Aropax (Seroxat) - The Bitterest Pill?

Source: Brisbane Times

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Bitter pills

IT BRINGS a wry smile to people's faces to hear that two drug companies made it into the top 10 most ethical companies in the world. Most of us benefit from medications developed by these multinationals, but we deeply distrust their methods. Old drugs are repackaged for new conditions, generic medicines are opposed, negative research results are withheld and developing countries are forced to pay crippling fees as part of deeply unfair medication pricing structures.

In September 2004 the blockbuster anti-inflammatory Vioxx was suddenly withdrawn from the market by its manufacturer, Merck & Co, after it emerged that the drug increased the risk of heart attack and stroke. At the time 250,000 to 300,000 Australians were taking the drug to treat the symptoms of arthritis. The company is facing more than 14,000 lawsuits in the US and a class action in Australia.

It soon emerged that Merck had either misrepresented or failed to disclose the health risks associated with the drug and that its highly effective public relations machine had capitalised on a generally uncritical medical profession

Merck was not one of the companies that made it into the world's top 10 ethical companies on the Geneva-based Covalence reputation index. Set up to provide a "barometer of how multinationals are perceived in the ethical field", the index classifies companies according to 45 criteria of business contribution to human development, including labour standards, waste management, the social utility of products and human rights policy.

Under those measurements, the drug companies GlaxoSmithKline and Bristol-Myer Squibb came in at No. 8 and No. 9 respectively.

Jon Jureidini is the head of psychological medicine at Adelaide's Women's and Children's Hospital, and the chairman of Healthy Skepticism, a website that exposes pharmaceutical company marketing techniques. He is deeply critical of Glaxo's failure to warn doctors and consumers about the potentially negative side effects of its anti-depressant Aropax/Paxil on children - a charge the drug company strenuously denies.

Jureidini says. "GSK has made mileage out of the fact that they have published two negative studies on the effects on children, but what they don't say is that they had to do that as part of another settlement."

"GSK is being hailed as an ethical company and I am sitting here working on a draft of a paper about their behaviour in relation to the study they publicised saying that Aropax/Paxil was safe and effective for children, whereas in fact the study showed just the opposite," Jureidini says.

"Donations by drug companies to patient self-help and advocacy groups are almost certain to score brownie points on an ethical measure. But many activists see such donations as covert marketing, making these groups advocates for a disease that suits their product," Jureidini says.

Medicines Australia, the pharmaceutical industry self-regulator with drug companies as its members, was quick to congratulate GlaxoSmithKline and Bristol-Myers Squibb on gaining "significant international recognition" for their work. "This is indicative of the pharmaceutical industry as a whole and reflects the value and contribution of the industry to society," Medicines Australia's chief executive, Ian Chalmers, said.

Yet only 18 months ago, the Medical Journal of Australia published a study that found the publication of incomplete or biased pharmaceutical trials is common. Interference was most blatant when the research showed potentially negative effects of a drug or treatment, it found.

Results like this confirm that despite their contribution to the health of people in the world, drug companies have a way to go before they achieve an "A" for ethics.