A Good Discussion About Losing One's Mind

April 8, 2004
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“Better Treatments Soon Are Called Unlikely,” the New York Times reported today. The subject was treating Alzheimer’s disease. There are a handful of drugs on the market, but it turns out their benefits are minimal.

The part of today’s story that was most shocking was the recounting of last July’s report in The Journal of the American Geriatrics Society that claimed Pfizer’s drug Aricept could delay a patient’s entry into nursing home care for nearly two years. Critics in as yet unpublished letters to that journal said the study’s data did not support the claim. The study’s authors were paid — you guessed it — by Pfizer. (For a great discussion of why it is getting harder and harder to trust medical journals, see Shannon Brownlee’s story in the April Washington Monthly, “Doctors Without Borders: Why you can’t trust medical journals anymore.”

Alzheimer’s is the “dread disease” of aging. Nothing strikes greater fear into Baby Boomers’ hearts as they contemplate their golden years. But despite the billions of dollars poured into industry’s coffers to pay for a research and development, we still only have a handful of drugs whose chief benefit is to the companies’ bottom lines, not their patients.

The sad fact is that scientists still don’t know what causes Alzheimer’s or even how the cognitive brain functions whose impairment we call Alzheimer’s work. If you don’t understand the basic science of natural functions like memory and cognition, how is it possible to come up with drugs to combat age-related impairments in those functions?

As if to counter the Times story, C-Span this morning interviewed the chairman of Pfizer. He complained about senior citizens importing low-cost drugs from Canada. He said it would choke off innovation in the U.S.

The truth is that we’re wasting our money when we subsidize drug companies with high prices in the vain hope that they will come up with the next generation of cures. The government, which is about to spend $540 billion on drugs for senior citizens over the next ten years, would be better off spending its marginal health care dollar on more research into the basic causes of the diseases that most concern us. Because until we know why we get sick, there is no possibility of coming up with a cure.

Who's Expected to Swallow This?

April 4, 2004
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Troubling questions on what the U.S. media didn’t say about the warning on anti-depressant drugs

By Merrill Goozner

Parents of children on anti-depressants received disturbing news last week. The Food and Drug Administration asked manufacturers of popular drugs such as Zoloft and Paxil to warn physicians and parents to watch out for hostility, agitation and suicidal tendencies among their young patients, especially when they are first put on the drugs.

The warning, which comes after a similar action by British regulators last fall, followed an FDA advisory committee meeting in which the issue of anti-depressants and suicides in kids received its first full airing in more than a decade.

At that meeting, the FDA reported that tests done on kids for five of seven anti-depressants showed “a potential signal” for increased risk of suicide attempts.

Unfortunately, these tests were never published in the academic literature.

Nor did they appear in the popular press.

Rather, if one goes back over the previous decade’s steady stream of published reports on so-called SSRIs — selective serotonin reuptake inhibitors — one finds almost universal praise for the drugs, including praise for their use in kids.

Indeed, even after the FDA issued its warning last week, most news accounts included statements from prominent physicians and researchers cautioning parents against taking their depressed kids off the drugs. Some physicians questioned the wisdom of the FDA action.

But a closer look at those press accounts raises a troubling question. Are consumers getting all the information they need when reading about the latest medical news over their morning coffee?

For instance, the day after the FDA warning, most of the nation’s prominent papers included quotes from psychiatrists expressing fears that the new label might scare off doctors who want to prescribe antidepressants for their patients.

“The consequences for not treating depression are very high,” Dr. Madhukar Trivedi, director of the mood disorders program at the University of Texas Southwestern Medical School at Dallas, told The New York Times.

“I worry that patients, family members or physicians might turn away from antidepressants that might be lifesaving,” Eric Hollander, a professor of psychiatry at Mount Sinai School of Medicine, told the Wall Street Journal.

What the Times didn’t tell its readers was that Trivedi is also a major contributor to the Texas Medication Algorithm Project, which was developed and funded by companies that make antidepressants and mood-modification drugs and is now being used around the country to persuade state Medicaid authorities to step up their use of the drugs in poor children and prison populations.

What the Journal didn’t tell its readers was that Hollander receives numerous grants from anti-depressant manufacturers to conduct his research.

USA Today quoted University of California at Los Angeles psychiatrist James McGough, who expressed the hope that “this doesn’t scare doctors away from prescribing antidepressants.”

What this 2 million-plus circulation paper didn’t tell its readers was that McGough’s research in using drugs for treating hyperactivity was funded by Shire Pharmaceuticals.

Unlike the press, medical journals in recent years have instituted mandatory conflict-of-interest disclosure policies. Guardians of the integrity of the medical evidence, especially when it came to the use of drugs, became increasingly concerned about the pharmaceutical industry takeover of what was once a purely academic exercise.

To combat industry’s undue influence, the New England Journal of Medicine a few years ago began requiring authors of articles that appeared in its pages to disclose who funded their studies.

The Journal of the American Medical Association, the Lancet and the British Medical Journal adopted similar policies.

Their reasoning was scientifically based. Study after study has shown that clinical trials funded by the drug manufacturer are much more likely to report positive outcomes than comparable trials funded either by the government or non-profit foundations.

No one should be surprised by those results. Who do you pick to include in the clinical trial? How do you interpret the data? What conclusions do you report?

The answers to all those questions can be subtly or overtly influenced by whoever funds the study. In science, as in life, he who pays the piper calls the tune.

And with drug companies increasingly dominating medical research, the published record on many drugs had begun to look like a press release written by the corporations that manufactured them.

This was certainly the case for the limited amount of published research on SSRI use in children. When industry funded the studies, their conclusion was nearly unanimous that these drugs are safe, and they work. When independent researchers looked at SSRI use in children, nearly half questioned their efficacy.

And how about the FDA reviewer who looked at the mostly unpublished studies (which were submitted to the agency to win patent extensions)? Twelve out of 15 studies, or 80 per cent, showed they were no better than placebo. No wonder the companies never published them. Why would anyone want to give their kid a drug that had even a remote risk of suicide if there was no proven benefit?

Unfortunately, average readers never got that information. Instead, what poured into the U.S. daily newspapers, weekly magazines and ubiquitous television segments was a steady stream of praise for SSRIs and their use in kids, mostly drawn from the published academic record without regard to its funding source.

It’s time for the news industry to follow the lead of the medical literature. When reporters interview the experts, they should always ask: “Oh, and by the way, who funded your study?”

Medical journals think doctors should be informed about conflicts of interest so they can properly evaluate the information.

Consumers deserve this from the media.

Merrill Goozner, author of The $800-Million Pill: The True Cost of New Drugs, is director of the Integrity in Science Project at the Centre for Science in the Public Interest in Washington, D.C.From the Hamilton Spectator (Ontario, Canada)

The Bush Administration's War on Clean Air

April 4, 2004
By

The New York Times Magazine’s cover story today exposes how the Bush administration and the electric power industry conspired to gut the Clean Air Act. The rules in question involved New Source Review, which until Bush’s EPA radically liberalized them forbade companies from substantially rehabilitating coal-fired plants (and thus vastly increasing their electricity output and use of coal) unless they installed scrubbers. Coal-fired plants are major contributors to acid rain, ground-level ozone, soot and mercury pollution, which has been much in the news lately.

The article didn’t cover the latest news. A number of state attorneys general have sued the government and won a temporary stay of the new rules. Meanwhile, the Republican-controlled Senate Environment Committee last December asked the National Academies of Science — the organization whose studies are usually considered the gold standard on scientific investigations — to study the impact of the rules as a sop to Sen. John Edwards (D-N.C.), whose state is a victim of ambient air pollution from power plants in states to its west.

But something strange is happening with that study. The NAS appointed a prominent global warming skeptic who has written for the right-wing Hoover Institution to chair the panel. Princeton University physicist Dr. William Happer’s other interesting credential is that he was fired from his post as chief of research for the Department of Energy by the incoming Clinton administration because of his views on global warming.

In late March, several former EPA enforcement officials wrote NAS to protest Happer’s appointment, and asked that Happer be removed from the panel. In my role as director of the Integrity in Science project at Center for Science in the Public Interest, I uncovered Happer’s appointment and informed the broader environmental community about his impending role.

The question now is whether the NAS will allow someone with preconceived biases and who may hold a grudge against environmentalists chair one of its prestigious panels. Is this another case of the Bush administration manipulating science?

Welcome

April 2, 2004
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Please feel free to submit letters and questions to GoozNews by clicking on this link.

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April 2, 2004
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MERRILL GOOZNER
JOURNALIST, AUTHOR

Who

Director of the Integrity in Science project at the Center for Science in the Public Interest and contributing editor to The American Prospect, Goozner is an accomplished journalist, author and researcher with over 20 years experience in the news business and three years teaching experience at the graduate level.

Experience

PROJECT DIRECTOR
CENTER FOR SCIENCE IN THE PUBLIC INTEREST
DECEMBER 2003 TO PRESENT
Directs the Integrity in Science project, which exposes conflicts of interest in scientific articles published in the academic literature and scientists quoted in the media. The project also conducts investigations and publishes exposes of conflicts of interest among scientists serving on federal advisory committees.

FREELANCE WRITER AND CONSULTANT
JUNE 2003 TO DECEMBER 2003
Completed first book: The $800 Million Pill: The Truth Behind the Cost of New Drugs, an in-depth investigation into innovation in the pharmaceutical and biotechnology industries, published by the University of California Press in Spring 2004. Wrote articles in the American Prospect, Washington Monthly, The-Scientist.com and other publications. Conceived and organized journalism training seminars for the Knight Center on Specialized Journalism at the University of Maryland and the American Press Institute.

PROFESSOR OF JOURNALISM
NEW YORK UNIVERSITY
SEPTEMBER 2000 TO SEPTEMBER 2003
Taught graduate students in the Business and Economics Reporting program. Developed, wrote and taught three graduate-level courses: The Social Impact of the Corporation – Covering Regulatory Agencies; Reporting Health Care Industries; Reporting the Global Economy. Freelance writing included articles in Fortune Small Business, Columbia Journalism Review, The American Prospect, The Washington Monthly, The Nation, Salon.com, Slate.com and Boston Magazine.

KAISER MEDIA FELLOW
2001-2002
Kaiser Family Foundation research support for a book on the relationship between innovation and pricing in the pharmaceutical industry.

CHIEF ECONOMICS CORRESPONDENT
CHICAGO TRIBUNE, WASHINGTON BUREAU
APRIL 1998 TO JUNE 2000
Areas of coverage include Social Security and Medicare reform; IMF, World Bank and international finance; federal budget, tax and monetary policy; trade; and macroeconomics. Special investigative project: pharmaceutical policy.

NATIONAL CORRESPONDENT
CHICAGO TRIBUNE, N.Y. BUREAU
JUNE 1996 TO APRIL 1998
Covered significant trend stories in the Northeast and Midwest for
the national desk; media, Wall Street and economics for business desk.

MICHIGAN JOURNALISM FELLOW
UNIVERSITY OF MICHIGAN
SEPTEMBER 1995 TO MAY 1996
Focused on the politics and economics of East Asia, especially China.
Completed one academic year of intensive Mandarin. Wrote a play, Metropolitan Star, workshopped but never performed.

CHIEF ASIA CORRESPONDENT
CHICAGO TRIBUNE
OCTOBER 1991 TO AUGUST 1995
Did it all, from earthquakes to economics. Traveled extensively throughout
Asia, including India, Pakistan, Thailand, Indonesia, Malaysia, Vietnam,
Hong Kong, China, Taiwan, South Korea and the Russian Far East. Four
series in four years, including an early report (1994) on the status of labor rights in Asia.

FINANCIAL REPORTER
CHICAGO TRIBUNE
JANUARY 1987 TO OCTOBER 1991
Specialized in regional economics, economic development and
business-government relations, with special emphasis on industrial policy, urban affairs, education, job training and health care. Also covered labor; the law as an “On the Law” columnist; and from time to time provided traditional corporate coverage. Two major series, including prize-winning projects on education reform and manufacturing modernization.

ASSOCIATE EDITOR
CRAIN’S CHICAGO BUSINESS
AUGUST 1983 TO JANUARY 1987
Covered economic development, government-business relations and
economics for the nation’s leading regional business publication, with special emphasis on industrial policy, urban affairs, education and job training. Conceived and executed two major series, including an award-winning investigation of Chicago City Hall minority contracting fraud.

INVESTIGATIVE REPORTER
HAMMOND TIMES
JANUARY 1983 TO AUGUST 1983
Covered county government in Northwest Indiana.

BOOKS

The $800 Million Pill: The Truth Behind the Cost of New Drugs, University of California Press, April 2004.

FREELANCE WRITER

“Overdosed and Oversold,” Op-Ed, The New York Times, December 21, 2004.

“Trial and Error: Why we should drive the drug industry out of the clinical test business,” a review of Marcia Angell’s The Truth About the Drug Companies, Washington Monthly, October 2004.

“Hype, Not Hope From Big Pharma,” Column, Center for American Progress website, September 28, 2004.

“Throwing Away the Rules: In its zeal to kowtow to business, the Bush administration is dismantling a century of regulations that protect middle class consumers from financial fraud and health hazards,” The American Prospect, May 2004.

“Higher Skills, Fewer Jobs: With advanced technology and skilled workers, America can keep a strong manufacturing sector, but rising productivity equals a smarter – and smaller – work force,” The American Prospect, January 2004.

“Prescription for Reform,” Washington Post, Op-Ed Page, Dec. 1, 2003.

“Putting Out Fires Along the Potomac,” Chicago Tribune Op-Ed Page, Nov. 7, 2003.

“Reconstructive Surgery: We can get Iraq off the operating table without breaking our bank,” The American Prospect web edition, Oct. 24, 2003. http://www.prospect.org/webfeatures/2003/10/goozner-m-10-24.html

“Natural Disaster: Why the energy bill moving through Congress will only fuel our unsustainable status quo,” The American Prospect web edition, Oct. 9, 2003. http://www.prospect.org/webfeatures/2003/10/goozner-m-10-09.html

“Bioterror Brain Drain,” The American Prospect, October 2003.
http://www.prospect.org/print/V14/9/goozner-m.html

“Nuclear Blackmail: The growing North Korean threat — and why containment may still be our best means of staving it off.,” The American Prospect web edition, Aug. 8, 2003.
http://www.prospect.org/webfeatures/2003/08/goozner-m-08-08.html

“Drug Antics,” a book review of Philip J. Hilt’s Protecting America’s Health: The FDA, Business, And One Hundred Years of Regulation and Katherine Greider’s The Big Fix, Washington Monthly, June 2003.

“The Right Drug Rx,” The Nation, Jan. 27, 2003.

“Medicine as a Luxury,” The American Prospect special issue on Globalism and the World’s Poor, Winter 2002
http://www.prospect.org/print/V13/1/goozner-m.html

“The War on the Home Front,” Commentary on National Public Radio’s Marketplace, Sept. 19, 2001
http://www.marketplace.org/shows/2001/09/19_mpp.html

“What’s Needed: Economic Security,” The Americans Prospect, Sept. 17, 2001
http://www.prospect.org/webfeatures/2001/09/goozner-m-09-17.html

“Free Market Shock,” The American Prospect, Aug. 27, 2001
http://www.prospect.org/print/V12/15/goozner-m.html

“Air Piracy,” The American Prospect, June 4, 2001
http://www.prospect.org/print/V12/10/goozner-m.html

“The Pharmaceutical Dialogue,” a three-day exchange with Andrew Sullivan, columnist for The New Republic; Slate.com; April 9-11, 2001
http://slate.msn.com/dialogues/01-04-09/dialogues.asp?iMsg=1

“Patenting Life,” The American Prospect, Dec. 18, 2000 (reprinted in Harvard University’s “World Health News”)
http://www.americanprospect.org/archives/V11-26/goozner-m.html

“The Economic Scaremongers,” Salon.com, Dec. 6, 2000
http://www.salon.com/news/feature/2000/12/06/recession/index.html

“Blinded By The Boom: What’s missing in the coverage of the New Economy,” Columbia Journalism Review, Nov./Dec. 2000
(http://www.cjr.org/year/00/4/goozner.asp)

“Duo only partially right about the U.S. tax problem,” book review of The Great American Tax Dodge, by Donald L. Barlett and James B. Steele in the Philadelphia Inquirer, Oct. 29, 2000.

“The Grateful Fed,” a review of Greenspan: The Man Behind Money, by Justin Martin in the Washington Monthly, November 2000
(http://www.washingtonmonthly.com/books/2000/0011.goozner.html)

“The Price Isn’t Right: the drug industry’s huge profits are rooted in taxpayer-funded research,” The American Prospect, Sept. 11, 2000
(http://www.prospect.org/archives/V11-20/goozner-m.html)

“Small Business and Washington: Love and Hate,” Fortune Small Business, Sept. 2000
(http://www.fsb.com/fortunesb/articles/0,2227,905,00.html)

“What Social Security Crisis?” Salon Magazine, April 27, 2000 (http://www.salon.com/politics2000/feature/2000/04/05/social/index.html)

“Den of Thieves,” Salon Magazine, March 23, 2000
(http://www.salonmagazine.com/news/feature/2000/03/23/ceo_pay/index.html)

“High Wired Act,” (a profile of Lawrence Summers) Boston Magazine, March 2000
(http://www.bostonmagazine.com/highlights/highwired.shtml)

“Where’s the Beef? Evidence to support the Fed’s fears about inflation is hard to find,” Salon Magazine, October 20, 1999
(http://www.salon.com/news/feature/1999/10/20/inflation/index.html)

“Crash of ’99?” Salon Magazine, October 1, 1999
(http://www.salon.com/news/feature/1999/10/01/rich/index.html)

“Tax Breaks Not Enough to Save Cities,” Salon Magazine, July 5, 1999
(http://www.salon.com/news/feature/1999/07/06/poverty/index.html)

“Summers’ Time,” Boston Magazine, May 1999
(http://www.bostonmagazine.com/highlights/summerstime.shtml)

“Forty Acres and Sheepskin,” The American Prospect, April 1999
(http://www.prospect.org/archives/43/43goozner.html)

“The Porter Prescription,” The American Prospect, July 1998
(http://www.prospect.org/archives/38/38goozfs.html)

Monthly Columnist, Chicagoland Enterprise Magazine, 1988-1991

1982: five-part series, “Housing the Poor,” Cincinnati Enquirer, features in New York Times Sunday business section (2); Business Week; Cincinnati Magazine; Village Voice.

OTHER EMPLOYMENT:

RESEARCH DIRECTOR
OHIO PUBLIC INTEREST CAMPAIGN
1976-1981
Major issues included plant closings and tax reform. Helped write and lobby for nation’s first state plant closing law. Ran statewide ballot initiative in 1980 to reform state tax code.

EDUCATION:
Masters, Columbia University Graduate School of Journalism; 1982
B.A. (with honors) in History, University of Cincinnati; 1975.

AWARDS: Chicago Headline Club Peter Lisagor Award (1984, 1985, 1986, 1987, 1988, 1989; 1999); Jacob Scher Investigative Journalism Award (1986); Education Writers Association National Award (1988).

HOBBIES: Reading; theater; jazz; golf

REFERENCES AND CLIPS AVAILABLE UPON REQUEST

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