Big Pharma Conspiracy Debunked

January 12, 2016

There are many conspiracy theories about huge, multinational corporations. One of the most common accusations is that drug companies routinely and actively hide evidence that their drugs are ineffective or even dangerous.

This idea is central to the claims made by anti-vaccination groups, who believe that an international cabal of evil and unethical doctors and medical experts are aware that childhood vaccines are dangerous to children but hide that information from the public and refuse to acknowledge it to protect drug companies’ enormous profits. This is part of the reason they are so zealous: they truly think that doctors are so greedy and callous that they help cover up dead and brain-damaged children to pad their bank accounts. (I have several friends in the medical profession who find that deeply insulting.)

A corollary to this claim is that money from drug companies is so powerful that not only are studies that might reveal a drug’s ineffectiveness not done because they refuse to fund them, but that scientists and researchers are afraid to even conduct research that might challenge Big Pharma’s bottom line. After all, the huge drug companies keep track of which researcher are looking into which drugs, and scientists fear offending the companies who pay for their research: Publishing a study calling into question the safety or efficacy of a popular drug–assuming any medical journal would even be brave enough to accept and print it–would be career suicide, according to the conspiracy folk.

There is certainly a grain of truth to this conspiracy theory–it’s undeniable that industries can and do sometimes pressure scientists to publish research favorable to them and bury or downplay unfavorable studies. This has happened many times, including tobacco companies’ research into the addictiveness of nicotine and more recently General Motors hiding studies of safety flaws in their vehicles.

But not all major industries are alike, and the fact is that peer-reviewed studies casting doubt on the efficacy of popular drugs, therapies, and devices are routinely published in some of the world’s most prestigious journals.

For example last year the British Medical Journal published a research paper titled “Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo controlled trials.” Its conclusion: “Paracetamol is ineffective in the treatment of low back pain and provides minimal short term benefit for people with osteoarthritis. These results support the reconsideration of recommendations to use paracetamol for patients with low back pain and osteoarthritis of the hip or knee in clinical practice guidelines.”

Recently researchers published a study in the journal Respirology that examined the same drug: The study, “Randomized controlled trial of the effect of regular paracetamol on influenza infection,” was a randomized, double-blind, placebo-controlled trial of adults with influenza-like illness and positive influenza rapid antigen test. The conclusion: “Regular paracetamol had no effect on viral shedding, temperature or clinical symptoms in patients with PCR-confirmed influenza. There remains an insufficient evidence base for paracetamol use in influenza infection.” There are many other similar studies easily found in a quick online search.

For those who don’t know, paracetamol is sold under the brand Tylenol, which is manufactured and marketed by McNeil Consumer Healthcare, a subsidiary of Johnson & Johnson, which in 2014 had revenues of nearly $75 billion.

In other words these studies (and others) found no evidence that taking Tylenol will help if you have the flu, and no evidence that it helps lower back pain. These studies were widely published and made national headlines along the explicit lines of “Tylenol Doesn’t Work” and “Everything You Thought About Tylenol Is Wrong.”

So what happened? Did these researchers refuse million-dollar bribes by Johnson & Johnson to scuttle the studies? Did the journal editors refuse million-dollar bribes by Johnson & Johnson to refuse to accept the studies or reject them in peer-review? Did the hundreds of mainstream journalists refuse million-dollar bribes by Johnson & Johnson to spike the story? None of the above; the simple and correct answer is that conspiracy theorists are wrong.

It’s akin to the claim that Big Oil has suppressed engines that run on water or air, or that drug companies have a cure for cancer but are refusing to market it because people dying of cancer is so profitable. No one denies that some in the pharmaceutical industry-like those in many highly profitable industries-has in many cases acted against the public good. As Dr. Steven Novella has noted many times including in his Science-Based Medicine blog, “There is much to criticize in how the pharmaceutical industry has tried to subvert medical research to their advantage. This is why they need to be carefully monitored and regulated.”

However satisfying it may be to demonize an entire industry, we must not be too quick to give the Devil more than his due. The image of Big Pharma as shadowy, corrupt entities spending vast resources to fool the public and do evil is surely unearned. Many people are alive today because drug companies developed life-saving medications and treatments, and many drug companies have offered deeply discounted prices on basic drugs for the masses in South America, Africa, India, and elsewhere.

As a practical matter drug companies would have a very difficult time actually preventing research from being done or negative studies published the way that, for example, the National Rifle Association has for decades intentionally prevented research into gun-related homicide trends. Science is self-correcting, and sooner or later the truth will come out about the safety and efficacy of a given drug or treatment. The vested interest in profits that makes Big Pharma such a notorious and easy target also encourages them to take steps to assure health and safety. It’s bad for business to sell drugs that harm your customers.

These studies are clear-cut, published and public examples of exactly what anti-Big Pharma conspiracy theorists claim doesn’t happen. It doesn’t matter, of course, since the conspiracy echo chamber isn’t interested in explaining inconvenient facts. Despite years of false accusations about me (being a shill for Big Pharma, for example), I have no dog in the fight and no allegiance to the drug industry. However the often-heard claim that drug companies overtly prevent studies unfavorable to their products from being published is, at best, greatly exaggerated. Johnson & Johnson’s billions apparently can’t prevent independent researchers from publishing studies questioning the effectiveness of their best-selling OTC pain reliever (nor, for that matter, can they prevent journalists from covering the results of the studies). The evidence is right there in plain view for those who wish to look.