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Friday 23 June 2017

The NHS, Pfizer and Lyrica. Corporate Profit and Patient Harm

Conventional medicine treats neuropathic pain with a drug called pregabalin, conditions such as fibromyalgia, shingles, diabetic nerve problems, spinal cord injury, and many others. It is an anticonvulsant and neuropathic pain agent - and a dispute over patenting rights with drug companies has cost the English NHS, and the British taxpayer, an estimated additional £54 million.

Pregabalin is a nasty little drug, with lots of nasty side effects. The Drugs.com website lists these, and they include infection, ataxia, blurred vision, constipation, diplopia, dizziness, drowsiness, fatigue, headache, peripheral edema, tremor, weight gain, visual field loss, accidental injury, xerostomia, abnormal gait, abnormality in thinking, amnesia, arthralgia, asthenia, cognitive dysfunction, confusion (dementia), edema, neuropathy, sinusitis, speech disturbance, vertigo, visual disturbance, myasthenia, amblyopia, and so on.

Yet the harm it is known to cause patients has not been the issue, as usual. The problem has been money and profits - as usual! From July 2014 to March 2015 most prescriptions for pregabalin were for the 'generic' (the cheaper but identical) versions of the drug. However, the manufacturers of the branded (the expensive) version, Pfizer and Warner-Lambert, did not like this. When their UK patent for Lyrica expired in July 2014 they claimed they still held a ‘second medical use’ patent for when it is prescribed for 'neuropathic pain'. So they took the matter to court. An interim judgment found in favour of Pfizer, so in March 2015 NHS England backed down and issued guidance forcing doctors to switch thousands of patients’ prescriptions for generic pregabalin back to Lyrica.

In September 2015 the High Court threw out Pfizer's patent claim as 'invalid', and the Judge stated that Pfizer had made ‘groundless threats’ to pharmacists about dispensing the generic drug. They, too, backed down, and the GP magazine Pulse says that "some pharmacies even triggered a significant event alert every time a GP prescribed so as not to fall foul of Pfizer’s ‘threats’."

So now, after two years, and an appeal, the English NHS is directing doctors to switch thousands of patients back to generic pregabalin. Well, all is fair in love (the love affair between the NHS and drug companies) and war (the battle for profit)!

Pulse analysed the cost of this decision, estimating that prescribing Lyrica instead of generic pregabalin had cost the NHS an extra £54m between February and September 2015 - less than a year! It stated a BMA spokesman, Dr Andrew Green, told them that patients had lost out.

               "Pfizer, by threatening legal action against pharmacists and doctors if they prescribed generically, have boosted their profits and denied patients effective treatments that otherwise could have been provided with that money."

Financially, this is certainly true. The NHS has been screwed by Pfizer, but by now it should be used to this, pharmaceutical companies have been screwing the NHS for nearly 70 years! Green added,

               "They now have a moral duty to pay that money back to the NHS."

Maybe. But there seems precious little 'moral duty' around within the NHS, and certainly not within the pharmaceutical industry! They are both locked together in a medical monopoly, together with most patients who depend on the NHS, and therefore depend on pharmaceutical drugs and vaccines.

What nobody has been spared, or even discussed, during all this time, have been the dangerous side effects of taking this awful drug.

Postscript 24 January 2018
The doctor's e-magazine Pulse reported that official figures show that pregabalin-related deaths rose from 4 to 111 between 2012 and 2016, and gabapentin-related deaths went from 8 to 59 within the same period. There has apparently been discussions about how to control this nasty little pharmaceutical drug.

As a result proposals were made to restrict pregabalin and gabapentin, but according to Pulse these restrictions were labelled as ‘onerous’ and unjustified by the BMA. Too bad, doctors seem to be okay about prescribing dangerous drugs that can kill us; but taking precautions to protect us is a little too onerous!

Well, that at least demonstrate something about the priorities of the conventional medical establishment!