Here’s a brain teaser for you. What do you do when the people who most need your product can’t afford to buy it? Purveyors of big screen TVs and other electronic knick-knacks have found the answer in buy-now-pay-nothing-til-2037 deals. And that works well where the punters are queuing around the block but just don’t have the readies.
But what to do when your potential customers don’t know they need your product? And even if they did, may not have the wherewithal to drop up to 13 large acquiring it? Give up? Then forget about a career in pharmaceutical PR. You get the government to pay for it, dummy.
The folks at Allergan have exactly this problem. Allergan make a nifty little thing called a lap-band. If you chop open an obese person and whack a lap-band in, they suddenly can’t eat as much and the theory is that should do all sorts of good things for them.
Lap-band surgery is starting to get very popular. Two years ago, just 8193 were done in Australia, but last financial year this had grown to 12,247. A whopping 50% increase in the market in just one year. There’s gold in them thar hills.
You don’t need Glenn Stevens to run the numbers to realise that the number of people with the necessary girth AND moolah is not going to last much longer. Solution: get the government (that is, the taxpayer) to step in and start picking up the tab.
Allergan’s done all the right things. Endow a university with some dosh to research how terrific its product is. Smile happily as the researchers go forth and tell the government. Glow contentedly when the government makes a recommendation that consideration be given to “boosting access” to its product. It’s all good stuff, but it’s not exactly moving like a freight train and where’s that government money?
Time for a bit of PR creativity. Time to introduce the new sport of Extreme Lobbying. Professor Dawn DeWitt, from the University of Melbourne, explained how it works to ABC’s AM program yesterday.
Professor DeWitt is helping the folks at the Monash Centre for Obesity Research and Education (funded by Allergan) with a new “trial” of Allergan’s lap-band product in 30 indigenous Australians in the Goulburn Valley. She wants to see if they have the same success as folks in the “white population”.
This is a product that has been installed in almost 18,500 Australians in the past two years. Even basic maths would tell us that more than 500 of those could have been of indigenous descent (and some of them may even have been from the Goulburn Valley). So what exactly will this trial tell us that that we don’t already know? Is there some suggestion that people in Goulburn Valley are constructed differently from the rest of us?
Professor DeWitt was ready with the answer to that one. She told AM that “if [the trial] does work then we can go to government and say look there really ought to be a special program to support this in an ongoing way.” Ah, right, so this has nothing to do with the health of indigenous Australians and everything to do with getting taxpayers to pick up the tab for lab-band surgery.
Indigenous Australians suffer 6 times the rate of Type II Diabetes when compared to the rest of the population. Unfortunately for Allergan, it also has significantly less purchasing power when it comes to surgical solutions. This latest trial is clearly nothing more than a disingenuous attempt to end-run that problem and open up a brand new government-funded gold mine for Allergan.
Extreme lobbying uses actual surgical intervention in order to make your political point (let’s hope Turnbull doesn’t start doing that — Rudd-ectomy anyone?). This trial is not asking patients to fill in a survey or keep a food diary. This is significant surgery that requires major re-operation in one in five cases.
In more than half of the recipients, it does not result in significant weight loss. At most, it has only a two in five chance of causing a remission of Type II Diabetes (for up to nine years). And even according to the lastest research funded by Allergan, patients only gain 1.2 years of life expectancy. To put these trial recipients through all of this for research purposes is questionable. But to do it as part of a lobbying exercise is outrageous.
If Monash’s Centre for Obesity Research is really that concerned about the rate of diabetes in indigenous Australians, how about spending some time and money looking at the fact that they consume twice as much soft drink as the rest of the population? Oh that’s right, silly me. No one’s going to pay them to do that.
Hi David, I love your work, but I feel you’re on more solid ground with the anti-sugar campaign than medical treatments.
Hi David,
Yes, I too am not so sure about how hard you are pushing this anti-surgery line. I think the jury is definitely still out on this one.
After all, a recent Cochrane review did find that surgery was better than conventional treatments http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD003641/frame.html and there are studies like the SOS Study that had ten year follow ups that found there were pretty good results from surgery http://content.nejm.org/cgi/content/full/351/26/2683
I also think that the first study that you are using to support your argument is not appropriate because it seems to be an analysis comparing different types of surgery, not an analysis comparing the efficacy of surgery compared to other methods.
It’s still an issue worth watching, but I know a lot of endocrinologists (not in the pay of any companies) are really impressed with the results they are seeing from bariatric surgery.
Dr Harvey M Tarvydas
Good on you. You are doing much more with your stance than is obvious but your overall attitude is commendable.
Amy’s “endocrinologists not in the pay of ” I am afraid that even she and them (endocrin’s) would not really know who’s paying who to influence who, that’s how sophisticated the system of influence has become. The generated ‘research’ (albiet some may be excellent) is designed as a necessity for the process (Govt acceptance & payment). Lots of meaningless research is given serious meaning by Doctors who really do not have the scientific skills (they think the opposite which helps to prove my statement often) to appreciate the meaningful from the meaningless. The predominant high self opinion in these matters clouds the appreciation of the scientific understanding that’s missing and as they are not scientifically trained it will never arrive. The relied on assessment is based on whether it makes sense to ‘me’ because ‘I’ understand science. Well a real scientist would never play in that muddy playpen. Medical practice can be pure and nobel in its own right (I know I have been a talent amoungs these that are so nobel and appreciate the bueaty of the work) and real scientists should be left to judge science.
There are many issues that evolve from this intellectual problem that seems too difficult to deal with for those of us who see the damage. Many thousands of patients suffer serious harm as a result and nothing is noticed while those poor unsuspecting Dr’s float about on cloud Innocence. How could one ever save a medical profession with this dilema.
The govt in all innocence depends on them even with a track record that would have one anticipate error in the opinion nearly everytime and sidelines scientists opinions.
Hi Harvey – I notice you included the title “Dr”. Just wondering, are you a doctor of medicine?
I think the point Mr Gillespie is making is not regarding the medical procedure itself, but the maneuverings of the company as it attempts to secure government funding to support sales of a product of (still) dubious medical value.
While it’s nothing new for a pharma company to emply flexible ethics in pursuit of profit, Monash would seem to be on very shaky ground if its Allergan funded research centre is testing Allergan products.
To ensure non-bias that university should trial the product against comparable brands or stomach restricting techniques, meaning that the “30 indigenous Australians in the Goulburn Valley” would need to be sliced open on several occasions to bring humanity the wealth of scientific knowledge this trial will surely render.