GHP April 2016

ghp April 2016 | 53 Research & Development Leading NHS cardiologist, Dr Aseem Malhotra, in late February highlighted a complete healthcare “system failure” that is resulting in the unnecessary deaths of tens of thousands of people globally every year. Writing for MailOnline, Dr Malhotra says that biased research funding, biased reporting in medical journals and commercial conflicts of interest are contributing to an “epidemic of misinformed doctors and misin- formed patients in the UK and beyond.” He claims public funding is often allocated to medical research because it is likely to be profitable, not because it will be beneficial for patients. Leading doctors supported Dr Malhotra’s claims and have called on Parliament’s Public Accounts Committee to conduct an independent inquiry into the safety of medicines. The calls for greater transparency in the prescription of medicines come from the immediate past presi- dent of the Royal College of Physicians, Sir Richard Thompson, the Chair of the BMA General Practition- ers committee Dr Chaand Nagpaul, the President of the Faculty of Public Health, Professor John Ashton, the Chairman of the British Association of Physicians of Indian origin, Consultant Psychiatrist Dr JS Bamrah and the editor in chief of JAMA Internal Medicine and Professor of Cardiology Rita Redberg. Citing recent studies, Dr Malhotra says that prescrip- tion drugs are the third most common cause of death after heart disease and cancer, with side effects of antidepressants and dementia drugs responsible for more than half a million deaths per year in the United States and Europe. The elderly are particularly vulnerable to polypharma- cy, with one in three hospital admissions in the over 75s a result of an adverse drug reaction. In addition to a “more medicine is better” culture exacerbated by financial incentives to prescribe more drugs and carry out more operations, Dr Malhotra reveals a more sinister side that is corrupting the information that is being given to doctors and patients when medical decisions are made. Citing recent examples from Australia and the UK he writes: “Medical journals and the media can be ma- nipulated to serve not only as marketing vehicles for the industry but be unwittingly complicit in silencing those who call for greater transparency and more independent scrutiny of scientific data.” In relation to cholesterol lowering statin drugs he calls for a full reassessment of all the statin studies. “Physicians should be aware that present claims about the efficacy and safety of statins is not evidence based,” he writes, demanding that the Clinical Trials Service Unit at Oxford University release the raw data for independent scrutiny. Dr Malhotra gives recent examples of where the National Institute of Clinical Excellence (NICE) and the drug regulator (the MHRA) have failed to manage lack of transparency and conflicts of interest over the prescription of several drugs including Tamiflu, Statins and Stroke drug alteplase. Gaming the system, manipulation of data and prolific scientific fraud is contributing to the unnecessary deaths of tens of thousands of people and the suffering of millions costing billions to our national economies every year. “Without full transparency and accountability no doctor can provide what we slogged through medical school and devote our heart and souls to: providing the best quality care for our patients. “For the sake of our future health and the sustainabili- ty of the NHS it’s time for real collective action against ‘too much medicine’ starting with the Public Accounts Committee launching a full independent inquiry into the efficacy and safety of medicines. The underlying scandal that may ensue is likely to dwarf that of Mid Staffs. Medical science has taken a turn towards dark- ness. Sunlight will be its only disinfectant.” Sir Richard Thompson, immediate past president of the Royal College of Physicians, commented: “DrMalhotra again draws the attention of doctors and the public to the too often weak and sometimes murky basis on which the efficacy and use of drugs, particularly in the elderly, are judged. There needs to be closer scrutiny of the evidence underpinning drugs, and devices, and then better promotion of the evidence, together with more education of the public, doctors and medical students in how to assess the value of prescribing drugs to different groups of patients. · Public funding allocated to medical research because it is likely to be profitable, not because it will be beneficial for pa- tients · UK’s leading doctors call for immediate inquiry into safety of medicines · Britain faces “epidemic of misinformed doctors and misin- formed patients”, senior NHS cardiologist warns