Oh, and another Big Pharma scandal: who could forget drug giant Merck's embarrassing revelation that they had even invented a fake medical journal they called "The Australasian Journal of Bone and Joint Medicine" which was basically a company promotions pitch for two Merck drugs: Fosamax (for osteoporosis) and Vioxx (the blockbusting painkiller, later withdrawn by Merck when the Journal of the American Medical Association revealed that Vioxx could cause heart attacks and strokes. Merck knew, but did not disclose these adverse effects).

Later it was also revealed that many Vioxx-friendly manuscripts published by legitimate medical journals had actually been prepared by paid ghost writers but attributed to academic researchers who did not disclose Merck's financial support.

Until they were exposed, Merck also did not disclose that they were the sole funders of all six issues of the phoney 'Australasian Journal of Bone and Joint Medicine'.

Once again, in answer to the question: 'Are medications the only treatment available for heart disease?' - if you ask the drug companies, their answer would be a big fat YES.

Carolyn Thomas
http://www.myheartsisters.org

I wholeheartedly (no pun intended) agree with the previous comment, the management of cardiovascular disease should be judged on a case by case basis, using medication and the management of risk factors, treating each person as an individual. One size does not fit all, especially in complex diseases.

That is a rather jaundiced view you have on the pharmaceutical industry Carolyn. I would not and could not in good conscience defend the poor behaviour of some members of the commercial arm of the pharmaceutical industry. However the vast majority of the members of the pharmaceutical industry, myself being one of them, genuinely care about beneficial health outcomes and not just for profit. Of course sales reps are going to tell doctors that their product is the only game in town, it’s a side effect of living in a free market.

A fully charitable not for profit pharmaceutical industry would never get off the ground, the same reason Starbucks and Wall-mart dominate the marketplace, they are the best at what they do with the facilities and the funding to being products on mass to the population.

Perhaps a proportion of the blame should be placed on FDA legislation of the industry that so many illegal marketing practices are occurring in the US. In other countries such as the UK we are not allowed to advertise prescription medication, we still have sales reps and marketing strategy but only a fraction of the proportion of other product providing industries.

I completely agree that lifestyle changes are core to many diseases but pharmaceutical treatment currently on the market has been shown scientifically to be safe, efficacious and produced to a high standard of quality. Unlike all exercise programs, diets and holistic alternatives which are almost entirely based on half truths and poor science.

Lifestyle changes rely on full patient compliance which for the most part people do not follow. Unless every person suffering with heart disease receives the full time attention of a dietician and a personal trainer, which I would love to see but lets face how would that be paid for?

Please do not take this comment as aggressive or in anyway a personal attack on your views I just wished to address the other side of your point.

Hi Carolyn,

I would not and could not defend “off label prescription” or fraudulent or biased scientific papers. Those practices are despicable and the sooner these cancers on the industry are found and cut out the better.

From the sounds of I think that your situation stems form both practicing doctors and sales reps dealing outside of the registered use of drugs. It is one thing for a paper to be published or a study to be undertaken by or on behalf of a pharmaceutical company, it is quite another to have these “opinions” approved by the health authorities. If a paper says that drug A can treat angina but it is indicated for gout it is not legal or ethical to start prescribing it to patients with angina.

A doctor should prescribe according to the registered indications not what a slick rep looking for commission tells them, they are not medical or scientific experts, they are sales people.

I can not comment on outside the UK as this is where my specialized knowledge is. With the NHS and prescribing rights being controlled by the local Primary Care Trusts doctors can not prescribe a drug unless it has been first approved for safety, efficacy and quality by the health authority, then assessed for cost effectiveness then the Primary Care Trusts say to the doctors you may prescribe this as first, second or third line etc. There is very little room for misinformation from the pharma company (in fact it is illegal to advertise a prescription medicine to the general public and only advertise to medical professionals on the facts as assessed and approved by the health authority).

Its rather late for me right now so I will have to keep this response relatively short and general due to my tiredness but I would genuinely like to continue this discussion. As a young person my career in the pharma industry is just beginning, I really want to discuss real concerns so I can either help allay fears and misconceptions or do my best to make whatever impact I can to help make a difference. Perhaps this sounds a little idealistic but I care, I want to see the best healthcare outcomes possible for people and I can see no better way than doing this as part of the industry and trying to become part of the solution.

Kind regards,

Christopher

Gina,
I am so happy you made your comments about the pharmaceutical industry. The comments made in September are extremely biased and misleading. They obviously don’t know how many billions of dollars go into research and development of a drug, many of which never make it to market.
I also would like to tweak your comment about "basic science and basic chemistry" The volume of information to prepare a physician for practice is astronomical. Biochemistry and basic science comes first and foremost in the curriculum and is reinforced for the rest of their years of education and medical practice. What we don’t get enough of, is pharmacology, clinical nutrition and alternatives to pharmacology. Physicians also don't get properly reimbursed for time spent educating the population on wellness and personal fitness. We are still a society that thinks retrospectively rather than prospectively. We want problems reversed rather than prevented. We also like to blame others, rather than accept personal responsibility for ourselves. Large companies are large targets. The above respondents need to walk through the halls of Merck, Pfizer, Lilly, Novartis, Johnson & Johnson, Etc, and realize the PEOPLE that make the drugs, believe they are doing it for the good of mall humankind.

That being said, without "Big Pharma" most of us would be dead right now. The general population wants someone else to care for them. We are responsible first for our own lives and well being. Living the "good life" kills us and then we want physicians and pharmaceutical companies to fix it.

Just one persons opinion.