Fwd: Bush wants pharma Trojan Horse unbridled

[Guest guest]

apfn-1 , Terry Melanson <mevlevi2000>

wrote:

 

Bush wants pharma Trojan Horse unbridled

 

By Evelyn Pringle

Online Journal Contributing Writer

 

March 28, 2005—The New Freedom Commission (NFC) was established by

executive order on April 29, 2002.

 

On that date at a speech in New Mexico, George W. Bush said mental

health centers and hospitals, homeless shelters, the justice and

school systems have contact with individuals suffering from mental

disorders but that too many Americans fall through the cracks of the

current system and so he created the commission to ensure " that the

cracks are closed. "

 

On July 22, 200,3 the NFC recommended redesigning the mental health

system in all 50 states and said, " Achieving this goal will

require . . . a greater focus on mental health care in institutions

such as schools, child welfare programs, and the criminal and

juvenile justice systems. The goal is integrated care that can

screen, identify, and respond to problems early, " in a press release.

 

Despite a nearly 500 percent increase in psychiatric drugs being

prescribed to children in the previous six years, the NFC recommended

a plan of mandatory mental health screening for all public school

students and follow-up treatment with drugs when needed.

 

The fact is, this is nothing more than another elaborate profiteering

scheme hatched by Bush and the pharmaceutical industry to convert the

millions of people in public systems into customers for new

psychiatric drugs in order to funnel more tax dollars to pharma.

 

David Oaks, director of MindFreedom, a coalition of groups which

advocate for the rights of people with psychiatric disabilities, says

the plan amounts to " No child left undrugged. "

 

A report by Allan Jones, claims the " pharmaceutical industry has

methodically compromised our political system at all levels and has

systematically infiltrated the mental health delivery system of this

nation. "

 

Jones says the NFC " doesn't have the Orwellian goal of drugging the

populace for a political purpose; it's the Orwellian goal of drugging

the populace for an economic purpose. "

 

Jones was an investigator in the Pennsylvania Office of Inspector

General (OIG), Bureau of Special Investigations, when the model for

this profiteering scheme was implemented in Pennsylvania. He calls it

a " Trojan Horse " for the pharmaceutical industry.

 

Jones recently answered questions from Independent Media TV regarding

his investigation of the unhealthy alliance between Pennsylvania

officials and pharma that facilitated the adoption of a scheme in

that state that could potentially lead to thousands of people being

prescribed dangerous psychiatric drugs for the sole purpose of

increasing drug company profits.

 

" It is a story of the betrayal of our society's most helpless

citizens, " Jones said.

 

The program being implemented in Pennsylvania was based on the Texas

Medication Algorithm Project (pronounced TMap), created in 1995 while

Bush was governor.

 

TMAP began with an alliance of persons representing pharma, the Texas

university, mental health and corrections systems and was made

possible through a $1.7 million grant from the Robert Wood Johnson

Foundation; a Johnson & Johnson related foundation. Johnson & Johnson

owns Janssen Pharmaceutica and Janssen/Ortho McNeil.

 

Let there be no mistake, TMAP's underlying goal was to create a

marketing scheme to ensure the sale of new psychiatric drugs. Because

clinical trials did not favor these drugs, an alternative market had

to be created. So the alliance came up with the idea to legitimize

the drugs by " Expert Consensus Guidelines, " rather than scientific

studies, by soliciting favorable opinions from doctors and

psychiatrists of its own choosing.

 

Originally, Janssen funded the " Expert Consensus " survey and

analysis, but by 1996 when its results were published, Eli Lilly and

Austrazeneca were also involved in the funding, and since that time,

Pfizer, Novartis, Ortho-McNeil, GlaxoSmithKline, Abbott, Bristol

Myers Squibb, Wyeth-Ayerst, Forrest Laboratories and US Pharmacopeia

joined in.

 

From then on, the " Expert Consensus " process became the standard

device for approving drugs for treating patients and was employed

repeatedly between 1996 and 2003.

 

The " expert doctors " chosen to participate in the process included

people who had already published articles favoring the new drugs and

not surprisingly, many were later found to have secret financial ties

to pharma.

 

For example, one doctor chosen was Jack Gorman, who, according to the

March 13, 1999, New York Post, resigned from New York's Psychiatric

Institute after it was discovered that he had received over $140,000

from drug companies in the year between April 1, 1997 and March 31,

1998.

 

As it turns out, Gorman received speaking fees, travel

accommodations, board memberships and consulting fees from Janssen,

Eli Lilly and Pfizer, including $12,000 from Pfizer at the same time

that he was conducting research on Pfizer drugs.

 

Twelve other researchers from the New York Institute were also

involved in the Expert Consensus process, and each was found to have

profited from drug company money.

 

Why Texas?

 

Pharma probably decided Texas was the ideal start-up location for its

new marketing scheme because it had the largest prison system in the

country, with approximately 150,000 inmates, and a well-populated

mental health system.

 

In Texas, political influence extends to state universities,

hospitals and prisons, with regents and administrators appointed by

the governor. So when it came time to persuade Texas officials to

adopt TMAP, in addition to flooding the state with lobbyists, pharma

began making campaign contributions to the governor, state lawmakers,

and even judges.

 

For example, in 1994, the industry made no contributions to Texas

politicians, according to the National Institute on Money in State

Politics. However, during the 1998 campaigns, it made over 250

contributions, totaling $152,000, to candidates running for state

office. In 2002, it made more than 400 contributions, totaling

$384,735, and poured millions more into state universities.

 

The money turned out to be well spent because in the end, pharma was

able to implement TMAP based on the decision of a few politically

appointed officials. In addition, Texas lawmakers expanded Medicaid

coverage to persons who would not ordinarily qualify and increased

funding for state institutions, paving the way for thousands of new

customers.

 

As governor, Bush backed legislation that required private industries

to increase insurance coverage for drugs, and before leaving for

Washington, recommended a $67 million increase in the state budget to

help pay for the drugs prescribed in public institutions.

 

The list of drugs chosen by the Expert Consensus included Risperdal,

Zoloft, Paxil, Zyprexa, Seroqual, Geodone, Depakote, Celexa,

Wellbutron, Zyban, Remeron, Serzone, Effexor, Buspar, Adderall, and

Prozac and all were manufactured by the above companies.

 

The adoption of TMAP came with the requirement to use these drugs on

all patients in the system. A doctor was free to choose which

patented drug to use, but could not prescribe a generic unless

treatment with at least two, often three, patented drugs failed.

 

Pharma claimed that these drugs were safer, more effective, and had

less side-effects than generics, and saturated the medical journals

with reports of favorable studies conducted by researchers who later

turned out to be directly funded by the drug companies.

 

Many practitioners disagreed with the endorsement of the new

antipsychotics. For instance, TMAP claimed Risperdal, Zyprexa and

Seroqual were safer and more effective than generics in treating

schizophrenia.

 

But according to the 2000 British Medical Journal, a study by Dr John

Geddes, funded by the British Department of Health, disproved this

claim. Geddes reviewed the results of independent clinical trials on

over 12,000 patients to determine the actual effectiveness and

dangers of the atypical and typical antipsychotics and found:

 

There is no clear evidence that atypical antipsychotics are more

effective or are better tolerated than conventional antipsychotics.

Conventional anti-psychotics should usually be used in the initial

treatment of an episode of schizophrenia unless the patient has

previously not responded to these drugs or has unacceptable

extrapyramidal side effects.

 

 

Its important to note that this study was conducted without drug

company funding.

 

Robert Whitaker, the author of Mad in America, found biased reviews

and deceptive reporting were used in approving and promoting these

drugs. Through an FIOA request, he gained access to FDA raw data on

the drug trials and found the FDA did not support claims that they

were safer or more effective than generics. In fact, he discovered a

letter to Janssen about Risperdal that said just the opposite and

included the warning: " We would consider any advertisement or

promotion labeling for RISPERDAL false,

 

misleading or lacking fair balance . . . if there is a presentation

of data that conveys the impression that Risperidone is superior to

haloperidol (a generic antipsychotic) or any other marketed

antipsychotic drug product with regard to safety or effectiveness. "

 

However, the FDA warning did not keep Risperdal off the list, because

according to Whitaker, " While the FDA had the authority to stop

Janssen from making false claims in ads, it had no control over what

physicians, paid by Janssen to conduct the trials, reported in their

medical journals or told the press. "

 

Pharma Expands Market Scheme To Pennsylvania

 

TMAP was lauded in NFC publications as a model program recommended

for the entire country. The Pennsylvania version of the program,

PennMap, was adopted in 2002, by the Department of Public Welfare

(DPW), Office of Mental Health and Substance Abuse Services (OMHSAS),

and fully implemented in January of 2003.

 

To help fund the costs that would arise under PENNMAP, the

Pennsylvania Office of Mental Health & Substance Abuse Services

(OMHSAS) created a special plan to pay for drugs prescribed to

persons not eligible for Medicaid and attached it to a program

designed to pay for HIV drugs with public funds.

 

Shortly after Jones began his investigation into the possible

financial influence by pharma on Pennsylvania officials in promoting

PENNMAP, he discovered an off-the-books slush fund account within the

OMHSAS.

 

" When charged with examining the receipt of drug company funds by

state employees, " Jones said, " I began to look at the overall issue

of pharma marketing and immediately became alarmed that tactics used

in marketing to the private sector were being replicated with public

employees. Trips, perks, travel, honorariums, consultant fees etc, "

he said.

 

" The most shady aspects of the program emerged quickly, " he said. The

recommended drugs were exclusively new, patented and expensive and

were selected by persons with financial ties to pharma; and the

claims of increased efficacy and safety made by the drug companies

and state employees, were contradicted by the available science.

 

These same sentiments had already been expressed in January 1999, by

Peter Weiden, MD, one of the participants in the " Expert Consensus, "

when he openly criticized the process in the Journal of Practice in

Psychiatry and Behavioural Health:

 

" The most important weakness of the EC Guidelines is that the

recommendations are based on opinions, not data. History shows that

experts' opinions about " best " treatments have frequently been

disproved, and there is no assurance that what the experts recommend

is actually the best treatment. One danger here is that clinicians or

administrators may misinterpret " current consensus " as truth.

 

" Another limitation involves the development of the survey itself.

Treatment options are limited to those items appearing on the

questions, and it was not possible to cover all situations.

 

" Another problem is potential bias from funding sources. The 1996

Guidelines were funded by Janssen (makers of Risperidone [Risperdal])

and most of the guidelines' authors have received support from the

pharmaceutical industry. This potential conflict of interest may

create credibility problems, especially concerning any

recommendations supporting the use of atypical antipsychotics. "

 

 

Jones discovered this type of conflict of interest with certain

Pennsylvania employees who had been paid honorariums of up to $2,000

for speaking at pharma sponsored events in their official

capacities. " It is illegal for a public employee to accept

honorariums and to consult with industry without permission, yet it

was happening openly, " Jones said.

 

When he tried to investigate the matter, " I was told that

pharmaceutical companies are major political contributors and that I

should not continue my probe, " he said. " I was effectively threatened

with loss of job, career and reputation, if I continued to

investigate the pharmaceutical companies. "

 

But Jones did continue to investigate and found that Janssen and

Pfizer had been actively courting Steve Fiorello, Pennsylvania's

state pharmacist. Each company had paid Fiorello as a consultant,

treated him to travel accommodations, and provided him with

educational grants to promote PENNMAP.

 

Then there was Gerald Radke, a former marketing director for Eli

Lilly, who was appointed deputy secretary of OMHSAS, by then Governor

Ridge. Radke's predecessor, Charles Currie, was also appointed Ridge,

but " when Bush became president, he tapped Currie to head SAMSHA, the

National Mental Health Entity, " Jones explained, and then

Ridge " appointed Radke from the Bush-friendly Eli Lilly. "

 

According to Jones, Pennsylvania doctors also benefited

through " trips, perks, honorariums, name in print, ego stroked, and

potential advancement. " For instance, the medical director of the

Mental Health and Substance Abuse office, Steven Karp, left his

position in state government to join the Texas group promoting the

TMAP model in Florida.

 

Throughout his investigation, his superiors at the OIG " maintained a

deliberate ignorance of what was going on, " Jones reports, " they did

not want to know, " he said.

 

His boss said the Department of Welfare (DPW) had to know what was

going on, but " drug companies write checks to both sides of the aisle

and that my concerns would go nowhere " Jones reports.

 

When he approached his boss for advice on preserving the record,

Jones was told to back off and prepare a summary of his concerns so

that when the investigation was over they could give it to the DPW.

Although his boss acknowledged that the DPW would do nothing, he said

that " if the shit hit the fan, they could say here, we told you. "

 

In 2002, Jones finally went to The New York Times with information

about drug company Janssen's attempt to influence Pennsylvania

employees during the formation of PENNMAP.

 

Not too long afterwards, Jones was pulled off the investigation and

he eventually did lose his job as well. His assistant, Katy Butler,

took over as lead investigator and closed the case without ever

disclosing the evidence of misconduct that Jones had filed in his

report.

 

However, getting the boot has not deterred him. Jones has continued

to investigate the matter as a private citizen and, in November 2002,

filed a lawsuit to preserve his right to speak about the influence of

pharma on the treatment of patients in state institutions.

 

http://www.onlinejournal.com/Special_Reports/032805Pringle/032805pring

le.html

 

 

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