About Lymphoma >  Big Pharma Conspiracy Theory?

Last update: 04/07/2010

Big Pharma Conspiracy: Are they withholding cures for cancer?

Here we address the theory that alternative medicine is a legitimate option, equal in plausibility to standard medicine, based on the conspiracy theory:

See Among the Top 10 [Dubious] Conspiracy Theories is .... Big Pharma
http://www.livescience.com/strangene...heories-1.html 

While discovery and marketing of medical products is driven by profit, companies must first prove the agent effective for a specific medical condition,   which is a challenging regulatory process, involving investigators, data monitoring boards, and FDA review.  The process requires controlled studies describing the methods up front, such as the number of patients, the defined medical condition, and how outcomes are measured, both positive and adverse. 

In contrast: Alternative Medicine has no such requirements.  For example, we have no idea about rates of response or how a response is even defined for a given alternative practice.  One in a thousand?  None?   We must take the practitioners word for it, or take on faith the accuracy and truth of a testimonial.  

The conspiracy theory is just not plausible:

Three in five Americans will get a serious cancer - including scientists, medical doctors, regulators, owners of drug companies - including, sadly, their loved ones and children.  

-- Thus, a conspiracy to hide cures for cancer would require the complicity of medical doctors and experts when their children get cancer.   

Would not the parents with knowledge of the conspiracy relent when their child was diagnosed?  Silence under such circumstances would be unthinkable, and also criminal.  

The conspiracy theory also does not explain the high cure rate for some cancers (eg. > 80% for Hodgkins disease), and that the majority of childhood cancers are cured. Is the conspiracy for some types of cancers and not others?  

Furthermore:

	Pharma, the entity that allegedly suppressing cures, is a collective of independent  companies,  which cannot make binding decisions on behalf of all.
	And if a conspiracy existed, why would any company invest so much time and money  developing and testing new cancer drugs? Are we to believe that "the industry" submit drugs for FDA approval with limited  potential to cure in order to keep the conspiracy alive? ... or that they are  intentionally passing on an opportunity to become wealthy and save lives for the good  of its competitors! Would we not see the companies that have developed cures protesting such a system,  vigorously by taking strong legal action?
	Are we to believe that FDA approves only drugs with limited benefit and that the agency  will reject drugs that are more effective?
	Are we to believe that Congress has enacted laws to ensure independent review of new drugs  by the FDA as part of this conspiracy? Or that the American public,  through its representatives, are complicit in the "conspiracy?"

Is our imperfect medical system partly to blame for fostering said conspiracy theory?
 

Admittedly, financial conflict of interest can lead to the misuse of clinical science, such as the overuse of certain approved tests and drugs - or the use of one drug over another.  However, this influence can only occur when there is no standard of care for a condition, when multiple (proven) protocols or procedures exist for a medical condition.  Lack of evidence from comparative studies provides a fertile landscape for "creative" marketing, bias, and defaulting to what is more profitable, even if unconsciously.  We support the Comparative Effectiveness Research initiative for this reason.

Admittedly, inappropriate marketing after the approval of medicines does sometimes occur.  However, FDA regulates drug commercials for that reason - the ads must include the indication and the known risks. While physicians can prescribe off-label use of approved drugs (for indications it was not approved for), the sponsors cannot promote such use in advertisements, and this use must be based on plausible science regarding the mechanism of the drug for  the unapproved indication, and also clinical reports supporting efficacy published to respected medical journals.

Inappropriate influences on approved medical practice requires our vigilance, and perhaps new legislation - but these influences are generally subtle and offset by clinical practice guidelines, set by professional associations based on clinical evidence from studies.  

Progress is uneven at times and varies for different medical conditions.  But knowledge and practice is based on a body of scientific and clinical knowledge.  That is, clinical practice is a group endeavor, evidence-based as opposed to based on the theories of individual practitioners acting independently without standards of evidence.

You might look up "Standard of Care" or "Clinical Practice Guidelines" to read more about such standards.

Brief background on drug development and approvals:
 

Before drugs can be marketed in our country they must be proven effective for a specific medical condition or indication, such as first line therapy for follicular lymphoma.   The evidence for approvals must be based on clear and convincing evidence of meaningful clinical benefit -- proving that the intervention provides benefit relative to the disease untreated, or treated differently ... or that it addresses an unmet clinical need. The evidence of clinical benefit - that the positive effects outweigh the risks - is derived from independent review of studies involving human subjects -- typically randomized controlled studies carried out by investigators at multiple centers.  Responses are measured independently based on standards for response that predict clinical benefit.  Follow up of the participants is required, as is the detailed accounting of adverse events.   - And such studies are subject to vigorous independent FDA review, and study methods must also be approved by Institutional Review Boards (IRBs).

If benefit is proven, marketing exclusivity (a temporary monopoly)  is granted to the sponsor.  This reward provides an incentive to persuade companies (and investors)  to do the expensive and high-risk research and testing, a test that is often failed - and these are very expensive failures. So the long-shot chance to make a substantial profit is what drives the expensive and high-risk research to develop and test drugs for the diseases that afflicts us.  Removing profit incentives would have a chilling effect on clinical research. However, profit incentives also makes it necessary to have a rigorous and independent review of the clinical data submitted to win marketing approval.

In conclusion:

The conspiracy theory to withhold cures from the public is just not credible or plausible, and is not supported by any evidence.

That drug research is done for profit does not support or give credence to the conspiracy theory or alternative medicine.   

Profit incentives are provided by our society to encourage needed but difficult clinical research. However, this agreement does not dictate what is approved by FDA, which, by law, is based on the rigorous review of evidence from clinical trials, and that evidence must be substantial.

Ironically, sadly, the peddling of  false hope for profit is what drives alternative practices, which runs unabated with no regulatory oversight or standards for evidence.  

More work is needed to remove inappropriate market influences on clinical practice of approved interventions, but clinical practice is mainly  guided by evidence from clinical research, subject to peer review, and vigorous regulatory review for the initial indication.

KarlS