supports unnecessary deaths,
– Major journals such as JAMA can’t claim to be independent – come on! – when their advertisers are, by and large, pharmaceutical companies,
– Result: hundreds of thousands of people are sickened or killed by drugs  every year.
Can you imagine if these shenanigans went on in any other industry?
It’s like that humorous response  Jack Welch gave to Bill Gates for claiming computers were more reliable than cars (an urban legend, by the way, but still entertaining).
Let’s call a spade a spade.
Is it really so “outrageous” to have a problem with drug advertisements in medical journals?
Is it that “paranoid” to demand a more rigorous FDA approval process?
Is it “off-the-wall” to be bothered by the fact that I have to wade through an avalanche of pens, post-it pads and coffee mugs from GlaxoSmithKline every time I go to the doctor? If that makes me “radical”…
We live in an advertising age – everything is brought to you by something else, and sports stadiums are named after office equipment. I can’t catch a game without being reminded to go stock up on ink cartridge refills. So it’s no surprise, I guess, that this extends to drugs. If pharmaceuticals are saving hundreds of thousands of lives annually, but at a cost of thousands of lives, let’s at least be honest about the costs in terms of human lives. Who is rational and who is emotional here? The folks questioning the disparity between the marketing and the facts, or the economically-motivated (read: fearful) folks deriding anyone who criticizes them as “radical”?