The malware of medical science

Just when you thought the pharmaceutical industry had used up every dirty trick in the book, it has been revealed that a ‘study’ of the epilepsy drug gabapentin (aka Neurontin) was never really intended to investigate the medication, but was primarily intended to get doctors to prescribe it more often.

A report published in the Archives of Internal Medicine examined documents uncovered in legal cases that show that a drug trial called ‘Study of Neurontin: Titrate to Effect, Profile of Safety’ (STEPS) was largely designed to involve doctors in a marketing programme that would appear like a scientific trial.

Actually, it was a scientific trial of a sort, but rather than studying the effect of the drug on patients, they were studying the effect of marketing on the doctors.

Parke-Davis sales representatives collected and recorded individual subject data. In a clear example of data tampering, they not only attended epilepsy patients’ office visits (under the guise of “shadowing” the clinician), but also actively promoted the use of Neurontin and blocked the use of competing medications, particularly lamotrigine (Lamictal), at those visits. They also rewarded participating investigators with free lunches and dinners.

Without informing either patients or physicians, the drug company’s marketing department monitored each investigator’s prescribing practices. It documented a 38% increase in prescriptions of Neurontin after investigators attended an introductory briefing, as well as a 10% increase in the average prescribed dose. It also compared prescribing patterns between study investigators and a control group of nonparticipating neurologists, and documented increased prescribing of Neurontin only among the study participants.

Big Pharma: the malware of medical science.

Link to good write-up in Internal Medicine News.
Link to locked study in the Archives of Internal Medicine.
Link to locked related editorial in the Archives of Internal Medicine.

4 thoughts on “The malware of medical science”

  1. I found the following article after reading this blogpost and doing a bit of searching: “But even though Pfizer pled guilty to criminal marketing of Neurontin in 2004 and was found guilty again in 2010, it earned $387 million from the drug in 2008. Who says crime doesn’t pay? …In just three years, Parke-Davis planted 13 ghostwritten articles in medical journals promoting off-label uses for Neurontin”

  2. Reminds me of my days in the vet tech program also – we had no nutrition course, so we had a guest speaker for the nursing class. Surprise! It was a sales rep from Purina. We got to hear the virtues of animal byproducts. After graduating, I was required to earn 12 credits a year in order to keep my degree. Purina (and Merck) offered online classes. I took the Purina nutrition one (it was cheap and I didn’t have to drive to Boston) and took the multiple-choice quiz at the end. 2/3 nutrition, The last 1/3rd asked us to identify the best possible diet for cats and dogs. It was usually like this: A. Some kind of meat. B. Some combo of meat and veggies. C. Purina’s new product for cats or dogs! Surprise again – Purina’s products were always the correct answer.

    For the efforts in the course (which took several days to complete), we were given a mug, a backpack, a watch and some other Purina nicknack. Oh, and one other thing: a renewal on our veterinary nursing certification. Because we now know that Purina is the best pet food. Yeah, right. I’d never feed my animal that crap, but at least now I know what the company is up to.

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