O/r + oS &<r,,yP * Exposing the Global Healthcare Agenda JACKY LAW ,» f. JACKY LAW is a pharmaceutical journalist. For the past 25 years she has written about health issues. For seven years she worked as associate editor for Scrip Magazine, a monthly international pharmaceutical title. She left in 2004 to write Big Pharma. Jacky Law acknowledges the enormous contribution of her editor, Dan Hind, and agent, Jessica Woollard, in making this book possible. Mention must also be made of those who offered valuable perspective in what are complex and often, contentious areas. They include Professor Martin Bobrow, Dr Philip Brown, Professor Joe Collier, Dr Peter Fletcher, Dr John Griffin and Professor Eric Topol. Jacky would also like to thank everyone at the top pharmaceutical titles Scrip Magazine and Scrip World Pharmaceutical News (www.scripnews.com) with whom she worked for seven years. Last but not least, she sincerely thanks all her friends and family for encouraging and putting up with her. Big Pharma Exposing the Global Healthcare Agenda JACKYLAW CARROLL & GRAF PUBLISHERS New York Carroll & Graf Publishers An imprint of Avalon Publishing Group, Inc. 245 W. 17th Street 11th Floor New York NY 10011-5300 www.carrollandgraf.com AVALON oiiblisbinq group Incorporated First published in the UK by Constable, an imprint of Constable & Robinson Ltd, 2006 First Carroll & Graf edition, 2006 Copyright © jacky Law, 2006 All rights reserved. No part of this publication may be reproduced in any form or by any means without the prior permission of the publisher. ISBN-13: 978-0-78671-783-5 ISBN-10: 0-7867-1783 I Printed and bound in the EU Contents Preface 1 Part 1 Not wanting to know 5 1 The cost of convenience 7 2 The company of giants 28 3 A question of trust 45 4 Old pills in new bottles 62 Part 2 When the good stay silent 85 5 The story of Vioxx 87 6 The SSRI story 104 7 A crisis in medicine 121 8 A bit of a lottery 140 Part 3 Counting the cost 161 9 The people vs pharma 163 10 The European patient 178 11 Genes, germs and general behaviour 196 12 Patients take the lead 216 Appendix 236 Notes 237 Index 257 Digitized by the Internet Archive in 2017 with funding from Kahle/Austin Foundation https://archive.org/details/bigpharmaexposinOOIawj_0 Preface When medicine is not an option ... On 5 June 1981, the first official report of what is now a global pandem¬ ic appeared in the weekly newsletter of the US Federal Centers for Disease Control. The report stated that a rare parasitic lung infection had shown up in Los Angeles in five young men. Moreover, all the men had an inexplicably depressed immune function. This date is now known as the start of the worst plague in modem history, AIDS (acquired immune deficiency syndrome). Before then, young men like Stewart Anderson had been diagnosed with what was known as Gay Syndrome, a mystery plague that mostly killed gay men. I interviewed Stewart in 1987, at around the time Princess Diana famously shook hands with an AIDS patient on national television. It may be hard for younger readers to appreciate the fear most people felt knowing a transmissible killer disease was at large. Official health advice, for example, included not having sex with Americans, so little was known about it. And ambulance men could be seen wearing full ‘spacesuit’ protection when dealing with patients suspected of carry¬ ing the mystery plague. Stewart had been living with AIDS for some years and just moved into a brand new and unusually bright basement flat in Hammersmith. He was a skinny guy in his 20s with a toothy smile and a face covered in the purple blotches characteristic of Kaposi’s sarcoma, a skin cancer common in AIDS patients. He said from the outset he wasn’t sure I was going to be able to convey what he wanted to say. I said I would do my best. It wasn’t until I visited him at the old Chelsea and Westminster Hospital a week or two later that I began to appreciate what he might be trying to express and what became the germ of an idea for this book. 1 PREFACE Nothing could have prepared me for the despair I felt in that ward of young men who should have been out starting lives, not visibly wasting away. The fear was palpable, and the many doctors, busily reading charts and talking among themselves, could do nothing to assuage it. They had nothing to offer. Stewart, who had been booked in for a blood transfusion, was nowhere to be seen. I wanted to ask the doctors if they felt the course of the disease could be altered by anything patients might do, knowing as I did how hard Stewart was fighting to extend his life. But I knew the answer already, and the doctors seemed to have more than enough to do. The question I should have asked was addressed in a special Newsweek report on the twentieth anniversary of AIDS, in June 2001. Sharon Begley, the writer, talked about how AIDS had changed what it meant to be a patient. The despair I had felt in those wards did eventually find channels of expression. ‘People with AIDS stormed scientific confer¬ ences, banded together in ways no other patients ever had,’ she wrote. ‘[They] helped revolutionize the process of testing experimental drugs and they inspired others.’ Stewart was nowhere to be seen because he had discharged himself. His main battle was to be optimistic, and hospital didn’t help. He was one of the world’s longest surviving patients, despite his Kaposi’s sar¬ coma having spread to his stomach and lungs. Just months before we met, he had developed the lung infection that had been the original diagnosis. It very nearly killed him. On the eve of 1987, he couldn’t stand up for longer than three minutes. ‘This kind of illness changes your attitude to life,’ he said. ‘Each breath is precious. I was determined to start the new year on my terms. There are things I still have to do. It is easy to give in and die.’ Stewart fought tenaciously for the right to make sense of his disease on his terms, and this was the message he wanted to convey. He went on to do a series of interviews, mine included, something very few people did at the time given the fear and prejudice surrounding the disease. He embarked on a strict macrobiotic diet and programme of cycling and swimming. He also founded, with seven others, the self-help group Body Positive. Stewart was just trying to make sense of his life before it was gone. All he knew was that he wanted as little medical interference as possible and that there must be some upside to his situation - Tui his life should not pass by in vain. ‘When you look in the mirror and see marks all over your body it is hard to feel good about yourself,’ he said. ‘But I have learned 2