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BBC1 20:30 TODAY ( 8.30 pm) "Who's Paying Your Doctor?"

April 14 2014 at 12:16 PM
admin 

http://www.bbc.co.uk/programmes/b041drpn


"Who's Paying Your Doctor?

Not currently available on BBC iPlayer

Duration: 30 minutes

With the NHS drug bill topping £10 billion in 2013, this investigation examines the tactics employed by drug companies to tap into that lucrative market and influence which medicines your doctor prescribes.

Strict rules govern drug company spending in the UK, but still they pay out millions to doctors to attend and speak at conferences. Panorama goes undercover to see this subtle persuasion at work and asks whether you should have the right to know who is paying your doctor.

And as Britain's most profitable drug company, GlaxoSmithKline, waits to hear whether it will face criminal charges following allegations of bribery in China, the programme reveals new evidence that GSK was recently paying doctors to boost prescriptions much closer to home, in Europe.  Show less


Today 20:30 BBC One

See all upcoming broadcasts of Who's Paying Your Doctor? (3) "

 
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10th April: "Tamiflu: Millions wasted on flu drug, claims major report'

April 14 2014, 12:36 PM 

This one belongs to Roche AND GSK

"...It [the Report] also claimed that the drug had a number of side-effects, including nausea, headaches, psychiatric events, kidney problems and hyperglycaemia.

Carl Heneghan, Professor of Evidence-Based Medicine at the University of Oxford and one of the report's authors, told the BBC: "I think the whole £500m has not benefited human health in any way and we may have harmed people.

"The system that exists for producing evidence on drugs is so flawed and open to misuse that the public has been misled."..."


http://www.bbc.co.uk/news/health-26954482

10 April 2014 Last updated at 01:56


"Tamiflu: Millions wasted on flu drug, claims major report
By James Gallagher Health and science reporter, BBC News

Hundreds of millions of pounds may have been wasted on a drug for flu that works no better than paracetamol, a landmark analysis has said.

The UK has spent £473m on Tamiflu, which is stockpiled by governments globally to prepare for flu pandemics.

The Cochrane Collaboration claimed the drug did not prevent the spread of flu or reduce dangerous complications, and only slightly helped symptoms.

The manufacturers Roche and other experts say the analysis is flawed.

Barry Clinch from Roche said Tamiflu had been approved by 100 regulators around the world

The antiviral drug Tamiflu was stockpiled from 2006 in the UK when some agencies were predicting that a pandemic of bird flu could kill up to 750,000 people in Britain. Similar decisions were made in other countries.
Hidden data

The drug was widely prescribed during the swine flu outbreak in 2009.

Drug companies do not publish all their research data. This report is the result of a colossal fight for the previously hidden data into the effectiveness and side-effects of Tamiflu.

It concluded that the drug reduced the persistence of flu symptoms from seven days to 6.3 days in adults and to 5.8 days in children. But the report's authors said drugs such as paracetamol could have a similar impact.

On claims that the drug prevented complications such as pneumonia developing, Cochrane suggested the trials were so poor there was "no visible effect".

Another justification for stockpiling was to slow the spread of the disease to give time for a vaccine to be developed. The report's authors said "the case for this is simply unproven" and "there is no credible way these drugs could prevent a pandemic".

It also claimed that the drug had a number of side-effects, including nausea, headaches, psychiatric events, kidney problems and hyperglycaemia.

Carl Heneghan, Professor of Evidence-Based Medicine at the University of Oxford and one of the report's authors, told the BBC: "I think the whole £500m has not benefited human health in any way and we may have harmed people.

"The system that exists for producing evidence on drugs is so flawed and open to misuse that the public has been misled."

Dr Tom Jefferson, a clinical epidemiologist and former GP, said: "I wouldn't give it for symptom relief, I'd give paracetamol."

The Cochrane Collaboration researchers have not placed the blame on any individual or organisation, instead saying there had been failings at every step from the manufacturers to the regulators and government.
'Wrong statistics'



However, there is disagreement about the findings and accusations that a simultaneous campaign to open up drug research is influencing the findings.

The pharmaceutical company Roche said "we disagree with the overall conclusions" and warned they could "potentially have serious public health implications".

Its UK medical director, Dr Daniel Thurley, told the BBC News website: "The definitive piece of research stands as the randomised control trials, which were shared with the regulators, which led to them in 100 countries around the world approving Tamiflu for treatment and prevention of flu."

He said the Cochrane group had used the wrong statistics, which "systematically underestimate the benefits" of the drug, and used "unorthodox" methods to analyse the side-effects.

He concluded: "One of the challenges we have here is actually knowing what they've done."

Prof Wendy Barclay, who researches the influenza virus at Imperial College London, said reducing symptoms in children by 29 hours would be "pretty beneficial".

She told the BBC: "Tamiflu works as well as any drug we have now or [that] is on the cards.

"Yes, I think they should replenish the stockpile. What else can you do if a pandemic strikes? We won't have a vaccine for the first six months."
Continue reading the main story
“Start Quote

It is a potential limitation of this study that the work has been carried out alongside campaigning on access to trial data”

Prof Kevin McConway Open University

She also questioned the validity of the research as it analysed the impact during seasonal flu: "If it works a little bit in season flu, the chances are they'll work quite a lot better in a pandemic situation and get more people back to school and work."

Kevin McConway, a professor of applied statistics at the Open University, said it was an "impressive" piece of work.

He said: "It is a potential limitation of this study that the work has been carried out alongside campaigning on access to trial data.

"The writers of the review have a clear position in this controversy, and, although I personally do generally agree with their position, I feel it does at times lead to some confusion between reporting the results of the review of these particular drugs and commenting on the general position on access to and use of unpublished data."

The Department of Health, which took the lead for the UK, said Britain was recognised as "one of the best prepared countries in the world for a potential flu pandemic" and "our stockpile of antivirals is a key part of this.

"We regularly review all published data and will consider the Cochrane review closely."

The World Health Organization, which classes Tamiflu as an essential medicine, said: "We welcome a new and rigorous analysis of available data, and look forward to consideration of its findings after it appears."



    
This message has been edited by SSRIAdmin on Apr 14, 2014 12:53 PM


 
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More on the Cochrane Report re Tamiflu

April 14 2014, 12:45 PM 

http://esciencenews.com/articles/2014/04/13/tamiflu.relenza.how.effective.are.they
[Sourced from British Medical Journal - BMJ]

"Tamiflu & Relenza: How effective are they?
Published: Sunday, April 13, 2014 - 01:40 in Health & Medicine

Tamiflu (the antiviral drug oseltamivir) shortens symptoms of influenza by half a day, but there is no good evidence to support claims that it reduces admissions to hospital or complications of influenza. This is according to the updated Cochrane evidence review, published today by The Cochrane Collaboration, the independent, global healthcare research network and The BMJ. Evidence from treatment trials confirms increased risk of suffering from nausea and vomiting. And when Tamiflu was used in prevention trials there was an increased risk of headaches, psychiatric disturbances, and renal events. Although when used as a preventative treatment, the drug can reduce the risk of people suffering symptomatic influenza, it is unproven that it can stop people carrying the influenza virus and spreading it to others. The latest updated Cochrane Review: Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children, is based on full internal reports of 20 Tamiflu (oseltamivir) and 26 Relenza (zanamivir) trials. These trials involved more than 24,000 people and the findings challenge the historical assumption that neuraminidase inhibitors are effective in combating influenza. The evidence also suggests there are insufficient grounds to support the use of Tamiflu in preventing person-to-person spread of influenza. This raises further questions about the most effective way to support drug regulation and public health policy decision-making. Claims about the effectiveness of Tamiflu against complications were a key factor in decisions made by governments around the world to stockpile these drugs in case of a pandemic. The US has spent more than $1.3 billion buying a strategic reserve of antivirals, while in the UK the government has spent almost £424 million for a stockpile of about 40 million doses.

In 2009, a lack of access to available trial data hampered the efforts of the Cochrane researchers to verify the safety and effectiveness of Tamiflu -- and led to questions over decisions to stockpile the drug while the risks and benefits remained uncertain. Today, The BMJ and Cochrane issue a joint call to government and health policy decision makers the world over, asking in light of the latest findings from the Cochrane Review, would you make the same recommendations today, choosing to stockpile Tamiflu?

Compared with a placebo, taking Tamiflu led to a quicker alleviation of influenza-like symptoms of just half a day (from 7 days to 6.3 days) in adults, but the effect in children was more uncertain. There was no evidence of a reduction in hospitalisations or serious influenza complications; confirmed pneumonia, bronchitis, sinusitis or ear infection in either adults or children. Tamiflu also increased the risk of nausea and vomiting in adults by around 4 percent and in children by 5 percent. There was a reported increased risk of psychiatric events of around 1 percent when Tamiflu was used to prevent influenza. Evidence also suggests that Tamiflu prevented some people from producing sufficient numbers of their own antibodies to fight infection.

The worldwide use of Tamiflu, has increased dramatically since the outbreak of H1N1 virus (Swine Flu) in April 2009. It was initially believed that it would reduce hospital admissions and complications of influenza, such as pneumonia, during influenza pandemics. However, the original evidence presented to government agencies around the world was incomplete. The Cochrane Review has benefited from access to more complete reports of the original research, now made available by the manufacturers, Roche and GlaxoSmithKline. Although the review has confirmed small benefits on symptom relief, there is little to justify any belief that it reduces hospital admission or the risk of developing confirmed pneumonia. Along with the evidence of harms from the medication, it raises the question of whether global stockpiling of the drugs is still justifiable given the lack of reliable evidence to support the original claims of its benefits.

Dr David Tovey, Editor-in-Chief, Cochrane, said: "We now have the most robust, comprehensive review on 'neuraminidase inhibitors' that exists. Initially thought to reduce hospitalisations and serious complications from influenza, the review highlights that Tamiflu is not proven to do this, and it also seems to lead to harmful effects that were not fully reported in the original publications. This shows the importance of ensuring that trial data are transparent and accessible."

Dr Tom Jefferson, Dr Carl Heneghan, Dr Peter Doshi, authors of the review, Cochrane Neuraminidase Inhibitors Review Team, said: "Drug approval and use cannot be based on biased or missing information any longer. We risk too much in our population's health and economy. This updated Cochrane review is the first time a Cochrane systematic review has been based only on clinical study reports and regulator's comments. It is the first example of open science in medicine using full clinical study reports available without conditions. And therefore the conclusions are that much richer. We urge people not to trust in published trials alone or on comment from conflicted health decision makers, but to view the information for themselves."

The review clearly recommends that guidance on the use of both neuraminidase inhibitors (oseltamivir and zanamivir) in the prevention or treatment of influenza should be revised to take account of the evidence of small benefit and increased risk of harms.

Dr Fiona Godlee, Editor-in-Chief, The BMJ, said: "This review is the result of many years of struggles to access and use trial data, which was previously unpublished and even hidden from view. It highlights with certainty that future decisions to purchase and use drugs, particularly when on a mass scale, must be based on a complete picture of the evidence, both published and unpublished. We need the full data from clinical trials made available for all drugs in current use. With the new European Clinical Trials Directive bringing in rules for future drugs, it highlights the enormous challenge we face. We need the commitment of organisations and drug companies to make all data available, even if it means going back 20 years. Otherwise we risk another knee-jerk reaction to a potential pandemic. And can we really afford it?"

Source: BMJ-British Medical Journal"



 
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