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Bitter pill: The big business of Big Pharma

It was marketed as being completely safe for mother and unborn child. In fact, one version, in a sweet syrup, was sold as "kinosaft" or "cinema juice" for parents to give babies to make them sleep while the adults went to the cinema.

It turned out that Thalidomide actually caused horrendous limb deformities to babies while in the womb, causing them to be born, for example, with feet attached directly to their hips, or arms attached directly to the shoulders. I was struck at the time by the fact that nobody was prepared to take responsibility for what had happened, neither the doctors who prescribed the drug, the governments of the countries where it was licensed, and least of all the drug companies who had invented it and marketed it. Until our newspaper campaign to get justice and compensation for the Thalidomide children made the drug companies think again, the children and their parents were left to fend for themselves.

As you might imagine, this left me with a sour impression of the pharmaceutical industry. A few good experiences with drugs made me mellow a little and I was beginning to think I had been too harsh and that the big "pharmas" had changed when I came across a new book by Jacky Law, a journalist.

Called "Big Pharma", it is filled with facts and figures about the international drug industry. She says that in one human lifespan the pharmaceutical companies have expanded into a global combine of colossal power and wealth. The industry now delivers better financial returns than all other industries. The figures are astounding. Ten drugs earned $48.3 billion in 2003. Top drugs like Lipitor (prescribed to lower cholesterol) can earn on their own tens of billions of dollars a year —one product accounting for more money in one year than most companies earn in a lifetime.

The pharmaceutical companies make such enormous profits, Law says, that the whole business has a momentum of its own that seems impossible to check. As a result, the very reason for the existence of the pharmaceutical industry needs a fresh evaluation. It is no good relying on the government either to hold the industry in check or even make certain that its drugs provide us with value for money. But what about science? Where are all our objective, independent scientists? Why haven’t they noticed all this and blown the whistle? Reading this book gives you the impression that nowadays it is hard to find a scientist who does not work for a drug company.

Law writes, "Just finding experts with absolutely no connection with a drug to sit on the regulatory panels that decide whether a drug should get a licence is not easy." She writes that this is a possible explanation for what happened in the Vioxx scandal in the USA.

Vioxx, trumpeted as a brilliant new painkiller, turned out to cause heart attacks and strokes. An official of the regulatory body, the Food and Drug Administration (FDA) told a US Senate hearing in October 2004 that his agency’s approval of Vioxx had led to "the single greatest drug safety catastrophe in the history of this country or the history of the world". Another FDA officer estimated that 28,000 Americans had had heart attacks and strokes as a result of taking Vioxx while he was arguing with his superiors about the drug’s risks.

Despite the book’s devastating indictments, the final picture is not without hope. Law points out that the human race can survive perfectly well without an endless supply of new drugs but the pharmaceutical industry cannot. So there is the possibility of a transfer of power. It seems to me that we might have sub-consciously realised this. Otherwise how to explain the surprising fact that in Britain we do not bother to take at least half the drugs prescribed for us. They go gently out of date in the bathroom cabinet. But a radical change would require a display of patient strength, a decision to play a bigger role in our own health care.

Thanks to search engines on the Internet we are already better informed about illnesses and their possible treatments than ever before. Law says we now need to move away from the medicalisation of society, the belief that every problem requires a medical solution, and break the pharma industry’s stranglehold by insisting that our leaders treat public health separately from the commercial interests of the pharmaceutical industry. Makes sense to me.

Phillip Knightley is a veteran British journalist and commentator