Welcome to Sydney Morning Herald = Online.=20 Skip directly to: Search=20 Box, Section=20 Navigation, Content.=20 Text Version.

=20

members | = login=20 | register

An unhealthy influence on the medical=20 establishment

September 16, = 2004

For children, they essentially double the risk of suicidal thoughts = and=20 behaviours, without providing any real benefit, with the possible = exception of=20 Prozac. Of every hundred youngsters treated with these drugs, the pills = will=20 cause an extra two or three to seriously consider killing themselves. =

Almost all the companies' clinical trials of these drugs in children = failed=20 to show they were significantly more effective than a placebo or dummy = pill.

Yet despite a lack of evidence that they work, and convincing data = showing=20 they cause harm, the use of these antidepressants among the young has=20 skyrocketed. In the US more than 11 million scripts are written every = year for=20 people under 18. In Australia, the use of antidepressants among people = aged 15=20 to 24, has increased 10-fold in 10 years.

So why have rates soared so high and why have regulators taken so = long to=20 tell people the truth about antidepressants? The answer is simple: drug = company=20 influence has fundamentally corrupted the medical establishment, from = the GP=20 surgeries to the world's most respected regulators.

Most doctors still learn about drugs from the visits of drug = representatives,=20 who bring food, flattery and friendship. Much of doctors' ongoing = medical=20 "education" is funded directly by drug companies, as are most clinical = trials.=20 As a result, unfavourable trial findings are often buried, while modest = benefits=20 are exaggerated by so-called "thought leaders", also on company = payrolls.

Prestigious royal colleges are themselves awash with pharmaceutical = funding,=20 and many patient groups have their noses in the trough, too. Even the = supposedly=20 independent regulators are sponsored by industry.

In the US, drug companies fund more than 50 per cent of the FDA's = drug review=20 work. In the case of Australia's TGA, the figure is 100 per cent. It = doesn't=20 mean all the hard-working bureaucrats are bought off, it just means the = drug=20 companies are paying the bulk of their salaries.

At the FDA there is clear evidence that company funding has helped = create a=20 culture of timidity, and the tardiness to warn about the risks of these = drugs in=20 children is just the latest example of that problem. Here, the TGA, = loudly=20 proclaims its independence. If so, why has antidepressant use in = Australia=20 skyrocketed 10-fold in 10 years among the young? But while there seems = little=20 political will to reform the current user-pays system of regulation, = there are=20 encouraging signs of change. Editors of the world's most influential = medical=20 journals have decided to get tough, demanding that all trials be = registered so=20 the results can be publicly scrutinised, whether positive or negative - = and=20 companies are falling into line.

In New York, the attorney-general has taken legal action against the = giant=20 drug manufacturer GSK, the maker of Aropax, accusing the company of = fraudulently=20 concealing data and misleading doctors and the public about the drug's = risks and=20 benefits in children. GSK has settled.

In Britain, a far-reaching parliamentary inquiry into industry's = influence=20 over the health-care system has just opened. That inquiry, being run by = the=20 powerful Commons Health Committee, is examining drug company impact on = doctors'=20 prescribing, medical education and scientific research, and it is = scheduled to=20 take evidence in Australia soon.

It will also examine drug company funded "awareness raising" and = investigate=20 whether such campaigns are inappropriately widening the definitions of = disease=20 in order to expand markets for new medicines.

While many public hearings are yet to come, it is expected the = British=20 inquiry's final report will call for a major winding back of drug = company=20 influence, and send a strong message to the world that doctors and the = public=20 should be getting much more independent information about medicines and = health=20 conditions.

There is little doubt that the debacle over the antidepressants will = make a=20 lot more people receptive to any such message.

Ray Moynihan's new book Selling Sickness will be published by = Allen &=20 Unwin next year. The tie-in SBS TV documentary Selling Sickness will be = screened=20 on October 5.