Monday 26 August 2013

Big Pharma and the nicotine wars

A couple of interesting stories about the influence of the pharmaceutical industry emerged over the bank holiday weekend. Firstly, The Times raised questions about the panel that advised the MHRA to regulate e-cigarettes as medicinal products...

Health experts who recommended that the Government tighten the regulation of electronic cigarettes failed to declare their financial interests in Big Pharma’s rival products.

... At the meetings held at the MHRA’s London headquarters in May 2011 and January this year, the chairman asked the expert panel to declare any interests. Minutes of the meeting in 2011 obtained by The Times under the Freedom of Information Act show that “no interests were declared by members”. However, some members of the panel worked as consultants for big pharmaceuticals companies and advised on nicotine.

... Paul Aveyard, Professor of Behavioural Medicine at the University of Oxford, is a consultant to McNeil and Pfizer on nicotine replacement therapy and nicotine vaccines, respectively. Professor Aveyard, who helped to produce guidance for doctors on prescribing licensed nicotine products, is also a for-mer consultant to Xenova, which developed vaccines for nicotine addiction.

Martin Jarvis, a Professor Emeritus of Health Psychology, University College London, and vice-chairman of the board of trustees of the anti-smoking charity Action on Smoking and Health, is a paid consultant to Pfizer. He has advised on an ingredient of Pfizer’s drug Chantix, treating nicotine addiction.

Christopher Marriott, formerly Emeritus Professor of Pharmaceutics, King’s College London, holds shares in three pharmaceuticals companies. One is Vectura Limited, part of Vectura plc, a FTSE 250-listed company whose inhalation products help to combat chronic obstructive pulmonary disease, better known as smoker’s lungs.

Secondly, the Polish press has been investigating the influence of Big Pharma on the EU's Tobacco Products Directive. The article—from Uważam Rze—isn't available online so I'm grateful to David Dorn for sending me the English translation.

Do we stand to lose because of pharmaceutical lobbyists in Brussels?

Work is continuing in the European Parliament on the new tobacco directive, which is to ban the manufacturing and marketing of menthol and slim cigarettes. This blow to smokers is, as always, motivated by concerns for our health. However, according to our information, there is more to this matter that meets the eye. If the regulations currently being drafted come into force, pharmaceutical concerns stand to profit. Tens of millions of euros per year are at stake, so lobbying at an unprecedented scale is taking place in Brussels.

The rapporteur of the draft is Linda McAvan, a British MEP from the Socialists and Democrats faction. She is a well-known anti-smoking activist. It is worth observing that the start of her work on the Tobacco Directive coincides with David Harley, former high-ranking S & D politician and colleague of the MEP in the presidium of this faction, joining the Brussels office of the lobbying firm Burston-Marsteller whose clients include some of the largest pharmaceutical companies, including Johnson & Johnson and Pfizer, which may earn millions on smokers. “Money is the only thing that counts in this matter” says Zbigniew Ziobro, MEP (Solidarna Polska). “A huge lobbying effort is under way. Lobbyists are chasing all MEPs. I have never met with them, but they continue to offer trips and dinners. This is barely disguised corruption, unmasked last year by a provocation arranged by British journalists, where three prominent MEPs promised to push through a piece of legislation for EUR 100,000” – the former justice minister added.

Not surprisingly, in November 2011, the bosses of the largest companies in the pharmaceutical sector, such as Johnson & Johnson, Pfizer and GlaxoSmithKline, sent a letter to the President of the European Commission, Jose Manuel Barroso, demanding that the work on the introduction of the new Tobacco Directive be sped up [I discussed this letter back in 2011 - you can read it here - CJS]. What is more, they demand that no research be done into the consequences of the new regulations. “Of course, an impact assessment is very important in creating responsible legislation, but, as stated in a resolution of the European Parliament regarding independence in assessing the impact of regulations, it may not “lead to greater bureaucracy and unnecessary delays in the legislative process” and “be misused as a means of blocking undesirable legal provisions”. In addition, an impact assessment does not replace the policy development process conducted by the Council and the Parliament. We are of the opinion that further delays are unacceptable” – we read in the letter. However, this demand was signed not only by the heads of the concerns, but also by Deputy McAvan.

“This provides a serious reason for questioning whether the rapporteur is really impartial” – Andrzej Grzyb MEP (PSL) commented our information.

Pharmaceutical companies argue that their lobbying in favor of the new directive stems from their concerns for human health. This is one side of the coin. However, it is also true that every additional restriction placed on smokers is worth a fortune for them in the form of increased sales of their pills, patches or chewing gum designed to help people quit smoking. In addition, concerns want e-cigarettes to be registered as a medicinal product, allowing them to increase their profits even further at the expense of tobacco companies. Interestingly, on 8 May of this year, a training course was held at the EP devoted to e-cigarettes. It was organized by … McAvan, MEP. She said that they should be classified as medicinal products, regulated as such, and that flavored versions should be banned. In reality, this would mean that only pharmaceutical concerns would be allowed to market e-cigarettes. “There is a huge conglomerate, with people from different political cultures. Because of this mull the scale of lobbying or, to speak bluntly, corruption, is huge. Such actions are a blow to our national interests under the guise of noble ideals. Often, lobbying firms have a huge influence upon the laws adopted in the EU. Large corporations have seen an easy way of looking after their interests. Corruption flourishes and this is very bad, because large concerns can block Polish small and medium-sized enterprises” – explained Ziobro MEP.

Every year, cigarette sales generate revenues of over EUR 160 billion for the national budgets of the EU countries. This is much more than the costs of providing health care to patients suffering from tobacco-related diseases. “On the one hand, the budget is stripped of revenues, ostensibly for health protection reasons. On the other hand, we are deprived of tax revenues, which are partly used to finance the health care system. This is unacceptable, but some people just don’t get it” – said Grzyb MEP. Poland is particularly interested in blocking the directive. We are the biggest cigarette manufacturer in the EU, and the second-largest producer of tobacco. Last year, the State budget earned PLN 24 billion because of smokers, i.e. over 8 per cent of its total receipts. By comparison, the entire budget of the Ministry of Health is PLN 3.6 billion, which means that the tobacco sector contributes 2.5 times more than our entire spending on health care.

The pharmaceutical sector is known for its not very ethical approach to business. In recent years, there have been many reports on the corruption scandals caused by this industry. In April 2011, Johnson & Johnson agreed to pay USD 70 million in penalties, following accusations in the USA regarding bribes paid to European physicians and the Iraqi government. In August 2012, Pfizer received a fine of USD 60 million for engaging in long-running corrupt practices involving medical professionals and public officials This pales into insignificance, compared with the amount which GlaxoSmithKline had to pay in July 2012. A court in Boston filed this company USD 3 billion for bribing physicians to prescribe children specific antidepressants.


Junican said...

It is amazing how none of this is ever reported in the press.

Rebecca Taylor said...

Interesting that you do not mention the lobbying of the tobacco industry on this directive, which has been very successful if you look at how many MEPs across the political spectrum voted against tobacco control measures.

BBC radio 4 did a good exposé of tobacco industry lobbying revealing among others unidentifiable hard copies of AMs that ended up being tabled by MEPs.

The letter that went to Barroso was signed by many MEPs, public health organisations as well as pharma companies. The idea that this proves some kind of collusion is a joke; my colleague Chris Davies, one of the biggest supporters of ecigs in the EP also co-signed that letter. How do you explain that?

You also fail to mention the Dalli scandal that preceded that letter, which some people suspect was instigated by the tobacco industry in order to delay the progress of the tobacco directive.

Klaus Heine Lehne, the chair of the Legal Affairs committee who was rapporteur for the tobacco directive in that committee, is a partner in a law firm that has tobacco industry clients, which is a far closer link to big tobacco than Linda McAvan has to the pharma industry.

Unknown said...

Rebecca Taylor - I think you misunderstand the real reason for why this directive is put forward in the first place. The reason is not public health. It has been put forward with health arguments and it is put forward by the health commissioner, yes - but the real reason for it is pure business. Money.

Briefly the big players in the pharma industry want a worldwide nicotine monopoly and have been fighting for grabbing the nicotine out of the hands of the tobacco industry since the invention of the nicotine gum in the 1980's.

The big pharma players have been very succesful in the last decades - lobbying heavily for smoking bans and high cigarette taxes all over the world, which of course have boosted the pharma revenues, while other industries have suffered. But since 2010 a new non-tobacco competitor entered the stage and took a serious bite of pharma's nicotine revenues: The E-cigarette.

This is the sole reason for the Big Pharma involvement in the directive and their letter to Barroso: They want the commission and the EU to strangle their smaller competitors in order to gain a monopoly.

All the public health groups that signed their letter is, one way of the other, beholden to the pharma industry, since the pharma giants are the only ones with any money in the whole field of public health.

Your suggestion that the MEP's signing the letter are not aware of these facts may in some cases be true. Putting one's name on a letter from the leaders of one of today's most criminal industries is a very naive thing to do, to say the least. I find it more likely that at least some of the MEP's know perfectly well what is going on and that they rely on the public igorance of the facts.

They maybe even rely on being forgiven for their actions if they point their fingers towards the old scapegoat, the tobacco industry. Like you do yourself. But in the end truth will prevail, as you know ...

Christopher Snowdon said...


I'm sorry that I didn't respond earlier but I only just saw your comment. Probably neither you nor many others will ever read this reply, but I should say that the tobacco industry lobbying is expected and well covered (such as in the radio 4 programme you mention). The pharamaceutical lobbying has not been at all well reported, which is why we have to look in the Polish press to mention it. It deserves wider attention, IMO.

As for the Dalli affair, it may be true that "some people suspect" that it was instigated by the tobacco industry, but I've covered the story exhaustively over the last year and can't find any evidence that this is so, nor does there seem to be any obvious motive.

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