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British scientist challenges pharmaceutical company over research
paper
By Chris Talbot
28 January 2006
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A British scientist, Dr. Aubrey Blumsohn, has criticised a
major pharmaceutical companys unethical behaviour
for putting forward a research paper in his name without giving
him proper access to the data on which the investigation was based.
The case has international significance as it raises fundamental
questions regarding the validity of scientific research that is
funded by the major drug companies where data and analysis cannot
be independently verified. Pharmaceutical corporations have been
under scrutiny over the vast sums of money they spend on promoting
their products regardless of patient needs, particularly after
the case of Vioxx and other anti-inflammatory drugs. But this
case raises the issue of science itselfin universities now
largely dependent on finance from industryand whether data
and its statistical interpretation are being manipulated to give
results favourable to business interests.
Dr. Blumsohn, well known as an expert in the medical field
of osteoporosis, is a senior lecturer at Sheffield University.
He has produced emails and taped telephone conversations demonstrating
how in 2002 and 2003 he was prevented from seeing the full data
of a study in which he was involved, despite the fact that his
name would be used as the lead author in research publications.
In September last year he was suspended from his job at Sheffield,
and it has since been revealed that he was offered a sum of £145,000
($256,000) by the university if he resigned and returned all clinical
and research data back to them. He would also have had to agree
to make no detrimental or derogatory statements about
senior university staff. Sheffield University threatened the Times
Higher Educational Supplement, which has revealed the details
of the severance deal, with a legal injunction.
Dr. Blumsohn had been involved in a study looking at the impact
of a drug, Actonel, manufactured by Proctor and Gamble, on women
at risk of bone fracture. There is no suggestion that the drug
is not effective and safe. But Actonel, which earns some $1 billion
a year, is in competition with a rival drug and market leader,
Fosamax, manufactured by Merck.
The research study took samples from thousands of women who
were suffering from osteoporosis to examine which of the patients
suffered fractures, and to match that to changes in bone turnover
(the rate at which the body replaces its own bone material) and
bone density. How drugs like Actomel and Fosamax work is still
a matter of debate, but it is recognised that Fosamax is better
at increasing bone density and reducing bone turnover. Proctor
and Gamble hoped that the Sheffield research would show that once
bone turnover had been suppressed by a certain amount (30 to 40
percent), further fall in turnover would not result in producing
fewer bone fractures, thus boosting the case for Actonel.
As is standard in such research the data collected by Dr. Blumsohns
team was blinded, i.e., it was coded so that the details
could not be known to the researchers and hence not influence
them. But a request from Professor Eastell, head of Dr. Blumsohns
research unit, to Proctor and Gamble to see the data after it
had been decoded and analysed by the companys statistician
was rejected. The company stated that it was standard industry
practice not to give academics access to data.
Only after 18 months of Dr. Blumsohn making repeated requests
was he allowed to visit Proctor and Gambles UK headquarters
to see graphs on a computer screen produced from analysis of the
data, though still not to perform his own independent analysis.
He expressed concern that the range on the axis of one of the
graphs had been chosen to exclude 40 percent of the data, thereby
supporting the case for Actonel. Proctor and Gamble since agreed
to withdraw the graph from a presentation.
Proctor and Gamble deny they were manipulating the data, and
claim that Blumsohn was given access to all the data related
to his research. But Blumsohn has a tape recording of his
meeting with the companys statistician, who complained that
if the 40 percent were included it would benefit Merck. Because
that is contradicting our original manuscript. I just know what
Merck are like. I think they are going to use it.
Dr. Blumsohn and Professor Eastell had already been told by
Proctor and Gambles statistician that it was intended that
their research, although under their names, would be written up
by the companys own ghost writer. Significantly they were
told that the ghost writer was familiar with ... our key
messages. Such a procedure has become widespread in research
sponsored by drug companies, ostensibly because a professional
writer is more effective than academics.
Dr. Blumsohn became aware that in his problem with Proctor
and Gamble over the access to data, he was increasingly coming
into conflict with the higher levels of Sheffield University.
He recorded a conversation with Professor Eastell, who told him,
The only thing we have to watch all the time is our relationship
with P&G. The financial support from Proctor and GambleProfessor
Eastells group had received £1.6 million ($2.8 million)he
said, is a good source of income, we have got to really
watch it.
Before he went public with his concerns last year, Dr. Blumshohn
spent months attempting to get a response to his complaints from
the university administration. The dean of his faculty and the
vice chancellor passed the matter on to the head of human resources,
to whom Dr. Blumsohn gave a full account of his concerns. After
he told her he was going to talk to medical journalists, he received
a threat of disciplinary action and then was suspended last September.
The university claims that Dr. Blumsohn did not raise his
concerns through the proper channels.
Concerns over research data from clinical trials and pharmaceutical
companies not publishing adverse results is not a new one. In
2004 the New York attorney general, Eliot Spitzer, sued GlaxoSmithKline
over allegations that it was holding back negative information
about its antidepressant drug Paxil, also known as Seroxat. Unpublished
results showed a possible increased tendency to suicidal thinking
in some cases. An internal document from the company said it wanted
to manage the dissemination of data in order to minimise
any potential negative commercial impact. GlaxoSmithKline
agreed to publish the results of clinical tests.
In April last year a study by the UK National Collaborating
Centre for Mental Health was published in the Lancet, accusing
drug companies of suppressing negative data about Selective Serotonin
Reuptake Inhibitors (SSRIs), the anti-depressant drug family to
which Paxil (Seroxat) belongs.
Following the GlaxoSmithKline case, major pharmaceutical companies
have agreed to publish the results of trials that they have sponsored,
within one year of the drug being approved. This does not apply
to drugs that are not being marketed, neither is it retrospective.
The case of Dr. Blumsohn emphasises that there is no requirement
for in-house research data and analysis to be vetted by independent
authorities, or even to be seen by the academics or medical doctors
who collaborated in the research.
Dr. Blumsohns case was raised during a House of Commons
debate in December 2005 about a report prepared by the Parliamentary
Health Committee entitled The Influence of the Pharmaceutical
Industry.* The report raises a variety of concerns about
the marketing techniques used by the drug corporations, and about
medical research, including the practice of ghost writingconcerns
which are highlighted by the Sheffield University research.
The Health Committee report recommended that the UK drugs regulator,
the Medicines and Healthcare products Regulatory Agency (MHRA),
should be reformed to make it independent of the industry by which
at the moment it is totally financed. This proposal was rejected
by the Labour government of Prime Minister Tony Blair, which has
made clear that it will see no serious criticism made of the pharmaceutical
industrythe third most profitable in Britain after finance
and tourism. The health minister declared, It is in all
of our interests that the industry maintains its currently strong
position.
* http://www.publications.parliament.uk/pa/cm200405/cmselect/
cmhealth/42/42.pdf
See Also:
New evidence of
over-marketing of Vioxx
and other anti-inflammatory drugs
[16 February 2005]
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