The holidays are here, but while we’re taking a well-deserved break let’s not forget that there’s still plenty of pharmacy-related issues out there in the world for us to think about.

Happy holidays everyone!
The 49th Media Resource Team

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Article on the Bayer HIV Tainted Drug Scandal

For centuries, clear and simple principles shaped the relationship between physicians and their patients: work for the good of the patient; do no harm; keep the patient’s medical information confidential. The medical profession’s respect for patient privacy is rooted in the foundation of medical practice, as evidenced by provisions included in the earliest versions of the Hippocratic Oath.

These principles can be seen between a physician-patient relationship, but what happens in the relationship between a pharmaceutical company and her patients? Should these companies be bound by their respective code of ethics?

Pharmaceutical company Bayer sold large amounts of blood-clotting medicine for hemophiliacs in Asia and Latin America in the 1980s. However, the medicine sold carried a high risk of transmitting AIDS.

Hemophiliacs are people who are unable to stop bleeding or prevent bleeds from starting. The medicine, called Factor VIII concentrate, basically provides the crucial ingredient for clotting which hemophiliacs lack.

However, in the early years, the medicine used pools of plasma from 10,000 or more donors. Since there was still no screening test for AIDS, it carried a high risk of passing along the disease; even a tiny number of HIV-positive donors would contaminate an entire pool of plasma.

In response, Cutter Biological (division of Bayer) introduced a safer medicine in 1984 and sold it in the West. Yet for more than a year, the old medicine was sold overseas – an attempt to avoid being struck with large stocks of a product that was increasingly unmarketable in the West.

There were other reasons as to why the old medicine was still marketed: the company (Cutter) had several fixed-price contracts and believed the old version would be cheaper to produce. Later, when the whole incident was revealed, Cutter claimed that some patients believe that the older version worked better than the newer one.

Nearly 20 years later, the precise human toll of these marketing decisions is difficult, if not impossible, to document.

But in Hong Kong and Taiwan alone, more than 100 hemophiliacs contracted HIV after using Cutter’s old medicine, records and interviews show. Many have since died. Cutter also continued to sell the older product after February 1984 in Malaysia, Singapore, Indonesia, Japan and Argentina, records show.

Recently, a group of HIV-hemophiliac patients from Taiwan are appealing a US court ruling barring them from suing pharmaceutical giant Bayer. The group’s first appeal was in 2003.

Dr Sidney Wolfe, who as director of the Public Citizen Health Research Group has been investigating industry practices for 30 years, said “these are the most incriminating internal pharmaceutical industry documents I have ever seen.”

This incident have led many to wonder about pharmaceutical companies and their aims:
- Are they out to heal us or just out to earn money?
- Should we place our full trust in the medications we take? Are they any safeguards we should take and how?

Although this incident questions the goals of pharmaceutical companies, there are companies which strives to help others in need. Take Merck for example. Being one of the first to develop the HIV medication, they are now ’selling’ their HIV medication at a very low cost to needy patients in Africa, where HIV infection rates are high.

As we have learnt in Pharmacy Practice I, resolving the goals of a commercial business and professional ethics of pharmacy is of utmost importance. As some of you are already aware, “Commerce with Conscience” is the direction some companies have taken. The most famous example would be The Body Shop, were founder Mrs Anita Roddick reconciled profits with her ideals of returning what she have gained to the society. The Merck example above is a prime example of a pharmaceutical giant providing social change.

Perhaps it is time for health-care related industries to change their goals.

Review by Chua Jia Ni  (Year 1)