One of the few laws of political science is that when governments make mistakes, they tend to be whoppers. Luckily for them, the public’s memory is short, and the outrage of today soon declines into the apathy of tomorrow.
From several articles published in a recent edition of the British Medical Journal, it appears that many governments around the world, including those of Britain and the U.S., may have made such a mistake in stockpiling billions of dollars’ worth of anti-flu medications, bought principally from Roche, the largest pharmaceutical company in the world as measured by capitalization.
First the governments overestimated the virulence of the new flu epidemic the drugs were supposed to counter, no doubt a forgivable mistake in the circumstances; but then it stockpiled the supposedly anti-flu drugs on the basis of inadequate evidence. It took published studies at face value without apparently realizing that the drug companies had withheld a great deal of data – 150,000 pages of it, as it turned out. When, after what seems like a rear-guard action to prevent it, the drug companies released all the data, re-calculation showed that the drugs were not quite useless, but had practically no value from the public health point of view. At best they reduced the duration of symptoms by a few hours and in some cases prevented the development of symptomatic disease. But they also caused serious side effects, and neither prevented deaths nor serious complications nor the rate of hospitalization. They did not prevent the spread of the infection either.
At first sight this seems like just another scandal caused by corporate dishonesty, but it is more than that: it is also the story of government incompetence or collusion. Not all governments bought into the wonders of the anti-flu drugs: and in fact a closer reading of the evidence available even before the companies released all their data might have saved the taxpayers what in the context of government spending is a little spare change.
One of the authors of the original report recommending that the British government stockpile the drug, and who is one of the authors who has now come to the opposite conclusion about their effectiveness, said that in 2009, before the new data were made available, a Japanese pediatrician called Keiji Haysahi wrote to him “concerned that he could not verify the data that supported some of the [positive] conclusions about oseltamvir [by far the most widely-sold anti-flu drug].”
In particular, he pointed out that the claims that the drug reduced secondary complications and hospital admissions were based on a 2003 analysis coauthored by Roche empoyees. Hayashi also noted that eight out of the 10 trials included in that analysis were never published in peer reviewed journals.
As Susan Sontag’s work belonged not so much to the history of literature as to that of self-promotion, these studies belonged more to publicity than to pharmacological science. Hayashi continued:
[The] studies on the influenza treatments were based on an incomplete and possibly biased picture of the evidence.
Now if Hayashi was able to see this, presumably everyone else involved should have been able to do so as well. And who better able than governments to force companies to reveal all their data?
Ironically, one of the articles exposing the situation was opposite a full-page advertisement from the manufacturers of the painkiller oxycontin. It showed a smiling old man who was saying; ‘The nurses work so hard it seems only polite to flirt with them.” The advert continues, “Arthur has been incorrigible all his whole life, so if there’s a twinkle in his eye you know he’s having one of his better days.”
What the advert doesn’t mention is that oxycontin kills 14,000 people a year in the U.S. alone.
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