{"id":39866,"date":"2013-09-09T21:13:50","date_gmt":"2013-09-10T01:13:50","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=39866"},"modified":"2013-09-09T21:18:33","modified_gmt":"2013-09-10T01:18:33","slug":"squalls","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2013\/09\/09\/squalls\/","title":{"rendered":"squalls&#8230;"},"content":{"rendered":"<div align=\"center\"><img decoding=\"async\" width=\"518\" border=\"1\" src=\"http:\/\/1boringoldman.com\/images\/gathering-storm.jpg\" \/>     <\/div>\n<blockquote>\n<div align=\"center\" class=\"big\"><a href=\"http:\/\/www.pharmalive.com\/non-profit-leaves-collaboration-with-industry-over-glaxo-stance\" target=\"_blank\">Non-Profit Leaves Collaboration With Industry Over Glaxo Stance<\/a><\/div>\n<div align=\"center\" class=\"big\"><strong><font color=\"#004400\">Pharmalot<\/font><\/strong><\/div>\n<div align=\"center\" class=\"middle\">by Ed Silverman<\/div>\n<div align=\"center\" class=\"smallg\">09\/09\/2013<\/div>\n<p align=\"justify\">Five years after the Innovative Medicines Initiative was launched with big hopes of regenerating drug development and discovery in Europe [<a target=\"_blank\" href=\"http:\/\/www.pharmalive.com\/europe-launches-3b-drug-discovery-scheme\">back story<\/a>], a high-profile clash has broken out among some of the participants &#8211; one of the world&rsquo;s largest drugmakers and a medical institute &#8211; that may test the limits of collaboration between industry and independent research groups.<\/p>\n<div align=\"justify\">  The spat involves GlaxoSmithKline and the Mario Negri Institute for Pharmacological Research, a non-profit based in Italy, which has withdrawn its involvement in an antibiotic resistance study. The institute is publicly objecting to the protocol design the drugmaker established and conditions for accessing data and publication. And in public remarks, the institute believes Glaxo has been inflexible and hypocritical. <\/div>\n<\/blockquote>\n<div align=\"justify\">A taste of the Negri Institutes article:<\/div>\n<blockquote>\n<div align=\"center\" class=\"big\"><strong><font color=\"#200020\">A failed attempt at collaboration<\/font><\/strong><\/div>\n<div align=\"center\" class=\"small\"> by Silvio Garattini, Vittorio Bertele, and Guido Bertolini<\/div>\n<div align=\"center\" class=\"medium\"><strong><font color=\"#0033ff\">BMJ<\/font><\/strong> 2013;347:f5354.<\/div>\n<p align=\"justify\">The Mario Negri Institute for Pharmacological Research, a non-profit independent foundation, has withheld its involvement in an Innovative Medicines Initiative project that included clinical research and development of a product owned by GlaxoSmithKline. Although we fully support the idea of further collaboration with industry, on this occasion the cooperation was not quite what we had hoped for. GSK set down the protocol for the clinical research in the partnership, and when we questioned some of the company&rsquo;s methodological choices &mdash; such as the comparator drug and sample size &mdash; it became clear that these were not open for discussion. A project agreement written by GSK and attached to the study protocol set out dozens of pages of rules and conditions that would effectively have made this a study controlled by GSK and not a collaborative study. GSK outlined a complex structure for governance of the trial with committees and boards and voting rules that effectively gave the drug company total control&#8230;<\/p>\n<\/blockquote>\n<div>back to <strong><font color=\"#004400\">Pharmalot<\/font><\/strong>:<\/div>\n<blockquote>\n<div align=\"justify\">They also chide Glaxo for its decision which, they write, is &ldquo;even  more inappropriate when publicly funded or independent, non-profit  institutions are contributing to the development of a drug and patients  are generously volunteering to participate. Secrecy definitely sounds  paradoxical when EU funds support the clinical research, as with IMI  projects&rdquo;&#8230; And the project is seen as symbolic of the role potentially  beneficial role the IMI can play in public health. Antibiotic resistance  has seen limited commercial development despite growing concerns over  antibiotic resistance. As BMJ notes, the IMI has gradually shifted its  focus from biomarkers to later-stage clinical development of  experimental medicines.<\/div>\n<p>    <\/p>\n<div align=\"justify\">For its part, Glaxo deflected the criticism. &ldquo;Public partners are  playing a leading role in the protocol design, site selection and data  analysis as part of this collaboration &ndash; aspects of clinical studies  that would normally reside just with the sponsoring company. There is an  unprecedented level of academic representation through the team,&rdquo; says  Scott White, who is in charge of the Glaxo project, in a statement. &ldquo;We&rsquo;re sharing the costs with society and they need to be part of the  decision making. There is a large component of sharing what data we  can. But industry has to work within a certain regulatory framework. To  preserve the integrity of data submissions, we have limits on what we  can share.&rdquo;<\/div>\n<\/blockquote>\n<div align=\"justify\">Petulant Italian Academics or Greedy British Pharmaceutical giant in action? You be the judge. My two cents is that <strong><font color=\"#200020\">OR<\/font><\/strong> questions are often <strong><font color=\"#200020\">AND<\/font><\/strong> questions in disguise. And as long as my psychoanalytic roots are showing, there&#8217;s a pattern here that regularly repeats. GlaxoSmithKline&#8217;s public reformation melts when things come down to dotted lines [see <a target=\"_self\" href=\"http:\/\/1boringoldman.com\/index.php\/2013\/09\/07\/signals\/\">signals&hellip;<\/a> and anything about ChinaGate]. That doesn&#8217;t necessarily mean they are lying rogues. It could well mean what Dr. Fiona Godlee said recently [<a href=\"http:\/\/1boringoldman.com\/index.php\/2013\/07\/11\/a-sticky-wicket\/\" target=\"_blank\">a sticky wicket&hellip;<\/a>]:     <\/p>\n<blockquote>\n<div align=\"justify\">&quot;Unless we can find a solution to the  commercial incompetence problem, we have to recognize that the  pharmaceutical industry has an irreducible conflict of interest in  relation to the way it represents its drugs, in science and in  marketing. And unless we can resolve this in a way that is more in the  public interest and in patients&rsquo; interest, I would argue that drug companies should not be allowed to evaluate their own products.&quot;<\/div>\n<\/blockquote>\n<p>     In a person, repetitive paradoxical patterns sometimes reflect unconscious conflict, structural problems, or even traumatized sectors of the persona. In other situations, they&#8217;re just learned bad habits. But their illogical nature is neither always stupidity nor evil, it&#8217;s a reflection of two mutually exclusive conflicting motivational systems trying to live in the same box &#8211; <a target=\"_blank\" href=\"http:\/\/1boringoldman.com\/index.php\/2013\/07\/23\/an-irreducible-conflict\/\">an irreducible conflict&hellip;<\/a>. In a giant corporation, the possible meanings of such paradoxical patterns like this increase geometrically, but figuring out such things is really none of our business. The best advice for our team is probably something as simple as &quot;<em><strong><font color=\"#200020\">the best predictor of future behavior is past behavior<\/font><\/strong><\/em>,&quot; and leave our analysis at that.    <\/div>\n<p align=\"justify\">The current solution being offered to PHARMA is <em><strong><font color=\"#200020\">data transparency<\/font><\/strong><\/em> &#8211; the AllTrials movement, the RIAT proposal, the EMA&#8217;s [currently blocked] data transparency proposal, the TEST Act, Clinical Trial registration, etc. The collective <em><strong><font color=\"#200020\">we<\/font><\/strong><\/em> are saying that you can&#8217;t hide your sheenanigans behind a wall of data secrecy anymore. We see where that has taken us, and it&#8217;s not a viable place and unjustified. What PHARMA hasn&#8217;t yet recognized is that <em><strong><font color=\"#200020\">data transparency<\/font><\/strong><\/em> is actually a generous offer. The alternative hinted at by Dr. Godlee is more stringent, and equally justifiable, &quot;<em><strong><font color=\"#200020\">You&#8217;ve proven that you can&#8217;t be allowed to even evaluate your own drugs.<\/font><\/strong><\/em>&quot; And that may well be where things end up if they keep holding out for some version of the status quo.     <\/p>\n<p align=\"justify\">This action by the Mario Negri Institute for Pharmacological Research reflects an increasingly prevalent attitude that I would only see as becoming more common or perhaps even regular. Another example: there was a time not very long ago when someone like Neal Parker of AbbVie [<a target=\"_blank\" href=\"http:\/\/1boringoldman.com\/index.php\/2013\/09\/06\/a-deal-breaker\/\">a deal-breaker?&hellip;<\/a>, <a target=\"_blank\" href=\"http:\/\/1boringoldman.com\/index.php\/2013\/09\/06\/a-window\/\">a window&hellip;<\/a>, <a target=\"_blank\" href=\"http:\/\/1boringoldman.com\/index.php\/2013\/09\/07\/who-was-that-guy\/\">who was that guy?&hellip;<\/a>] could get away with making his assertions without much challenge. If you watched his <a target=\"_blank\" href=\"http:\/\/www.youtube.com\/watch?v=54OY1auPQqU#t=727\">video<\/a> performance, that&#8217;s not at all what happened at the Brussels meeting. <\/p>\n<div align=\"justify\">So maybe I can get away with showing a few more of my own roots. After sailing for a time, a sailor learns to read the wind and waves, making constant adjustments accordingly. It becomes second nature, automatic, the joy of sailing. But really good sailors learn to keep a third eye constantly scanning for signs of a coming storm that will change all the rules. How many squalls does Sir Andrew Witty and GSK have to get hit by before he learns how to be a real captain that anticipates a gathering storm? We&#8217;ll see&#8230;    <\/div>\n","protected":false},"excerpt":{"rendered":"<p>Non-Profit Leaves Collaboration With Industry Over Glaxo Stance Pharmalot by Ed Silverman 09\/09\/2013 Five years after the Innovative Medicines Initiative was launched with big hopes of regenerating drug development and discovery in Europe [back story], a high-profile clash has broken out among some of the participants &#8211; one of the world&rsquo;s largest drugmakers and a [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[2],"tags":[],"class_list":["post-39866","post","type-post","status-publish","format-standard","hentry","category-politics"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/39866","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=39866"}],"version-history":[{"count":11,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/39866\/revisions"}],"predecessor-version":[{"id":42023,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/39866\/revisions\/42023"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=39866"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=39866"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=39866"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}