NHS should fight back against profiteering drug companies

Antibiotics are beginning to fail. For someone completely dependent on antibiotics every day (3 different types daily and a few administered directly into my veins every couple of months) this worries me.

There are already a few strains of CF bugs that are resistant to most antibiotics - they are the true bogeymen of the CF world, talked about in hushed tones - and the common chest infection that most CF people have, pseudomonas, shows on and off resistance to the usual antibiotics.

But even I, someone who is more interested in antibiotic resistance than the average member of the population, was shocked to read recently that there have only been two new classes of antibiotics invented in the LAST THIRTY YEARS.

We should all be worried - infections are a bit like freedom fighters, they've got nothing to lose, everything to win and are highly proficient at adapting and resisting any of the tactics we use to try and kill them. And to be frank we've barely varied our tactics since 1980.

David Brennan, Chief Exec of big drug company Astra Zeneca has called upon the public sector to work with it to help find a way to solve the problem of antibiotic resistance. This is because drug companies see little value to their shareholders in spending money creating new antibiotics because the speed at which infections become resistant to them does not make it a worthwhile investment, regardless of the human benefit.

A spokesman for Astra Zeneca was quoted as saying: ""If we think [a treatment is] not commercially viable, we can give it to somebody in the public sector who is willing to spend money to develop it."

But to me this statement seems very one-sided. Drug companies make vast profits from the NHS - just look at the controversy surrounding GlaxoSmithKline's 10 per cent profit increase on the back of the swine flu panic. Plus their patent protection on drugs allows them to keep the cost of purchase high for a substantial period of time before they are legally obliged to divulge drug ingredients to allow cheaper, non-brand versions of the drug to be created.

A commercial approach to medicine works if profit proves an effective driver to creating new treatments. But if a focus on profit also means that vital drug treatments do not receive investment then to me something is clearly wrong with the system.

It has bothered me for some time that the NHS doesn't seem to use its huge buying power to exert demands upon drug companies. It must be one of the biggest, if not the biggest unified drug purchaser in the world, and it seems crazy that pharmaceutical companies are selling drugs to our Government at a vast profit but then also telling the Government to spend its own money creating cures for diseases that are unattractive to pharmaceutical shareholders.

I wonder what Astra Zeneca's reaction would be if the NHS said it would only buy its leading antibiotics for the whole of the UK population if they invested a proportion of the resulting profit in creating new antibiotics? Negotiation and bartering are the key to any purchasing agreement and at the moment it seems the Government is held to ransom over the threat of allowing its citizens to develop untreatable infections, when it should actually be using its huge monetary resources to ensure it holds the advantage over drug companies.

If we are forced to take a commercial approach to drug treatments, then the Government should quickly learn that two can play that game.

Drug companies rubbing their hands with glee at the 'discovery' of three new mental illnesses?

This week the American Psychiatric Association (APA) announced the updated fifth edition of their Diagnostic and Statistical Manual of Mental Disorders (DSM) and it appears they have identified three new illnesses: "mixed anxiety depression, psychosis risk syndrome and temper dysregulation disorder."

My only experience with mental illness is as follows: I was having a pretty shit day because I couldn't breath. I think feeling miserable about that is a pretty bog-standard normal reaction. I happened to be going to the doctors to update my prescription list and he said I looked rather down and did I think I was depressed and started asking me if I ever felt low or cried for no reason. Which made me cry.

So there he is thinking I'm depressed when actually I was only crying because I found the whole situation confusing and I was scared that maybe I was depressed and hadn't noticed it, which confused me even more. Anyway I turned down his suggestion of some mild anti-depressants but it completely shocked me at the ease that these drugs can be obtained. I mean, Jesus, girls cry all the time, it's just our way of venting frustration.

So of the new illnesses outlined in the APAs' manual lets just think about psychosis risk syndrome. By the psychiatric association's own admission this isn't even an illness. Its basically saying to someone they're at risk of developing a mental illness because they're experiencing abrupt personality changes. And from experience, someone telling you you might be mentally ill is incredibly stressful, and truly makes you question your sanity. There is a great article outlining the effects of over-diagnosis here.

So what's the point of the APA's manual? Well give this some thought:
"The US Senate Finance Committee has investigated at least 16 APA psychiatrists over their undisclosed financial ties to drug companies, including the APA’s own President, Alan Schatzberg who has stepped down as principal investigator of a National Institute of Health (NIH) funded study after months of Congressional scrutiny into his ties to the drug he was studying.  He was found to have actually initiated the patent application of the drug he was studying to “treat psychotic depression.” You can read more about this here.

Another investigation published in April last year by people working for three major US universities, including Harvard medical school, found :
"Ninety percent of the authors of 3 major clinical practice guidelines in psychiatry had financial ties to companies that manufacture drugs which were explicitly or implicitly identified in the guidelines as recommended therapies for the respective mental illnesses. None of the financial associations of the authors were disclosed in the clinical practice guidelines."

Drug companies make shed loads from selling drugs. In 2007 it was estimated that drug company GlaxoSmithKline made £1 billion per year in profit from anti-depressant Seroxat. According to Forbes, at its peak, drug company Eli Lilly made $3 billion dolllar profits from Prozac in 2000 (profits fell subsequently when it lost its patent protection).

So the more illnesses that can be discovered, the more drugs can be invented to cure it. And more over, as the drop in profit from Prozac shows, there is a continual need for new drugs to be created as a drug company's patent only lasts a prescribed period of time before it must give up its secrets to a generic drug maker.

No wonder there is a concern over the conflict of interest between APA members and drug companies.

And although it's a US manual the DSM is used worldwide as a basis for diagnosis, research and medical education. I'm not saying that your local GP has a conspiracy going with GSK but a recent study by Rethink reveals that over two-thirds of GP's don't feel equipped to take responsibility for mental health - perhaps indicating they might rely on the APA's mental health 'bible' more than they should?

Patients are being offered antidressants or other drugs for mental illness when they're normally at they're lowest ebb, and most likely to doubt their own opinions, especially when they conflict with those of a doctor. But don't feel that drugs are your only option. Ask about therapy, counselling, the documented benefits of exercise in helping mental illness. Rest and exercise may create zero profit for a drug company but they can be fantastically valuable to a patient.