Prof David Healy: Pharmageddon – Evidence-Based Medicine or Marketing? Introduction
Well, today we’re going to be continuing with the theme about can we trust the science? And it was born out by two things that landed on my desk in the last week or so, and one was a 53-page document, which was written and co-signed by many respected researchers and practitioners to the Australian ATAGI Group, which is the Advisory Group on Immunisations and the Therapeutic Goods Administration, the TGA. And one of the co-signatories is Professor Ian Brighthope, who I’ve spoken to on several occasions and will be having back to discuss this further in more detail in another episode.
One of the co-signatories that I saw there was Professor David Healy, a Professor of Family Medicine in Canada. And I know David’s work because I’ve read his wonderful book back in 2012 called Pharmageddon, bringing together two words from the (1) Pharmacology, pharmaceutical industry; and (2) Armageddon. And I think the name is pretty self-explanatory that we need to be very cautious in 2012. Well, how do we reflect on that in 2022? How have things gone in the meantime? Well, I think like me, I’m sure many of you will be shocked by the way in which so many people have become marketing and compliance officers for an industry that has repeatedly been found guilty of fraud and illegal marketing. Now that is the pharmaceutical industry.
Now, David is an expert in the lack of transparency in data issues that afflict the conduct of things like randomised controlled trials. The governance and manipulation of data by trial sponsors, which in the vast majority of cases is the pharmaceutical industry, producing a product that they want to bring to market and in general about the integrity of medical literature, as well as regulatory bodies, the integrity of regulatory bodies like the FDA and the TGA. This is a subject that we need to get our heads around and, well, I won’t spoil it for you. I hope you enjoyed this conversation I had with Professor David.
Dr Ron Ehrlich: [00:00:00] I’d like to acknowledge the traditional custodians of the land on which I am recording this podcast, the Gadigal People of the Eora Nation and pay my respects to their Elders – past, present, and emerging.
Hello and welcome to Unstress. My name is Dr Ron Ehrlich. Well, today we’re going to be continuing with the theme about can we trust the science? And it was born out by two things that landed on my desk in the last week or so, and one was a 53-page document, which was written and co-signed by many respected researchers and practitioners to the Australian ATAGI Group, which is the Advisory Group on Immunisations and the Therapeutic Goods Administration, the TGA. And one of the co-signatories is Professor Ian Brighthope, who I’ve spoken to on several occasions and will be having back to discuss this further in more detail in another episode.
Dr Ron Ehrlich: [00:01:04] One of the co-signatories that I saw there was Professor David Healy, a Professor of Family Medicine in Canada. And I know David’s work because I’ve read his wonderful book back in 2012 called Pharmageddon, bringing together two words from the (1) Pharmacology, pharmaceutical industry; and (2) Armageddon. And I think the name is pretty self-explanatory that we need to be very cautious in 2012.
Well, how do we reflect on that in 2022? How have things gone in the meantime? Well, I think like me, I’m sure many of you will be shocked by the way in which so many people have become marketing and compliance officers for an industry that has repeatedly been found guilty of fraud and illegal marketing. Now that is the pharmaceutical industry.
Now, David is an expert in the lack of transparency in data issues that afflict the conduct of things like randomised controlled trials. The governance and manipulation of data by trial sponsors, which in the vast majority of cases is the pharmaceutical industry, producing a product that they want to bring to market and in general about the integrity of medical literature, as well as regulatory bodies, the integrity of regulatory bodies like the FDA and the TGA. This is a subject that we need to get our heads around and, well, I won’t spoil it for you. I hope you enjoyed this conversation I had with Professor David. Welcome to the show, David.
Prof David Healy: [00:02:45] Good to be here.
Dr Ron Ehrlich: [00:02:46] David. I have known of your work for many, many years since you’ve written that book Pharmageddon, which I want to talk about. But more recently you’ve written a letter, co-signed a letter to our TGA in Australia and the advisory board that advises on immunisation. Before we dive into that, I just wondered, you know, you were a psychiatrist and author and also a psychopharmacologist. I wondered if you might share your story with us?
Prof David Healy: [00:03:13] Yeah. Well, the story is not quite like those words sound. The story is much more than this. You know, I ended up after that, first of all, trying the medicine, I thought I’d do some research and the brain at that stage was something that was a bit of a black box and nobody quite knew how it worked. And you know, there were important things that I thought might work out slightly better if I knew how the brain works, which was how to attract a woman or something like that.
Dr Ron Ehrlich: [00:03:45] Okay. Absolutely.
Prof David Healy: [00:03:48] So but yeah, and this I ended up accidentally working on the serotonin system before the SSRI group of drugs like Prozac came on stream. And it was awfully clear to me that was that the pharmaceutical industry was interested to use me to talk to family doctors to explain to them about the serotonin system. And the industry aspect to all this is the industry thought I was one of them, so they were quite happy to share how they operated. And it’s very clear that the serotonin they were talking about was completely different to the serotonin that I’d be working on in the lab.
Dr Ron Ehrlich: [00:04:25] Mm-Hmm.
Prof David Healy: [00:04:25] I think that what they had was a bio battle. The serotonin that the industry used was just marketing copy. It’s got nothing to do with what goes on in us.
Dr Ron Ehrlich: [00:04:38] Interesting.
Prof David Healy: [00:04:38] Yeah, that’s how it was clear early on. I mean, they were keen on the idea that the SSRI was Prozac and Zoloft correct the abnormality in the serotonin system, but there’s no open about it in the serotonin system and people who are depressed. OK.
Dr Ron Ehrlich: [00:04:53] Interesting.
Prof David Healy: [00:04:54] The drugs don’t correct ff you go on these drugs, you end up with a more abnormal serotonin system after you’ve been on them than you have before you started, OK. So when you’re in a world like this where you know one thing on this side and a completely different take on the other side, you know, it ends up being an interesting world and trying to work out how to navigate through all this was interesting.
As I say, the industry thought I was very much one of them, and so they got me to talk of meetings. And before one meeting, I got an email saying, you know, you’ve agreed to talk with this, and we went to all the authors to produce an article from this meeting. And here’s your article.
Dr Ron Ehrlich: [00:05:40] Wow.
Prof David Healy: [00:05:40] Well, I downloaded the article, much to my surprise, it’s a very good idea. You know, someone’s written this and it’s obviously known the kinds of things I say and how I say them. And has written enough, though, that if I put this up with other articles that I’ve written in front of a group of people, close friends who knew the kinds of things that I say and ask them to pick up the article that I have written, they wouldn’t take this with that, you know?
So as it turned out when I really got involved in this, I had I knew there would have to be an article and they had some ideas about a useful article. So I said to the company, “Well, you know, thanks for this, but I had agreed to do my own article and I’ve got it just here, you want to see it?” And they said, “Sure, OK, it’s a bit unusual but fine.”
Dr Ron Ehrlich: [00:06:33] Writing your own article, who would have thought?
Prof David Healy: [00:06:36] Yes, exactly. So I emailed the article over to them and they said, “Oh, this is rather good. You know, we’ll hang on it. But there are some important commercial messages in the other article, so we’ll get the guy who’s going to chair the meeting.” A guy called Siegfried Casper, who is a professor of psychiatry in Vienna, where Freud used to hang out, OK, so “We’ll get him to be the author of the other article that one that we sent you first of all.
And all they did then was to change his name. I mean, swap his name in front of mine. The article is exactly the same. It’s a good article full of references, but it’s got his name in this rather than mine. And so that gives you a feel for the kind of things that can happen.
Dr Ron Ehrlich: [00:07:22] What year are we talking about when that occurred?
Prof David Healy: [00:07:25] OK. That was 1999. But the ghostwriting of the medical literature really begins during the 1980s and by 1999, probably even before that, it’s kind of pretty well all articles on the drugs you might take. This isn’t just mental health drugs, it’s heart drugs and bone drugs and gut drugs and vaccines. The articles are entirely ghostwritten for the last 20 years, and at least maybe even 30 years.
Dr Ron Ehrlich: [00:07:54] I remember reading an article, a book actually from the former editor of the New England Journal of Medicine, Marcia Angell, who was talking about economic rationalism and deregulating the market. This became the norm within the industry, and that was way back in the 80s. So, as you say, the big psychopharmacology and you mentioned serotonin. It’s predicated on imbalances of brain chemistry. That’s the theory. Is that measurable?
Prof David Healy: [00:08:26] I know it’s not. No, no, no. I mean, this, as I say, if when you hear all this stuff, what you’re hearing is just marketing copy. It’s got nothing to do with the science, you know, and what people need to realise is just that they need to ask the awkward questions is, you know, can we see the data for this claim?
Yeah, just the point you made, which is, you know, are you able to measure that? Do you really know that things have been put right, you know, these are the kinds of questions that anyone who gets put on these drugs needs to ask. But the doctors should also be asking them and haven’t been, you know, it’s just nice and convenient, the bit of good marketing copy to tell the patient when they come in the door, you know that this will put your serotonin levels right.
This would put the chemical imbalance right, which leaves everybody happy because that’s what the patient wants to hear. And that’s what the pharmaceutical company wants to hear and makes life easy for the doctor. But that’s an excess a bit in there, which is up till the 1990s, people believe in pills, but they were a little wary about it, but we have the benzodiazepine tranquillisers. You know, people have said, well, these are nice drugs, but I really shouldn’t be taking them. It’s not right.
Dr Ron Ehrlich: [00:09:47] This is Valium things like probably.
Prof David Healy: [00:09:49] Yes, exactly. And I should be able to get by without pills because nobody thought Valium was correcting anything. It’s like opiates. You know, they’re nice, but they’re not actually correcting anything. With the SSRI is the idea that there’s a chemical imbalance that these drugs put, right? Sounds like you’re being put right. Something’s wrong and it is being put right. And even if you’re reluctant to take pills, it almost feels like a moral duty to put things right.
Dr Ron Ehrlich: [00:10:20] Mm-hmm. Which is very clever marketing and so much. I think that’s part of what confuses people when it comes to health. I mean, when we’re buying cars, phones, clothes, we expect marketing. You know, we know I’m not confused about whether Ford is better than GMH. I know both are trying to present the best, but I don’t think we really expect that of health and certainly, patients don’t.
But I’m amazed at the psychology and this is what I’m interested in your views as a psychiatrist about how readily the medical profession embraces this paradigm generally in general health. But we see it. I like to use the word on steroids now, but with the vaccine, the approach just and I’m just intrigued. What do you think drives this rush to accept the marketing hype?
Prof David Healy: [00:11:17] Yeah, that’s a really good question. And one of the tricks is this, you know, you can get SSRI over the counter in the form of antihistamines. Most of the drugs, like Prozac and Zoloft are antihistamines, but they’ve got the serotonin reuptake inhibitor that is optimised a bit. But some of the antihistamines you get over the counter are just serotonin reuptake inhibitors.
Dr Ron Ehrlich: [00:11:41] Mm-Hmm.
Prof David Healy: [00:11:42] And if we go get the antihistamine over the counter, most of us, if it doesn’t suit us, we stop it. But if you get one from your doctor in the form of Zoloft and it doesn’t suit you, the doctor will educate the pharmaceutical company and say to you, “Look, these drugs aren’t really working yet. You know, you’ve got to work through this and everything will be alright later on.” Or maybe you’ll even increase the dose of the pill if the pill is causing the problem. This is a disaster.
So there is something about our own natural caution, which we exercise when it comes to cars and things like this and over the counter drugs somehow go out the window when we go to a doctor who says, “Well, know, no, you do need these pills and you know you need to keep on taking them.” And we don’t want to make the doctor unhappy, particularly when things start going wrong because he’s the route to salvation.
If things go wrong, so you don’t want to make them unhappy and that happens a lot. Doctors don’t realise that we as doctors having under pills think we’re doing the right thing. We really are genuinely trying to help.
Dr Ron Ehrlich: [00:12:52] Oh yes, I have no doubt about it.
Prof David Healy: [00:12:54] Lost sight of the fact that, well, we may be doing more harm than good and we need to be keeping an eagle eye on all this and trying to work out if the price of what giving hoping to help the person has become too poison them.
Dr Ron Ehrlich: [00:13:08] Hmm. But I’m, you know, the fact that regulators, policymakers who we should really expect more from. Okay, I understand the busy general practitioner is thinking, Well, these are I think the words are now key opinion leaders, but we don’t expect them to be product champions. And I think they’re two terms that have come up recently in an article from the British Medical Journal. But it’s the highest level that is perhaps the most shocking because they are the people that set public health policy. Is this where the blur the line between industry and advisor becomes very blurred?
Prof David Healy: [00:13:47] Well, there are two things there. What is the regulator like the TGA, and the TGA is a bunch of bureaucrats. They’re really not super scientists. They know very little about things. They just do the business of ticking boxes.
The person we should be looking after is that doctor who’s much more trained in trying to work out, is this drug actually helping or not? And who has you down in the room and can ask all the questions and call his friends in to ask you questions and do tests and things of that work? Is this drug causing a problem or not? The regulator can’t do all these things and, you know, is usually a regulator because they don’t like meeting people. You know, they left medicine and got into bureaucrats.
As regards the key opinion leaders, pretty universally, I hate to say it, because, well, at one point I would have been viewed as maybe one of them. They’re the second rate. You know, they’re the guys who haven’t really got the really good jobs, but who industry write their articles for them. So you’ve got people like Siegfried Casper, who you’re told has more than a thousand articles to his name.
Now, people 30, 40 years ago, who had won Nobel Prises and had written all their own articles might have three or four hundred. This guy’s got a pass. You know and told you shouldn’t, because he’s got so many options, so he didn’t write any of them, you know? But this is the kind of person who the industry is able to media train and trot out to answer the awkward questions and things of that, you know?
So we’ve got a situation just a bit of a sham. And the key thing I think for me is those family doctors who are often the best doctors, not specialists like me, who really just see a bit of the person who works in their heart, who just knows that the heart doesn’t know anything else about human beings.
Family doctors are often the people who see people in the round and who have known the person over time, know the family, know the community, et cetera, et cetera. There are often the people best placed, but they risk going out of business if they don’t realise that actually, the magic lies in them and nothing of the pill.
Dr Ron Ehrlich: [00:16:07] What a message. What a great message. Now you as a psychopharmacologist then in 2012, and this is how I first came to know of you brought two words together that we do know. One is Pharmacology and the other is Armageddon. And you wrote a book called Pharmageddon 2012. Can you tell us a bit about that book?
Prof David Healy: [00:16:28] Yeah. Well, OK. It seemed very clear to me back then working in the UK as I was then that medicine was changing and changing fast. You had the idea that there was the national health system in the UK, which is very much public medicine, which most people in the UK are very proud of. And over the state, you had what we view as corporate level, what we viewed back then as private medicine, OK? And that things seem to be changing fast and the NHS ethos was on its way out the window to some extent that, you know, the governments in both the US and the UK were supporting corporate medicine. And that’s what we’ve got now.
I mean, the way health services are running in the UK and the US, which used to be completely different, polar opposites. Now it’s hard to tell the two apart. And you could see that that was happening and that’s where the book came from. Time to work out. What are the forces driving all this?
And amongst the key forces driving is the fact that when we thought we needed to control the pharmaceutical industry, which I guess we do and we thought we were going to do this with what is called randomised controlled trials. RCTs. OK. But these were going to be difficult for the industry to get through, you know, to get the pills through. But if they did get through, then at least we knew these pills worked.
Prof David Healy: [00:18:01] They were introduced, and RCTs were introduced following the thalidomide crisis and seemed like a good idea. OK. Let’s force the industry to prove the pills work, OK. An industry at the start were unhappy at this having the hurdle rate, so they quickly realised, actually, you know, we can make money out of this. We can make these things work for us. And they did. They began to people who promoted acid used to promote it. Evidence-based medicine who told doctors, you know, “Aren’t you practising according to the evidence?”
That might sound personal to people listening in until you realise the industry is saying this because they were the only ones running RCTs. And if they run RTCs and have all the data and people like you and me can see what actually happened in this trial, if they then ghostwrite the articles to claim that five shows the drug worked wonderfully well and there were no harms, then they control everything.
Doctors will feel yes, we should practise according to the evidence, which is in the very best journals not realising actually that, well, these are adverts. They’re not… And what’s even worse when you look at this is when these trials go into TGA. Our FDA in the United States industry may deliberately tell the regulator, you know, this is a negative trial, but we don’t want you to mention that to anyone.
And the regulator agrees with the industry right up a negative trial as positive. They say, this drug worked wonderfully well and it was free of harm, and the regulator does nothing about that, and that includes TGA. So, you know, were there, depending on the regulator, to look after us. They aren’t. If they’ve been able to tick the box, they left these things through and do nothing else from moving forward.
Dr Ron Ehrlich: [00:20:05] Well, these regulators, the FDA and the TGA, I think it’s worth reminding our listener that these are actually industry. This industry funding within these bodies isn’t it? It’s almost a revolving door. Is that how the industry works? Is that how these regulators work?
Prof David Healy: [00:20:23] Well, yes. And that’s absolutely true and very important. But there’s a more important point here, I think, which is people get slightly fooled. I mean, they hear the word regulator and they don’t quite know what that means. And if you take it away from drugs for a second, then just think food, okay?
And the regulator is faced with some company who’s coming in with the butter. So the regulator sees this yellow lump in front of them, and it could be large coloured to look like butter could be real butter. OK. And here’s got some kind of criteria. You can check the chemical composition, and if it’s this that he can tick the box butter. And if it’s that he says, no, it’s not butter, OK?
But his job is not to decide if this is good butter or not. Or if butter is good for you or not, it’s simply to tick a box. Now, he may have moved into the job from the butter company, if you see what I mean, but in a sense, that’s not important.
It’s just got a very simple job, which is to tick a box. If you know, the chemical composition of this block of yellow stuff makes the composition of butter. You know, that’s the same with pills. You know, they’re not. They don’t really, you know, you don’t have to understand a single thing about pills to be a regulator. You just need to see, does this match fat enough so you can tick a box?
Dr Ron Ehrlich: [00:21:53] Now, the science in medicine is another interesting topic, which I think again, people need to become more aware of. What percentage of the science in medicine is actually that finds its way to the coalface of the practises, what percentage of the science in medicine is funded by the pharmaceutical industry in your estimation?
Prof David Healy: [00:22:14] Well, when it comes to the control trials get under all funded by industry, there are very few that aren’t funded by industry, and they get written up by industry. The doctors whose names are on the authorship line haven’t written these articles.
Dr Ron Ehrlich: [00:22:31] No, as you’ve mentioned.
Prof David Healy: [00:22:33] Just that their names are there because the industry figure that these are the people who, you know, people like David Healy, when they come to use these drugs if they see that name, that they’ll think this is a quality mark, basically, you know, this means and it’s okay. And when you put all of this began, the articles used to be in obscure journals, but the industry figured it would be much better if they appeared in the New England Journal of Medicine?
Are the Australian medical journals so they think for the last 20 years or so are the very best journals? The articles company trials which have been ghostwritten or where there’s no access to the data, appear in the very, very best journals with the Professor of Medicine and Harvard and the Professor of Surgery and Yale and the Professor of Psychiatry and maybe Sydney, you know.
Dr Ron Ehrlich: [00:23:26] Mm-Hmm. Which kind of suggests that the influence of the drug companies permeates. How far does it go? I mean, you know, we’re talking about you just mentioned universities. I mean, we should really expect more from our universities to be independent, but presumably, they’re not.
Prof David Healy: [00:23:43] No, they’re not. And yeah, I mean, I think we have sold our birthright down the river, basically. And as I say, doctors risk going out of business because they’re so lacking in the things that trying to count. And the other thing about it is that the pharmaceutical industry needs patients and doctors more than we need them.
If we can hang together, you know, and say, Well, we’re not using these pills unless we can see the industry would have no option but to agree to play ball. But they’ve been thinking about these things ahead of us, you know, they’re a step ahead and it’s not a particularly clever. It’s just that they’re very focussed on the bottom line was most doctors and most patients aren’t. We just tried to live life and get rid of some inconvenient problems away. We’re not trying to solve the bigger problem about what’s the pharmaceutical industry doing.
Dr Ron Ehrlich: [00:24:45] But isn’t that part of? I mean, that is clearly part of the issue is that we would expect those in positions making decisions to insist on the data that the pharmaceutical industry is one step ahead of us, ensuring that the people who make that who should be making that decision, are actually key opinion leaders and product champions. Is that the way it works?
Prof David Healy: [00:25:08] Yes, sure. One of the oddities is, and I think the vaccine story brings this out. Over the last 20 years or so worked with a lot of lawyers, good lawyers as opposed to just trying to chase the money are the ones who are trying to get the message out about what’s actually happening and worked with a lot of people in the industry also who have, I mean, the good guys, the most part have not been doctors blowing the whistle because they haven’t. It’s been people within the industry to blow the whistle about what’s going on in their brain works with all these people, you know, who have seen the ghostwriting and the lack of access to the data and fraudulent stuff being done and things like that.
You know, what’s been offered at the vaccine story is that all these hard-bitten people used to dealing with industry and figuring without getting the can’t trust these guys, you got to check everything with the vaccines have rolled over and somehow seem to think that given how important all this is, this awful plague that we’ve gotten the wonderful things vaccines can do that somehow industry is going to have behaved itself this time. And in actual fact, if anything, things are worse.
Dr Ron Ehrlich: [00:26:20] Yes, I mean, as I’m following this story, as I did with your book and I’ve read many times at the books, I’ve been aware of this influence for many, many years, and even I am shocked at the way you’ve said that rolled over. It’s another aspect of this control over the trials is the control over the data, isn’t it? Because this is a big issue as well, isn’t it?
Prof David Healy: [00:26:46] Oh, totally, yes. And there are a few aspects to it. One is if you can see the data well, there’s a few tricks that can tell you about a bit apprehensive how much time we have, but it in trials, which you wouldn’t guess if you can’t see the data. Like, for instance, in one of the Pfizer trials of drug use for nervous problems. This man dies of his burns now people die from accidents of all sorts during the course of a clinical trial. OK, so when you see death by burns, look, first of all, you won’t see death by burns in the paper written about the trial.
But if you get some of the background data, you’ll see death by burns. OK, but only when you get to see the data behind the background paper, but realise, well, this man was on this drug, which made him suicidal. He puts petrol over himself intending to kill himself sets fire to it. But doesn’t die for five days and dies from his burns five days later. So gets counted as death by burns rather than suicide.
You’ve got to see the data, that kind of thing happening, and that’s the kind of thing that TGA and FDA don’t look for. They don’t see. I mean, one of the other things here is the regulators. TGA don’t see the data. People assume they must know they think they may have notional access, but what they operate on is a report that the company writes about what their trials show.
Dr Ron Ehrlich: [00:28:23] Hmm. I mean with this Pfizer vaccine, I mean, they were wanting to hold on to that data for… Did I hear this correctly for 75 years?
Prof David Healy: [00:28:35] Yes, you did. And they’ve been forced to change that.
Dr Ron Ehrlich: [00:28:39] But I mean, the hubris, the hubris to actually suggest…
Prof David Healy: [00:28:42] Well, the surprise, I guess to some extent was, I mean, from their point of view, they’re probably a surprise to anyone who is going to insist that they should have to share the data. So they thought they were being generous, saying when you can see it in 75 years, wow, they have been forced to show earlier now. But even then you have a situation where industry has controlled things so that what you get to see is not the raw data. Like, for instance, if you or I were in this trial, ideally the raw data, I mean, we are the data OK. And the idea that we don’t have access to our data is kind of crazy.
But for people to work out what went on in this trial if need be, you know, they need, let’s say there’s been an accident, you’ve had some accident and you’ve got burns and you know, people need to be able to call you up and find out, well, what does burns mean? You may end up saying, I tried to kill myself, you know, I didn’t die. But hey. So the data, I mean, again, again, in the antidepressant trials, you see the regulators see suggest that the president’s doing awfully well right up to the day that they kill themselves.
Dr Ron Ehrlich: [00:29:55] Mm hmm.
Prof David Healy: [00:29:57] And the doctor looking at them in the clinic is asking a bunch of questions that the patient says, OK to our yes, to our yes or whatever. If they then die, you know, you need to be able to get hold of the patient’s wife and you know, ask her what happened, and she’ll say, “Well, no, he really wasn’t like that at all. He was suffering the entire way through.” You know, knowing what happened in the trial means that able to get hold of people who are in the trial.
Prof David Healy: [00:30:25] Now. Well, Pfizer going to show us won’t let us get hold of you or me or whoever else is in the actual trial. The other thing is when they’ve got the whole thing gained nicely, which is when you go and when you went into the trial, you’ve got an iPod or on your phone, you’ve got an app or whatever which let you record the adverse events that were happening.
Dr Ron Ehrlich: [00:30:50] Mm-Hmm.
Prof David Healy: [00:30:51] But only let you record 10-12 adverse events that a company could pass off as well. This shows you having an initial reaction to the vaccine, which is a good thing. You know, very early on, those things work. I mean, it can even mean that they have conditioned doctors to say to patients who talk about a pain in the chest as well. That’s a sign that the vaccine is highly effective.
Dr Ron Ehrlich: [00:31:18] Yeah.
Prof David Healy: [00:31:18] But the thing is that there isn’t anywhere for you to talk about the awful things that might have happened, and lots and lots of people have had pretty serious problems happen to them, you know. When they actually take the vaccine and this is written out of the script and any effort to talk about what the patients who come to me talk about gets branded as misinformation because it didn’t show up in the clinical trial.
The clinical trials are supposedly the only way we know what a vaccine or drug is really doing, and it’s not anyway, we know what a vaccine drug is really doing is for you to talk to me or me to talk to you about what’s happened to us since we have this vaccine or drug.
Dr Ron Ehrlich: [00:32:03] Mm-Hmm. Well, you’ve written you’ve co-signed a letter to our regulatory bodies for the ATAGI, the Advisory Group on Immunisation and the TGA, the Therapeutic Goods Administration, to 53-page letter with very thorough references and explanations. I wondered if you might share with us, and give us a kind of an executive summary of what that is about.
Prof David Healy: [00:32:29] It’s about pointing that the vaccine trials are ghostwritten is one point and at least one of the ones for children, we know that the ghostwriter was in New Zealand. She was writing for a company based in Dublin and trials that happened in the United States and in the case of the adult trials in Argentina and Brazil and places like this. So you have the ghost-writer has no idea what actually happened at the time, but ghostwriters of good people.
I mean, they’re really skilful writers and things like that. But if they don’t see the data things that you know, well, they’re going to produce marketing copy. But this is what’s being produced for a US company. So you’ve got the entire world there, from New Zealand to the United States and Argentina and things of that. And it’s producing copy that says to get the media and other people that this vaccine was 95% effective.
But what people need to realise here is that. In the case of the antidepressant, say you could say that these drugs were very effective at reducing rating scale scores. Now they actually weren’t that effective, but you could say they are effective because they reduced rating scale scores.
But if you ask the average person, what does a drug working mean in the case of an antidepressant? The answer would be, well, we’d expect these drugs to keep you alive. I would expect them to help you get back to work. In the case of antidepressants, more people die on the drug than on placebo in clinical trials, and there’s no evidence that they get you back to work.
Prof David Healy: [00:34:19] And the same is true for the vaccines, this headline idea that they’re 95% effective. Well, that’s true, but it was a particular trick that was used they didn’t look at doesn’t keep you alive. More people die on the vaccine than on placebo, and that’s from what we know. We also know that a lot of people have gone missing.
So what do the true figures actually look like? Oh, goodness only knows what. OK, so the other aspect is in terms of the function you’re left with, again, it’s you know, as that was pointing out to the TGA, that’s the companies have not looked at how you were overall, even if you’re not dead if you’re alive, how physically healthy are you? You know, after you have a vaccine and we just don’t know from the trials that were done.
So you know the point I’m trying to look at, I mean, I guess the mid issue was this, but it’s one thing to have these things ghostwritten and lack access to the data. And people, if they’re scared about COVID, should be completely free to get the vaccine. But it becomes a different matter when you mandate people to take the vaccine, say to them that you have to take it or you lose your job or whatever.
Dr Ron Ehrlich: [00:35:44] …which is happening, obviously.
Prof David Healy: [00:35:46] Which is what’s happening, and that’s bad. But when that’s happening on the basis of fraud, then it becomes even more complicated.
Dr Ron Ehrlich: [00:35:55] Now that you mention 95% effective as that figure. And I wanted to also ask you about the difference between relative risk and absolute risk because you know, there is a big difference. And yet it’s never mentioned by any of the so-called experts or key opinion leaders, which I think I’ll refer to them in the future as… What’s the difference, can you talk to us a little about the difference between relative risk and absolute? You mentioned 95% effectiveness there, and I assume that’s a relative risk value, is it?
Prof David Healy: [00:36:29] Yes, it is. Yeah, when you look at the number of people who supposedly called… I mean, what they were doing at the trial was looking at the number of people who caught COVID who had been vaccinated versus the number of people who caught COVID who hadn’t actually been vaccinated.
Now there was a big difference between the two groups. The unvaccinated group were more likely to have caught COVID during the course of the trial than the people who had the vaccine. And if you’ve got a big figure like 95 out of 100 who were unvaccinated caught COVID and only possibly five out of 100 who were vaccinated, then you got a 95% effective outcome.
But in actual fact, whether it’s 20000 in each group and if only 95 out of 20000 aren’t people caught COVID, well, actually. That’s not 95% less effective than the vaccine group, it ends up boiling down to something like 20 or 30% more effective for the vaccine. OK. But even there the problem was you can’t trust what’s happening.
I mean, there’s the absolute and relative risk, which is one thing. But that’s added on top of the fact that there’s a steer in. If you read the design of the actual trial, they say to the doctor, whoever is doing it, well, actually, a lot of the people who are monitoring you and me in these trials were fast-food workers, they weren’t doctors or nurses and they were told, you know, you don’t have to send the patient along for testing if you think they’ve had the vaccine.
This is the kind of I mean, the reaction you have to the vaccine is rather like COVID. So if you think they’ve had the active vaccine, you don’t have to test and just assume this is a reaction to the vaccine. So you end up having a lot more people who are placebo being tested. I mean, you can see it’s more likely to happen if the people in the fast-food workers running the trial have the randomisation codes in front of them telling them who is on the vaccine and who’s on placebo. Yeah, you know, so it’s you know that the whole thing is beyond belief, really.
Dr Ron Ehrlich: [00:38:58] The other thing that came to light, too, was that they did have the control group who didn’t have the vaccine and they had the vaccine group. And generally you would run that trial for a year or two and see how the control group was going in terms of not just whether they got COVID, whether they got hospitalised. Did they die with adverse reactions? Follow that through for two years. And that would be how you would do it. But that’s actually not what happened. We kind of lost the control group, didn’t we?
Prof David Healy: [00:39:28] We did. Yeah, the control group and the control group were told, Well, you know, you might have non-placebo, but if if you’re in the trial and a placebo, you can’t travel. So, you know, if you love to travel, you’ve got to get yourself more shots. So everybody was on a placebo. Well, not everybody, but most people actually taking a placebo and end up going on to get a further bunch of shots.
So, yeah, this is one of those things which leaves us unable to judge at the end of the day, which is which group have the better outcome? We know that strictly speaking, just from the short term trial in the very, very short term, we know more people taking the vaccine died than people in the control group. But what you’d really like to know is over the course of a year or two. How did things actually look? And it does look at the moment like for the most part, except maybe the elderly that across broader populations, the evidence is that one can the other more people who have the vaccine seem to be dying than people who didn’t have the vaccine?
Dr Ron Ehrlich: [00:40:37] I mean, that is you’ve just rolled off the tongue that that statement and that statement is quite a huge is huge. And we’re not hearing about it. In the letter that you’ve written to TGA and ATAGI, you talk about all-cause mortality trends over the 2020-2021 period. I wondered if you know you share some of the some of that with us. I mean, you mentioned it.
Prof David Healy: [00:41:07] Yes sure. One of the problems is that we hold up randomised controlled trials as being the gold standard knowledge. We do these because they really let people know what a vaccine or a drug does, right? As I mentioned on a few occasions, the randomised controlled trials, even with serious efforts to hide the bodies, show more people dying on the vaccine than on the placebo.
Now the thing is, everybody listening to the programme, everybody reading any newspaper which we still have these days of shooting any media of any sort will be aware that there’s been countless because every day of our life for the last two years, the dashboards show the people dying in hospital and the people who are getting seriously ill and ending up in ICU that the unvaccinated.
So how do you reconcile this kind of story, which looks like, you know, the vaccines work terribly well with the gold standard knowledge, which says, Well, actually, you know what people are dying on the vaccine? And the answer is, I don’t know, and no one does know. OK.
The problem we’ve got, I think, is that everybody’s bought into the idea that vaccines work. So when you look at what’s happening at hospitals, you’re forcing the figures to fit into. What you believe must be happening is the vaccines work. Problem is this if you get COVID at home, a bunch of things can start happening, which is that if you’re not vaccinated, the doctor who comes in to see you is more likely. You think, well, this person’s more at risk, so maybe we should send them to hospital, whereas that’s a fact probably keeping you home is a safer mask.
Dr Ron Ehrlich: [00:42:52] But it’s usually the case.
Prof David Healy: [00:42:54] Yeah, of course. Once you get into hospital, you know, people then get screened for COVID. And if you’re COVID positive that you get a bunch of drugs which aren’t terribly safe like remdesivir, which is, you know, not something I’d advise anyone to take in hurry.
Dr Ron Ehrlich: [00:43:13] Okay, which appears to be said that the TGA was very, very quick to quickly approve that and that came through very quickly.
Prof David Healy: [00:43:24] Yeah, sure. I know people who were involved in helping run the remdesivir trials, but Ebola, and they were told, you know, if you happen to drop the virus on the way to the patient, that’s no problem. You’re just I mean, they’re being told in the course of the trial that, you know, it’s no problem if the patient doesn’t get this drug. So anyway, you’re not sure so anyway.
But so there’s a bunch of things that could happen to you when you go into hospital. If you’re unvaccinated again, if you go into hospital with COVID and are vaccinated, you’re much less likely for people to figure out what we’ve got to give you something. I mean, because you’re on something and you know, the vaccine. The mantra again and again, again, you hear from people who have been triple vaccinated and who then catch COVID, and you say, well, it wasn’t too bad. And they hear it from the doctor.
Well, that’s because you’re vaccinated would have been much worse if people weren’t vaccinated? Yes. But then the trick is, you know, people who just stop it was to go into ICU. And let’s say the big hospital was a bad night to advise you because they’ve got heart attack. Nothing to do with the vaccine. Nothing do with COVID. You know, they’re going to hospital. They end up going into ICU.
Well, you’ve got to be screened when they go into ICU for COVID. Because if you’ve got COVID, who we have to isolate you from the other patients that you may just have COVID without suffering from it, you may not be the reason why you didn’t give you the heart attack. But if you’ve got a heart attack and you also happen to be positive for COVID and you later doc, well, you become a COVID death, you know, so there’s a bunch of things like this that none of us really know how to work all this without some genuine collaboration.
You know how we ended up with the figures we’ve got? Yeah. How many people who just happened to have COVID were classified as a COVID death when they weren’t treated, they didn’t die from COVID. They just also, you know, things like this that need some genuine. Cooperation between people, both people who are pro-vaccine and people who may be anti, but it needs a cooperative effort. And that’s just not what we’re getting at the moment.
Dr Ron Ehrlich: [00:45:38] Nor does it actually look. I mean, I tend to be an optimist. I just cannot see how this is going to play out as we’re rolling out another booster. I mean, you know, booster after booster here. I mean, I know we were. Another thing was the way that TGA’s suppressed any alternative for early treatment. That was another aspect that I know you’ve called them to task about. Have you had any response to this letter?
Prof David Healy: [00:46:03] No, I haven’t. No, no. Just so people are clear, I’m not advocating any other treatments. One of the problems is the people to some extent advocating other treatments, which may well work, but it almost looks like on the one hand, you’ve got a bunch of people throwing vaccines at us, on the other hand, got a bunch of people throwing other treatments, which are not vaccines at us. But there is a third option, which is let’s be a bit more conservative.
Let’s not put you on too many vaccines at all, and certainly not too many other pills. You know, there’s a lot that can be done at home in terms of being able to manage people who’ve got COVID if they have COVID in terms of looking at their oxygen levels and things of that and not requiring them to quit the hospital. Hmm.
Dr Ron Ehrlich: [00:46:50] I mean, coming back to the psychiatry aspect and psychopharmacology aspect, we did a programme with Dr Martin Whitely recently. He was the author of Overprescribing Madness: What’s Driving Australia’s Mental Illness Epidemic? You know, he was talking about overprescription and I was surprised 95 % of anti-depressants in Australia are prescribed by GP. Yeah.
So that’s an interesting one. But the DSM five, as a psychiatrist, the DSM five running into 900 pages, I guess the conclusion from that might be we’re all suffering from mental illness. How did you view that? Because this sets us up for a pill for every, every, not just ill, but every mood we might have. How did you reflect, had another one of the pharmaceutical industries influence or ghostwriting?
Prof David Healy: [00:47:42] Well, yeah, I think we’ve moved in since 1980s, probably earlier, began earlier, and it’s across medicine. It’s not just mental health. We’ve turned to operationalism. OK. We don’t like the fact that Dr A might see you and treat you one way Dr B might see you and treat you in a different way. It looks like, you know, everybody should be doing the same thing. OK?
And because of that, we’ve rather than the judgement of the doctor, we’ve turned to things like your blood pressure and committees say, “Well, this is what your blood pressure should be.”, and they have an awfully tight. So the way a blood pressure should be for young, young, 20-year-old person rather than people like me anyway, who need a bit more blood pressure to get the blood to our brain as we get a bit older, you know? But we get patients that were in our 20s in the same way it’s true for lipid levels and things like that.
And in terms of mental health dysfunction, rating scales for focus. Have you got ADHD for your mood, et cetera, et cetera? And once you start producing figures like this, the pills become the answer for, you know, the industry are awfully good able to generate rating scales for the conditions they think that be have to sell pills for.
And you know, you get told you in when we used to have newspapers things that you’d find a little column on the health page, you take the scale and check and see if you’ve got bipolar disorder. And when you ask all the questions you’re told to, you know, take this scale to your doctor and ask if you’ve got bipolar disorder.
OK, so industry are good at that kind of thing. And that’s what’s driving a lot of what we’ve got now at the moment, which is concerned about the judgements patients make about their own lives and are concerned about the judgement as a doctor working with them, which would come to with them. OK. Broadly speaking, as a doctor up till 30, 40 years ago was in the business of trying to help you live the life you wanted to live.
Prof David Healy: [00:49:54] Now, the chances that if he or she is using a rating scale are checking your lipid levels or checking your blood pressure sugar levels and things of that. He’s helping you live the life Pfizer wants you to live rather than the life you want to live. OK. And across the board generally, I think feeding into all that is we’ve been sold this idea of wellness, you know, previously we used to want to be holy in quotes, you know, and we have got up there and things of that.
And medicine and health was a minor part of our life. God is not a minor part of our life, and holiness is a minor part of life and health is everything these days, and that’s a development that has really taken place at speed during the last 20 or 30 years. And it’s hard to see what’s going to stop, you know.
Ultimately, it’s better. I think it’s a bit like nuclear weapons. You know, it’s hard to see what the arms race is going to stop, would you produce a gun that’s more efficient than the guns we have. The other guy has to try to produce the same kind of gun. So there’s an arms race. But ultimately, when we get to nuclear weapons, although Putin may change our ideas about this thing up to nuclear weapons, we have a state of affairs where these things are too efficient to use. And it’s the same is true of pills.
You know, we’ve got all these pills, which are vaguely effective. And everybody thinks if you’re on four effective pills, this has to be much better than just one are known. But in fact, we know once you go over three effect of pills, you’re beginning to be counterproductive. You cannot use 10 effective pills without killing people earlier. Hmm.
Prof David Healy: [00:51:43] You know, there is a bit of a limit to the arms race. You can produce all these effective pills, but you can’t use them. And we get back to a point where doctors and patients in a conversation and not operating according to a rating scale really have to be the people who try and work out.
How do we help you live the life you want to live? Which of these pills is going to help you most rather than all of them? And we haven’t quite got to. I mean, there’s a lot of people are beginning to talk about the prescribing these days, reducing medication, but we’re not actually doing it, we’re still increasing the burden and the industry with vaccines is not going to stop with the COVID vaccines.
They’ve got a ton of other vaccines coming our way. And the worry is, it’s fine. I don’t mind producing a ton of vaccines. What I’m worried about is, is that successfully introduced mandates saying you have to have this vaccine. They can do the same with the other vaccines coming our way as well.
Dr Ron Ehrlich: [00:52:51] How do you think an individual should or could navigate that other than extricating themselves from society?
Prof David Healy: [00:52:59] Yeah. Well, that really is close to the point that we’re at. That is the dilemma that faces you and me and lots of other people, which is you can see the situation that we’re in, which is the authorities have to think that they can actually decide what we should be doing. And it’s one thing for them to be up to deciding what we should be doing if there really are experts there rather than just bureaucrats. It’s and also if the data they’re dealing with is good data. But if it’s fraudulent data and it’s just a bunch of bureaucrats and politicians telling us how to live our lives, well, that’s very tricky indeed.
Dr Ron Ehrlich: [00:53:42] David, thank you so much for joining us today and sharing your wisdom and knowledge with this, and thank you for the letter that you’ve written or co-written with one of the signatories on there is Professor Ian Brighthope, which has been I know very well through ACNEM, the Australian College of Nutrition and Environmental Medicine. Thank you so much for joining us.
Prof David Healy: [00:54:04] It’s been great, Ron.
Dr Ron Ehrlich: [00:54:07] Well, that raises so many issues that I knew it would, and it speaks of not just the way medicine is practised, the way the chronic disease is approached, but certainly the way this pandemic is approached as well. And if you’re a regular listener of this programme and you’ve listened to an episode that I did last year, The Elephant in the Room, which dealt with some of the issues David raised and I mentioned his book in that war The Trust the Science??? (which is a question mark, not a statement) and any of my Healthy Bites where I go into the many Ps of the pandemic.
It kind of makes you realise, well, maybe what we do need to realise as both members of the public and as health practitioners is that health over the last 20 or 30 or 40 years in particular over the last 40 years, has become a commodity and a poorly regulated commodity. Oh yes. Evidence-based medicine is championed as the gold standard in medicine. But the British Medical Journal just last month in February of 2022 publish an article called The Illusion of Evidence-Based Medicine and makes so many of the points that David made today and in his book in 2012.
And others have also made whether we’re talking about the truth about drug companies from the former editor of the New England Journal of Medicine, she was Marcia Angell. She was the editor for 20 years until she wrote an editorial called The Truth About Drug Companies and would then be dismissed from the most prestigious journal, one of the most prestigious journals in the world.
Professor Ray Moynihan wrote a fabulous book in the mid-2000s, A Selling Sickness. John Abramson from Harvard University School of Public Health, Overdosed American. And it’s worth noting that America consumes 50% of the world’s psychotropic drugs. Mental health issues. And yet is only 55% of the world’s population.
Dr Ron Ehrlich: [00:56:17] And in the OECD, the Top 40 OECD countries, their big spend on health care. I mean, they spend almost 20 % of their GDP on health care. They come in at about number 39 or 38. Their health is appalling. And of course, their response to the pandemic can be the highest proportion by far of the population is a testament to their poor health and a testament to spending money on health care and particularly on pharmaceuticals is certainly not a shortcut to good health. In fact, as David pointed out, quite the opposite often.
So, you know, these kind of books and along with that was Ben Goldacre’s book Bad Pharma, and he initiated a thing called the AllTrials Campaign, which was designed to compel drug companies to release the raw data of the trials. That was initiated around 2013. Well, and there have been over 700 signatories of that very impressive list of signatories.
I’m certainly proud that the Australian College of Nutrition and Environmental Medicine was a signatory to that, but clearly it has had no effect because of minimal effect. Because of the power and the influence of the pharmaceutical industry in lobbying, in setting policy, in controlling journals, universities.
This is so pervasive that it’s not a conspiracy theory. I want to make that clear, too. It’s not a conspiracy theory. This is just a very elegant business model. And a testament to that business model is that the pharmaceutical industry is now worth 1.2 trillion dollars a year, 1.2 trillion dollars a year.
So when you hear that the pharmaceutical industry has been fined over the last 20 years, $70 billion, that would be enough to shut almost any other industry down. This is petty cash, the inconvenient marketing expense to the pharmaceutical industry. But what surprises me is how pervasive that influence has become. And now, as I used to refer to news outlets are now media outlets, and many of those are media outlets for the pharmaceutical industry. And I ask you this question as well.
Have you yourself unwittingly become a marketing and compliance officer for an industry which has repeatedly been found guilty of fraud, and illegal marketing, been fined billions of dollars and literally in some instances cost hundreds of thousands of lives. Hundreds of thousands of lives because of poorly regulated pharmaceutical products.
Are you a marketing and compliance officer for that? Or should we be asking questions? Ignorance, as I’ve said, it a powerful tool and practise it regularly. It’s why I do this podcast. I get to ask people that know much more than the questions. And guess what? They answer them and I learn a lot, and I hope you do too.
But when ignorance is combined with ego, arrogance and hubris and it informs public health policy, that’s a problem. And we really do have a problem in our world today. Quite a disturbing problem. And I really when I asked David, how should we as individuals navigate this? I really don’t know the answer to it. What I do know is that I’m trying to present information in a holistic manner, linking lots of different aspects of health, not just for individuals, but also for the planet. And they’re intimately connected.
So that’s what this Unstress programme is about. And at this stage in my life, I was also about to launch the Unstress Online Wellness Programme and community, and who knows where that will lead us to. But it will be a group of like-minded people sharing information in an open and honest and respectful way with an ever-growing advisory board. I am proud of that. I’ve spoken to a lot of people, practitioners that I’ve worked with and I’ve spoken to on this podcast that I’ve invited to become part of the advisory panel so that we can have at least this platform a reliable platform. It’s certainly not the only platform. There are many others, and I think we need to seek those out. I think independent journalists provide us with real news nowadays. I know that I subscribe to lots of different newsletters.
Michael West is an example in Australia. Who gives, I believe, objective health overview, and I’m very proud to support that and so on. The Unstress online platform and programme and community is going to be very much about as a place to come to and listen to and exchange ideas about that.
So look out for that. That’s actually happening. Yes, I know I’ve been talking about it for some time, but hey, it takes time to do these things if you’re not particularly well resourced and we are now that we are working on it. hope this finds you well. Until next time. This is Dr Ron Ehrlich. Be well.
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 as a substitute for care by a qualified medical practitioner. If you or any other person has a medical concern, he or she should consult with an appropriately qualified medical practitioner. Guests who speak in this podcast express their own opinions, experiences, and conclusions.