Tuesday 18 May 2010

Big Pharma versus Big Tobacco

The Washington Examiner hits the bullseye when it says that the regulation of nicotine products comes down to a straight fight between Big Pharma and Big Tobacco. The situation in America is now so messed up that the interests of neither liberty nor public health (however defined) are being served.

It's a full-fledged regulatory rumble between Big Tobacco and the even bigger Big Pharma -- the sort of ugly influence game that will become the norm as government sticks its arms deeper into the economy.

So says Timothy P. Carney, the newspaper's lobbying editor. And lobbying is the name of the game. Big Pharma's problem is that other industries keep producing better nicotine products which, given time, may turn out to be more effective stop-smoking aids. Whether it's the e-cigarette or Camel Orbs, alternatives to Big Pharma's 'medicinal nicotine' are making up market share and the drug companies want the government to stamp them out. 

All these products deliver, for all practical purposes, nothing but nicotine. Big Pharma's approach is to claim that the nicotine in their products is safe (which is true), but that nicotine becomes magically harmful when it is delivered in the products of their competitors.

Their other line of attack is to claim that their competitors' products are marketed to—or at least might appeal to—children. RJ Reynolds, for example, have committed the crime of designing reasonably attractive packaging for Camel Orbs.

Would this appeal to children? Who knows? But if it does, then surely so will this Nicorette product.

Camel Orbs have been accused of having a "candy-like appearance, added flavors, and easily concealable size"—all of which apply equally to Nicorette's Mint Mini Lozenges. They have been accused of having "a very minty taste and seemed to deliver a jolt of nicotine". Ditto. It is said that very young children could die if they eat a whole pack of Camel Orbs. Ditto again.

Either both of these products should be banned or they should both be legal. The group that will advise the FDA on what do is the Tobacco Products Scientific Advisory Committee (TPSAC), and that's where the conflict of interests come into play.

Jack Henningfield is one of nine voting members on the TPSAC, and he is also one of eight patent holders of a cutting-edge nicotine chewing gum that has not yet been commercialized.

Henningfield is also vice president of health policy at a consulting firm that counts drug maker GlaxoSmithKline as a client. Glaxo holds the license for Nicorette, the leading nicotine gum currently on the market.

Camel Orbs may or may not be a real health risk, but they are certainly competition to Nicorette's gums and lozenges -- and Henningfield's patented gum. Yet our government will count on Henningfield and others in the pay of Nicorette's maker for counsel on how to regulate Camel's product.

And it doesn't stop there...

Neal Benowitz, another committee member, has also worked as a consultant to Glaxo as well as Pfizer, the Wall Street Journal has reported. Pfizer makes the quit-smoking drug Chantix.

Boston University professor Michael Siegel has reported on his blog that the committee's chairman, Dr. Jonathan Samet, "has received grant support from GlaxoSmithKline. In addition, the organization that he directed -- the Institute for Global Tobacco Control -- is funded by GlaxoSmithKline and Pfizer."

Finally, committee member Dorothy Hatsukami has been paid by a small drug maker to study its proposed nicotine vaccine.

Michael Siegel, who remains the go-to man for these issues, writes...

The last individual in the world who you would want to serve on such a panel would be a Big Pharma consultant, especially one who consults specifically in the area of smoking cessation medications. The fact that this individual also has a personal financial interest in such medication and who also has testified in court on behalf of Big Pharma simply adds insult to the public's injury.

Pharmaceutical funding has been one of the key developments in the story of the anti-smoking movement in the last 20 years. Many millions of dollars have been spent financing groups who have campaigned for smoking bans, higher cigarette taxes and other tobacco control measures that have pushed smokers towards pharmaceutical nicotine. 

I have never been one to see the anti-smoking movement as a pharmaceutically led enterprise. The money has helped enormously, no doubt, but anti-smoking campaigners were around long before the drug companies got involved and their prohibitionist aims have not changed significantly.

Until recently, it could be said that the interests of public health and the pharmaceutical lobby merely happened to coincide. That is no longer the case. Big Pharma's attempts to use regulation to prevent its competitors from selling virtually identical, safe and probably more effective nicotine products is the final proof that this is all about money. As Carney concludes:

It's an ugly game, this use of regulation to kill competitors and guarantee business, and conflicts of interest are unavoidable. The Pharma-vs-Big Tobacco scrum shows that Obama's project of increasing government control is at odds with his talk of cleaning up government.


Anonymous said...

There is one big difference between the two: Big Pharma has complete and utter dominance of the public domain. Big Tobacco is completely excluded from the debate.

While the anti-smoking groups may have initially been "grass-roots" organisations, who essentially despised smoking and smokers, they were up against a significant minority of the population, being smokers. When the first nicotine gum was introduced in 1984, the anti-smoking groups quickly became extensions of Big Pharma's marketing and lobbying. Their campaigns of hate and segregation were suddenly flush with cash, allowing these hate-mongers to pursue their zealotry full-time, recruit like-minded bigots to their cause and to argue with increasing force that, first Big Tobacco, then smokers themselves should be excluded from any public debate on the subject.

Big Mick said...

The entire TPSAC voting member panel is made up of anti-smoking zealots with major ties to Big Pharma and anti-tobacco groups. The proponents of THR are excluded or ignored. This does not bode well for US tobacco consumers. It does mean more taxes from and sales of cigarettes. It also means even more money flowing into Big Pharma's pockets.
In the case of the FDA regulation of tobacco I see Big Tobacco and Big Pharma on the same side. It has long been rumored that Camel Orbs, Sticks and Strips were introduced as throw away products to protect the cigarette market.
The US FDA needs to take lessons from it's Swedish counterpart.