Fwd: Pfizer-Wyeth Merger: Good for Business, Bad for Patients

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ALLIANCE FOR HUMAN RESEARCH PROTECTION Promoting Openness, Full Disclosure, and Accountabilityhttp://www.ahrp.org  and http://ahrp.blogspot.com FYIBelow, an OpEd piece by John Abramson, MD, on ABC News, provides one of themost succinct insightful explanations of how the information base ofmedicine has been corrupted by the pharmaceutical industry. Specifically,its control over medical research, its undue influence over physicians,journal publications, clinical practice guidelines, continuing medicaleducation,  has effectively undermined the integrity of American medicineand the viability of our healthcare delivery system."It's hard to believe that despite spending twice as much per person as theother industrialized countries, Americans live an average of 1½ years lessin good health. And if the rate of potentially preventable deaths in theUnited States were declining as quickly as it is in Austria, Ireland andNorway -- three countries that lead in this respect, and each spend abouthalf as much per person on health care as the United States does -- 100,000fewer Americans would be dying each year."Dr. Abramson also sheds light on the Pfizer-Wyeth pharmaceutical mergerwhich, contrary to Pfizer's PR, will NOT spur the company to develop newproducts. The merger will increase Pfizer's marketing power to convincedoctors and patients to use its expensive high profit products--many ofwhich are ineffective and dangerous (e.g., Neurontin, Bextra, Zoloft).Fanfare surrounding the merger effectively deflected attention from Pfizer'spending $2.3 billion payment to the Department of Justice for allegedlyillegal marketing of Bextra.Dr. Abramson points out how Pfizer's merger will injure American taxpayers:To pay for the merger, Pfizer will borrow $22 billion from Goldman Sachs, JPMorganChase, Citigroup and Bank of America -- all of who accepted billionsof dollars in government bailout funds to .  "Pfizer's acquisition of Wyethmight be pretty darned good for the shareholders and some of the executives;but instead of federal bailout money being used to save jobs, the taxpayers'money will be used to put at least 18,000 hardworking, well-trainedAmericans out of work."Hopefully President Obama's administration will pay heed to the real issuesthat plague our unsustainable healthcare system.Contact: Vera Hassner Sharavveracare212-595-8974http://abcnews.go.com/print?id=6762939ABC News <http://abcnews.go.com/> Good for Business, Bad for Patients? Pfizer's Plan to Buy Rival Wyeth Could Mean Bad News for Patients, PhysicianSaysOp-Ed By JOHN ABRAMSON, M.D.Jan. 30, 2009 — It's perfect. Pfizer buys Wyeth's pipeline, the behemoth marketing power ofPfizer gets leveraged, the work force gets consolidated and the $22 billionborrowed is read as a sign that banks are willing to lend again. Well, not quite perfect but pretty darned good. The problem is: pretty darned good for whom? Both Pfizer and Wyeth areattending to their primary responsibility: maximizing profits and deliveringthem to shareholders. Improving Americans' health most effectively andefficiently is not their job, but convincing us all -- including doctors --that it is, is. We desperately need to find a way to contain health care costs and at thesame time improve access. Seems impossible, but the almost unimaginablelevel of dysfunction in American health care actually creates enormousopportunity. It's hard to believe that despite spending twice as much per person as theother industrialized countries, Americans live an average of 1½ years lessin good health. And if the rate of potentially preventable deaths in theUnited States were declining as quickly as it is in Austria, Ireland andNorway -- three countries that lead in this respect, and each spend abouthalf as much per person on health care as the United States does -- 100,000fewer Americans would be dying each year. The core problem with American medicine isn't really access or cost. It'sthat medical knowledge itself has been turned into a commodity, produced anddisseminated with the primary goal of optimizing profits rather than health.Eighty-five percent of clinical trials are now commercially funded, and theodds are four to five times greater that the commercially funded trials willconclude that the sponsor's drug is the treatment of choice compared withnoncommercially funded trials of exactly the same drugs, according to alecture given at Harvard Medical School in October by Dr. Catherine D.DeAngelis, the editor in chief of the Journal of the American MedicalAssociation. That's just the beginning. Those studies are then bundled into review articles (often sponsored by thedrug maker); presented at continuing medical education courses that arefunded directly or indirectly by the drug maker; supported by "key opinionleaders," recognized experts who happen to be getting paid by the drugmaker; incorporated into guidelines -- the majority of expert authors havingfinancial ties to one or more of the drug companies making a drug beingconsidered in the guidelines; and, of course, touted by the drug reps liningup to get some face time with the doctors, who -- according to thePharmaceutical Research and Manufacturers of America's research --overwhelmingly find the information delivered by the reps up to date, usefuland reliable. The Failure of the Medicine MarketWhat we've got is a good old-fashioned case of market failure. Butunderstanding the magnitude and consequences of the failure of the market tooversee the relevance and integrity of commercially generated medicalknowledge is virtually impossible to see unless you're a corporate insideror have a subpoena to gain access to the unspun scientific evidence (closelyheld as proprietary information by the drug companies) and other corporatedocuments. Actually it's a double failure. First, the kinds of things that get researched are those that offer thegreatest potential return on investment. So our medical knowledge grows inthe direction that is most profitable for the medical industry and all toooften, this is not the direction that will improve Americans' health mosteffectively and efficiently. Then we get into the failure to ensure the integrity of the commerciallyproduced medical knowledge that informs doctors' prescribing decisions. Forexample, on the same day (perhaps not coincidentally) that Pfizer's plan toacquire Wyeth was announced, Pfizer also announced a pending $2.3 billionsettlement with the Department of Justice to settle allegations that itmarketed its arthritis drug Bextra off-label (allegedly having encourageddoctors to prescribe Bextra for conditions for which the FDA had not deemedthe drug effective). The second story got far less coverage, probably as aresult of Pfizer's fortuitous choice of that particular day to announce therecord-shattering settlement in process. And in order to pay for Wyeth, Pfizer will borrow $22 billion from GoldmanSachs, JP MorganChase, Citigroup and Bank of America -- all banks underpressure to increase lending since accepting government bailout funds. So what effect will Pfizer's acquisition of Wyeth have on American healthcare? Pfizer's purchase of Wyeth will diminish its imperative to develop newproducts that genuinely improve health to replace the older blockbusterdrugs going off patent; the new Pfizer will have even greater marketingpower to convince doctors and patients to use its products (often in lieu ofless expensive and more effective approaches); attention is beingeffectively deflected from Pfizer's pending $2.3 billion payment to theDepartment of Justice for allegedly illegal marketing Bextra; and instead offederal bailout money being used to save jobs, the taxpayers' money will beused to put at least 18,000 hardworking, well-trained Americans out of work.Pfizer's acquisition of Wyeth might be pretty darned good for theshareholders and some of the executives, but it sure won't help the Americanpeople. This work is the opinion of the author and in no way reflects the opinion ofABC News. Dr. John Abramson, a clinical instructor at Harvard Medical School, is theauthor of "Overdosed America: The Broken Promise of American Medicine" andserves as an expert to plaintiffs' counsel in litigation involving thepharmaceutical industry, including both Pfizer and Wyeth.  ABC News Internet Ventures FAIR USE NOTICE: This may contain copyrighted (© ) material the use ofwhich has not always been specifically authorized by the copyright owner.Such material is made available for educational purposes, to advanceunderstanding of human rights, democracy, scientific, moral, ethical, andsocial justice issues, etc. It is believed that this constitutes a 'fairuse' of any such copyrighted material as provided for in Title 17 U.S.C.section 107 of the US Copyright Law. 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