{"id":40157,"date":"2013-09-19T18:02:24","date_gmt":"2013-09-19T22:02:24","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=40157"},"modified":"2013-09-19T18:20:00","modified_gmt":"2013-09-19T22:20:00","slug":"wisdom","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2013\/09\/19\/wisdom\/","title":{"rendered":"wisdom&#8230;"},"content":{"rendered":"\n<p align=\"justify\">It&#8217;s a funny thing &#8211; getting old. When you read something that&#8217;s really wise, you still almost automatically think of the author as <em>older<\/em> and <em>wiser<\/em>, at least I do. I often feel that way when I read Howard Brody&#8217;s blog <a href=\"http:\/\/brodyhooked.blogspot.com\/\" target=\"_blank\"><font color=\"#009900\">Hooked: Ethics, Medicine, and Pharma<\/font><\/a>. He just seems to be able to step further back from the fray than I can. I feel that same way about Roy Poses of <a href=\"http:\/\/hcrenewal.blogspot.com\/\" target=\"_blank\"><font color=\"#0066ff\">Healthcare Renewal<\/font><\/a>. There&#8217;s a $5 word, perspecacious, that covers what I&#8217;m talking about. And for all I know, I&#8217;m older than both of them. <\/p>\n<div align=\"justify\">Recently, a lot of us have been stirred up by the testimony of Neal Parker, a former FDA lawyer now working for Abbot who spoke on behalf of AbbVie, one of the companies suing the European Medicines Agency to block their proposed data transparency program [see <a href=\"http:\/\/1boringoldman.com\/index.php\/2013\/09\/06\/a-deal-breaker\/\">a deal-breaker?&hellip;<\/a>, <a href=\"http:\/\/1boringoldman.com\/index.php\/2013\/09\/12\/right-on-the-money\/\">right on the money&hellip;<\/a>]. Dr. Poses wrote about my take on things and added some of his usual wisdom [<a href=\"http:\/\/hcrenewal.blogspot.com\/2013\/09\/why-trust-drug-company-executives-after.html\" target=\"_blank\">Why Trust Drug Company Executives After One Admits Commercially Sponsored Clinical Research Is All About &quot;Competitive Advantage?&quot;<\/a>]. This week, Dr. Brody also weighed in. This is the part that struck me reading it:<\/div>\n<blockquote>\n<div align=\"center\" class=\"big\"><a href=\"http:\/\/brodyhooked.blogspot.com\/2013\/09\/science-vs-trade-secrets-can-pharma.html\" target=\"_blank\">Science vs. Trade Secrets: Can Pharma Tell the Difference?<\/a><\/div>\n<div align=\"center\" class=\"big\"><strong><font color=\"#009900\">Hooked: Ethics, Medicine, and Pharma<\/font><\/strong><\/div>\n<div align=\"center\" class=\"middle\">by Howard Brody MD<\/div>\n<div align=\"center\" class=\"small\">September 16, 2013<\/div>\n<p>  <\/p>\n<div align=\"justify\"> &#8230; &ldquo;1 Boring Old Man&rdquo; draws two conclusions from this presentation and the ensuing Q&amp;A:<\/div>\n<ul>\n<li>\n<div align=\"justify\">What companies like AbbVie      most want to hide is how much they are doing drug promotion under the      guise of scientific research<\/div>\n<\/li>\n<li>\n<div align=\"justify\">People who talk like this      simply cannot be trusted to negotiate in good faith; all they care about      is competitive advantage, and if screwing the public provides competitive      advantage, so be it<\/div>\n<\/li>\n<\/ul>\n<div align=\"justify\"> There is a third lesson highlighted by a <em>BMJ<\/em> News account from which the blog draws some of its information&mdash;the drug firms themselves are divided over this issue with other firms not wanting to go as far as AbbVie. Other firms seem to have decided that with public trust in them now down in the toilet, the only &ldquo;competitive advantage&rdquo; they might enjoy is tied to coming clean.<\/div>\n<p>     <\/p>\n<div align=\"justify\"> So what do I make of all this? Well, I agree at least in part with our fellow blogger, but I would add a further lesson.<\/div>\n<p>     <\/p>\n<div align=\"justify\"> First, I agree that when a guy starts a discussion by announcing that if I disagree with the position that his company takes, then I am opposed to both the public health and to &ldquo;balance,&rdquo; I would want to grab for my wallet and head for the door. That guy is just way too slippery for me to spend time with. So yes, whether such people could ever negotiate in good faith is a serious question.<\/div>\n<p>     <\/p>\n<div align=\"justify\"> But there is another issue here as well. I want to give Neal Parker just a little more credit than others apparently were. For all his slipperiness, he had decided that there were a couple of things at stake&mdash;preserving the public health and advancing science on the one hand; preserving his company&rsquo;s competitive advantage on the other. In his own head he thought he had a formula for &ldquo;balancing&rdquo; these two goals. But what I think he proved is that the people in the audience who reacted with shocked disbelief to some of what he said, and Parker himself, were bound to misunderstand each other because they were speaking different languages. If you spoke Parker-ese, or Pharma-ese, then everything he said was perfectly logical and indeed irrefutable. Which shows to me one more reason why we must find a way to detach the scientific research enterprise from Pharma funding (as I argued in HOOKED). There is no way we can square the true goals of science and the public health with the clearly commercial agenda of the drug industry.<\/div>\n<\/blockquote>\n<div align=\"justify\">See what I mean about that <em>stepping back further<\/em> thing? He&#8217;s talking about a <em>confusion of tongues<\/em>, and of course, that has to be right. The most high-minded person in Pharma-dom is going to talk <em>competitive edge<\/em> talk. And most everyone with any sense in the medical science field could&#8217;ve told Neal Parker that the argument he thought would be so <em>balanced<\/em> would have closed a show off Broadway in a New York minute. Dr. Brody is right. We don&#8217;t speak the same language. BMJ Editor Fiona Godlee said it in a similar wise comment at a UK hearing recently [<a target=\"_blank\" href=\"http:\/\/1boringoldman.com\/index.php\/2013\/07\/11\/a-sticky-wicket\/\">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<div align=\"justify\"> and I know I&#8217;m older than she is&#8230;&nbsp;<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>It&#8217;s a funny thing &#8211; getting old. When you read something that&#8217;s really wise, you still almost automatically think of the author as older and wiser, at least I do. I often feel that way when I read Howard Brody&#8217;s blog Hooked: Ethics, Medicine, and Pharma. He just seems to be able to step further [&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":[1],"tags":[],"class_list":["post-40157","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/40157","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=40157"}],"version-history":[{"count":7,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/40157\/revisions"}],"predecessor-version":[{"id":40165,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/40157\/revisions\/40165"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=40157"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=40157"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=40157"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}