The Illusion of Evidence-Based Medicine

The British Medical Journal

Now, this week we explored the science in medicine again, and it’s an exploration that I think should be at the top of our agenda because it impacts every one of our lives in ways that we could previously never really have imagined. But it is true we are told to trust science. It is becoming very clear that science is tainted, and nothing could describe that more accurately than a recent article in perhaps the most prestigious medical journal in the world, The British Medical Journal.

It’s certainly been around for a long time, and it has been at the forefront of almost every major medical breakthrough. The British Medical Journal is worth listening to. If you needed an article to summarise what is going on in health care, not just in this pandemic, in health care globally, particularly in the western world, it could be the illusion of evidence-based medicine.

“Evidence-based medicine has been corrupted.” I’m quoting now. “…by corporate interests, failed regulation and commercialisation of academia, argue these authors.” And I think it is rather timely because, in this week’s episode, I spoke to Professor of Family Medicine in Canada, Professor David Healy. 

David wrote a book 10 years ago called Pharmageddon. He’s a psychiatrist. He’s an author. He’s a psychopharmacologist, and his speciality is investigating data, how research is done, how transparent that research is, and the influences on regulatory bodies. That’s his speciality, and it was a real treat to have him on. He was a co-signatory of a letter which I became aware of this week. Well, last week, actually.

It was to the TGA, it was written to the chair of the Therapeutic Advisory Group, the ATAGI Group on Immunisation. All the signatories, of course, Brendan Murphy, who’s now Secretary of the Department of Health. Professor Paul Kelly, the Chief Medical Officer in the Department of Health and the TGA, etc., as well as the Health Minister Greg Hunt and many others. 

Pfizer

It kind of drew its intent. There were many things that it went through. One of the things that it wanted an explanation of was the release through Freedom of Information of the Pfizer data for their mRNA gene technology vaccination.

This was their initial research, which came out in February 2021 and what is perhaps most sobering about that data, now, bear in mind, this is the first three months of the trial from December 2020 to the end of February 2021. Bear in mind, that Pfizer didn’t want to release this data for 75 years. 

This is the company that our government and many governments around the world, the regulatory bodies like the TGA, like the health departments, like the chief medical officers, like the AMA, like the NHMRC. This is the company that they have just accepted their word on. And remember, Pfizer had been found for illegal marketing many, many times. Billions of dollars and lives have been lost. But here we are, accepting it.

Here are the first three months of this trial in the vaccine, which produced something like 42000 adverse reactions. Actually, worst of all, 12 000 plus deaths. Usually, in a trial, if there are two or three or four deaths, the trials immediately halted, and you know, the whole thing is reviewed, but not here, not here. All these deaths were actually they didn’t want to release this.

This letter to the TGA, of which David Healy and Professor Ian Brighthope are just some of the signatories. Professor Ian Bright Hope has been a regular guest on our programme, talking about other things around nutritional and environmental medicine. Other things that were brought to the attention of the TGA through this letter. It’s a 53-page letter which has been circulated to all of those people. 

The all-cause mortality data from the Official UK, EU, and US databases indicate a positive correlation with COVID-19 gene-based vaccine rollouts during 2021, so all-cause mortality went up once the vaccine.

Look, this is just we could go through this 53-page document, and you know, and dissected, but I thought I’d rather focus on the article that came out almost at the same time, which was sort of an executive summary of it because it nails really what this problem is about. And that is the illusion of evidence-based medicine. I’m quoting here. I think it’s worth quoting. 

“The advent of evidence-based medicine was a paradigm shift intended to provide a solid scientific foundation for medicine. The validity of this paradigm, however, depends on reliable data from clinical trials, most of which are conducted by the pharmaceutical industry and reported in the name of senior academics.” Now, you know, this is a problem about independence, and it’s a theme that we’ve explored, and I’ve been aware of for many years, and that is the influence of the chemical, food and pharmaceutical industry.

What I hadn’t appreciated was the media outlets, and social media platforms have now become the voice for these kinds of industries, and it shocked me, particularly when I saw vaccine mandates rolled out, but not even worse than that rolled out to children. 

This is novel gene therapy never before used on humans, which is rolled out now on children, and the data for it is given to us by the very pharmaceutical industry that has repeatedly been found guilty of fraud. Patients die because of the adverse impact of commercial interests, and one only has to look at various… Let me just share with you some instances of pharmaceutical products which have caused people to die.

Pradaxa

Pradaxa is an example of a drug, an anticoagulant. 60,000 people died on that OxyContin. If you want to get an idea of how the pharmaceutical industry works, I would recommend watching a six-part series called Dopesick starring Michael Keaton, and it’s the OxyContin story. Michael Keaton plays a very well-meaning country, a GP who gets drawn into the allure of evidence-based medicine, unaware of the illusion of evidence-based medicine. 

This is a really important point to make because I know many practitioners who will pick up the prescription pad, and I know other practitioners which will spend an hour talking to their patients about lifestyle, diet and environmental and nutritional medicine. Some of those practitioners with the prescription pad run five, 10 or 15-minute consultations. 

Other integrative functional practitioners run maybe 30-45 minutes or an hour-long to explore the cause of disease. Whatever approach they take, one thing I know for sure that is each of those practitioners wants the best for their patients.

But this is a story that is very easy to miss for a busy practitioner. But once you hear it, impossible to ignore, and here, OxyContin is an example of that. And that programme Dopesick is an example, a dramatised version of that horrific and over 500000 people have died in the US alone because of OxyContin. 

It was listed by the regulatory bodies. It’s an opioid, and opioids are known to be addictive. That is just accepted that the FDA labelled OxyContin on the advice of Purdue, the drug company and that it was not addictive. It was a breakthrough opioid that was non-addictive, and you could continue to up the dose with impunity.

Well, it destroyed townships because of the drug problem that it unleashed. It killed hundreds of thousands of people. So there’s another one, and here’s another one, Avandia, a drug for diabetes. 50% of people with diabetes who took Avandia developed cardiovascular disease. 20% died. You know, that was known years before they withdrew it from the market, and they knew about the problem with OxyContin too many, many years and many, many lives, but before they withdrew that. But this was the problem. 

When I read this article, which says patients die because of adverse impacts of commercial interests, that is true, particularly throughout the last 30 or particularly in the last 20 years, and one could argue, perhaps in the last two or three years, the pharmaceutical industries responsibility and this is critically important.

“The pharmaceutical industry’s responsibility to its shareholders means that priority must be given to hierarchical power structures, product loyalty, public relations propaganda over scientific integrity.”. 

Their responsibilities to the shareholder, not to you or me unless we are shareholders, of course, but not to our health. The ideal business model for a drug company is to have as many patients as possible managed for as long as possible, so they certainly don’t want to kill people. That’s not a great business model. 

You don’t want to do that, but to keep people going in there on their medication indefinitely, if possible, is what makes this model so appealing. The influence that they have through lobbying organisations is just phenomenal. It extends right through to the universities because ever since the market-driven economy of neoliberalism emerged in the 1980s, the corporate university is again becoming part of a quote from this article. 

“The corporate university, because they’re forced to get funds, also compromises the concept of academic leadership. Deans, who reach their leadership positions by virtue of distinguished contributions to their disciplines, have in places been replaced with fundraisers and academic managers who are forced to demonstrate their profitability or show how they can attract corporate sponsors at the universities.”

Now, this brings on now. This is worth also quoting because you are hearing from these people all the time. The people you hear in the media are exactly what I am about to describe.

“In medicine, those who succeed in academia are likely to be key opinion leaders (KOLs in marketing parlance), whose careers can be advanced through the opportunities provided by industry. Potential KOLs (key opinion leaders) are selected based on a complex array of profiling activities carried out by companies. For example, physicians are selected based on their influence on prescribing habits of other physicians. KOLs are sought out by the industry for their influence and for the prestige that their university affiliation brings to the branding of the company’s products. 

As well paid members of the pharmaceutical advisory board and speakers’ bureaus, KOLs present results of industry trials at medical conferences and in continuing medical education.” This is really important, this last sentence. “Instead of acting as independent, disinterested scientists and critically evaluating a product’s performance, they become what marketing executives referred to as ‘product champions.’

I’m not sure what they are paid, how much or how little. It actually shocked me how little some of these key opinion leaders are, who become product champions are paid. Remember, the pharmaceutical industry is a 1.2 trillion dollar industry. 

Pfizer alone, in the first 12 months of this pandemic issuing vaccines generated $16 billion worth of sales. Now, to put that in perspective, a drug company hits the jackpot when they get a billion dollars worth of sales. They are called blockbuster drugs. 

But for a company to have $16 billion worth of sales in the first year of the drug is a truly magnificent result for the shareholders. So “product champions” who are key opinion leaders may sit on boards. They may be paid honorariums for five or $10000 to go and speak. They may only be paid a few hundred dollars. 

Some key opinion leaders and I suspect I may know one or two of them proudly, would announce that they have never received a cent from the pharmaceutical industry. But the kudos that goes with them being on the media are perhaps enough to inspire them. 

Or they may be so enamoured by the data that the drug companies, even though they have been found guilty of fraud and illegal marketing, are so enamoured by the data that the drug companies have given them that they have to rush this to market in our product champion. 

This is why I include “Professors” in my 10 Ps of the pandemic. Regular listeners will remember that. This is really a problem that is outlined in the article: “The Illusion of Evidence-Based Medicine”, and they come up with some solutions.

“Our proposals for reforms include the liberation of regulators from drug company funding.” It’s sobering to know the FDA and the TGA are industry-funded bodies. “Taxation is imposed on pharmaceutical companies to allow public funding of independent trials.” You see, independent trials cost a lot of money, which is why the science in medicine is mainly funded by drug companies. 

Now there are organisations in Australia without any hint of irony that refers to themselves as the “friends” of Science and Medicine. We don’t need friends of this kind of science in medicine. We need scrutineers, and we don’t seem to have them. 

“So taxation imposed on pharmaceutical companies to allow public funding of independent trials; and, perhaps, most importantly, anonymised individual patient-level trial data posted, along with study protocols, on suitably accessible websites so that third parties, self-nominated or commissioned by health technology agencies, could vigorously evaluate the methodology and trial results”.

Now, this means making raw data available. This is a problem in health care, and David Healy wrote a book on pharma called Pharmageddon. He dealt with this issue shortly after he published that book and then went on to set up the AllTrials campaign, which would compel pharmaceutical companies to release their raw data. That clearly hasn’t happened. But it’s a noble undertaking.

“With the necessary changes to trial consent forms, participants could require trialists to make data freely available.” When you sign up for a trial, you say to the drug company, I will not sign up for this trial unless you publish the raw data. If they refuse, then you should refuse too. 

“The open and transparent publication of data is in keeping with our moral obligation to trial participants — real people who have been involved in risky treatment and have a right to expect that results of their participation will be used in keeping with the principles of scientific rigour. Industry concerns about privacy and individual property rights should not hold sway.”.

This is important to each and every day, and it is a story that is very easy to miss. I’ve said this before. I am shocked at how many seemingly well-meaning people, not seemingly well-meaning people, unquestioningly well-meaning people, have unwittingly become marketing and compliance officers for an industry that does not deserve it. 

We deserve better. We deserve better from our regulatory bodies. We deserve better from our governments. We deserve better from our professional organisations. And this 2022 article: The Illusion of Evidence-Based Medicine says it all. I hope this finds you well. Until next time.

 

 

This podcast provides general information and discussion about medicine, health, and related subjects. The content is not intended and should not be construed as medical advice or a substitute for care by a qualified medical practitioner. If you or any other person has a medical concern, they should consult with an appropriately qualified medical practitioner. Guests in this podcast express their opinions, experiences, and conclusions.