Sunday, 14 July 2013

How much do Pharma pay Scientists and/or Neurologists?

Should scientists and/or neurologists receive payments from Pharma? #MSBlog #MSResearch

"For those of you who have raised the issue of scientists and/or neurologists consulting for Pharma will find this paper interesting."

Andrew Jack (BMJ pharmaceuticals correspondent). Bring me sunshine: EU drug companies make payments to doctors public. BMJ 2013;347:f4342.

Excerpts:

...... The European pharmaceutical industry has pledged to release details of the payments it makes to doctors and healthcare organisations by 2016, in the latest move towards bringing “sunshine” to funding arrangements that critics argue distort prescribing practices......

..... It comes at a time of growing debate and research suggesting that even modest payments and incentives to doctors can influence their choice of medicines......

..... It also follows a surge in voluntary and legislative efforts around the world to boost transparency in links between drug manufacturers and doctors, partly driven by substantial fines for aggressive marketing, including GlaxoSmithKline’s record $3bn (£2bn; €2.3bn) penalty agreed in the US last year.....

...... Under the Affordable Care Act in the US, companies will from this autumn be required to release information on payments to doctors. Ad hoc disclosures forced by individual settlements in recent years show the scale of payments: a dozen companies in 2012 alone paid more than $1bn.....

...... In the UK, the Association of the British Pharmaceutical Industry (ABPI) has this year begun releasing aggregated information, which showed £40m in payments during 2012....

..... There is also a broader debate about the interpretation of the findings. Many of the systems include not only payments to individual prescribers but also research funding to their institutions, such as for clinical trials, none of which may end up in individuals’ pockets.......

...... While transparency should largely be welcomed, some doctors raise the concern that exposure or fear of misinterpretation of funding may deter some of the best medical “thought leaders” from contact with industry. If that weakens access to the best thinking, research, and clinical experience, it could set back drug development and prove counterproductive. But with so few data currently available, the fresh efforts around the world at bringing sunshine will at least allow a more serious informed debate about the implications than was possible in the past......


"Have your say."

28 comments:

  1. If you are supplying a service should you not get paid for a service?

    If the University gets all the spoils is there an incentive to do anything as you could sit on your a**e (a*s) and do nothing.



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    1. Perhaps the Blizzard Institute should be renamed Gordon Gekho Towers - greed is good in MS Research.

      If you have nothing to do, what about some research for your employer? I have a vision of your lab of thousands of mice running round why you tend to your home brew kit, Prof G at his desk counting his fridge magnets from all his overseas jollies. Do you get a PhD student to monitor your stock and shares?

      I think Jessie J was right "it's all about the money".

      As you sit in the gardens of your millionaire houses, give a thought to people like me in a one bedroom flat living off disability allowance. Without us you wouldn't be so wealthy.

      When I go to bed tonight (you will fast asleep in your four poster bed in a onesie supplied by Biogen) worrying about the future, I get comfort from the following: it's easier for a camel to pass through the eye of a needle than for a rich an to enter the kingdom of heaven.

      Gordon Gekho, Bernie Madoff, Asil Nadir..... Prof G, Prof Mouse





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    2. The good news is that the NHS breaks-up you will be able to establish third party providers to sell back different services including R&D to the NHS. A free market shake-up for the NHS is on the cards. There would be no reason to let the NHS, or the University, to take money for consultancies, etc. You could put all the money through a company. Thought of that? It would also provide a vehicle for paying less tax; this is the vehicle Red Ken (Livingstone) used.

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    3. Excuse my ignorance but who is Gordon Gekho? Is he a scientist or medic?

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    4. Blizard is one Zed/Zee after Sir William Blizard

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    5. Gordon Gekko is a fictional character, the main antagonist of the 1987 film Wall Street and the anti-hero of its 2010 sequel Wall Street: Money Never Sleeps,both directed by Oliver Stone. Gekko was portrayed by actor Michael Douglas,

      Gekko is claimed to be based loosely on several actual stockbrokers, including Stone's own father Louis Stone.

      According to Edward R. Pressman, producer of the film, "Originally, there was no one individual who Gekko was modeled on," he adds. "But Gekko was partly Milken", who was the "Junk Bond King" of the 1980s, and indicted on 98 counts of racketeering and fraud in 1989.

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    6. Bernard Lawrence "Bernie" Madoff is an American former stockbroker, investment advisor, financier, and white collar criminal.

      Polly Peck International (PPI) was a small British textile company which expanded rapidly in the 1980s before collapsing in 1990 with debts of £1.3bn, eventually leading to the flight of its CEO, Asil Nadir to Northern Cyprus

      PS Your vision is some strange dream that has no bearing on reality

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  2. Recently I did a consultancy for a piece of pooh company and tried to donate the fee to an MS charity, I did the work but the worms did not pay the fee... I don't have the energy or resource to chase them.

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  3. You know what, if there were drugs that actually seriously improved the conditions of all MSers -- perhaps not full functionality but at least a degree of improvement and progressive disease stability -- then I bet all this harsh rhetoric directed at MS researchers would massively peter out.

    Much of this chagrin is borne out of frustration, but I think you already know that.

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  4. If a Neurologist works for the NHS and does the consultancy, the payment should be paid to the NHS. How can any patient trust the MS drugs? How can we be sure of the long term side effects? Do we really know the treatment works, or is it just coincidence? The trials are on selected patients and who knows if they suit everyone. Surely this is a conflict of interest. I think I'll stick to Physio, swimming, healthy eating and lay off the fags and drink and take my chance, as I've done for the past 35 years.

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    1. What if Neurologist does not work for the NHS?

      As we have said before ProfGs time is split with the University

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    2. The point I was trying to make obviously not very well, was about the integrity of the trials. If Neurologists are not directly paid for this work, there can be no doubt about the trial results. I believe Neurologists should be rewarded, but if the NHS gets the money from drug companies, it can be passed onto the doctors or scientists via their salaries. This would give me more confidence in new drugs and treatments.

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  5. Come up with a cure and you should be paid £10m each. Unfortunately no one knows the cause and the treatments do not promote recovery. The big payouts to neuros, researchers, pharma companies are immoral.

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  6. I want to leave my money to the NHS after I die. It's a great institution and, although riddled with numerous flaws and faults, I am eternally grateful to it. After my parents, I regard it as the other family member that has always looked out for me and tried its best to take care of me.

    I salute you NHS. All consultancy money earned by greedy neurologists that work for the NHS must be ploughed back into the NHS.

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    1. Dr Dre what about private practice? Should Prof G keep the money he makes on Harley Street?

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    2. Dr Dre not everyone lives and works in a socialist country. Money is what makes the world go around, and ideas and skills too. If these guys have the skills and someone wants to pay for them why shouldn't they get paid? Don't you realise that socialism in the UK and Europe is over; you can't afford it. I suggest you leave your money to a Venture Capitalist; they will do more with it than the NHS. Or possibly Bill Gates if you want to choose worthy charity.

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    3. Mistake here. Prof g does not do private practise.

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    4. I'm guessing he hasn't got the time - two jobs (NHS and University) and consulting work for pretty much every pharma company plus numerous conferences and lecture tours. I'm sure I've seen him doing the night shift at my local McDonalds.

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    5. His mentor Ian McDonald said you get into bed with all of them or none of them.....so there you have it ProfG is a ho :-)

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  7. Just thinking about big pharma......I need a shower. Cant we get back to the science. Thats a big enough mountain to climb. With regard to neurodegenerative diseases the NIH (dont know about NHS) stop sitting on your hands. We're not tackling baldness or erectile dysfunction. The stakes are much larger.

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  8. I disagree with some of the posters here. Prof G and others absolutely should get paid for their work. They are professionals and some of the best at what they do and deserve to be richly compensated for what they do and know. I hope they are or become multi-millionaires and are able to retire someday in style. There are some who think that if another gets more than they, that somehow they are getting shorted. This is not how real life works.

    Yes, there are probably times where there are ethical issues with pharma and doctors/researchers, but I have to believe that the vast majority treat these issues morally to the best of their ability.

    Another poster said it is all about the money. Yup, I will agree with that. And say this-- I don't like the fact that drugs cost so much money any more than any other MSer. However, the fact that there is so much money to be made is making all drug companies focus on these diseases and will eventually find a cure--not for some utopian reason or wanting to cure for the good of man-- but to make money. Not debating whether this is right or wrong, but just stating the fact. And since it does no good to whine and complain about it, the least we can do is support those great researchers who are working towards that cure.

    Thanks Prof G, MD, MD2 etc. for all your hard work and time spent keeping us up to date on the current research. I hope you all are the ones who discover the cure and not only have the satisfaction of accomplishing something great, but become wealthy beyond your wildest dreams.

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    1. Your comment is both embarrassing and scary, SamH.

      Firstly, the money will never be extrapolated from a cure because the money will always be in the medicine. If MS could be cured with one or two infusions then it will not be worth Pharma's time, but if it can be perpetuated by a lifetime's dependency on drugs then Bob's your uncle.

      Your aspersions that clinical professionals deserve to be 'richly compensated' for basically doing their jobs pretty much sums up all that is wrong with the modern world. No-one wants to make a living anymore, everyone wants to make a fortune. The bankers that brought the world to its knees felt entitled to be 'richly compensated' for their catastrophic ineptitude and still fell entitled further.

      I support anyone working to alleviate the insidious progression caused by MS, but the current regime, including this blog, is more interested in propagating hugely damaging toxins that cannot claim to fix MS damage (or else it will work for everyone) and is ripping tax payers off by defending Pharma's exorbitant price fixing.

      Also, I'd appreciate it if ignorant Americans would refrain from telling me that my country's social systems and health care institutions are beyond hope. Britain always sorts its stuff out, and I have faith that despite right-wing concerted efforts to paint my NHS as a dying beast, we Britons will defend it to the death.

      The NHS is bigger and more relevant and important than Jesus. That is the truth. Tell me I'm wrong.

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    2. "Britain always sorts its stuff out, and I have faith that despite right-wing concerted efforts to paint my NHS as a dying beast, we Britons will defend it to the death."

      Dr De, Finally we agree on something. I'm with you all the way on this. As a Welshman, it's a source of huge pride to me that a fellow countryman (Aneurin Bevan) was instrumental in the formation of the NHS. It's perhaps the greatest achievement of this country for all its faults. Yes it can be made better but as you say, we will defend it to the death.
      Any suggestions that any of us are in it for the money can be refuted.
      Personally, I hope the cure for MS is imminent and I'm put out of a job! There are many other things I could turn my hand to.
      Incidentally don't know if anyone saw this on the front of today's Indie? This is the sort of thing we're fighting against.
      http://www.independent.co.uk/news/uk/politics/nhs-hit-for-millions-by-overcharging-scam-8708292.html

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  9. Dr Dre-- First, I agree with your point that pharma doesn't want a cure. They want to suck all the money they can out of us and the system. I don't dispute that. And, I think it stinks. However, the potential for profit is what drives these companies and brings us treatments. If there wasn't the big money involved, they wouldn't be developing Lemtrada and the other drugs at the same pace. Just stating the facts, not my personal opinion about its cost to society.

    You are actually comparing researchers who profit to the greedy bankers who screwed the economy? Wow.

    I don't believe that everyone should be "richly compensated" for doing their job. I think they should for being GREAT at their job. There is a difference. For some it is money, others prefer other compensation. The point is that everyone is motivated by something, and that something usually is what makes them succeed at whatever they are doing. I hope Team G wins a nobel prize for curing MS. A daily paycheck with no motivation=mediocre.

    The point is, I want everyone to succeed in whatever their aspirations are. Since this post is about money, yes I hope all the researchers do well financially, even if it isn't their primary goal. Have you ever heard what happens if you put crabs in a bucket? Google the story, its a good one. I prefer to lift and support others and lift them instead of pull them back to my level.

    Lastly, your comment towards Americans who comment about your NHS system would better be directed towards an American who is actually commenting about it. You are just proving that you have stereotypes in your mind about Americans by projecting them onto me. Should I be offended? I believe that each society does the best they can, and there are problems and benefits to every system. Its not my place to nitpick another country, so I don't.

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    1. SamH, not everyone wants to be rewarded with huge monetary dividends for doing a good job, and only offering a 'daily pay check' does not incite mediocrity. Bankers are on colossal pay cheques but that doesn't validate that they're worth it. There are cosmetic surgeons that earn infinitely more than a neurosurgeon, but that is only because our values of worth and rewards are comprehensively skewed. An extraordinary human rights lawyer like Sharmishta Chakrabarti, who works for the civil rights charity Liberty is one of Britain's most brilliant minds and could make millions by lawyering for huge corporations, isn't driven by money. She works in the wish to create a fairer and better society.

      MD2 et al, I know, are not big earners. Until their work betters the conditions of all you MSers out there then I don't even qualify them as being 'GREAT at their jobs, but to say that by not being bestowed with accolades and money they are less motivated and mediocre, is almost offensive. Just because an individual earns lots of money does not make them great. Any clinician/ researcher with a soul will eschew big money in favour of better care for all their patients and beneficiaries.

      It's depressing to think that we live in a society that primarily values success above everything else. What happened to valuing intelligence? Wisdom? Good character? Decency? Do these thing not mean much to you, SamH? Your analogy of crustaceans begetting mediocrity is negligible because we all know that the very thing that has destroyed MS research is that of scientists trying to demean each others' research in efforts to make a name for themselves. The scientists that have promoted CCSVI and other nonsense treatments are very well paid and claim to have been pulled back by basic scientists like MD1 that are jealous of them, but that is so wrong. Motivation through money has seriously messed up MS research and that needs to stop.

      Americans are a mad brood generally speaking, and somebody (not you, SamH) commented that our 'socialist' way of doing things is over. This blog is given to you free of charge for your perusal thanks to socialist thinking. An American doctor would never invest so much of their time and energy into doing such a thing everyday for no money. It amazes me how many American blogs embrace AdSense and other marketing gimmicks in a bid to generate rudimentary profits, yet most British bloggers don't do that because we're not that way inclined.

      Britain was always a nation that valued the need for money but was never a slave to it. The Americanisation of British culture an abhorrent emergence that has been embraced by our politicians and peer groups. It must be stamped out and cannot be allowed to influence our medical ideology.

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    2. I think we are both right, based on our personal points of view. I personally am a business owner doing what I love and trying to make some money while doing it--all while dealing with this crappy disease.

      Of course money isn't the only motivator. That is the quickest way to failure in life, in my opinion. However, it is not money that is the root of all evil, but the LOVE of money. I would like to make a lot of money, yes, but what is important is what I do with it. Buy a boat--No. Help my sister who had a stroke--Yes.

      I do not know what is happening socially in England, but in America we are declining as a country. Why? Too many people expecting others to take care of them instead of them working hard and making it happen for themselves.

      This is a debate for another venue, not an MS blog. We shall agree to disagree--sound good?

      PS We visited England/Wales a few years ago. It was beautiful and we enjoyed everything about our visit. Although in Wales I made the mistake of asking someone where the "bathroom" was, and she gave me a very strange look and said "You wish to take a bath?" Um, I meant toilet... :)

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    3. SamH, I do accept that we must respectfully agree to disagree. While it is evident that you are a smart, educated person, I have great issues with the prevalent U.S. concept that the vast majority of unemployed or poor people are so out of their own fecklessness. We, as human beings, have a responsibility to each other and must not look down our noses at those not on our social level.

      I genuinely believe those of us that live here are lucky to call ourselves British. We got our health care paid for, got our university educations paid for (up until 1997 at least) and have a valuable social welfare system to help us during bad times.

      While Britain is riddled with an unfair clandestine class-system and ruled over by a pointless ornamental Monarchy, it remains a fantastic country. The progressive infiltration of American influences like school proms, obesity and plastic mouldings is seriously ruining our culture, I still believe that the pendulum will swing the other way within a generation and there will be a backlash to American cultural hegemony, the way it was in the mid-'90s when Britpop launched a breed of national youths that despised the increasing Americanisms that was diminishing our way of life. When that happens the NHS will be the first thing we band around to save.

      Hate money, love people.

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    4. Dr. Dre Your socialist fervour is most inspiring, I'm definitely warming to you after a few disagreements in the past. I hate the way that socialism has become a dirty word these days.

      SamH Glad you enjoyed Wales (it's where I'm from). Laughed out loud about the "bathroom anecdote". We don't really go in for euphemisms in Wales!

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