Thursday, August 05, 2010

How to undermine Big Pharma's influence on the NHS

There is an ongoing debate on Bright Green Scotland about Caroline's backing for homoeopathy.

The question of Big Pharma has come up.

Now I am not proposing that the solution to corporatised medicine is to give everyone homoeopathy.

But one pathway to undermining the power of the pharma corporations  is

(a) to understand the financial bias that is pushing medics to prescribing expensive patented medicines.

(b) to find out whether promising lines of CAM (Complementary and Alternative Medicines)  are in fact more cost – effective.
I am thinking of
  • acupuncture, 
  • magnetotherapy, 
  • some herbs (not “herbalism” as a whole entity), 
  • clinical ecology (=food intolerance, indoor air quality &c), 
  • acupuncture, and 
  • certain forms of psychotherapy, (hypnosis for PTSD, Cutting the Ties to deal with toxic relationships), 
  • food supplements like glucosamine, and 
  • homoeopathy.

Before the opposition start accusing me of being anti-scientific, I am proposing that these things should be examined scientifically.

All of these lines I incorporated into my practice, and I had low prescribing costs. All of these CAMs have a poor evidence base, because of the economic problem associated with research - you cannot get a patent on a traditional medicine, therefore there is no incentive to spend £loadamoney investigating it.

It is up to the Government, through the MRC, to assess these treatment modalities.

On homoeopathy, the key point, as comedians and scientists never tire of pointing out, is that there is no *material* apart from sugar in the pills. If matter is the only effective agent, H cannot work, therefore it does not work, therefore studies that show it does work are erroneous. QED.  Which is a scholastic argument, not a scientific one. Scholasticism argues from authoritative principles, science argues from observation.

As I link on an earlier blog , there is some evidence from physical experiments that ultra high dilutions, if prepared in a certain way, may retain unexpected properties. If this can be established, homoeopathy could be re-examined more objectively, with less examiner bias.

Its a small point, this Homoeopathy debate, and I think Caroline is doing the right thing, especially if she calls for an audit of homoeopathic practice in the NHS.

While on the subject of undermining the influence of Big Pharma, there is the matter of preventive health too. About 1/5th of NHS spending is down to treating ill-health caused by non-green policies – unemployment, poor housing, pollution and poverty. Maybe more if social disintegration were counted. This is in my book.

Now, let’s all get going on the Resistance to the Cuts.


Derek Wall said...

I think both the philosophy of social science and homeopathy are quite big and difficult debates.

As you I am a bit cynically when it comes to the bright green 'three minute hate' campaign against Caroline Lucas on homeopathy....any way main focus should be on challenging big pharm thanks for opening up the debate.

DocRichard said...

Hi Derek

Thanks for commenting here. I don't think BGS was doing hate, just nervous that Caroline would bring down the wrath of Goldacre upon our heads. I was pretty nervous of entering this particular quagmire for the same reason, but now that I have absorbed Reilly's paper, I feel more confident. There is more to it than H=placebo. Several studies show greater than placebo effects, but the a priori (no material > no effect) thing causes hypercriticality.

We need to get to a fuller, molecular understanding of H2O, given its importance to our planet.

Anonymous said...

mmm I posted here.


refs to Goldacre etc?

DocRichard said...

Sorry, anon. I did have a look at the Goldacre page. I need to go back in more depth. Reluctantly. This Hompthy is not really my thing at the moment, I have a job to do on Spirit Level. Why don't you take a look at Reilly's paper, while I take a look at Ben, and we can come back and compare notes.

Give me a handle. You can still be officially anonymous, but a few letters so I know which anon you are wd be nice.

DocRichard said...

Anon, I have put up a reply on the other page.