Tunnah’s musings: bad pharma, good pharma or better patients?

Paul Tunnah

pharmaphorum

As the world sees Lance Armstrong turn from hero to villain, Paul Tunnah muses on whether there is hope for bad pharma if the whole debate moves on from black and white arguments and into the middle ground of patient solutions.

I feel rather sorry for Lance Armstrong. It may not be popular sentiment to say that right now, but I suspect I’m not the only one.

I’ve never been one for following cycling much, but I can appreciate the commitment, single mindedness and pure talent required to win the Tour de France seven times. Oh – and then there’s that little thing about coming back from metastatic testicular cancer when all the odds were against him. I defy anyone to read “It’s not about the bike” (and if you haven’t then go and buy it now) and not be totally inspired by it.

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“…then there’s that little thing about coming back from metastatic testicular cancer when all the odds were against him.”

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But, of course, we all now know that Armstrong took a wrong turn, with seemingly infallible allegations of extensive doping to power him on to those superhuman victories. His decision to leave the most recent USADA case unchallenged has led to him being labelled guilty of the charges, banned for life and stripped of his titles, including all seven yellow jersey victories.

So is Armstrong the Herculean sporting hero and cancer fighter, who has inspired millions through his exploits, or the pantomime villain who has robbed more honest sportsmen of their victories?

The reality, it seems, is that he is actually both at the same time.

It is very hard to cling onto any semblance of hope that the doping allegations against Armstrong are false, but does any of this diminish how impressive his fight back from cancer is? Does it change the fact that his work with the Livestrong Foundation has provided hope and inspiration for millions of cancer sufferers?

Not in my mind.

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“…human nature means we like to see things in black and white, good and bad – you can’t have something that is both.”

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The trouble is that human nature means we like to see things in black and white, good and bad – you can’t have something that is both. The same argument so often unfolds in the whole discussion around Ben Goldacre’s book ‘Bad Pharma’ – something that came to the fore this week when we published a response to his arguments by Nick Broughton.

A barrage of comments then unfolded around how good or bad pharma is, mirroring the type of debate I have seen on other channels where the book has been discussed. Essentially, it boils down to Goldacre’s argument that pharma is ‘bad’ because in failing to publish all clinical trial data it is harmful to patients. The counter argument is that pharma is ‘good’ because of all the benefits brought to patients over the years by new medications it has developed and the countless lives it has saved.

The trouble with this debate is that, as with Armstrong, both conclusions are valid, but the black or white standpoint does nothing to help resolve the issue. It’s a bit like saying that Armstrong is definitely innocent and should be allowed to keep his titles because of all his charity work – hardly fair to the other cyclists competing. Likewise, to say that the Livestrong Foundation should shut down and all of its work be dismissed because Armstrong might have cheated is equally ludicrous.

As I have said before, pharma is an industry comprised of hundreds of thousands of people. In any case it therefore intrinsically cannot be good, or bad, even if you could label each individual within it in that way. There are far more than two sides to every story and solutions to problems almost invariably sit somewhere in between.

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“There are far more than two sides to every story and solutions to problems almost invariably sit somewhere in between….”

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Balance is required to address the real issues raised by Goldacre, balance on both sides. To demonise the pharma industry (which I genuinely do not think is the aim of the book) will surely lead to a defensive posture and further resistance from all sides to collaborate in resolving the data transparency issues. But to ignore the issues and simply focus on the good that pharma has done will not help patients either. This is not intended to be critical of either Goldacre or Broughton – exactly the opposite as both are brave enough to stand by their genuine and passionate views which they eloquently communicate, thus providing an excellent starting point for triggering the type of debate that eventually leads to solutions.

Trust me, there are many people within pharma that want those two sides to come together in the middle and find a workable solution, so let’s throw away the good and bad labels and focus on the practical solutions, with those who have a willingness to change. After all, if a ‘bad cyclist’ can do so much to help patients, then there is every hope for bad pharma.

Oh…and in the interests of there being two sides to every story we will be featuring an interview with Ben Goldacre soon too so you can hear more on his perspective first hand, even if you have not read the book.

Until next month, stay well.

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About the author:

Paul Tunnah is Founder and Managing Director of www.pharmaphorum.com, the primary facilitator of thought leadership and innovation for the pharmaceutical industry featuring news, articles, events / company listings and online discussion. For queries he can be reached through the site contact form or on Twitter @pharmaphorum.

Do patients really care if pharma is ‘good’ or ‘bad’?