Wednesday, December 26, 2007

Is Pfizer guilty of being a "Constant Gardener" in Nigeria?

The WSJ Health Blog discusses details of Nigeria's legal case against Pfizer.
AP reports:

The now-controversial trials for the antibiotic Trovan [by Pfizer] were conducted in Kano [Nigeria] on 200 children during a meningitis epidemic in 1996. Nigeria alleges Pfizer conducted the trials illegally, without the full knowledge and consent of the government and the parents, causing the death of 11 children and injury to dozens of others.
A message left with Pfizer headquarters in New York was not immediately returned Tuesday, but Pfizer has always denied any wrongdoing, insisting the drug saved lives.

Nigeria's Kano state and the federal government have instituted separate civil and criminal cases against Pfizer. The federal authorities demand $7 billion in damages.

Judge Atiku, who is presiding over the civil case in Kano, postponed further hearing to Jan. 29, 2008.

The Health Blog concludes:
The cases are an extreme example of the ongoing tensions between multinational drug companies and the developing world, and some industry-watchers are waiting to see whether other developing countries follow with their own legal actions.
While I don't agree with opaque tactics which the 'big pharma' drug industry may employ to justify spurious testing, I do find myself appreciating one comment left on the Health Blog by "An Observing Pharmacist."

The kids who received Trovan (taken as a pill) did just as well as the kids who took an IV antibiotic. Pills are easier to distribute and administer than an IV, so the hope was to treat more kids and people effectively.

Nigeria is reaching into the deep pocket [of Pfizer] hoping to pull out some cash.

Testing methods of delivery of a particular pharmaceutical is at the heart of 'evidence-based medicine' where assumptions must only be made in creating a hypothesis to be scientifically proven or disproven.

Last year a trial conducted as part of the search for an effective oral formulation of an existing MS disease-modifying drug failed miserably. There was hope that an oral pill would become available for MS sufferers who are currently only offered self-injectible or IV delivered drugs to curb the progression of the disease. Once an effective oral drug is available, the blockbuster status of current MS drugs will diminish dramatically as will the pharmacy costs to the patient and their insurance companies.

I don't know if Pfizer is guilty of misbehavior in this case. I certainly hope not. But it does appear that Nigeria is looking to reap some considerable financial benefits at the ultimate expense of the number of patients who must pay for the resultant increased costs of current and future Pfizer medications.

It's unfortunate that the government of Nigeria is looking to the American model of 'sue, sue, sue' to punish Pfizer for being their "Constant Gardener."

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