Saturday, 14 February 2009

A breath of fresh air from Big Pharma's GSK

Big Pharma regularly comes in for a lot of critiscism from all sides. At the extreme we have some CAM practitioners and followers, as well as conspiracy theorists and anti-vaccine campaigners accusing them of killing hundreds of thousands with their "allopathic" approach to medicine. More reasonable critics accept that, whilst their drugs play a crucial part in keeping us healthy and alive, they follow dubious business practices, focus too much on "me too" drugs and are less that open with their research. A low point for the industry was surely their attempt to take the South African government to court in 2001 to block their imports of cheap generic HIV drugs.

A lot of this may be about to change following proposals put forward by GlaxoSmithKline's new CEO, Andrew Witty. The Guardian today focussed on reports that GSK is to:

- reduce the cost of drugs to the 50 least developed countries in the world, charging no more than 25% of the price charged in the UK

- plough 20% of it's (vast!) profits back into developing countries to help develop their healthcare services, hospitals etc.

- develop a "patent pool" of IP on processes and chemicals it has patents on, to be made available to NGOs and scientists from other companies in order to support the development of new drugs for a range of diseases.

However, other proposals that reflect a significant change in the ethos of GSK's business practices are likely to attract less attention from the mainstream. These further changes will bring about a new sense of openness from the company, which it is hoped other companies will follow. The first of this is greater transparency in GSK's payments to doctors. This is to be welcomed and will hopefully put a stop to the constant whinging claims from CAM practioners and their supporters that anyone criticising them is in the pay of Big Pharma.

The second of these proposals is a commitment to publishing data and results from all of GSK's research, regardless of whether the outcome is positive or negative. This is something that is likely to please Ben Goldacre, who has been calling for an international register of clinical trials for some time.

Whilst it's clear that these proposals are to be welcomed because they are the right thing to do, it's worth bearing in mind that at least some of these proposals make good business sense for GSK. For example, reducing the cost of drugs in the developing world will allow them to compete more effectively with the cheap generic drugs industry that has grown in China and India.

There are also areas where more work could be done. For example, Witty hasn't said a great deal about how GSK could provide more support in the fight against AIDS. In fact, his "patent pools" idea excludes the development of HIV drugs. This is something that has attracted critiscism from Michelle Childs, Director of Policy at Medecins Sans Frontieres, who stated:

"He is saying there is no need for a patent pool for HIV. Our position is that there is an urgent need for a patent pool for HIV because of the rising prices of new first and second line drugs for patients who develop resistance."

Whilst there is more that could be done, this is certainly a very bold a positive step for Witty and GSK. What remains to be seen is the reaction from the rest of the industry. With any luck they will follow where GSK leads.

ETA: James over at JDC325 discusses what some big pharma companies actually are doing in relation to providing free or cheap AIDS drugs to the developing world here.

Monday, 9 February 2009

Virgos need not apply - Hiring through horoscope

I've checked the date, and we're still a good few weeks away from 1st April. But how else can you explain an Austrian insurance company selecting employees based on their star signs?

The Salzburg insurance company has performed a statistical analysis of its employees' star signs and have determined that those who are Capricorn, Taurus, Aquarius, Aries and Leo are their best workers. They therefore want to make sure that Sales & Management recruits for 20 new roles also have said star signs.

Now, I haven't been able to find any details of this statistical analysis, and if anyone else has come across it I'd love to see it.

Perhaps the most worrying thing about this is that it doesn't seem to be illegal. In fact, the Salzburg employees council have said:

'When an employer considers star signs and says: "I want to only hire Pisces, for an example, it must be assumed that within this group of people born under the sign of Pisces there are old and young people, women and women etc. It does appear like a certain limitation, but it is not discrimination.'

It'll be interesting to see how astrologers react to this. On the one hand I can see them being happy that a mainstream business is buying into the whole astrology idea, but at the same time I doubt they'd be happy at it being used to discriminate.

The mind boggles!

There DEFINITELY is a god, claims number 23 bus

A campaign was launched last year on the Guardian's Comment is Free site, raising funds to place a few adverts on London buses explaining that god doesn't exist. The campaign was launched by Ariane Sherine as an attempt to counter the increasing numbers of religious adverts found on the tube and buses. With an initial plan to raise £5,500 from online donations, the campaign eventually raised over £150,000 allowing a much larger advertising push than anticipated. The campaign first went national and has now gone global.

A lot was said about the wording of the advert, which read:

"There probably is no god. Now stop worrying and enjoy your life"

Many thought the wording was too weak, questioning the need for the word "probably". Surely if it was an atheist advert it shouldn't need that word?

Many thought the "probably" implied agnosticism rather than atheism, though I see no problem. A read around the different forms of atheism shows how you can be a de-facto atheist whilst still enternaining a very very very small possibility that you are wrong. After all, I might also be wrong about the celestial teapot.

A complaint was made to the Advertising Standards Agency about the advert by professional loon Stephen Green of Christian Voice. The complaint was rejected, and the inclusion of the word "probably" may have helped. The ASA judged that:

the ad was an expression of the advertiser’s opinion and that the claims in it were not capable of objective substantiation.

Since then, Christian groups have decided to go ahead with their own campaign. One of the key differences between their adverts and the Atheist one is their certainty. One advert reads:

There definitely is a God. So join the Christian Party and enjoy your life

I'm sure somebody at some stage will submit a complaint to the ASA, though I'm not sure how far that will get. It seems from their guidelines that first of all a complainant would have to show that the existence or otherwise of god is capable of objective substantiation, and then that the conclusion that god exists is false. I would love to be a fly on the wall at the ASA meeting to decide this. The prospect of the ASA having to decide on the existence of god is quite interesting but it would never get that far.

I'm on two minds as to whether to submit my own complaint or not. Do I really want to lower myself to the level of Christian Voice?

What is most interesting however is how the religious seem unable to contemplate even the remotest prospect that they are wrong. The word "probably" is so threatening to them that you won't find it in their adverts.

Sunday, 8 February 2009

MMR: Wakefield hearing uncovers research falsification

Dr Andrew Wakefield is nearing the end of his GMC hearing on charges of conducting research unethically. This relates to the Lancet paper that sparked the media "controversy" over the MMR vaccine in 1998, apparently linking it to bowel disease and Autism. We all know what happened next... ill informed journalists and columnists demanding the withdrawal of the vaccine, the Blairs refusing to confirm or deny whether Leo had been vaccinated, a massive drop in immunisation, and now finally a return to Measles being endemic in the UK.

A lot has been written about who was to blame for this. Whilst it may have been tempting to pin it all on Wakefield I think it's fair to say the press should take a massive share of the blame.

What is only properly coming to light now however is how flawed Wakefield's research was. An article in today's Sunday Times by Brian Deer look at some of the evidence that has been uncovered through the GMC hearing.

We had been told that the Lancet paper showed evidence of 12 previously normal children contracting from bowel disease and behavioural problems indicative of Autism only a short time after receiving MMR. Nobody has ever been able to replicate these findings, and no other evidence linking MMR to Autism has ever been found. Still, Wakefield stood by his research.

The previously unreleased papers show a pattern of falsification, misreporting and selective reporting of the evidence that led to Wakefield's conclusion. These include:

- children showing indications of behavioural problems before the MMR jab
- children showing similar problems several months following MMR, when Wakefield had claimed it was two weeks later
- pathology records showing that Wakefield's bowel disease diagnoses were inaccurate and misleading

Sometimes people get things wrong, which is why scientists regularly review and reproduce each others work. Could Wakefield simply have been mistaken, made errors, and just not been very good at his job? Or is these something else that can account for the poor quality of his research and conclusions?

What has also been uncovered through this hearing is that before his research Wakefield will have had a vested interest in the outcome. Wakefield had already been working with a lawyer, representing the anti-vaccine lobby group JABS in order to seek compensation for families who claimed MMR had damaged their child.

Wakefield had sought funding from the Legal Aid Board, claiming to have found a "new syndrome" (remember, this is before the research). This funding was to "seek evidence which will be acceptable in a court of law" to establish a link between MMR and Autism. So far Wakefield has earned over £430,000 from families seeking compensation.

The last word should perhaps go to Wakefield, who, at the press conference announcing the Lancet paper (itself an unusual event) said:

“It’s a moral issue for me. I can’t support the continued use of these three vaccines, given in combination, until this issue has been resolved.”

Moral. Indeed.