· Public funding allocated to medical research because it is likely to be profitable, not because it will be beneficial for patients
· UK’s leading doctors call for immediate inquiry into safety of medicines
· Britain faces “epidemic of misinformed doctors and misinformed patients”, senior NHS cardiologist warns
Leading NHS cardiologist, Dr Aseem Malhotra, has today 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 misinformed 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 have today 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 president of the Royal College of Physicians, Sir Richard Thompson, the Chair of the BMA General Practitioners 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 prescription 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 polypharmacy, 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 manipulated 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 sustainability 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 darkness. Sunlight will be its only disinfectant.”
Sir Richard Thompson, immediate past president of the Royal College of Physicians, commented:
“Dr. Malhotra 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.
“The time has come for a full and open public inquiry into the way evidence of the efficacy of drugs is obtained and revealed. There is real danger that some current drug treatments are much less effective than had previously been thought.”
Professor John Ashton, President of the Faculty of Public Health, said:
‘Public health relies on a comprehensive, accurate and cost effective evidence base to ensure we make decisions based on the best available research that improve and protect people’s health, as well as prioritise care in the best way for patients. A public inquiry could be a useful tool in ensuring that research is published in a transparent and independent way.”
Dr J S Bamrah, Chairman of the British Association of Physicians of Indian origin, commented:
“There has been an alarming increase in prescriptions in the modern world which cannot be simply explained in terms of increasing disease. The context of this in regards to the dangers of over-prescribing cannot be overstated. As Dr Aseem Malhotra rightly points out, there are a number of areas where there are incentives and conflicts that doctors and researchers have either been complicit or complacent, or plainly they have failed to declare their conflicts of interest. In some cases this will have led others to believe in their authoritative assertions.
“In my own field of psychiatry there are been much abuse and overuse of a number of drugs, and this pattern is destined to repeat unless someone like Dr Malhotra stands up to the establishment. His expose deserves a high level independent inquiry by the government as otherwise patients will continue to rely on medications they need not have been prescribed by trusted doctors.”
Rita Redberg, Professor of Cardiology at the University of California, San Francisco and editor of JAMA Internal Medicine, said:
“As a practicing cardiologist for 30 years as well as a journal editor for seven years, I know how important it is to have reliable high quality data in peer-reviewed medical journals. It is crucial for clinicians to be able to trust what they read. We need this trust and transparency to be able to accurately advise our patients on risks and benefits of medical treatments.
“In addition, all conflicts should be disclosed, such as relationships with industry and any other potential biases. Clinical trial registration before trial initiation on publicly available sites such as clinical trials.gov and publishing of all results is essential, even if results are negative or show harms of a treatment. We need to know that we have full access to all relevant information. Our current system needs more work and efforts towards achieving these goals.”