Big Pharma's new friend

stelvio · May 2007

The BBC is busy marketing Pfizer's latest
http://news.bbc.co.uk/1/hi/health/6705667.stm
Note the complete abscence of any critical comment whatsoever anywhere.
Wonder how much the BEEB charge ?

Flying_Monkey · May 2007

Is simoncp busy or something? [;)] This would be about the BBC if every other news outlet wasn't reporting exactly the same story today, many as their main headline. So in the absense of any real issue about the BBC here, there may be several reasons:

1. There's a lot of concern about drug pricing and availability within the new assessment procedures for the NHS. Some of this may indeed be whipped up by drug companies. But some of it certainly comes from consumer groups.

2. Journalists are often given to putting out press releases as if they were 'news' without much in the way of extra comment.

And I totally agree with you that the lack of serious critical comment in the media about pharmaceutical issues is worrying...

Those who would give up Essential Liberty to purchase a little Temporary Safety, deserve neither Liberty nor Safety

papercorn2000 · May 2007

I was thinking the same thing, that's almost quarter of an hour!

God told me to skin you alive.
http://www.ekroadclub.co.uk/

Smeggers · May 2007

WHy does it have to be critical when its an article in general praise of the drug?

For journalistic non-bias?

I'm big enough to make my own mind thanks.

Hickory Dickory Dock,
A baby elephant ran up the clock,
The clock is being repaired

stelvio · May 2007

This would be about the BBC if every other news outlet wasn't reporting exactly the same story today, many as their main headline.

Mea Culpa; foolish assumption on my part that the BBC might be expected to be more competent than mainstream commercial media.

stelvio · May 2007

I'm big enough to make my own mind thanks.
[/quote]

I like to make up my own mind too, but personally I prefer to have a few facts rather than journalistic gloss.
facts such as: what is the evidence the drug works and where is that evidence published ? what side effects have been identified ? How many people have had the drug and for how long ?

Smeggers · May 2007

"Trials have shown the drug was effective after a 12-week course, with 44% of smokers managing to stop."

"The main side-effect of the drug, which costs about œ1.95 a day, seems to be nausea."

Its in the article? Also its pretty fair to assume as its gone through clinical trials in accordance with NICE / FDA and I am certainly not qualified enough to question the detail of that.

I suspect what you are really saying is, what a waste of money a stop smoking drug is?

Hickory Dickory Dock,
A baby elephant ran up the clock,
The clock is being repaired

Melvil · May 2007

Well, on one level its nice to get at least some media attention on the forthcoming smoking ban. I'm surprised its been so quiet about it.

I say this because I just know there'll be a sizeable majority of the english who'll say 'oh but we didn't know' when they light up in pubs and restaurants.

******************************************************************************
See Baby Elephants and more at: http://www.flickr.com/photos/47331519@N00/

mjones · May 2007

<blockquote id="quote">quote:<hr height="1" noshade id="quote">Originally posted by stelvio

I like to make up my own mind too, but personally I prefer to have a few facts rather than journalistic gloss.
facts such as: what is the evidence the drug works and where is that evidence published ? what side effects have been identified ? How many people have had the drug and for how long ?
<hr height="1" noshade id="quote"></blockquote id="quote">
In which case you'll need to read what NICE has to say about it:
http://www.nice.org.uk/page.aspx?o=431452

NICE's evaluation criteria are extremely strict, so they will only have issued this guidance if there is robust evidence for the treatment's effectiveness. Hopefully they'll eventually get round to homeopathy and other quack medicine so we can stop wasting NHS resources on fashionable placebos ...

stelvio · May 2007

In which case you'll need to read what NICE has to say about it:
http://www.nice.org.uk/page.aspx?o=431452

[/quote]

Exactly !
Now why could the BBC not, at the very least, put that link in their web-page ? Note that there is a link to Pfizer on the the BBC page.

stelvio · May 2007

<blockquote id="quote">quote:<hr height="1" noshade id="quote">Originally posted by Smeggers

"Trials have shown the drug was effective after a 12-week course, with 44% of smokers managing to stop."
"The main side-effect of the drug, which costs about œ1.95 a day, seems to be nausea."
<hr height="1" noshade id="quote"></blockquote id="quote">

How many in the placebo group stopped smoking ? Maybe the placebo was even more effective ?
After 12 weeks the main side effect was nausea, but who knows what happened by after 12 months; maybe they had all become impotent, developed liver failure and grown antlers ???
And were any of these trials conducted by somebody other than the manufacturer ?
Anybody who takes this drug on the basis of these claims deserves whatever happens to them.

DaveyL · May 2007

"This compares with 18% of those given a placebo and 30% of those taking another anti-smoking drug, bupropion, which is also available on the NHS."

That's also in the BBC article. That's twice you've asked questions which were answered in the beeb article...

More generally, I suspect we have another climate change thread on our hands here. People spouting off who know absolutely hee-haw about pharmaceuticals and clinical trials. Soapbox, you gotta love it.

stelvio · May 2007

<blockquote id="quote">quote:<hr height="1" noshade id="quote">Originally posted by DaveyL

"This compares with 18% of those given a placebo and 30% of those taking another anti-smoking drug, bupropion, which is also available on the NHS."
<hr height="1" noshade id="quote"></blockquote id="quote">

But that is all the article tells you, almost the only factual content, and it leaves a lot of unanswered questions, which we might expect journalists to try and answer, rather than just parrotting the press release from Pfizer.

Is this drug safe in the long term ?
Were the trials actually carried out in a reliable way ?
Were any of the trials done by somebody other than Pfizer ?
Was the drug given to enough people to actually detect rare but serious side effects ?
Is it possible benefits are being exaggerated and adverse effects ignored ?
How many of those who had stopped at 12 weeks still stopped at 12 months ?
Were the difference between placebo and drug groups actually statistically significant ?
Where are these "trials" published if we wantt to look at them ourselves ?

If only Tony Blair had such tame journos, we might all be celebrating the tremendous success of the Iraq invasion.

Smeggers · May 2007

I dont think the BBC necessarily has a duty to answer all those questions, its not Nature or Scientific American after all? (I dont even think they would go THAT detailled).

I'll ask again, is the journalistic argument just an excuse because you fundamentally don't agree with the drug?

Hickory Dickory Dock,
A baby elephant ran up the clock,
The clock is being repaired

stelvio · May 2007

<blockquote id="quote">quote:<hr height="1" noshade id="quote">Originally posted by Smeggers

I dont think the BBC necessarily has a duty to answer all those questions, <hr height="1" noshade id="quote"></blockquote id="quote">

Absolutely, how dare journalists question Pfizer's press releases. They will be telling us that nice Mr Blair was lying over WMD next; outrageous !

Actually, personally, I prefer journalists to ask tricky questions, and not to report stuff without making some attempt to understand what is going on.
I am also a bit pi$$ed off with the BBC, which should be able to do a bit better than the Mail or Express.

Smeggers · May 2007

Your getting the world of 'science' and 'politics' all mixed up my friend.

Hickory Dickory Dock,
A baby elephant ran up the clock,
The clock is being repaired

Flying_Monkey · May 2007

Stelvio's fundamental point is a good one: the media in general are poor at communicating science to the public. If they relies too much on pharmaceutical companies (or indeed on anti-pharma campaigners) for their information then people aren't going to be able to make informed assessments. The very least they can do is provide links to the NICE review documents.

I think it is also worth questioning whether we need expensive drugs paid for by the state to stop people smoking. There is a strong case for non-pharmaceutical approaches, based on, to put it simply, assisted will-power.

Where the OP is a bit of a diversion is simply to target the BBC as being the main offender. Hardly. It's generally better than most on these kinds of things, especially if you compare it to the snake-oil promoting Mail and Express or the free papers like Metro which really do seem to publish company press releases as written.

Those who would give up Essential Liberty to purchase a little Temporary Safety, deserve neither Liberty nor Safety

ankev1 · May 2007

<blockquote id="quote">quote:<hr height="1" noshade id="quote">Originally posted by Flying_Monkey

Stelvio's fundamental point is a good one: the media in general are poor at communicating science to the public. If they relies too much on pharmaceutical companies (or indeed on anti-pharma campaigners) for their information then people aren't going to be able to make informed assessments. The very least they can do is provide links to the NICE review documents.

Those who would give up Essential Liberty to purchase a little Temporary Safety, deserve neither Liberty nor Safety

<hr height="1" noshade id="quote"></blockquote id="quote">

You just been on holiday in Somerset or something?

DaveyL · May 2007

Surely, in the case of medicines, it's up to the potential patient to make an informed assessment along with their GP, and nothing to do with what any media source publishes? This makes it sound as if the BBC or any other media source is the last port of call before someone commits to a particular treatment!

Joe Sacco · May 2007

There is always the free drug available to all. It's called "will power"

stelvio · May 2007

Avandia, also a great drug, for diabetes, according to the BBC report
http://news.bbc.co.uk/1/hi/health/886448.stm

now being investigated for heart problems
http://news.bbc.co.uk/1/hi/business/6678757.stm

oops !

DaveyL · May 2007

So what conclusions would you draw from that second BBC article?

Absinthe Minded · May 2007

<blockquote id="quote">quote:<hr height="1" noshade id="quote">Originally posted by Joe Sacco

There is always the free drug available to all. It's called "will power"
<hr height="1" noshade id="quote"></blockquote id="quote">Worked for you so it should work for everybody then? Humans are complex, as is nicotine addiction. If you think that everyone deals with nicotine withdrawal in the same way then you are badly mistaken....

<hr noshade size="1">Ja sam napisao ovo ovde samo zbog toga da izgledam pametan...

See My route to work!

Joe Sacco · May 2007

<blockquote id="quote">quote:<hr height="1" noshade id="quote">Originally posted by Absinthe Minded

<blockquote id="quote">quote:<hr height="1" noshade id="quote">Originally posted by Joe Sacco

There is always the free drug available to all. It's called "will power"
<hr height="1" noshade id="quote"></blockquote id="quote">Worked for you so it should work for everybody then? Humans are complex, as is nicotine addiction. If you think that everyone deals with nicotine withdrawal in the same way then you are badly mistaken....

<hr noshade size="1">Ja sam napisao ovo ovde samo zbog toga da izgledam pametan...

See My route to work!
<hr height="1" noshade id="quote"></blockquote id="quote">

Not at all, the withdrawal symptoms are going to be very similar for all. I didn't say it was easy to give up which is why will power is required. Lots of things are not easy, just seperates the winners and losers I guess.

stelvio · May 2007

<blockquote id="quote">quote:<hr height="1" noshade id="quote">Originally posted by DaveyL

So what conclusions would you draw from that second BBC article?

<hr height="1" noshade id="quote"></blockquote id="quote">

1. Sell Glaxo shares; also those of Takeda who manufacture a very similar drug.
2. Treat all Pharma company claims about the benefits of drugs with extreme caution.
3. If your diabetes is not controlled with diet/exercise/metformin, ask for Insulin not tablets.

Absinthe Minded · May 2007

<blockquote id="quote">quote:<hr height="1" noshade id="quote">Originally posted by Joe Sacco:

Not at all, the withdrawal symptoms are going to be very similar for all. I didn't say it was easy to give up which is why will power is required. Lots of things are not easy, just seperates the winners and losers I guess.<hr height="1" noshade id="quote"></blockquote id="quote">Agreed, but it is just that similarity that can make the difference between being a winner, or a loser. It is for this reason that different methods work with different people and this is why it is a good thing to have options rather than have everybody try to kick the habit using the method that you found best.

<hr noshade size="1">Ja sam napisao ovo ovde samo zbog toga da izgledam pametan...

See My route to work!

Pizzaman · May 2007

<blockquote id="quote">quote:<hr height="1" noshade id="quote">Originally posted by Joe Sacco

<blockquote id="quote">quote:<hr height="1" noshade id="quote">Originally posted by Absinthe Minded

<blockquote id="quote">quote:<hr height="1" noshade id="quote">Originally posted by Joe Sacco

There is always the free drug available to all. It's called "will power"
<hr height="1" noshade id="quote"></blockquote id="quote">Worked for you so it should work for everybody then? Humans are complex, as is nicotine addiction. If you think that everyone deals with nicotine withdrawal in the same way then you are badly mistaken....

<hr noshade size="1">Ja sam napisao ovo ovde samo zbog toga da izgledam pametan...

See My route to work!
<hr height="1" noshade id="quote"></blockquote id="quote">

Not at all, the withdrawal symptoms are going to be very similar for all. I didn't say it was easy to give up which is why will power is required. Lots of things are not easy, just seperates the winners and losers I guess.
<hr height="1" noshade id="quote"></blockquote id="quote">

I gave up smoking using only will power, but I hardly think that makes me a 'winner'. All I did was stop slowly killing myself.

You can't really turn this into a winner/loser comparison anyway, considering nicotine is supposed to be as addictive as heroin and freely available to boot. I think that different people respond differently to it. In the same way, I manage to drink alcohol fairly regularly without being an alcoholic, whereas George Best couldn't manage that and died because of it.

It doesn't make you a 'loser' if you have to chew bits of gum to give up, it will just cost you more. As long as you don't smoke in the end, who cares how you do it?

Joe Sacco · May 2007

<blockquote id="quote">quote:<hr height="1" noshade id="quote">Originally posted by Pizzaman

<blockquote id="quote">quote:<hr height="1" noshade id="quote">Originally posted by Joe Sacco

<blockquote id="quote">quote:<hr height="1" noshade id="quote">Originally posted by Absinthe Minded

<blockquote id="quote">quote:<hr height="1" noshade id="quote">Originally posted by Joe Sacco

There is always the free drug available to all. It's called "will power"
<hr height="1" noshade id="quote"></blockquote id="quote">Worked for you so it should work for everybody then? Humans are complex, as is nicotine addiction. If you think that everyone deals with nicotine withdrawal in the same way then you are badly mistaken....

<hr noshade size="1">Ja sam napisao ovo ovde samo zbog toga da izgledam pametan...

See My route to work!
<hr height="1" noshade id="quote"></blockquote id="quote">

Not at all, the withdrawal symptoms are going to be very similar for all. I didn't say it was easy to give up which is why will power is required. Lots of things are not easy, just seperates the winners and losers I guess.
<hr height="1" noshade id="quote"></blockquote id="quote">

I gave up smoking using only will power, but I hardly think that makes me a 'winner'. All I did was stop slowly killing myself.

You can't really turn this into a winner/loser comparison anyway, considering nicotine is supposed to be as addictive as heroin and freely available to boot. I think that different people respond differently to it. In the same way, I manage to drink alcohol fairly regularly without being an alcoholic, whereas George Best couldn't manage that and died because of it.

It doesn't make you a 'loser' if you have to chew bits of gum to give up, it will just cost you more. As long as you don't smoke in the end, who cares how you do it?

<hr height="1" noshade id="quote"></blockquote id="quote">

I was meaning it in the broader sense. Winners get on and do it, losers don't, that's all.

And whatever method you use to give up still requires will power as even now I still fancy a smoke at certain times many years after quitting. You never forget that nice feeling, and why would you.

dubnobass · May 2007

<blockquote id="quote">quote:<hr height="1" noshade id="quote">Originally posted by stelvio
Is this drug safe in the long term ?
Were the trials actually carried out in a reliable way ?
Were any of the trials done by somebody other than Pfizer ?
Was the drug given to enough people to actually detect rare but serious side effects ?
Is it possible benefits are being exaggerated and adverse effects ignored ?
How many of those who had stopped at 12 weeks still stopped at 12 months ?
Were the difference between placebo and drug groups actually statistically significant ?
Where are these "trials" published if we wantt to look at them ourselves ?
<hr height="1" noshade id="quote"></blockquote id="quote">

Lots of good questions, but not the sort of questions journalists usually ask because journalists are usually journalists and not scientists.
The facts about varenicline:
http://www.emea.europa.eu/humandocs/Hum ... hampix.htm
(most useful documents here will be the 'scientific discussion' from section 4 onwards, and 'product information' in section 5.1)

Those should answer some of your questions, at least.

If I had a baby elephant, I'd re-enact THAT scene from Blue Peter, with John Noakes, on a daily basis. Wouldn't you? "Ooh, gerroff me foot!"

avdave · May 2007

A drug that costs less per day than 10 fags can't really be considered as expensive. And anyone who can afford to smoke could afford this drug should it ever gain approval as an over the counter medcine. There really is no need for anyone else to have to pay for this, just those who wish to use it. As for diabetes drugs none of them are actually an improvement in function over insulin. What they attempt to do is to try to make compliance easier. A great number of diabetics fail to control their condition effectively and drug companies see the solution to this problem as a potentially huge market. In comparison an anti smoking drug is really very small scale as it fails one of the two no no's of drug design. The first of course is not to kill the patient the second is not to cure the patient. In both cases you end up with someone who no longer needs your product. In diabetes no one is making a pill to cure you, but to maintain you for as long as possible as a 'customer'

PRD · June 2007

Varenicline has been available for a few months now, so it isn't new in the sense of being new on the market as GPs have been able to prescribe it. This sort of story is placed in the media by big Pharma who just love the publicity as they cannot legally advertise Prescription Only Medication (POMs) direct to the public.

Giving up smoking is very difficult and a very low percentage manage it by willpower alone. The most successful method appears to be use of Nicotine Replacement Therapy (NRT) ie Nicotine patches or gum along with appropriate support from self help groups or professional counsellors and even then it isn't easy.

Big Pharma's new friend

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