The Conflict of Interest between Governments, Doctors, Researchers and the Pharmaceutical Industry (1)

Seven medical researchers and one patient advocate gathered in an opulent Marriott hotel in College Park, Maryland, on a sweltering July day in 2010 to review a promising drug intended to reduce blood clotting and prevent heart attacks and strokes. The committee is one of many advisory groups that decides annually whether the Food and Drug Administration (FDA) should approve a treatment for the American market. On that day, representatives from the agency and AstraZeneca, the drug’s manufacturer and one of the biggest pharmaceutical companies in the world, gave presentations to the panel about the drug’s preclinical and clinical data.

Little drama was generated by the event. Advisors politely questioned and complimented company scientists in the cool sanctuary of the conference room. By day’s end, the panel had decided to approve, seven to one. FDA later gave its approval, as usual. The medication, ticagrelor, sold well and became a multibillion-dollar success under the brand name Brilinta. Although it currently costs 25 times as much, it modestly reduces the risk of death from vascular causes, heart attacks, and strokes.

This is Giant Big Bad Pharma for you – killing for profit, misleading doctors, harming patients and people, in which the profit and the money is in the medicine and the vaccines and not in the cure, because there is no money in the cure.

Before such advisory panels convene, the FDA, which has its main office in Silver Spring, Maryland, should be using  a tried-and-true system to look for potential conflicts of interest.  But this other corrupt and bribed agency made no mention of any financial conflicts among the voting panelists, which included four doctors, prior to the Brilinta vote. AstraZeneca and companies that sell or are developing cardiovascular therapies similar to Brilinta showered the four with cash for travel and advice as Brilinta’s sales took off later. For instance, from 2013 to 2016, those firms provided more than $200,000 in lodging, honoraria, and consulting to cardiologist Jonathan Halperin of the Icahn School of Medicine at Mount Sinai in New York City. For instance, AstraZeneca claims it paid Halperin more than $11,000 in expenses and fees during that time for his work as the chair of the data monitoring committee for a multimillion-dollar clinical trial of Brilinta sponsored by AstraZeneca and run by Duke University, as well as for his service on an advisory board and a data monitoring committee for a clinical trial of Brilinta led by the University of California, San Francisco.

Brilinta fits a pattern of conflicts of interest that are referred to as pay-later conflicts that have largely gone unnoticed—and completely unpoliced. Science discovered widespread post-approval payments or research support to panel members after looking at compensation records from pharmaceutical companies to doctors who advised FDA on whether to approve 28 psychopharmacologic, arthritic, cardiac, or renal drugs between 2008 and 2014. The agency’s anti-conflict of interest measures are not intended to stop such future financial ties.

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