The stench of dead rat behind the headlines?

Is there a stench of dead rat starting to percolate as the latest high profile drug row hits the headlines? The National Centre for Clinical excellence is once again vilified and demonised as the bogey man. It wasn’t so long ago that the highly emotional argument about Herceptin, the breast cancer drug, was raging with equal force. News coverage told how the drug was being held back rather than being openly available to sufferers in their fight against the evil disease.

This week we see a similar argument, this time levelled at donepezil, rivastigmine and galantamine – drugs which could help those suffering from Alzheimer’s disease. These drugs which could improve quality of life, will not be readily accessible on the basis of cost. Alzheimer’s disease groups and charities have condemned the decision, saying it disregards the quality of life for Britain’s elderly. The argument is highly emotive and it’s entirely natural that sufferers of this disease use every available means to fight for a semblance of good health, but there is another issue that is worth considering: who is the puppet master that pulls the strings and stands to benefit from this emotionally charged debate?

Step back and consider the awesome lobbying force of the drug companies who fight for lower prices for medicines and want to get them in the system as quickly as possible. PR and lobbyists for these drug industries are using ingenious means and stepping up spend in order to influence how to provide prescription drug benefits, as the debate intensifies. It can’t be ignored that NICE (National Institute for Health and Clinical Excellence) stands in their way; if margins are to be maintained, the billions spent on research and development of medicines has to be recouped. The global PR powerhouses lend a helping hand and are happy to plunder the pharmaceutical buck. It’s one of the most lucrative and less talked about arenas of PR. These willing hands are there to accept the cash, never mind the ethics, to fulfil a brief .

NICE (The National Institute for Clinical Excellence), is crucial for the drug companies. It is an independent body made up of doctors, scientific experts and the Department of Health and was set up to give verdicts on which drugs were cost effective for use in the NHS. The government invariably accepts its recommendations. Ministers claim not to be able to influence NICE, but these documents reveal that there has been a steady and constant flow of high level executives and lobbyists from drug companies. The pharmaceutical industry contributes to the UK’s economy on a grand scale. Its total investment in research and development in 2004 was more than £3.4 billion, which equates to around a quarter of the UK’s total manufacturing industry expenditure

The Guardian revealed that multinational drug companies have been lobbying ministers in an attempt to override the independent appraisal process in order to get their more expensive new medicines approved for large scale use in the NHS. For over eight months, senior executives from 10 drug companies, who were highly critical of the National Institute for Clinical Excellence (NICE), have been meeting ministers to urge for favourable decisions on their drugs. These are well organised and highly lucrative campaigns operated on a local and global level. Consider the organisation and the budgets needed to create the required avalanche.

NICE had originally allowed Pfizer’s Alzheimer’s drug to be used, then turned their decision around saying their drugs should only be used in a minority of cases with only moderate disease. Pfizer, naturally unhappy with the turn of events, went on to claim that NICE’s methods and processes were flawed and demanded a meeting whereby all companies making drugs for Alzheimer’s could put their case forward. The documents for the meeting outlined Pfizer’s net wealth which in 2004 was over $11 billion.

If we evaluate NICE , its core role for all its bureaucratic rigour is as an “ independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health”. This is against the interests of the drug giants who want to get their products to market as soon as possible. History has a few lessons; wasn’t thalidomide supposed to be a wonder pill? From 1956 to 1962, approximately 10,000 children were born with severe malformities including phocomelia, because their mothers had taken thalidomide during pregnancy.

One of the key PR tricks is to use lobby groups to stimulate debate, and the ever increasing use of the web has to be marvelled at ! Websites may prove to be the tool of the future for pharmaceutical disease awareness PR. Studies show that nearly 80 percent of web users have searched this largely unregulated arena for health care information, and drug companies have taken notice. More dubious practices by drug companies include developing front websites that appear to have non-commercial sponsors. For example, sites for the Erectile Dysfunction Institute (EDI) , and the Prostate Cancer Institute (PCI) were both part of the drug company Pfizer’s Viagra marketing campaign, and include links that direct potential consumers to their products. Sobering thoughts; so as the debate about the sluggishness and inconsistency of NICE takes hold and poignant hostages are produced, consider the price of crystallising opinion.