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FEATURE: Andrew Jack Balancing Big Pharma’s books BMJ 2008; 336: 418-419 [Full text]

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Trouble ahead for "Big Pharma"

Manthan D. Janodia, D.Sreedhar, Virendra S.Ligade, N.Udupa   (24 February 2008)

There is no right answer to the wrong question

Aubrey Blumsohn   (27 February 2008)

Trouble ahead for "Big Pharma" 24 February 2008
Manthan D. Janodia, Lecturer, Department of Pharmacy Management Manipal College of Pharmaceutical Sciences, Manipal University, Manipal 576 104, Karnataka, India, D.Sreedhar, Virendra S.Ligade, N.Udupa Send response to journal: Re: Trouble ahead for "Big Pharma"	The article highlights the testing time ahead for "Big Pharma" or the MNCs. Though Multinational Pharmaceutical Companies have always been at the forefrunt of expanding medical knowledge, they are to be blamed for increased scrutiny in the recent years and receiving brickbats from the regulators, the public, insurance companies and various patient advocacy groups. The crunch and shrinking of new drug pipeline evidently shows how desperate big pharmaceutical companies are to extend the patent life of some blockbuster drugs through heavy advertising to the medical practitioners as well as to the patients where it is permitted. Even in the past, these MNCs had a few blokbuster in the kitty through which they earned the major share of their total revenues. With increasing grip of regulatory agencies over approval of new drugs, pressure from promoters and stakeholders, public becoming aware of the gimmicks and tactics of MNCs, market failures of some promising molecules, increasing price pressures and eroding Intellecutal Property has made it tougher for pharmaceutical companies to susatin the momentum of growth. In addition to all the worries, generic drugs poses a serious challenge to these MNC companies in coming years. With governments in the US and the EU trying to contain the cost of healthcare including the cost of medicines "Big pharma" has an uphill task to perform and create a positive atmosphere with their "positive" strategies. Competing interests: None declared
There is no right answer to the wrong question 27 February 2008
Aubrey Blumsohn, Consultant in Laboratory Medicine Sheffield Teaching Hospitals NHS Trust, S10 Send response to journal: Re: There is no right answer to the wrong question	The article by Andrew Jack of the Financial Times (BMJ 336:418-9 "Balancing Big Pharma's books") completely misses the point. If the point is missed there is no chance of solving the crisis. The real long-term problems facing "Big Pharma" (a science based industry) are hardly difficult to understand. They are: Multiple instances of overt scientific fraud Regulatory collusion with that fraud Attempts to cover-up that fraud and to redefine the meaning of science itself Provision of misinformation and malinformation to doctors and patients Government and regulatory collusion to subvert the free market and to prevent consumer litigation Refusal to allow science to be properly scrutinized Increasing evidence that the peer reviewed scientific literature cannot be trusted There is no real sense of this in the Jack article. Instead we read: "It reflects public opinion that is risk averse, sparked by fears such as the reported patient deaths caused by Merck's painkiller Vioxx, or GSK's diabetes drug Avandia. Cautious regulators have responded by imposing ever tougher barriers that must be overcome to approve new medicines." Anyone who wishes this industry well (as I do) must realize that to summarize the problem as a public relations issue is not going to help anyone - least of all the industry itself. The health of this industry (including its long-term financial health) would benefit if a few of its leaders were appropriately sanctioned, if necessary through imprisonment. Competing interests: Discussed these things before