Wednesday, February 27, 2008

Secrecy, Collusion and Bad Medicine

The drug industry's long and ignoble history of secrecy

In 2004, UK researchers commissioned by Nice to develop guidelines for prescribing antidepressant drugs to children tried to obtain unpublished trials from the drug companies. They were refused. They then contacted the individual researchers who had worked on the trials. Only then did a picture emerge of increased risk of attempted suicide, and a lack of efficacy. Nice concluded by banning the drugs for under-18s with the exception of Prozac.

Yesterday's report suggesting that modern antidepressants offer no significant clinical benefit over placebo has been dismissed by the drug industry as "just one study" which should not be allowed to undermine the wealth of research showing that the selective serotonin reuptake inhibitor (SSRI) antidepressants are effective.

But that is to miss the point. The Hull University researchers have demonstrated how partial access to research can give a distorted view of a drug. The non-disclosure of data on the SSRIs has raised doubts about the trustworthiness of all research on antidepressants.

We should be relieved that the licensing authorities have an absolute right to see all trial data, positive and negative, before approving a drug. But, bizarrely, Nice, with the responsibility for deciding which drugs should be used by the NHS, only gets what the drug companies agree to give it. The Health Select Committee has called for action to remedy this omission. Ministers must respond.