[Marxism] Medical Science, or Manipulation of Medicine by Corporations?

["Tony Abdo" <gojack10@xxxxxxxxxxx>]

The current controversy over cholesterol spotlights the frequent fraud in
decision making within capitalist for-profit medicine.  These shenanigans
are going on as the US medical system is being progressively dismantled
through the rampant privatisation of services.  Tony

Saturday, July 17, 2004 by the Associated Press
Groups Blast New Cholesterol Guidelines
by Linda A. Johnson

TRENTON, N.J. - Most of the heart disease experts who urged more people to
take cholesterol-lowering drugs this week have made money from the companies
selling those medicines.

Consumer groups on Friday blasted the new cholesterol guidelines as being
tainted by the influence of major pharmaceuticals that make blockbusters
such as Lipitor and Pravachol. Last year, drug makers earned $26 billion
worldwide on cholesterol-lowering medicines, the top-selling class of drugs.

The new guidelines issued Monday by the American Heart Association and the
federal government were aimed at preventing heart attacks. They were written
by nine of the country's top cholesterol experts. At least six have received
consulting or speaking fees, research money or other support from makers of
the most widely used anti-cholesterol drugs.

The new guidelines would add about 7 million more Americans to the 36
million already encouraged to take the pills to lower their cholesterol,
according to Dr. James Cleeman, coordinator of the National Cholesterol
Education Program, which drew up the guidelines. NCEP is run by the National
Heart, Lung, and Blood Institute.

Cleeman said that regardless of connections to the drug industry, the advice
to high-risk heart patients to lower their LDL, or "bad cholesterol," is
sound science. The new guidelines were based on results of five drug studies
since 2001, and about 80 experts besides the authors reviewed and endorsed
them, Cleeman said.

But consumer advocates said the failure to make the conflicts of interest
clear is inexcusable.

"It's outrageous they didn't provide disclosure of the conflicts of
interest," said Merrill Goozner, with the Center for Science in the Public
Interest.

"It doesn't mean that their research is wrong," Goozner added, but doctors
and the public need to know "that the people who are giving you this advice
have their research funded by a party who has a self interest in the outcome
of that research."

Coincidentally, Goozner's group on Monday released a study showing that at
least 24 of 164 studies it reviewed in four medical journals did not
disclose important conflicts of their authors.

Many studies of new and existing drugs are funded by their manufacturers,
and Goozner and other experts say studies showing the drugs did poorly
rarely are published. Last month, New York Attorney General Eliot Spitzer
sued drugmaker GlaxoSmithKline PLC, saying it committed fraud by withholding
information about the dangers of its antidepressant Paxil to children.

The American Medical Association then urged creation of a comprehensive,
government-run registry for all drug study results so unfavorable ones
aren't buried. Meanwhile, Merck and Bristol-Myers Squibb are quietly seeking
federal approval to sell low-dose, non-prescription versions of older
cholesterol drugs that already have generic competition.

The heart institute posted information on industry ties of the new
guidelines' authors on its Web site Friday. Cleeman said all the authors
except him "have some connection with industry."

Newsday first reported on the conflicts in Thursday's editions. They said
six authors had earned money specifically from cholesterol drug makers,
including Pfizer Inc., Merck & Co., Bristol-Myers Squibb and AstraZeneca LP.

Cleeman and Dr. Rose Marie Robertson, chief science officer of the heart
association, both said they felt financial disclosure was covered because
most of the authors also worked on the last guideline update, in 2001, and
made their connections known then. Cleeman said information on the two new
authors is available from the organizations they represent, the heart
association and the American College of Cardiology.

Dr. Sidney Wolfe, co-founder of Public Citizen's Health Research Group, said
disclosure, even in a publication, is not adequate.

"These people should be disqualified from being the principal authors of
publications that have the imprimatur of the government on it," he said. He
noted that side effects such as possible liver and muscle damage can make
the drugs more dangerous than beneficial to people who have only a moderate
risk of heart attack.

The updated guidelines say people with the greatest risk of heart attack,
more than a 20 percent risk in the next decade, should try to get their
level of LDL, or bad cholesterol, below 70, instead of the current
recommendation of below 100. For people at high or moderately high risk of
heart attack, the goal should be to get the level below 100, instead of the
current goal of below 130.

The risk level is determined by a calculation of risk factors, such as prior
heart attack or stroke, presence of heart disease or diabetes, family
history, high blood pressure and smoking. The guidelines also urge people to
adapt a healthier lifestyle, by getting more exercise, losing weight,
quitting smoking and other steps.

© Copyright 2004 Associated Press

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