Bad Science and BadPharma author and campaigner Dr Ben Goldacre and Stephen Whitehead, ABPI, CEO, went head-to-head to debate for and against the motion ‘Pharma is not getting its act together’ this week at the Royal Institution. The event, organised by PharmaTimes magazine and held on 26 February, attracted over 400 guests and was moderated by Dr Phil Hammond.
Goldacre was supported in his arguments by Dr Fiona Godlee, editor in chief, BMJ, and Sir Iain Chalmers, co-founder, The Cochrane Collaboration. Stephen Whitehead called on Dr Beat Widler, CQA and Quality Risk Management expert and managing partner at Widler & Schiemann and Dr Richard Tiner, formerly president of the Faculty of Pharmaceutical Medicine (2009-12) and ABPI medical director (1996-2009).
The debate was intellectual, but at times lacked passion as Goldacre and his team set out arguments from his book, directed largely at trial transparency and historical failures. Whitehead, in the meantime, highlighted all that pharma has done recently in the interests of openness, including GSK signing up to AllTrials and Roche putting in place systems targeting transparency and a scientific committee to review Tamiflu data.
Challenged on the independence of a multi-party group to review Tamiflu data funded by Roche, spokesperson for the company, Susie Hackett, took an opportunity to respond from the floor posing an unanswered question: "How else would this happen, without company funding?"
Goldacre claimed his agenda was to: "Identify the change agents and find people who are willing to recognise the imperfections and move forward." He repeatedly appealed to the audience to: "Get in touch and talk to me," as he argued that many pharma people are ethical, but need to fight back against a system that is broken.
He said he had little interest in marketing and conflict of interest , claiming it should to be irrelevant to HCPs. Instead, Goldacre cited the core of this story as missing trial results and the need to get the right information to the right doctor and patient at the right time.
Whitehead suggested that the debate on this matter so far, especially on Twitter, had been inappropriate as the issues are too complex, especially for 140 words. Further, he said: "I am tired of seeing my industry attacked by people with an unwritten agenda. Yes, there are examples of bad practice, but to say that they are the norm is like saying all doctors are like Harold Shipman, all nurses like Beverly Allitt." Importantly, he explained, the industry had started the process of engaging in transparency long before Ben had published his book and he branded the title for the debate "insulting".
"The industry is committed to transparency," Whitehead confirmed. "It is not about the when, but the how." He went on to explain how the ABPI is announcing a new initiative to ensure transparency and that the industry complies with all the requirements laid down in the Code of Practice. He concluded: "I don’t recognise the picture of the industry painted by Ben. Medicine is not broken. It is responsible for saving life on an epic scale. I want to talk about good pharma. Not perfect pharma, but good pharma."
Other interesting points raised during the discussion were around the difficulties of comparing data compiled to standards 20 years ago with today’s more rigorous approach to designing and running trials. There were also no solutions presented to answer the question of whether a company would become liable and risk ruin, for example, should a drug approved 20 years ago now prove to be dangerous in a certain patient profile that might not have been identified at that time.
The quality of the presentation and debating meant that the two hour debate over ran and calling the audience to order after the summing up, Phil Hammond ran the second vote to see only a minor 4% shift on the original views: at the outset, a majority of 35 per cent of the audience disagreed that pharma isn’t getting its act together and after the debate this had changed to only 39%. Those who strongly disagreed with the motion had shifted from 11 to 19% of the audience.
, Clinical Trials
, Ben Goldacre
, Bad Pharma