Talk:Pharmaceutical industry/Archives/2015

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I deleted the last sentence in the introduction. "The most sucessful and influential industries..." I have done research on the topic and cannot find any conclusive evidence of such facts. The only research I found, which seemed biased, suggested the pharmaceutical industry had profit margins of approximately 26% which does not seem accurate for many smaller companies. The deleted sentence could be true but to make such assertions about an industry the contributor should cite the source. Johnbushiii (talk) 18:52, 8 April 2008 (UTC)

Based on my brief exploration of Wikipedia, I don't think the degree of bias in this article is typical of Wikipedia in general. There are key facts missing (e.g. in the discussion of AIDS drugs, no mention is made of the millions of dollars worth of medicine donated to African countries by the drug companies). If facts such as these were included, a more balanced article would result, but perhaps the author's agenda would not be served. I will try to find time to edit the most blatant portions of this article. 68.72.111.4 (talk · contribs)

If you have something to add to this article, please do. I have previously written neutral content to debiasify the article. JFW | T@lk 08:13, 29 August 2005 (UTC)

I edited some items. Thanks... btw, I wrote the first item on this discussion page.

Medicare Part D

I added a short note on Medicare Part D because of the size of the revenues associated with this program. CommodiCast 21:51, 9 October 2005 (UTC)

Numerous additions

In the last few days I rearranged and added a number of sections. CommodiCast 20:28, 12 October 2005 (UTC)

Duplication in other articles

I wonder if anyone else feel that the (very nice) sections on Drug discovery and development would be better placed in the articles of those names? There is a lot of duplication between those articles, this one, and the article on regulatory requirements. --Dogbertd 09:42, 24 November 2005 (UTC)

Drug Manufacturing

Drugs don't grow in trees (well, some do) and need to be manufactured. There is a section missing on this subject, I think. Maybe I'll write it some day, including fermentation, chemical synthesis, outsourcing, etc. The pharmaceutical industry is quite wastefull compared to other chemical industry branches, but it has the best public image. Maybe I'll comment on this too.

Bibliography

Needs to be setup with the ISBN rather than a link to Amazon.com. This should be done or the books deleted. Cordially SirIsaacBrock 01:08, 20 January 2006 (UTC)

Sanofi-Aventis R&D spending

The article had stated that Sanofi-Aventis R&D spending was USD $9.3 billion. However the actual source (Source: Wendy Diller and Herman Saftlas, "Healthcare: Pharmaceuticals," Standard & Poor’s Industry Surveys, 22 December 2005, 13) for these figure list Sanofi-Aventis as spending USD $3.9 for R&D. Since this is most likely a typo, I have corrected the error.

Well done. Thanks. JFW | T@lk 22:11, 28 March 2006 (UTC)

Citation needed in Controversy section

The bullet point that begins, "From 1980 to 1997..." should have a citation for the statistics given concerning favorable study results. In addition, the last two sentences could use either some documentation or an external link. I'm not trying to dispute the points one way or the other, but a reference would be especially informative, given its location in the controversy section.

Direct Quotations

In the Drug Discovery section, I am not sure, but are those just cut and paste quotations from another site? Sorry for not delving into it at the moment, but it seems like that should be addressed. Perhaps by rewording and creating new text or by at least a more clear recognition of the source. As it is, they are in quotes, but by the paragraph and barely noticeable. Sorry for just complaining and not doing anything about it. Let me know if I'm off on this, otherwise I'll eventually get around to putting myt money where my mouth is and addressing it myself. --Gbinal 10:08, 10 April 2006 (UTC)

I noticed that. Needless to say, it is unacceptable. Those quotations are disembodied in their current form. Furthermore, they are not cited properly. At best, it is terribly poor writing; at worst, it is academically dishonest. I will correct the problem in the near future and clean the whole article up while I am at it. Firewall62 06:44, 17 July 2006 (UTC)

I have removed the copyright violations. JonHarder 15:24, 24 November 2006 (UTC)

There is another copyvio in the discussion of industry sales; a sentence is lifted straight from Forbes magazine. I was just looking for figures when I noticed it. I will get to it soon.Academic38 (talk) 09:15, 11 December 2008 (UTC)

Edits

I've given this article a bit of an overhaul. Expanded the history section. Tried to rationalise all the different levels of headings. Integrated the disparate points collected under 'controversy' in to the topics to which they refer. Added some new bits and pieces. EverSince 22:29, 7 December 2006 (UTC)

In the table of companies by 2008 sales there is a mistake. GSK and Novartis have been given the same sales figure by mistake. The sales (in M$) for Novartis should be 36,172. (Andyfinlay (talk) 19:06, 10 January 2010 (UTC))

Pharmaceutical Industry vs Company

This article blends the concept of the entire pharmaceutical industry into the idea of the single company. I don't think that is particularly useful. These two topics have distinct uses, especially when it comes time to pick an appropriate internal link for another Wiki article. For example, a company that manufactures plastic bottles of use to both the pharmaceutical industry and beverage industry is better linked to the pharm industry link, while a drug company in NJ or its CEO is better linked to the pharm company link. A city that has a great number of pharmaceutical companies within its borders should link to pharm companies, while an association that represents the pharm industry has a broader "industry" nature. Such a distinction between industry and firms would allow for development of more sophisticated discussions within Wiki, such as 1)how the industry as a whole deals with the AIDS crisis or lobbying in Washington, DC, versus 2) where individual companies are located, who works for them, and maybe some microeconomic issues like liability, advertising, local government regulation, and hiring. This seems to be an issue on many industries, such as ceramics industry, food and beverage industry, et al. I've been working on the plastics industry myself. Pat 22:18, 13 May 2007 (UTC)

Restructuring

There are too many sub-sections with only a few sentences, these should be expanded or (preferably) consolidated. Also, many of the sections should link to main articles (if they exist) or split into new articles. For instance, "From drug discovery to market" should link to the separate articles on "Drug Discovery" and "Drug Development". The overall arc of the article should also be rethought. The introduction could use a little more substance. History is a good start to the main body of the article, but there is no logical order to the sections that follow. Criticisms should generally be worked into the article where appropriate, and not given their own section unless there is nowhere else to put them. More specific topics should be placed at the end of the article. I apologize for not implementing these suggestions myself; maybe when I have more time. AAMiller 22:01, 6 August 2007 (UTC)

Still a mess, but it's a start...AAMiller 00:26, 7 August 2007 (UTC)

Kevin trudeau

i think tat kevin trudeau, being an important part of the pharmceutical company criticism organizations, belongs as a see-also reference on the phrmarceutical company talkpage. the editors who have revered my edits have given no reason why apart from their possible prersonal dislike of Mr. Trudeau's work and i dontthitnk that sa valid reason to violate wikipedia: NPOV. and otehr guidelines protecting wikipedia from bias. Smith Jones (talk) 00:31, 10 January 2008 (UTC) Smith Jones (talk) 00:31, 10 January 2008 (UTC) Smith Jones (talk) 00:31, 10 January 2008 (UTC)

Kevin Trudeau has nothing to do with the pharmaceutical industry. Whether a link belongs in the "See also" section should be approached with common sense, and common sense is that a random altmed proponent isn't an appropriate link for a few reasons:

1. There's nothing in the article about Trudeau.
2. The other links in the section are clearly logical extensions of the functions of the industry itself.
3. Trudeau is only one of many that have ever criticized the industry, and it's not the Wikipedia norm to list every detractor in the See also section.
4. A dedicated article to the criticisms of the industry may be appropriate, and a Trudeau link would possibly make sense there. — Scientizzle 00:48, 10 January 2008 (UTC)

kevin trudeau was indeed metnioned in the article earlier, in a referfnece regarding his detractions of the pharmceutical community.

i admit that there is not al ot of supporting evidence CURRENLY INto the article

trudeau is a leading well-known and notable critic snad his name belongs there just as james randi's name belong on a sylvia browne article.

i like your suggestion of a Criticiims of the Pharmaceutical INdustry idea and i will create it later tonight. Smith Jones (talk) 00:54, 10 January 2008 (UTC)

Smith Jones you said "MR. Trudeau's presitigous name" in one of your edit summaries. How is his name prestigious? According to the article on him "On November 19, 2007, he was found in contempt of court again for "patently false" claims in his weight loss book" and "The FTC currently restricts his ability to promote and sell any product or service." "Trudeau has criminal convictions in the early 1990s for fraud and larceny." It seems that all he is really notable for is his products which he is not allowed to sell. Somehow I don't think the words of a convcited fellow who was convicted for crimes in this area (false claims about health products) are reliable. Also seeing as it is currently illegal for him to promote his products within the United States (where he is a citizen) it seems inappropriate to reference any source in which he does that in an article that is not about him or his products. I think the comment should be removed entirely. JamesStewart7 (talk) 05:53, 10 January 2008 (UTC)

Indeed, Trudeau is one of the greater scam artists of the modern era. Somehow his repeated convictions for fraud, etc., don't dissuade his supporters from believing his quackery-of-the-month.

Additionally, the statements continually added by User:Smith Jones regarding Trudeau are of no benefit to the article's content as a whole. — Scientizzle 06:06, 10 January 2008 (UTC)

if being a convicted felon makes him unrleliable then i will have to agree with you and i wont add his name to this article agian. however, i dont think that this discredits him on an article relating to his CLAIMS, (which ae not by definiton true or false, merely statements of act that he made). do you agree with me on that count? Smith Jones (talk) 20:27, 10 January 2008 (UTC)

No real disagreement here. Trudeau is notable as an encyclopedic subject for many reasons, and his claims agains the pharma industry may merit treatment on Wikipedia, on his article in particular, but perhaps in a wider altmed vs evidence-based-medicine/big pharma article. Additionally, there are certainly many different people and organizations that have leveled various claims against this industry as a whole, and those deserve attention; howwever, criticism sections easily become magnets for editors to add any claim from their cause du jour irrespective of the strength and relevance of the claims and whether it truly contributes to a further understanding of the topic (or exists as just another jab at the subject with a wikilinked name-drop). Sections that suffer too greatly from this syndrome tend to lose focus, becoming a melange of complaints rather than an academic treatment of the variety, nature and strength of established criticisms. Trudeau's claims are easily dismissed (for better or worse) by their general pseudoscientific nature and conspiracy theory mongering; his reputation makes it difficult for many to take him seriously, particularly concerning claims of this nature. In total, Trudeau lacks the gravitas of the other orgaizations already cited in the criticism section and his inclusion just doesn't fit--it's a bit like trying to adding criticisms from Sean Penn into a critique of American foreign policy...the guy's clearly notable, but likely doesn't merit much attention on these views (outside of his own article, perhaps). — Scientizzle 21:49, 10 January 2008 (UTC)

Requested move

I have proposed that this article be moved to Pharmaceutical industry. We can then write a short article instead of this for "Pharmaceutical company". See comments above at #Pharmaceutical_Industry_vs_Company. Eric Kvaalen (talk) 08:56, 7 September 2008 (UTC)

Sounds like a plan. EverSince (talk) 04:47, 12 September 2008 (UTC)

The opponents of the industry

I just thought its wierd that theres not a presence of the opposition of the modern pharm industry,like treating only symptoms and not looking into permanent cures, and their being the one who got most drugs illegal and that kinda thing. —Preceding unsigned comment added by 69.231.239.8 (talk) 08:20, 29 November 2008 (UTC)

= == Pharmaunternehmen

Wann gibt es schlechte Nachrichten für die Pharmaindustrie

Missing Teva in the first list

Where is Teva in the list of top companies by revenue, on the Teva wikipedia page it says the revenue was 11 billion, and I can't see the company in the list on this page. Is it a mistake? Can some one edit the list? —Preceding unsigned comment added by 132.68.249.235 (talk) 23:11, 24 January 2010 (UTC)

Me-too drugs redirect here but no mention of it!

Make its own article or include something in here? —Preceding unsigned comment added by 99.29.121.91 (talk) 00:40, 31 July 2010 (UTC)

Me too! Er, I mean... I was also wondering about this. *Vendetta* _{(whois talk edits)} 09:03, 6 February 2011 (UTC)

Have made an attempt to introduce the topic. Any help to improve/wikify would be appreciated TomorrowsDream (talk) 12:20, 7 February 2011 (UTC)

Thank you very much! I really appreciate what you've added - it is very clear and informative, and answered my random curiosity about that redirect! *Vendetta* _{(whois talk edits)} 05:09, 9 February 2011 (UTC)

identification of pharmaceutical products

How do one identify the pharmaceutical products and taking into account the input-transformational-output 41.191.104.250 (talk) 20:04, 15 February 2011 (UTC)model.

Reads like Pharmaceutical industry marketing

The entire section on R&D is very biased, really needs to be redone. Neosiber (talk) 23:31, 30 April 2011 (UTC)

WP:SOFIXIT. — Scientizzle 14:48, 3 May 2011 (UTC)

jkjl lkjlk kj;lk j;lkj — Preceding unsigned comment added by 41.95.14.101 (talk) 04:32, 26 November 2011 (UTC)

Drug Manufacturing II

This has been mentioned before. It seems a major omission to have no information on drug manufacturing processes. There are a few related articles dotted around, so perhaps at least a links section could be created to, for example: Validation_(drug_manufacture); Good_Manufacturing_Practices; Tablet#Manufacturing; Spheronisation; Tablet_press; etc.

Jpedant (talk) 23:58, 18 November 2011 (UTC)

Origens of the word Pharmacuetical

I added the origens of the word pharmaceutical. 2602:306:C518:62C0:1E75:8FF:FEBB:2125 (talk) 06:15, 17 July 2012 (UTC)

"Some researchers who have tried to reveal ethical issues with clinical trials or who tried to publish papers that show harmful effects of new drugs or cheaper alternatives have been threatened by drug companies with lawsuits."

This can be variously described as non-neutral POV or as unsupported by any citation from a reliable source. The first citation describes a case in which from the company's point of view, was not a lawsuit for "revealing ethical issues" but for breaking a confidentiality agreement. In fact, the court ruled in the company's favor. One could reasonably include this item in the article as an example of a lawsuit against a physician employee who claimed to have ethical concerns, but balance would also require stating that the lawsuit was filed for violation of a confidentiality contract, and that a neutral court ruled in the company's favor. You can't just present the defendant's version of the story, especially when a competent court has reviewed the case and ruled against him.

The second citation includes no examples of individuals being sued by a pharmaceutical company. So it is completely irrelevant to the statement that cites it as support.

As a minor aside, both articles are news stories written by journal editors, not scientific papers, so neither is peer reviewed. Alfred Bertheim (talk) 04:34, 4 March 2013 (UTC)

Hi Alfred, first, please don't make null edits to leave messages in edit summaries. As for the text, the first ref does support the edit, and I'm sure many more could be found. If you want to present another view saying this doesn't happen, or saying what the company argued, by all means do that. The second source also supports the view that researchers who act as whistleblowers face penalties. And sources don't have to be peer-reviewed, particularly not for material like this. SlimVirgin ^(talk) 04:50, 4 March 2013 (UTC)

I will refrain from blank edits to leave messages if you will engage instead of acting unilaterally. Otherwise my concerns are left here where they are not seen, while you edit the article in way that reflects only your own point of view. I created null reversions as a courtesy rather than starting a reversion war, in spite of the fact that you were acting unilaterally.

The first article includes the statement that "However, in November 1998 Organon concluded from its expert advice that embarking on a study using a dose of 2.5 mg was responsible." In fact, Organon was correct and Dr. Stiekema was wrong. The results of the trial show no dose response effect. http://www.ncbi.nlm.nih.gov/pubmed/15193678 So the doctor violated his confidentialty agreement, company and its other advisors were completely correct, and the court ruled against him. How can this be presented in such a one-sided way?

The second article contains only allegations and nothing that has been ruled on by a court or which was witnessed by neutral observers. One of the two accusers is anonymous, and the other has earned large book and movie royalties off her allegations. You can caveat the inclusion of these allegations by including the word "claim", but in the absence of evidence, you could equally well include the statement "Some people claim that pharmaceutical companies are engaging in a worldwide conspiracy to poison members of ethnic minorities". Where do you draw the line in posting unsupported allegations? They simply are not noteworthy without supporting evidence. Alfred Bertheim (talk) 05:08, 4 March 2013 (UTC)

Please stop removing that sentence. I haven't removed your addition of the Dutch researcher, but this isn't about just one case, and it would look odd simply to add those details with no lead in, as though this has only ever happened once. Also, the award against him was overturned; I've added that and a source. SlimVirgin ^(talk) 16:45, 4 March 2013 (UTC)

Slim, thank you for engaging and not simply deleting my post. I have no objection to the first sentence provided that you identify supporting references. As currently constituted, there is only a citation saying that a single researcher was sued for breaking confidentiality after having an ethical concern that other company advisors did not share. I do not think this is sufficient to support the broad conclusions in the opening sentence that the industry as a whole is routinely using litigation to silence critics. Perhaps its true, but citations of reliable sources are required by Wikipedia policy; otherwise this is original research.

I respectully object to your deletion of the material about the outcome of the trial. It shows that the company and its advisors were correct in their assessment, and I believe this is a relevant piece of information. Without this information the paragraph leaves the impression that the company knew its design would hurt patients and was trying to cover it up. If the trial had shown that Dr. Stiekema was right and patients were injured, wouldn't you strongly insist on including that information?

It is not my intention to have a confrontational relationship with you or anyone else on this site. Let's try to listen to each other with an open mind, and perhaps we will both learn something.

Respectfully Alfred Bertheim (talk) —Preceding undated comment added 17:16, 4 March 2013 (UTC)

Source query

Hi Alfred, I see you restored some of this again. Is the source a secondary source? SlimVirgin ^(talk) 17:00, 9 March 2013 (UTC)

Organon conducted the trial according to the originally planned protocol and found that the dose that Dr. Stiekema opposed provided the same reduction in mortality as the other three doses examined.

j

Hi Slim,

Primary sources are permitted when they serve to source factual material. Indeed, every statement in this article about the Organon episode references a primary source.

On several occasions you've criticized me for removing material instead of bringing it up on the talk page and seeking concensus. But then you unilaterally removed my additions without prior discussions. To me, it seems that the rule you are actually seeking to implement is that you have final say over what is included in the article. If you are unable to compromise here (The initial sentence you wanted has been left intact) I think it is time to seek mediation by a neutral 3rd party. — Preceding unsigned comment added by Alfred Bertheim (talk • contribs) 17:28, 9 March 2013 (UTC)

Primary sources shouldn't be used to support their own claims in cases where the claims might be disputed. It's better to find review articles or other secondary sources; see WP:MEDRS. I see that you're relying on primary sources elsewhere too. Secondary sources should be used for just about any material you want to add, making sure that they are directly related to the article; see WP:SYN.

Yes, I reverted your change. When changes are made to long-standing material (whether removals or additions), and an editor reverts with a reasonable objection, the usual thing is to discuss. SlimVirgin ^(talk) 17:37, 9 March 2013 (UTC)

Request for Mediation

The request may be viewed here. http://en.wikipedia.org/wiki/Wikipedia:Dispute_resolution_noticeboard#Pharmaceutical_Industry Talk Page. Albert Bertheim Talk page — Preceding unsigned comment added by Alfred Bertheim (talk • contribs) 23:22, 9 March 2013 (UTC)

I am requesting mediation of my disagreement with SlimVirgin regarding paragraph 4 of the Controversies section of this article. I've added a summary of my position below, and expect that SlimVirgin will add a summary of her position as well.

1. The first sentence of the paragraph "Researchers who have tried to reveal ethical issues with clinical trials, or publish papers showing harmful effects of drugs – and who saw themselves as whistleblowers – have faced or been threatened with lawsuits from drug companies, or have lost their jobs." - The references cited establish only that a single pharmaceutical researcher at Organon disgreed with his colleagues about the safety of a clinical protocol, was unable to reach agreement with the company, and was sued for violating confidentiality when he took his case to outside ethics committees. The generalization of this statement to the plural "researchers" and "drug companies" is an original synthesis. According to the Original Research guidance page:

   "The verifiability policy says that an inline citation to a reliable source must be provided for all quotations, and for anything challenged or likely to be challenged"

   The phrase "researchers who tried to reveal ethical issues" violates Wikipedia's neutral POV policy because it implies that Organon's lawsuit was motivated by the desire to prevent revelation of an ethical issue. No evidence is presented to support this conclusion. In fact, the lawsuit occurred after the information was disclosed. Furthermore, the ethics committees that this information was revealed to apparently allowed the trial to go forward, as the dose that Steikema opposed was included in the trail protocol as actually performed (http://www.ncbi.nlm.nih.gov/pubmed/?term=Simoons+ML%2C+Bobbink+IW ), suggesting that they ultimately agreed with the company's position that no ethical problem existed.

2. According to the same reference, the dose that Steikema opposed was not only equally efficacious to the higher doses that he did not oppose, it was nominally (but non statistically significantly) more efficacious than the doses that he agreed with. I believe this information is relevant to judging the company's motives (it would certainly be considered relevant if Dr. Stiekema's position had been vindicated by the results of the trial) and should be included in the paragraph. It has been repeatedly deleted by SlimVirgin without good cause.
3. SlimVirgin errs in stating that the source used for the results of this trial violates MEDRS standards. These standards do not explicitly prohibit the use of primary references, but advise against their use as a source of opinions or conclusions regarding safety or efficacy of a treatment regimen, especially when there is a diversity of opinion in the literature that is not represented by the cited source. When the information being sourced is not a conclusion, but simple factual information such as the mortality rate associated with a specific treatment arm of a specific clinical trial, there are no "disputed claims" and no need to restrict sources to reviews and meta analyses to prevent "cherry picking". Here is the MEDRS standard:

   "Reliable primary sources may occasionally be used with care as an adjunct to the secondary literature, but there remains potential for misuse. For that reason, edits that rely on primary sources should only describe the conclusions of the source, and should describe these findings clearly so the edit can be checked by editors with no specialist knowledge. In particular, this description should follow closely to the interpretation of the data given by the authors or by other reliable secondary sources."

   I conclude that the data in this paper is relevant, that and that it is properly sourced. Following SlimVirgin's reasoning, one could not cite court papers as evidence that a lawsuit had been filed. I believe the citation was removed solely to protect the non-neutral point of view of the paragraph.
4. There is no citation supporting the phrase "or who tried to publish papers showing the harmful side effects of drugs". This is original research. It should be sourced or removed.

I conclude that this entire paragraph as it currently stands is a violation of NPOV built up from original syntheses and the systematic efforts of certain editors to exclude information that provides a more neutral POV treatment of the events. Thank you for taking the time to review this. I will respect whatever decision is made by the mediators.Alfred Bertheim (talk) 23:07, 9 March 2013 (UTC)

I've really lost track of what you want here. The section is poorly written and obviously incomplete, so this feels like dancing on the head of a pin. You made the section even worse by three times removing [1] [2] [3] that researchers who have tried to reveal ethical issues with clinical trials have been threatened with lawsuits or lost their jobs, along with the sources. But you must know that this is true, and the sources were good, so it seems an odd thing to remove. The third time [4] you replaced it with just one (not very notable) example from the Netherlands, with no preamble, as though this has happened only once, ever, then you added primary source material to it to show that the researcher was wrong and the company was right. You also left out that the award against the researcher was overturned on appeal. See the fourth paragraph of your version. It said:

Dr. Koos Stiekema was was sued by the pharmaceutical company Organon for violating his confidentiality agreement after discussing his concerns that the lowest dose of the drug pentasaccharide being tested patients with acute coronary syndrome would not be sufficient to prevent myocardial infarctions with three ethics committees. Organon's other experts agreed that the trial design was safe, and a court awarded Organon ₤550,000 for the trial delay costs that resulted from Dr. Stiekema's disclosures. Organon conducted the trial according to the originally planned protocol and found that the dose that Dr. Stiekema opposed provided the maximum reduction in mortality among the four doses examined. At the time of the original court decision, the British Medical Journal ran an article prominently referring to Dr. Stiekema as a "whistleblower", but the journal never commented on the trial results demonstrating superior efficacy for the dose that Dr. Stiekema had opposed.

So I restored the introductory sentence (researchers who have tried to reveal ethical issues, etc), which is fully sourced, but I left your Dutch example, though I think it should be removed. I removed [5] the sentence that says or implies that the researcher was wrong, because it relies on a primary source (see the section above); if you find a secondary source, I don't mind if you restore it, though I think it's too much detail. And I've added quotes from the sources to the footnote, which offers a number of examples, to show that it's not just one Dutch researcher that we're referring to. The paragraph now looks like this (see fourth paragraph): "Researchers who have tried to reveal ...".

Rather than trying to remove material from this section, or arguing about one sentence, if you're interested in this issue, it would make more sense to build it up. It badly needs someone to work on it. SlimVirgin ^(talk) 17:31, 10 March 2013 (UTC)

Whence this bias?

I have a serious problem with this section of the text:

Drug companies are like other companies in that they manufacture products that must be sold for a profit in order for the company to survive and grow. They are different from some companies because the drug business is very risky. For instance, only one out of every ten thousand discovered compounds actually becomes an approved drug for sale. Much expense is incurred in the early phases of development of compounds that will not become approved drugs.[13] In addition, it takes about 7 to 10 years and only 3 out of every 20 approved drugs bring in sufficient revenue to cover their developmental costs, and only 1 out of every 3 approved drugs generates enough money to cover the development costs of previous failures. This means that for a drug company to survive, it needs to discover a blockbuster (billion-dollar drug) every few years.[13]

This is in no way neutral POV, when it manages to completely elide the fact that this is one of the largest and definitely one of the most profitable industries in the world, with revenues in the hundreds of billions and net incomes of twenty percent! There doesn't appear to be any discussion of these facts in a section that discusses the cost and difficulty of drug development. The cited source (a website) is argumentative and not of any particular academic or scholarly authority. This seems to me well below the standard of quality we should expect from Wikipedia. Graft | talk 22:35, 1 August 2013 (UTC)

Information needed (cost of the industry today)

Can we get information like - what is the cost of pharma industry today in the article ? Thanks. --Abhijeet Safai (talk) 10:08, 23 October 2013 (UTC)

dubias best selling drug, under 'Industry Revenues' section

It's definitely wrong and has been for a few years now, since lipitor went generic. The source if from '06... Maybe I'm blind but it doesn't appear to have been discussed even though the "dubious discuss" tag was added a year ago. so I'm going to go ahead an update that information to at least something relatively accurate.

Numerous sources have "humira" as the best selling drug world wide for 2013, although in the United States it seems Abilify and Nexium sell more. one source has Enbrel and Advair as the second and third top selling world wide, respectively. (although one source has Remicide in the number two position world wide.) Let me know if you see any issues with the final outcome Pharmaceutical_industry#Industry_revenues

DustBowlTroubadour (talk) 09:10, 6 August 2014 (UTC)

Potential source

Here's a report about profits in the pharmaceutical industry by the BBC. It discredits the claim that pharmaceutical companies spend most of their money developing drugs—the majority is actually spent in marketing. Maybe the article already covers all of this thoroughly, but in case it doesn't, I hope this link helps. – Maky ^« talk » 19:17, 6 November 2014 (UTC)

Its a pretty complicated issue that has been worked over many times before. To an finance expert, R&D spending is "capital expenditure" in which you spend the money to develop products that will reach the market a decade later; marketing expenditure is spent to generate revenues over a much shorter time horizon. These are very different in that you have to apply a cost of capital to R&D expense. Its a lot like paying cash today for a house that you won't be able to move into for 10 years - you have to adjust the amount you paid years in advance of getting a payoff for the interest you could have been earning with that money in the bank.

Another issue is that the net profits of pharma are not all that high compared to other successful research-intensive industries. Pfizer, Merck, and GSK had net margins averaging 32%, 12%, and 18% over the last 3 years. Apple, Microsoft, and Qualcomm earned 23%, 26%, and 29%. In either case, the product either brings value or its isn't worth the money. You can decide for yourself if you want to pay for it. Formerly 98 (talk) 20:27, 6 November 2014 (UTC)

Thanks for the explanation. However, are both sides of this argument represented in the article and thoroughly discussed? That's why I posted the source. (Sorry, I'm working on another project so I don't have time to read it. I saw the news article and just thought I'd share it as a potential source.) – Maky ^« talk » 20:50, 6 November 2014 (UTC)

Questionable deletions

I've been looking over some of the changes to this article over the past year and several deletions jumped out at me as questionable:

1. discussion of similars
2. examples of specific whistleblower experiences
3. top 20 companies by revenue / top 15 by sales
4. $19 billion per year spent on promotions
5. 28% of American Psychiatric Association budget
6. $855 million per year on lobbying
7. scientific publications are often authored by contractors
8. multiple reasons for regulatory capture deleted
9. developing world discussion initial paragraph
10. reasons Doctors Without Borders refuses drug donations
11. list of regulatory authorities
12. further reading bibliography

I intend to replace most of those deletions unless there are policy or guideline-based reasons they should not be included. EllenCT (talk) 22:09, 9 January 2015 (UTC)

the deletions were made bit by bit, and if they have been standing for a while you should discuss them here before adding anything back. This article was hijacked by anti-pharma people a while back and some useful NPOV corrections have been going on for a while now. So please take it slow, take into account the edit provided, and please discuss them one by one, in separate sections. Thanks. Jytdog (talk) 22:20, 9 January 2015 (UTC)

You are welcome to make separate sections for any of the proposed replacemnets, and I will be happy to do so if there is some policy or guideline requiring it. EllenCT (talk) 00:08, 10 January 2015 (UTC)

I'd also ask you to step very carefully here. This industry has a long history, and it should be seen as a whole. Wikipedia is not a place for righting great wrongs, making social statements, or hanging a wreath of shame around the neck of those whose behavior you disagree with. Formerly 98 (talk) 22:44, 9 January 2015 (UTC)

Neither is Wikipedia a place to try to hide verifiable reports of widespread patterns of abuse from reliable sources because the industry employees who have been removing them believe they are shameful. WP:NPOV and WP:COI and other policies and guidelines are quite clear on this matter. If there are legitimate reasons that any of the specific deletions should not be restored, please state them. EllenCT (talk) 00:08, 10 January 2015 (UTC)

Actually Ellen, the article as it stands is status quo, so as I understand it the burden is on you to obtain a consensus to change it. It would be good to see your remarks on specific items you wish to add.

This was not a simple wholesale removal of negative material, as appears to be implied by your post, but a general cleanup of the article, which is still in progress. Nearly one-third of the material that I have added discusses "negative" issues including the marketing of unsafe drugs and its effects on patients, the marketing of ineffective drugs, and failure to maintain production standards leading to the deaths of children. The sections on the elixir of sulfonamide episode and the thalidomide episode have been greatly expanded, as has information about the other abuses that regulation was passed to address. A very explicit picture of a child malformed by pre-natal exposure to thalidomide was added as well.

Much of the material that was removed violated sourcing standards or was out of date. For example,

• The "discussion of similars" was based mainly on articles that were over 10 years old and which reflected reimbursement schemes that no longer exist. I plan to update this, including the example of how the existence of a "me too" hepatitis C regimen from Abbvie is putting pricing pressure on Gilead and its $86K price tag for sovaldi, and is thought by many analysts to be leading to a price war.
• There were multiple lengthy discussions of specific scandals involving specific companies included in the article. These are fine additions to the articles covering the specific companies involved if properly sourced. But presenting them here in a manner that implies that the given scandal is representative of behavior found throughout the industry is WP:SYNTHESIS.
• Many items, such as the company revenues from 2008, were removed because they were simply out of date. The fact that they were not updated for 6 years suggests to me that they should not be re-added, as no one seems interested in keeping them up to date.
• Some were removed because they represented clear violations of WP:NPOV. It's really not our place to say in Wikipedia's voice that pharma is obligated to give its products away in the third world or that it should spend less on marketing. As a percent of revenue, Pfizer's marketing spend is similar to Microsoft's. That's a value judgement, and we're supposed to stay away from that.
• In some cases, minority viewpoints were over-represented. If Docs without Borders doesn't want Pharma's drugs thats a good thing to add to the Doctors without borders article. But PATH, the Bill and Melinda Gates Foundation, the Medicines Patent Pool, and the Task Force for Global Health all find pharma a perfectly fine partner. There's no reason to highlight the single organization that doesn't want to accept free drugs.

With respect to the reference to "industry employees", I respectfully request that if you have a concern about potential conflicts of interest, that you take them up at WP:COIN and not engage on comments about other editors on the article Talk page. This sort of thing is strongly discouraged by the guidelines at WP:TALK.

Formerly 98 (talk) 02:24, 10 January 2015 (UTC)

@Formerly 98: I think I can reach a suitable compromise with you on most of these objections, but why do you say reporting the industry's marketing spending implies that they should "spend less on marketing"? Do you think reporting the lobbying budget implies that they are spending too much on lobbying? EllenCT (talk) 02:45, 11 January 2015 (UTC)

EllenCT this is too diffuse and pinning people to "what they think" about vague things, is not how we work here. Please present a diff or copy/paste of the specific content you want to add in a new section below, and we can discuss it. Thanks. Jytdog (talk) 03:05, 11 January 2015 (UTC)

I support reinstating at least some of these deletions on a case by case basis. The pharmaceutical industry is an industry which makes issues like budgets for advertising and lobbying relevant along with other things not mentioned like cost of research and development and raw materials. Getting into issues as specific as reasons Doctors without Borders may refuse pharmaceutical donations or the exact budget of the APA may be a little bit too granular for a page as broad as "the pharmaceutical industry". If multiple NGOs refuse pharmaceutical donations this would strengthen your argument that it is worthy of inclusion. Industry's involvement with regulation is also very relevant and affects many facets of society from pharmaceutical companies to users and the way doctors prescribe medications.

WP:TALK does not really provide guidelines for or against discussing specific conflicts of interest on article Talk pages. In some cases it might be appropriate to address and in others it might be more appropriate to bring up with the user directly. Doors22 (talk) 21:54, 10 January 2015 (UTC)

Thanks for your input. Could you be more specific. Difficult to discuss specifics of individual edits in response to a broadly phrased comment.

Please remember to sign your posts with four tildes. EllenCT (talk) 23:14, 10 January 2015 (UTC)

EllenCT (talk) is allowed to make changes and have them be discussed and revised by other editors on an ongoing basis. By mentioning her requested changes on the talk page prior to actually making any changes she is being a very commendable contributor to Wikipedia and following practices that are not adhered to by most editors. My general feedback is to avoid being overly specific about certain companies, incidents, organizations etc. and keep the focus of the whole industry in mind.

I also noticed you added a comment that Pfizer's marketing expense as a percent of its revenue base is similar to Microsoft. I quickly reviewed their latest available annual statements and did not find this to be correct. Would you mind sharing your source or why you believe to to be true? Thanks. Doors22 (talk) 23:09, 10 January 2015 (UTC)

They're only different if you compare Microsoft's sales and marketing (only) to Pfizers Sales, marketing, general and administrative budget. Since Pfizer does not break out its advertising budget separately (most companies don't), to get a comparable number you have to add Microsofts 15,811 in sales and marketing to its 4821 in general and administrative. That gives a total of 20,632 in SG&A, which is 24% of revenue. Pfizer's SG&A is 14,355 out of 51,504 in revenue, which is 28%. Close enough considering we don't know the exact numbers. The year before Pfizer spent 28% and MSFT spent 26%. In any case its a minor point. Its not our opinion that counts, its what is in reliable sources. Preferably ones that are up to date. I'll add that currently about 10% of the article is dedicated to marketing issues of the late 1990's to mid 2000's. That's a lot given that the industry is 200 years old.

I'm unclear on whether you are advocating edit warring as a way of settling differences, but Ellen has already been put on notice that there are concerns about here proposed edits. It would be best to discuss them rather than getting into a flurry of reversions and counter-reversions.

I'll repeat my request that you offer specifics regarding what edits you would like to see made to the article. Formerly 98 (talk) 00:53, 11 January 2015 (UTC)

Besides being WP:SYNTHESIS, I don't think you can realistically take a single pharmaceutical company and a single technology company to compare SG&A expenses as a proxy to make a point about marketing & advertising. Apple spent 7% as a point of comparison.

I reviewed Ellen's history and did not see anything out of the ordinary regarding sanctions or warnings against her account. I am not advocating edit warring, but it is a little concerning that you are using this kind of language before there have been any changes. Just like any edit, Wikipedia guidelines support an editor making a change and if anybody disagrees they may discuss on the talk page before deletion.

Your statement about the pharmaceutical industry being 200 years old is a good one. This is an article on the pharmaceutical industry but not history of the pharmaceutical industry that I see does not yet exist. Being that issues post-2000 represent practices, rules, regulations, participants that are relevant in today's landscape I think it makes sense to spend more time on these more recent issues.

In terms of changes that Ellen has proposed, I am fine with reinstating from her list #s 2, 3, 4, 6, 7, 8, 9, 11, 12. I did not understand what was meant by "discussion of similars" and as you have pointed out it is probably too specific to mention Doctors without Borders' response to the industry unless this is representative of a wider attitude. I would argue that the advertising budget for the APA belongs on the Psychiatry page as it is a subset of the pharmaceutical industry.

As suggested by Jytdog (talk), I agree that it is completely reasonable to make edits independent of one another so they can be discussed separately. Doors22 (talk) 01:53, 11 January 2015 (UTC)

thanks Doors. This abstract converation is a bit silly and I suggest discontinuing it. If anybody wants to discuss a specific deletion please bring a diff so we can have a concrete, productive discussion. As I mentioned I watched the changes as they went and I thought they were quite good, and a lot of great content was added. But I'd be happy to discuss any specific changes. Thanks! Jytdog (talk) 01:59, 11 January 2015 (UTC)

Specifics

Here's the list of specifics, with my thoughts:

1. discussion of similars – probably worth mentioning the subject to WP:Build the web, but not to take us back to the 1990's POV.
2. examples of specific whistleblower experiences – single-organization specifics probably don't belong in this article. Also, the sensational whistleblower experiences that we read in the news are not exactly representative of the average experience. There was, for example, no mention of them being paid 15 to 30% of the money that their old employer gets fined (by statute, under the False Claims Act. Isn't the record payment to a pharma whistleblower some US $60 million, or has it gone up since the last I heard?
3. top 20 companies by revenue / top 15 by sales – current information might be welcome, but I'd just link to a separate list.
4. $19 billion per year spent on promotions – de-contextualized statistics are never a good idea
5. 28% of American Psychiatric Association budget – specifics probably don't belong in this article
6. $855 million per year on lobbying – de-contextualized statistics are never a good idea
7. scientific publications are often authored by contractors – minor details probably don't belong in this article. (Since journal articles aren't part of a literary contest, I put "hiring someone who can write in grammatically correct sentences" into the "minor details" category. Perhaps others will disagree, but I'm definitely in the camp that says the idea and the research work are far more important to science than having the time and ability to write a style-manual-compliant description of what you did.)
8. multiple reasons for regulatory capture deleted – "multiple reasons" was four sentences, containing only two actual reasons ("revolving door" and "friendships"), and sourced to a pop science book. I would like us to WP:Build the web to that article, but I can see why someone might have removed it.
9. developing world discussion initial paragraph – I don't think it's important, but as a matter of style, I might support adding something like this introductory (to the section) material back, if it were well-sourced.
10. reasons Doctors Without Borders refuses drug donations – single-organization specifics probably don't belong in this article
11. list of regulatory authorities – I'd rather see a separate list (also for the list of industry associations, which was removed as well).
12. further reading bibliography – general articles often don't benefit much from these. To be reasonably comprehensive and not UNDUE, you'd have to list dozens.

That's my two cents. I'd maybe add a couple of these back in, but I think that most of the removals were probably good on balance. WhatamIdoing (talk) 23:55, 11 January 2015 (UTC)

Do you think the statistics about the amount spent on marketing and lobbying were de-contextualized before they were removed? I.e., if they are the top industry by spending in both categories, is that noteworthy? I think the "revolving door" reason for regulatory capture was the one which was not removed; perhaps there were a different two reasons? I wonder why you suggest that the percentage of the APA budget funded by the pharmaceutical industry would not be of interest to the general reader? I strongly disagree with your assertion that we should not include the fact that industry-sponsored consultant "co-authors" often prepare manuscripts for submission to journals on the part of faculty who in many cases later claim they never had a chance to review such articles before publication, especially when something goes wrong. As for your speculation about the qui tam whistleblower, do you think you can be held personally liable for something that your employee orders you to sign in the course of your duties in a way that could cause you to be fired for insubordination if you refused? Why would you want to keep such narratives out of this article? EllenCT (talk) 04:03, 12 January 2015 (UTC)

Thanks for your comments @WhatamIdoing: and for taking the time to be so specific and thoughtful.

1) Yes, I agree we should add some updated material about the "me too" issue. But it should be up to date and nuanced. Presenting "me too" as a simple scam undertaken to game the system as in the material I removed isn't really an accurate picture of current realities. In some ways it is an inevitable byproduct of parallel R&D programs and in some ways it benefits consumers by giving PBMs more negotiating power as we are now seeing with Sovaldi.

7) I think it is appropriate to have some nuanced material about ghostwriting in the article. Its widely acknowledged as a problem (but distinct from the use of medical writers to assist in manuscript preparation). But it should be encylopaedic and not simply quoting the most vociferously critical article that can be found in the literature in Wikipedia's voice.

8) I'm pretty skeptical of "regulatory capture", which I tend to see as loaded language for "I disagree with the FDA's decision, and the only reason they could possibly see it differently from me is because they are corrupt". About 1/3 of drugs are still rejected at the end of multi-hundred million dollar development programs, which sounds to me like something less than capture. But I'll look for some balanced sources.

9) I like the idea of having some stuff in there about the developing world and drug access, but again I think it needs to be nuanced. A lot of people who don't allow homeless people to move into their spare bedroom seem to get quite hot blooded in their insistence that pharma has a moral obligation to provide every person who could potentially benefit from a drug with it at a cost that does not affect their standard of living. It would be nice if we lived in that kind of world, but realistically no one inside or outside of pharma is living up to that standard. Good to include some discussion, but once again it should not simply be the industry's most vociferous critics being quoted in Wikipedia's voice.

Formerly 98 (talk) 16:18, 12 January 2015 (UTC)

"Do you think the statistics about the amount spent on marketing and lobbying were de-contextualized before they were removed? I.e., if they are the top industry by spending in both categories, is that noteworthy?" — No, I don't think that giving exact numbers is good. Saying "this industry spends more than any other industry" might be okay; saying "this industry spends a greater percentage of its gross sales" (assuming that it's actually true that pharma spends more than, say, defense aerospace) would be fine.

"I wonder why you suggest that the percentage of the APA budget funded by the pharmaceutical industry would not be of interest to the general reader?" – I wonder why you believe that the general reader of this article cares the budget of one (1) American organization in a single medical specialty. Or, to put it another way, why APA and not AMA? Or BMA? Or all the medical professional associations, rather than just one?

"I strongly disagree with your assertion that we should not include the fact that industry-sponsored consultant "co-authors" often prepare manuscripts for submission to journals on the part of faculty who in many cases later claim they never had a chance to review such articles before publication, especially when something goes wrong." — It's normal for one or two people to write most of an article. It's a bit funny, though, how all those authors somehow managed to submit their information and all the required paperwork without "having a chance" to read the articles. I would understand "not choosing to take advantage of the opportunity" to read the articles, because they're doubtless busy people, but that's a little different. Maybe the journals need to tighten up their submission processes, so that in addition to filling out a form that provides financial disclosure, the alleged authors are all required to sign a form saying "I actually did read this article, and if I ever claim otherwise, a copy of this form will be sent to the media as proof that I either lied to the journal before the article was published, or lied to the press afterwards"? But it's not really our job to solve the real world's problems.

"As for your speculation about the qui tam whistleblower, do you think you can be held personally liable for something that your employee orders you to sign in the course of your duties in a way that could cause you to be fired for insubordination if you refused? Why would you want to keep such narratives out of this article?" — Because that's true in every industry, not just this one. The whole point of making people (i.e., individual employees) swear something is true, explicitly under penalty of perjury, is so that those people will be thinking "Hmm, sign this and (maybe) go to jail, or refuse and (maybe) lose my job: which do I pick today?" This approach is far more in the public interest than "Hmm, sign this, and, hey, nothing bad will ever happen to me personally if I do swear to a pack of lies here!" This isn't unique to pharma. In fact, the system was created for military weapons manufacturers, and it is a serious factor in the financial industry, where it applies at every level, from the biggest of the banks and securities companies all the way down to the part-time bookkeeper who is told to "forget" to report cash transactions because the owner doesn't want to pay income taxes.

"we should add some updated material about the "me too" issue." – There's another benefit, which is that some people can tolerate the near-copy better than the original (or believe that they can, which in terms of patient compliance, is basically the same thing). WhatamIdoing (talk) 05:03, 16 January 2015 (UTC)

Complaints about only researching drugs rich people can afford?

Is this in the article? http://www.motherjones.com/politics/2015/01/not-just-banks-warren-sets-sights-big-pharma — Preceding unsigned comment added by SCW2015 (talk • contribs) 16:13, 23 January 2015 (UTC)

It's an exaggeration to say the pharma industry is "only researching drugs rich people can afford", but maybe there is something that could be said about that perception. However, I don't think the political posturing described in the article you link is particularly relevant or notable by itself. ChemNerd (talk) 16:26, 23 January 2015 (UTC)

Unsure how to even deal with that. The subject of this article is an industry -- businesses. On what planet does it make sense to criticize companies for doing what companies do, which is make money? There ~could~ be a section, maybe, on things like Institute for OneWorld Health and Bill & Melinda Gates Foundation which are addressing needs of the developing world and could maybe be within the scope of this article. Jytdog (talk) 16:29, 23 January 2015 (UTC)

On a planet where publicly funded research is plummeting, down from 1.5% of GDP in 1960 to 0.3% today? On a planet where paid advocacy editing is widespread and growing? There is a detailed discussion of the problems at Orphan drug. EllenCT (talk) 13:04, 6 February 2015 (UTC)

We criticize companies for making money when their prices, and profits, are so exhorbitant that they no longer fill their social purpose, and no longer benefit society, because people can't afford their products. If you read the peer-reviewed journals, or reliable business sources like the New York Times, you'll see that there are many WP:MEDRSs criticizing the pharmaceutical industry for charging so much money for their products, like the new $100,000 a year drugs for cancer and autoimmune diseases, that the patients who need drugs can't afford them. On a planet where the cost of asthma inhalers, which people with asthma need to survive, has gone up from $10 to $250 http://www.nytimes.com/interactive/2014/01/08/us/procedures-inhalers-standalone.html .

On a planet where the cost of digoxin, a 250-year-old drug that requires no research, went from 10 cents to $1, because, as the manufacturer says in his financial statements, they're a monopoly and they can do it.

On a planet where some of the top oncologists in the country, like Peter Bach at MSK, the developer of imatinib, published a letter in Blood complaining that their patients can't afford the drugs that they themselves have developed. This letter was reported in multiple WP:RS and WP:MEDRS, and I posted this to Wikipedia. But Wikipedia editors like you have been going around Wikipedia deleting well-sourced criticism like that.

And it is notable to say that the drug companies are "only researching drugs rich people can afford" when doctors publish statements saying that repeatedly in peer-reviewed journals. --Nbauman (talk) 16:59, 13 February 2015 (UTC)

Please do not use Wikipedia Talk pages as a WP:SOAPBOX per WP:TPG. Comments here like "On a planet where..." have no place on an article Talk page. And "we" (assuming that 'we" is referring to Wikipedia) do not and cannot criticize anybody based on any editor's opinion. We report what reliable sources say, giving weight as it is due in the sources. Please check your ax at the login page. And please restrict comments here to discussing article content and sourcing. Jytdog (talk) 22:53, 13 February 2015 (UTC)

You're the one who started the thread, with your question, "On what planet does it make sense to criticize companies for doing what companies do, which is make money?" You say, "We report what reliable sources say, giving weight as it is due in the sources," etc. I agree. Please follow your own advice. When multiple sources like the ones specifically mentioned in WP:RS criticize companies for making too much money [6], we report it. --Nbauman (talk) 02:11, 14 February 2015 (UTC)

we give WEIGHT per reliable sources and we do not give weight to FRINGE views. Jytdog (talk) 02:26, 14 February 2015 (UTC)

WP:MEDRS says: "Core general medical journals include the New England Journal of Medicine, The Lancet, the Journal of the American Medical Association (JAMA), the Annals of Internal Medicine, the British Medical Journal (BMJ), and the Canadian Medical Association Journal. Core basic science and biology journals include Nature, Science and Cell." WP:SOURCE says: "Other reliable sources include: university-level textbooks... books published by respected publishing houses... magazines... journals... mainstream newspapers." Do you finally agreed with these guidelines? --Nbauman (talk) 04:49, 14 February 2015 (UTC)

While something along the lines of the section header is going too far, there is a kernel there that can be included in the article. Most pharmaceutical companies are for profit and develop drugs with that in mind. So important areas like vaccines and antibiotics are not a priority for most companies, in part because the returns are low relative to medications that treat chronic conditions. With Vaccines in mind, companies found ways to make what was relatively inexpensive, very expensive. I think this kind of thread could be properly handled without violating NPOV. Sample sources [7] and [8] [[[User:Mattnad|Mattnad]] (talk) 12:11, 17 February 2015 (UTC)

Organizing the article

I think a good model for an article on the pharmaceutical industry is this chapter from the U.S. Industrial Outlook 1994 [9] or [10] . This series, published by the Department of Commerce, was discontinued after 1994, but they used to produce good, concise reports on every industry. You could do worse than starting with this 1994 study and updating it. Of course, an article on the pharmaceutical industry in 2015 would be much different than an article in 1994, but many important basic concepts are the same. If you know of something better, I'd like to see it. The pharmaceutical industry (SIC 283) was Chapter 43, "Drugs". --Nbauman (talk) 11:56, 18 February 2015 (UTC)

These are obviously well-written reports, but I think they are a little to focused on the purely economic aspects of the industry. All the detailed information about the U.S. share of the international market and prospects for export growth are of course a little US-centric and would be hard to keep up to date in any case. I think they did a good job though in discussing the controversial areas of pricing, "me too drugs", and environmental issues, in that they describe criticism without taking sides as WP:NPOV requires us to do here. Formerly 98 (talk) 12:56, 18 February 2015 (UTC)

Recent edits

(Transcluded from a user talk page for broader discussion by Formerly 98).

I read or skim about 10 of the major medical journals every week, so I could contribute with peer-reviewed sources, which to any normal person would be WP:RS. Here's one on industry influence on clinical trials.

http://archinte.jamanetwork.com/article.aspx?articleID=1898873 Industry Collaboration and Randomized Clinical Trial Design and Outcomes Nitin Roper, Nasen Zhang, Deborah Korenstein JAMA Intern Med. 2014;174(10):1695-1696. doi:10.1001/jamainternmed.2014.3590

Here's another:

http://archinte.jamanetwork.com/article.aspx?articleid=2109855 Research Misconduct Identified by the US Food and Drug Administration: Out of Sight, Out of Mind, Out of the Peer-Reviewed Literature Charles Seife, MS JAMA Intern Med. February 09, 2015. doi:10.1001/jamainternmed.2014.7774 [Free full text]

(Even though there was deliberate fraud, leading to prison for 1 investigator, which changed the conclusions of the results, the FDA didn't disclose that fraud to their own advisory committee members, nor did it correct the published conclusions based on that fraud, or publicly disclose the fraud so that the journals could correct the results. Seife lists the excuses the FDA gives for not disclosing fraud.)

Quote: That misconduct happens isn’t shocking. What is: When the FDA finds scientific fraud or misconduct, the agency doesn’t notify the public, the medical establishment, or even the scientific community that the results of a medical experiment are not to be trusted. On the contrary. For more than a decade, the FDA has shown a pattern of burying the details of misconduct. As a result, nobody ever finds out which data is bogus, which experiments are tainted, and which drugs might be on the market under false pretenses. The FDA has repeatedly hidden evidence of scientific fraud not just from the public, but also from its most trusted scientific advisers, even as they were deciding whether or not a new drug should be allowed on the market. Even a congressional panel investigating a case of fraud regarding a dangerous drug couldn't get forthright answers. For an agency devoted to protecting the public from bogus medical science, the FDA seems to be spending an awful lot of effort protecting the perpetrators of bogus science from the public

(This was also published in journalistic form in Slate:

http://www.slate.com/articles/health_and_science/science/2015/02/fda_inspections_fraud_fabrication_and_scientific_misconduct_are_hidden_from.single.html Are Your Medications Safe? The FDA buries evidence of fraud in medical trials. My students and I dug it up. By Charles Seife Slate Feb. 9 2015)

These pro-industry edits are going against ongoing articles and mainstream opinion in all the major peer-reviewed journals. --Nbauman (talk) 23:04, 12 February 2015 (UTC)

Nbauman, could you give some specific examples of edits you are concerned about? Formerly 98 (talk) 00:08, 13 February 2015 (UTC)

First of all, you copied those comments from my talk page, after removing issues concerning POV-warring editors on which you depend for support in your years-long campaign to slowly remove criticism from this article. You did not "transclude" them. Secondly, do you think that there is any chance at all that Nbauman is not concerned about the fact that this article does not describe the facts to which he refers? Why do you think that a comment on my page would be referring to any specific edits on this one? EllenCT (talk) 01:35, 13 February 2015 (UTC)

Ellen, I removed part of the post for two reasons, both meaning to be courteous.

• The personal attacks on other editors that were present in the full post are not permitted on article talk pages
• The original post included comments that could be interpreted as declaring an intent to canvass.

If you and Naubaum would like to see that material here, please feel free to add it. But the personal attacks will not help your cause or make your viewpoints appear unbiased in the eyes of other editors. Formerly 98 (talk) 02:00, 13 February 2015 (UTC)

The JAMA Internal Medicine article was quite interesting, if a bit disingenuous in a few places.

• I strongly agree that the information about failed FDA inspections should be included in publications describing the trials if they impact the interpretation of results. If it is a single site among 500, its kind of a trivial detail.
• There is no sign of the "FDA burying misconduct". The information on FDA inspections, failure rates, the type of failure, and the severity of the failure have been on the FDA website for a decade or more.

• There is a searchable database of inspections and their results here
• The results are summarized in slide sets here
• Or if one prefers, once can download the entire dataset as an Excel file here. I did so and found that among 8508 inspections conducted by FDA over the last decade or so, 81 found evidence of data fraud, about 1%. Importantly, a typical Phase 3 trial involves between 50 and 1000 trial sites, so one might hope that the reason these incidents are not being reported is because they typically have no effect on the overall result.

The paper is a bit misleading, I'm afraid, it states that "If onewere to exclude the data fromthe patients at that site, the claim of a statistically significant mortality benefit disappears. For this reason, among others, the FDA wrestled with whether it was appropriate to allow the manufacturer to claim a mortality benefit." This is at best an overstatement of the facts. The FDA immediately threw out all Chinese data from this trial because the person identified in the fraud (who was identified and reported by Bristol Myers) had a role in handling data from all Chinese sites. Reading the FDA approval summary, no one ever considered throwing out only the single site that got the negative inspection, and that is the only selection of trials that would have led to a non-statistically significant effect on survival.

The "wrestling" over the survival benefit was due to a reviewer who was not even assigned to the NDA team, chiming in and criticizing what he felt was inadequate follow-up of the patients from the trial. His criticisms are described first hand and in detail, the word "China" does not appear in his comments.

This is of course why primary research papers such as this one are not permitted by WP:MEDRS. The results need to be reviewed and put in context by uninvolved researchers.

Best, Formerly 98 (talk) 02:02, 13 February 2015 (UTC)

Formerly 98, copying my private comments to EllenCT on her Talk page without asking my permission violates WP:TPO, and is discourteous besides. I was at a public lecture this week where I recorded a speaker's presentation. I asked her a question, and she responded. I wanted to post the exchange to an email list, so I emailed her first to make sure she didn't have any legitimate objections. That's my idea of courtesy. In the future I assume you will ask me first.

I also wonder why you happened to read my comment on that page, and whether you were WP:HOUNDING either me or EllenCT. (If EllenCT wants to email me without worrying that somebody else is following us, she can click on "Email this user" on my Talk page.)

If you want some specific examples of edits that deleted important material and made the article worse, then start with EllenCT's diff above [11]

The biggest problem is that it deletes all the supporting evidence that is critical of certain pharmaceutical practices, most of which is from WP:MEDMOS reliable sources.

For example, you (by "you" I mean all the editors who made these changes) deleted all reference to the Pfizer Trovan clinical trial. This was an important incident that was covered widely and is a major case history in the ethical problems of clinical trials that's still discussed in ethics textbooks today. It's important because it established the principle (not always followed) that you can't use third-world people as guinea pigs for clinical trials. (And there was the forged permission letter from the Nigerian ethics committee, signed on an obviously fake letterhead.) I once had a bibliography of at least 20 citations to that incident, and there were many more, so it certainly meets WP:NOTABILITY and WP:WEIGHT.

I'm trying to find out what you were referring to about Pfizer, but you deleted the text and apparently replaced reliable links with uninformative, generic links like [12] that don't support the claims that, for example, Pfizer paid a $2.3 billion settlement. What did they pay a $2.3 billion settlement for?

Doctors Without Borders was one of the main critics of Pfizer in the Trovan case, since they were on the ground giving tested drugs when Pfizer was giving untested drugs.

In fact, there's no mention of Doctors Without Borders or Médecins Sans Frontières in the entire article. By WP:NOTABILITY, WP:WEIGHT, publication in WP:MEDRS or any standard you want to apply, MSF is one of the most significant critics of the pharmaceutical industry, and deleting them -- censoring them -- from the article is like deleting Darwin from a Texas biology book. Why did you delete them, other than the fact that you personally disagree with them?

I've been writing and editing for over 30 years. When I look at edited drafts of a (legal or medical) manuscript, editors and authors usually insert specific facts, more precise facts, and more supporting evidence. You're deleting specific facts, precise facts, and supporting evidence.

As an example of medical writing, read Charles Seife's article in JAMA IM. That's what he does. He gives specific cases and specific facts -- just what you're deleting in EllenCT's diff.

I've read as much of this talk page as I can and I'm not too hopeful.

I'm not pro- or anti-pharmaceutical industry. I just want to reflect the consensus and significant minority viewpoints in the peer-reviewed journals.

I want to survey the peer-reviewed medical literature, and other reliable sources like the New York Times, Washington Post, and Wall Street Journal, and professional societies (right out of WP:RS and WP:MEDRS), and provide our readers with a guide to important ideas about the pharmaceutical industry that are missing in this article even though they have WP:NOTABILITY and WP:WEIGHT because they are repeatedly published in those sources.

What you are doing in most of this Talk page and the article is advocating your own personal ideas about the pharmaceutical industry, in other words, POV pushing.

For example, this is not the place for Formerly 98 to say that the JAMA IM article was "a bit disingenuous in a few places." It's not your place as a Wikipedia editor to say, "There is no sign of the 'FDA burying misconduct'." Your personal opinion is not a consideration in a Wikipedia article. The author of a peer-reviewed journal said that, many other authors said that in peer-reviewed journals and other WP:RSs, and that's all that matters to Wikipedia. Look at the top of this Talk page: "This is not a forum for general discussion of the article's subject." I'm sure you've read WP:OR, but you're not following it. I am certainly not going to get into a debate with you over whether a WP:MEDRS is right or wrong. That's not what we do in Wikipedia. We establish WP:NOTABILITY and WP:WEIGHT.

This entire article seems to have been edited by POV editors. What I would like to do is get some non-POV editors to contribute, particularly by resolving these POV deletions, from someplace like Wikipedia Project Medicine (without WP:Canvassing). A long-time Wikipedia medical editor gave me some suggestions as to how that can be done. Don't look for it on my talk logs, it was in real life. --Nbauman (talk) 05:39, 13 February 2015 (UTC)

• Without getting too much into the detail, this article is about an industry. Not everything in it is subject to WP:MEDRS, though much discussion of industry issues can be found in medical journals as well as economic and other ones. There are also several good books on the industry, which would better sources than web-only media. For example Bad Pharma (2012, the title gives a clue where he's coming from) by Ben Goldacre, who is so far only referenced here to an article of his in The Guardian. Wiki CRUK John (talk) 12:22, 13 February 2015 (UTC)

John, first let me apologize for engaging in an off-topic debate on the article Talk page. I have struck my remarks as we should limit ourselves to discussing improvements of the article here. However, I must say that I disagree with your comment describing me as a "POV Editor". I began working on this article in October 2014. The amount of space dedicated to criticism of the industry before and after my edits is summarized in the table below. I've defined "criticism" very narrowly here and believe that this is a fair if not conservative representation.

Article Version	Total Text (Words)	"Criticism/negative"
October 2, 2014	6674	3201 (48%)
Current	6905	2268 (32%)

For comparison, the Essay WP:CRIT recommends that "Generally, criticisms within an article (other than a "Criticism of ..." article) should in total be well under half of the article, even if sourcing supports filling almost every line of the article with criticism. The minimum is that required by neutrality but the maximum should, in a neutral way, leave a majority of the article as not criticism." According to this standard, the article has been moved from "seriously imbalanced" to something that is in the ballpark of Wikipedia standards.

Given this, I think it would be more productive to discuss individual edits than characterizing other editors as biased or POV warriors. In fact, I would appreciate it if you would strike your comment, which I believe is a violation of Wikipedia talk page guidelines (WP:TALKNO) or at least comes very close to being one. We all have different opinions, but bias is most obvious when it differs from one's own!

I do think we should be careful about piling on with more criticism of the industry given the stats in the Table above. A good choice from my POV would be to add substantative criticism while removing more trivial ones. Best, Formerly 98 (talk) 14:50, 13 February 2015 (UTC)

(That was --Nbauman, not me, to be clear.) Wiki CRUK John (talk) 15:06, 13 February 2015 (UTC)

My apologies Formerly 98 (talk) 15:27, 13 February 2015 (UTC)

I get a total of 7,000 words, and 2,100 words (30%) of criticism. That includes the diethylene glycol days and the FD&CA of 1938, (330 words) and Thalidomide and the Kefauver-Harris Amendments 360 words).

Somebody wrote in I think this week's NEJM, "We learn more from mistakes than success." Maybe that's the way the pharmaceutical industry developed. The "criticism" is important because the industry was shaped by its mistakes, with FDA regulation, lobbying, etc. WP:CRIT (some of which I agree with) is an essay, not a guideline.

The Pharmaceutical fraud section is the largest (450 words), probably because it gets a lot of news coverage. The DOJ does all the investigation and drops a press release into the laps of the newspapers, and it offers a good story, without any work, without the cost of legal review for libel, about the big corporation brought down. I don't see how that illustrates anything insightful about the pharmaceutical industry. It's just one story over and over again: the company promotes a drug for an unapproved use and gives kickbacks, they make $5 billion in extra sales, an insider reports them, they pay $2 billion in fines, they come out ahead, and nothing changes. Compare that to the Charles Seife story where the drug company malfeasance actually destroys the integrity of the research and lets the public use drugs that nobody can certify as safe or effective.

The marketing stuff is about 600 words of criticism -- or actually 500 words if you don't count as criticism the rebuttal and defense of the industry at the end. As a medical writer in real life I think it's really disorganized, about what you would expect if it turned into a tug of war with industry critics writing something and industry defenders coming in to delete it. It looks like the blind men tried to reassemble the elephant.

I would point to WP:NPOV, "Writing for the opponent" Writing for the opponent, which "is the process of explaining another person's point of view as clearly and fairly as you can, even if you strongly disagree with it." I think the Criticism section, or any section that criticizes the pharmaceutical industry, should at least explain the critics as clearly and fairly as possible, and then you can put a rebuttal at the end.

The pharmaceutical industry is a big sector of the economy, and includes the US, Western Europe, Japan, developing countries and undeveloped countries. It's a big subject, and it's pretty hard to cover in 7,000 words. This article obviously requires sub-articles, and "Criticism of the pharmaceutical industry" should be one of them. Agreed? --Nbauman (talk) 22:36, 13 February 2015 (UTC)

A "Criticism of ..." article would be a classic WP:POVFORK. Best to weave criticim into the fabric of this article as it's due. Alexbrn ^{talk|contribs|COI} 05:49, 14 February 2015 (UTC)

If we weave the criticism into the article, and present the criticism in proportion to the publications in WP:MEDMOS sources, the criticism will be a lot longer than some people would like.

For example, here's an article in the current JAMA Dermatology: Dermatologists, Imiquimod, and Treatment of Molluscum Contagiosum in Children: Righting Wrongs. Kenneth A. Katz. JAMA Dermatol. 2015;151(2):125-126. doi:10.1001/jamadermatol.2014.3335. In order to qualify for a 6-month exclusivity extension, the FDA required 3M, the manufacturer of imiquimod, to perform 2 RCTs in children. The 2 RCTs found that imiquimod was ineffective for molluscum contagiosum and had adverse effects. Yet 3M never published the studies, and imiquimod continues to be used for molluscum contagiosum.

The point is that the peer-reviewed journals are constantly publishing articles criticizing pharmaceutical industry practices. If we want to include them in proportion to WP:RSs, we will have a lot to include.

In principle, we could have an article on "Pharmaceutical industry marketing" in which we could include all these criticisms, and then add the pharmaceutical industry defenses to make it NPOV. --Nbauman (talk) 10:37, 14 February 2015 (UTC)

Sounds POVish to me, like a focal point for consolidating criticism (set off with another focal point for a "defense"). This is precisely the kind of to-and-froing we want to avoid. I'm interesting in your assertion that most quality sources are (adversely) critical. What data backs that? Some tables of search results would be interesting. Alexbrn ^{talk|contribs|COI} 12:45, 14 February 2015 (UTC)

I think my biggest concern has been the way in which the article as I found it several months ago appeared to be a WP:SOAPBOX to tell the world how shameful the pharmaceutical industry is. That's really not the purpose of Wikipedia. The problem was not just that the article was NNPOV, it was that like all heavy handed political screeds that beat their point into the ground telling people what they should think, it was BORING.

This industry has a complex history of having been engaged in some of the worst scandals of any industry, while simultaneously having generated products that reduced childhood mortality by 2/3s. Its a rich and complex history. Casting it as some sort of Evil Empire doesn't capture that complexity. That's what I've tried to capture in the sections that I have written, but I am only up to about 1970 or so in the history of the industry.

There is a lot of legitimate criticism and concern out there, but it needs to be described in a NPOV manner, which I think includes the following:

• Covering what is in reliable sources in a proportionate way
• Writing objectively. Our role is to present facts and not to tell people what to think.
• We don't need to add every criticism that has been offered by anyone at any time, just because someone said it. Nor on any given subject do we need to scour the literature for the most scathing quote that can be identified so we can include it in the article.

As an example of what I regard as problematic criticism, I would point to the Criticism of Coca Cola Company article which I have recently cut back. Some of the criticisms included there were

• If you drink the product and don't brush your teeth, they will decay
• If you drink too much you will become obese
• The company refused to give its "secret formula" to the Indian govt when they demanded it so they could give it to competitors
• They have sometimes opposed bottle deposit laws
• Unnamed sources have accused them of bribing the American Dental Association to keep them from being criticized even more harshly than they are now.
• They refused to relabel their bottles in Catalan when asked to do so by a Spanish nationalist group
• They did not boycott the 2014 Olympics
• Someone once claimed that the Coca Cola label contains encrypted anti-Islam phrases
• The company loses money in Vietnam

And so on. The existence of a reliable source is a minimum requirement for adding material to an article, but we don't add EVERYTHING for which we have a reliable source. The point is to write an informative, interesting, and balanced article. Formerly 98 (talk) 14:29, 14 February 2015 (UTC)

Editors like Jytdog have falsely accused me of attacking the pharmaceutical industry. What I actually do is report the views of the WP:RSs in the peer-reviewed journals, whether they're critical or not. For example, here's a column by Richard Lehman in BMJ in which he praises Medtronic for finally releasing their data. http://blogs.bmj.com/bmj/2015/02/09/richard-lehmans-journal-review-9-february-2015/ (This is a device, not a drug, but the principle is the same.) And he defends Medtronic against a critical editorial in The Lancet. He also criticizes Roche for not releasing their data on oseltamivir as they promised.

They've criticized the drug companies for many things, such as overpricing AIDS and other drugs in the underdeveloped world, but when companies like GlaxoSmithKline finally responded to their criticism they've praised them. I don't know who's right or wrong. All I can do is report both sides.

A major criticism of the drug companies in the WP:MEDRS peer-reviewed journals, including for example Lancet, BMJ, and Annals of Internal Medicine, is that they don't release clinical trial data so that independent investigators can evaluate it. The drug companies say that it's a trade secret (and the FDA accepts that), but the doctors say they want that data because it would save patients' lives. This is a major, important issue that belongs in the article by any standard of WP:WEIGHT. I don't know how you could explain that debate to readers in a balanced way so that they could understand it, and cut it down to one sentence.

Yes, casting the industry as the Evil Empire doesn't capture its complexity. Some drug companies have reduced childhood mortality by 2/3. Other drug companies have sold products that they must have known would kill children. Some drug companies have made essential drugs like asthma inhalers unaffordable, because as they openly tell investors, they can get away with it and it's profitable. You can't explain that complexity in the one-sentence throwaway lines like this https://en.wikipedia.org/wiki/Pharmaceutical_industry#To_healthcare_professionals or this https://en.wikipedia.org/wiki/Pharmaceutical_industry#Direct_to_consumer_advertising . A lot of the problem is that this is just disorganized writing. But I'm not going to spend a day rewriting and organizing it if some POV editor is going to come along and summarily delete it.

And user:Alexbrn, where did I say that most quality sources are (adversely) criticial? I can't find it. --Nbauman (talk) 00:14, 15 February 2015 (UTC)

I'd like to propose again that we have a separate page on Criticism of the pharmaceutical industry. In support of that, I just saw this page, New York City Police Department corruption and misconduct. It's customary in WP to have a separate page of criticism, when the criticism on the main page would get too long. It does not violate WP:POVFORK. The alternative that you're suggesting -- just delete the criticism when it gets too long -- would have the effect of deleting much of the criticism of the pharmaceutical industry, even when it's justified, in violation of WP:NPOV. --Nbauman (talk) 21:29, 14 March 2015 (UTC)

wouldn't that just be a WP:POVFORK? Jytdog (talk) 21:38, 14 March 2015 (UTC)

Nbauman, as I see it, the policies and guidelines limit the amount of criticism that can be added in two ways.

• WP:CRITICISM limits criticism to "significantly less than 50% of the article"
• WP:POVFORK says you can't create a second article covering the same topic to avoid the restrictions of WP:POV and WP:CRITICISM

I believe these limitations are here mainly to prevent Wikipedia from being used as a soapbox.

If you want to add criticism, you have to do it without pushing the percentage of the article dedicated to criticism back toward 50%. One way to do that would be to also add positive or neutrally descriptive material so that the overall article remains balanced. Some such areas that need to be covered and have not yet been covered yet include:

• A more detailed coverage of reimbursement schemes in the United States and other major markets.
• A more detailed coverage of the drug approval process in the United States and other major pharmaceutical markets. There is currently no mention of CHMP, of the European centralized and mutual recognition pathways, of FDA advisory committee meetings, of ANDAs or of the impact of the Hatch-Waxman amendment
• Some discussion of the relative percentage of prescriptions that are filled by generic vs patented drugs in developed and developing worlds, and of efforts such as the Medicines Patent Pool to increase availablity of drugs in the developing world.
• The massive downsizing and consolidation that has been a key characteristic of the industry since 1990, and the increasing percentage of pharmaceutical research that is performed in developing economies
• The increasing percentage of pharmaceutical drugs that are biologicals, and how the difficulty of making exact copies of such drugs has led in many cases to exclusivity that far outlasted patent protection, along with the increasing move to development of "biogenerics"

I very much welcome the contributions of other editors to this article. But its strange that in the case of this and other articles about corporations and industries, there are so many volunteers to help add criticism or complain that criticism is inadequately covered, and so few lined up to help add information about markets, products, regulation, history, or economics of these same corporations and industries. (In the case of the Merck and Co. article, at one point an editor actually deleted the section describing the company's products, calling it "unnecessary"). All these aspects are important in an encyclopedia article, and the policies and guidelines are in place specifically to make sure that we don't make political commentary the focus of our articles on companies or any other subject. Formerly 98 (talk) 00:09, 15 March 2015 (UTC)

FWIW, I believe the usual standard for deciding whether to create a dedicated Criticism or Controversy article is the existence of enough RS that discuss the criticism or controversy as a whole. Thus we have Creation-evolution controversy, for example. The problem is that such articles are very difficult to keep neutral - they have a strong tendency to become a coatrack for negative information about the subject, and need a lot of watching by editors willing to deal with POV pushing. Nbauman, one thing to keep in mind is that even such an article would still exclude a lot of criticism; ideally, it would only include information that is discussed in the aforementioned RS (that discuss the criticism in the context of the whole). One alternative, if you feel it may be warranted, is to create articles on individual controversies which may be independently notable - e.g. the Vioxx controversy probably meets that standard. Sunrise (talk) 01:42, 15 March 2015 (UTC)

Added: one point in favor of controversy articles is that it does take some of the pressure off the main article. So for better or worse, if the article is created, the majority of the criticism that is here will probably be moved there. For example, Evolution#Social_and_cultural_responses and War on Terror#Criticism (though the latter is definitely on the short side). Sunrise (talk) 02:03, 15 March 2015 (UTC)