Ben Goldacre v Stephen Whitehead: Is pharma getting its act together?

Hannah Blake

pharmaphorum

pharmaphorum’s Hannah Blake attended PharmaTimes’ head-to-head debate between Ben Goldacre and the ABPI’s Stephen Whitehead which tested the proposed hypothesis that “pharma is not getting its act together”.

Is pharma cleaning up its act? Or is it still avoiding the situation?

Yesterday saw the first live debate, organised by PharmaTimes, between Ben Goldacre and the ABPI’s Stephen Whitehead about the clinical trial transparency discussion that has been ongoing in the industry for a while now. While Ben proposed the motion for pharma to get its act together, calling the current situation “embarrassing”, Stephen stated that the attack was a “complete travesty of the truth”.

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Figure 1: Everyone takes their seats in the auditorium of The Royal Institution, London ahead of the debate. 

So how did the evening turn out?

Moderator Dr Phil Hammond, who is a GP, writer, broadcaster and comedian, started the evening off with a live audience vote. At the beginning, the vote found that 46% of the 400-odd audience agreed that “pharma is getting its act together”. Approximately 69% believed that all clinical trial results should be publicly available. But when asked whether the audience trusted pharma to do this, 62% disagreed.

Proposing the motion, Dr Ben Goldacre stepped up to the podium first. Stating his objectives clearly, Ben proceeded to state that if he was in charge, he would cancel all primary clinical research for one year and then would spend that year analysing and auditing previous trial data. This would increase innovation and improve medicines of today, allowing the industry to move forward. But he joked that he doubts he would be put in charge anytime soon…

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“At the beginning, the vote found that 46% of the 400-odd audience agreed that “pharma is getting its act together”.”

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According to Ben, 50% of all trial results haven’t been published and that if the results are positive, they are twice as likely to be published. His main point of discussion was that engaging the public in this debate is extremely important: “Pharma has tried and failed to fix this issue behind closed doors.”

This point was agreed by Fiona Godlee, current Editor of the BMJ, who said: “There’s a simple answer here, not a complex one. People want clinical trial data so let’s give it to them for public scrutiny.”

Opposing the motion was Stephen Whitehead, chief executive of the ABPI, who stood up for the pharma industry, stating that it’s not all “Bad Pharma” like Ben’s book suggests, but that instead there are many examples of “Good Pharma,” such as the fact that in the last ten years over 350 drugs for hard-to-treat diseases have been approved.

“The pharma industry is not perfect … no industry is. But we have been on trial for several months. The accusations have been a complete travesty of the truth. It is an attack on the credibility of the 67,000 colleagues in the UK who work hard and imaginatively to deliver great medicines to patients. It’s a betrayal of the confidence of the thousands of doctors, nurses and ethics committees who have been involved in running the hundreds of thousands of trials Ben dismisses as ‘flawed’. Possibly most important, it’s alarming to patients who may think the drugs they are given are not adequately tested. This is simply not true.”

Extract from Stephen Whitehead’s opening speech at the debate. Source: ABPI UK1

Dr Beat Wilder, independent CQA and managing partner at Widler &amp, Schiemann, stated that the “Devil is in the detail” – he surmised that while we need open clinical trial data, what data is it exactly that we need? Not all clinical trials have the structure to be published. And “what impact will bringing historic data to the forefront have on patients?” he questioned.

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“…another culprit in the discussion is medical publishing companies – it’s hard to get negative data accepted…”

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Fiona’s speech consisted mainly of the recent withholding of Roche’s Tamiflu data. However, a representative from Roche was in the audience and said: “It’s a fair criticism of Roche that we haven’t been more active in the debate, but we are listening, that’s why we are here tonight.”

For those in favour of pharma cleaning up its act, the biggest controversy of the night was when Stephen Whitehead said the ABPI would not respond to “PR-driven initiatives such as AllTrials”. Ben Goldacre, along with the BMJ, is leading this campaign for data transparency and already GSK, NICE and 80 patient organisations, among others, have signed up to the petition. And as Ben tweeted last night, “The ABPI is rapidly isolating themselves. How will this look?”

A member of the audience, during the floor debate, said that another culprit in the discussion is medical publishing companies – it’s hard to get negative data accepted in journals nowadays, as journals want impact and will therefore often reject negative data. Fiona answered this by saying she was “bored” of this argument, because it “is not true”. In the long-run, she said, it shouldn’t just be up to journals to publish this data, but in specific clinical trial databases.

Another member commented on the “elephant in the room”: the uninformed patient. How will access to clinical trial data be received by people who don’t know how to interpret it? What impact will it have on patients who have used a particular drug in the past when only half its data was published? These are the questions that arose at the event, and were left unanswered.

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“How will access to clinical trial data be received by people who don’t know how to interpret it?”

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Ben’s conclusion was that the ABPI needs to stand up and show leadership, and not to shy away from this important issue.

Stephen concluded by saying that the ABPI doesn’t deserve this attack, as the healthcare industry is about saving lives and that’s what it does every day. He also said that there are future ABPI initiatives starting over the next few years – it’s not the what, but the how. “The world is changing and we are there with it,” he said.

A vote at the end of the night showed that attitudes in the audience hadn’t changed much over the course of the debate, with 58% agreeing with Stephen Whitehead by saying that “pharma is getting its act together”. The biggest change was in the number of people who voted “neither agree nor disagree” – this started with 21% at the beginning, and ended with 7%, so at least the debate changed some peoples’ views. But as PharmaTimes has said2, these results should be taken with a pinch of salt as the audience was mainly pharma…

To finish, remember what Stephen Whitehead said: “Ben is an agent for change. So is good pharma. Let’s work together!!”

References

1. http://www.abpi.org.uk/our-work/news/2013/Pages/270213.aspx

2. http://www.pharmatimes.com/Article/13-02-27/Goldacre_vs_Whitehead_Pharma_is_cleaning_up_its_act.aspx

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About the author:

Hannah joined pharmaphorum in early 2012, after graduating with a degree in Magazine Journalism &amp, Feature Writing in 2011, and leads our news coverage, in addition to liaising with new and existing feature authors. With over three years’ experience working within the journalism industry alongside university, Hannah has written for a number of different print and online publications, within the women’s lifestyle, travel and celebrity sectors. Now focussed on the pharma sector with her role at pharmaphorum, Hannah is embracing the challenges of working within a fast growing media organisation in this rapidly changing industry sector.

For any queries or contribution suggestions, please contact her here or via Twitter @Hannah_Blake2.

Has pharma got its act together on data transparency?