I went to a lecture today by Dr. Peter C. Gøtzsche. He was visiting from Denmark, where he works on assessing the results of clinical trials and putting the validity of their findings to the test. His book is coming out soon in the US, so he was here to give us a synopsis of his book and go over some of the main points therein.
I don’t know if it was just me, but the whole thing had a lot of tones of conspiracy theories. More on that in a few minutes (or seconds, if you read that fast).
In many places in the world, if you go to a physician for a medical condition, chances are that the physician will prescribe or give you a medication. You place your trust on their training and intellect that the drug will be beneficial and you’ll be okay. But where did they learn that the drug works? Medical school? Maybe, but you can’t possibly cover all the known drugs in the four years of medical school or even in the years after that. In fact, most physicians learn about the proper use of medications through their peers, journals, and from the drug manufacturers themselves.
Any physician (or healthcare provider) worth their salt will look to learn more about the practice of medicine and how to improve their own practice. They’ll go to medical conferences (and pay attention) and listen to their peers on medical subjects of interest. They’ll also try to fill the gaps in their knowledge by reading journals and other literature on medicine and science. Finally, pharmaceutical companies themselves will give information on the safety and efficacy of their products. This last part is there Dr. Gøtzsche (henceforth “Dr. G”) gets heartburn.
According to Dr. G, pharmaceutical companies operate on a business model that is similar to that of organized crime. That is, pharmaceutical companies lie, cheat, and steal to get ahead. They’ll directly and indirectly bribe anyone that needs to be bribed to get medications on the market, and they have their tentacles in almost every industry and government organization in the world. Not only that, but Dr. G asserted a few times that medications kill enough people to be the number three leading cause of death.
Now, that’s the part that gives me heartburn. It gives me heartburn because there isn’t any really good data to assert this. We only know that people with medical conditions require medication, and many of them die. Did they die because of the medication? Without medication, would they have survived their condition? An even bigger problem is that there is no good ethical study that can be done to prove or disprove this. Do we not give medication to people and see what happens?
I must admit that I agree that many of the pharmaceutical companies’ practices are “sketchy” at best. One of the things that really bothers me is that they change the chemical formula of a compound just slightly and get their patent renewed (a concept known as “one pill, many patents“). And, as we have come to know with the advent of patent trolls, it can be very profitable for a company to retain their patent.
Only recently did pharmaceutical companies get restrained in their ability to “wine and dine” their clients. Gone are pharma dinners, and I’m going to miss them (because of the food). They’re also not allowed to give “swag” at medical conferences. So the opportunity for a doc to change their mind over a pen or a paper pad is gone… But there are other ways to get to them, according to Dr. G. He stated that physicians serve on advisory panels for pharmaceutical companies. Physicians are also given incentives for referring patients to trials and for referring patients to new drugs… Again, according to Dr. G. (I keep writing that this is according to him because I have not read up on his evidence presented in his book.)
Now, for the “tones” of conspiracy theories. Dr. G said a few times that he may not be allowed to go back home, or not allowed to work, or be otherwise reprimanded when certain people read his book. He tried to make it sound like he was half joking, but it didn’t come off that way. In my view (and that of others I talked to after the lecture), he came off as someone saying that we should read his book because it’s revealing and because it may have cost him his livelihood or his life… Not because of the evidence therein. But that’s just me.
One last thing. During the Q&A session, this post-doc asked if pharmaceutical companies were also being disingenuous about vaccines. Dr. G answered that he had no knowledge about vaccines, but that didn’t stop the post-doc from continuing the conversation aimed at vaccines after the lecture. Make of that what you will.
René F. Najera, DrPH
I'm a Doctor of Public Health, having studied at the Johns Hopkins University Bloomberg School of Public Health.
All opinions are my own and in no way represent anyone else or any of the organizations for which I work.
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