SCIENCE
TRINITY NEWS September 22, 2009
IN BRIEF
Who’s really filling in your prescription?
LUKE MAISHMAN TECHNOLOGY
AUGMENTED REALITY FOR NEWEST IPHONE LAUNCHED
To what extent does Big Pharma influence the medical profession? Ronan Lyne takes a closer look, with unsettling results THERE IS a war being conducted for your prescription. The opposing sides? The pharmaceutical companies who want to profit by selling you drugs you don’t need, and your doctors, whose job is to prescribe the most effective drugs to treat your condition. Unlike most other products, however, it is your doctor who decides what you take, not you. And the stakes – and profits – are far higher. But your doctors may have already fallen victim to peer pressure, subtle bribery and outright disinformation, all in the name of profit. The news that major US pharmaceutical company Pfizer, makers of Viagra, have recently agreed to pay out a multi-billion dollar
“Even peer-reviewed academic journals, supposedly the bastion of scientific integrity, are not free of pharmaceutical companies’ influence” settlement to the US government over fraudulent marketing brings the testing, promotional and marketing practices of pharmaceutical companies under the spotlight once again. The $2.3bn settlement was paid out due to Pfizer’s intentionally misbranding drugs and promoting them to doctors for conditions for which they were not tested; allegations of bribery are still under investigation. This is not the first time Pfizer have been found guilty of such practices; however, while they may have crossed a line, their competitors aren’t far behind. Suffering from high blood pressure? There can be a hundred different possible prescriptions, some of which have been tried and tested for thirty years or more, some of which are new to the market. There may be many variants, each one promoted by a different company.
TRINITY RESEARCHERS
DR. STEFAN HUTZLER FOCUSES ON FOAM
FOAMS ACCOMPANY many of our daily and nightly routines: you come across them when shampooing your hair or brushing your teeth, or when enjoying your cappucino or a heady pint. But understanding the structure of foams and how this in turn determines its flow properties is important not only for the food industry and personal care products; whenever foams are solidified they may be used as packaging or building materials. Metallic foams, for example, have been used as structural elements in cars where they help to reduce the impact of a crash. And most recently, fibres have been produced that consist of solidified bubbles and that can be woven into a fabric. The School of Physics Foams and Complex Systems Group addresses the issues above by performing experiments, theory, and simulations. The group is fascinated by the beauty and complexity of foams, not unlike the three-year old or younger visitors of the Bubble exhibition which recently finished in the Science Gallery.
Medical professionals are supposed to use their scientific training, along with published, independent clinical data to decide which of these drugs is most appropriate for your condition. But at every front, these companies and their agents are vying to sway your doctors into prescribing their products, from taking them out to expensive dinners, to suppressing the results of clinical trials in some cases. In-office marketing is conducted by drug sales representatives, who are the pharmaceutical company’s most expensive marketing tool. There is one rep for every 7 doctors in the UK & Ireland, and they command salaries of €100,000 per year and upwards. A drug rep’s job is to convince doctors to prescribe the drug under promotion, by whatever means necessary. Drug reps are trained to build a rapport with doctors, so that their word and the information they disseminate is trusted. They also supply doctors with branded pens, notepads and mugs so that even on a subconscious level, the doctor is constantly bombarded with the brandname of the drug in question. Drug reps usually promote only one drug at a time, and can be considered experts on the drug in question, thus they are a primary source of information for doctors. They are required to bring research papers containing the statistics, but by becoming a trusted source of information, many doctors barely glance at the statistics, and are more susceptible to spin. The drug reps may also hint at “off-label” uses for the drug in question – that is, prescribing the drug for conditions for which it has not been tested. For example, tricyclic antidepressants are frequently used to treat migraines and chronic pain; it is, however, strictly illegal for companies to promote or suggest this type of prescription. In Pfizer’s case, drug reps allegedly promoted their drugs in exactly this manner, and also bribed doctors to encourage them to prescribe the drugs in question. Neurontin, an anti-epilepsy drug, was promoted variously for use in attention-deficit disorder, depression, and alcohol withdrawal syndrome, all of
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Money pills: are our doctors swayed by big pharma when prescribing us medicine?
which can be treated with safer, cheaper and more established drugs. As devious as drug reps’ in-office marketing tactics can be, they pale in comparison to the rest of the promotional strategies used by Pfizer and their ilk. Continuing professional development [CPD] is an important part of medical professionals’ competence, and is required for upkeep of their licenses to practice. By attending conferences and educational seminars, doctors are kept up-to-date with the latest clinical research and practice methods. However, instead of being funded by taxpayers or doctors themselves, most of these educational seminars are hosted and sponsored by pharmaceutical companies, who see it as an opportunity to extend their influence over prescriptions. In the past, doctors were frequently flown to exotic destinations and accommodated at luxury hotels to attend “educational events”, furthering the culture of gifting; however, new guidelines from the European Federation of Pharmaceutical Industries and Associations have curbed these practices – at least somewhat. Doctors may still be wined and dined in expensive restaurants – they just can’t bring their spouses anymore.
“A drug rep’s job is to convince doctors to prescribe the drug under promotion, by whatever means necessary” However, the most worrying influence comes from pharmaceutical companies’ use of research journals to subtly promote their drugs. Leading academics and medical professionals [aka “key opinion leaders”, in pharm marketing-speak] are often bankrolled to speak at the above CPD seminars, using their reputations to support a new
drug. But even peer-reviewed academic journals – ostensibly the bastion of scientific integrity – are not free of pharmaceutical companies’ influence. Recently, US Ivy League medical schools Columbia and NYU were rocked by scandals involving academic staff attaching their names to ghostwritten papers. The papers, which are drafted by pharmaceutical companies to show their products in a positive light, and are published in medical journals for marketing purposes, generally downplay the risks of the drug in question, as well as any adverse drug reactions. Pfizer, again, are guilty of this practice, particularly in relation to Neurontin, where they either suppressed negative results or published them in foreignlanguage journals. And again, they are only distinct from their peers in that they were unfortunate enough to get caught – the practice is widespread. The practice has been condemned by medical ethics experts and US Senators, one of whom is putting pressure on the National Institutes of Health to crack down on such practices. But as the line begins to blur, it becomes apparent that it is up to individual universities to tackle the problem at the source, or risk their reputation. For smaller universities, however, the benefits of ghostwritten research – publishable and citable in journals of repute – may outweigh the drawbacks. The practical implications cannot be underestimated. If the information supplied to doctors is deliberately misleading, it jeopardises patient health and finance. So is there a viable solution? Many doctors are turning away from corporate sponsorship and refusing to accept any forms of hospitality from drug reps. Organisations such as No Free Lunch [nofreelunch.org] campaign for stricter legislation surrounding pharmaceutical companies’ marketing habits. And as a patient? Educate yourself about your treatment. Ask your doctor about generics and alternatives. Encourage him or her to take the No Free Lunch pledge, and let evidence, rather than profit, decide.
It’s the knowledge economy, stupid Not only should research grants not be cut, but increased funding for science and technology projects is imperative to get us through this recession HOW MANY Leaving Certs students did you know this year? And of those, how many chose a science or engineering course? There has been a 25 percent increase in the number of applicants to higher-level science courses, as students flock to what seems like a safe bet and a certain job. But just how wrong are they? It seems that, even before they try, many are doomed to failure - nightmarish estimations of first year failure rates of 39 percent are an unfortunate reality. Sorry, Junior Freshmen, but that’s how it is. And even for those who persevere, it
seems the future might not be as rosy as your guidance counsellor would have had you believe. Despite much-feted talk of Ireland’s Strategy for Science, Technology and Innovation (SSTI) investment plans, the nowinfamous Bord Snip recommends slashing the amount spent in the area of science and technology by at least €27.3 million. And amidst the recession that has gripped the country it seems the dreaded Brain Drain might once again become a reality. But why should we encourage our boffins to stay their difficult course? Do we really need the men and women in white coats with
funnily-shaped glassware and even funnier social skills to save us from our economic slump? In my naturally wholly unbiased opinion, the answer is yes. For the entire duration of the spectacular and gigantic saga of our banks’ fall from grace, our science and technology sector has not only been steady, but has actually been storming ahead. True, some jobs were lost in manufacturing sections of TEVA and Intel, but in the last few months, there have also been 95 jobs created in Galway by Lumension and the Netezza Corporation of Massachusetts, 250 jobs created by Sim2Learn, 300 jobs created by InTune, and 160 jobs created in Carlow by Sigma. Sigma also contributed to the economy with a hefty €20 million investement. With Helsinn Birex investing another €13 million in Dublin, and US insurance firm Unum setting up a software servicing centre, that’s a total of 1005 jobs created. All of these jobs were made possible by a highly technically educated workforce; by those boffins who slaved away in the Hamilton ends of their respective universities. The future for research funding in many countries looks grim, none moreso than in Britan, where academics are rushing their grants proposals in before the Conservatives cut spending after the next general election. This is now Ireland’s chance to attract bright minds from all over the globe and build a world industry of innovation and ingenuity. It’s the knowledge economy, stupid. Hugh O’Sullivan
WITH THE release of iPhone OS 3.1, augmented reality applications are finally available to purchase from the App store, albeit for users of the iPhone 3GS only. This technology makes it possible to look through the iPhone camera at a city street, for example, and have computer-generated information [such as nearby restaurants] overlaid. The applications are only available for the iPhone 3GS, as they rely on the newest model’s digital compass for direction and positional information. One such proof-ofconcept example, the Nearest Tube application, unsurprisingly helps users to find the nearest London Tube station by tilting and moving their iPhone. Similar applications exist for the Paris and New York metro systems, with varying amounts of additional tourist information.
NO, REALLY
JUDGING EACH OTHER BASED ON OUR TUNES ALONE HAVING OTHERS see the music collection on your iPod may cause them to judge your character and personality. Writing in his recent paper, “You Are What You Listen To”, Dr Jason Rentfrow of Cambridge University confirms that yes, people do make assumptions about you based on your music collection.
PSYCHOLOGY
TODDLERS NOT QUITE AS SELFISH AS EXPECTED IN CONTRAST to their apparent selfish nature, toddlers appear to be inherently altruistic, at least according to Harvard researchers. Studying 14- to 18-month old children, they found that the toddlers helped others to reach their goals, without the possibility of concern for reciprocation or the effect on their reputation. They suggest that toddlers learn to be more discriminating with their help as they age and encounter more diverse social situations and a wider variety of people. Similar research conducted with chimpanzees, our closest primate relatives, showed that they are much less altruistic by comparison, and are far less likely to share resources, making the roots of human altruism more complex than previously expected.
ENVIRONMENT
STENCH OF DEATH CAN BE USED AS PEST CONTROL BIOLOGISTS FROM McMaster University in Canada recently discovered that the smelly blend of chemicals emitted by dead cockroaches acts as a universal insect repellant. To study the process, they mashed up the bodies of cockroaches, as well as using intact corpses and alcohol extracts. They found that cockroaches avoided the areas in which the scent was placed. In addition, other species of insect were also repelled by the stench, leading the researchers to suggest that the chemicals act as a signal to other insects to avoid death or disease, and that this mechanism has been conserved across species. They hope that it may offer a new method to protect crops and repel pests from houses and buildings, but more research is needed before any of these ideas may be applied.