Sunday, June 29, 2014

GSK & Opera: From Ribena to China -Act 2

As GSK hit the news again and despite promises they seem to carry on from Ribena days.

GlaxoSmithKline has confirmed the existence of a sex tape featuring Mark Reilly, the former manager at the centre of the company's corruption investigation.

The Chinese corruption scandal at GlaxoSmithKline was sparked by a sex tape involving Mark Reilly, the former manager at the centre of the company’s ongoing bribery investigation, it has emerged.

In an extraordinary twist on the scandal that has engulfed the pharmaceutical giant since early last year, GSK has confirmed the existence of footage showing Mr Reilly, who is separated from his wife, having sex with his Chinese girlfriend in his Shanghai flat.

The covert video of Mr Reilly, who stepped down as head of GSK’s China business last July, was sent by email to senior GSK executives on March 16 last year, in an apparent bribery attempt.



SHANGHAI — The police in Shanghai have arrested a British investigator who specialized in advising foreign investors on fraud, cheating and other business risks in China, a spokeswoman for the British Embassy in Beijing said on Wednesday.

The investigator, Peter Humphrey, has been held by the Shanghai police since early July. He is managing director of ChinaWhys, a risk management consulting firm that has done work for GlaxoSmithKline, the British pharmaceutical group that is facing graft and bribery allegations in China, raising speculation that his detention might be linked to that case.

A spokeswoman for the British Embassy, Hannah Oussedik, would say only that he had been formally arrested. “We can confirm the arrest of a British national, Peter Humphrey, in Shanghai, China, on Monday, 19th August,” Ms. Oussedik said in a brief telephone interview. “We are providing consular assistance to the family.”
The Wall Street Journal, which first reported Mr. Humphrey’s arrest, said that his wife, Yu Yingzeng, was also formally arrested in Shanghai, and that they were both accused of illegally buying information about people. Ms. Oussedik said that she could not confirm those details. Ms. Yu is a naturalized American citizen. American officials in Beijing and Shanghai declined to comment.

 

FT:Sex tape adds to murk of GSK China scandal




In The Cockroach Catcher, Dr Am Ang Zhang had an interesting discussion with his Junior who had just transferred from one of the top London teaching hospitals:
“Do you agree that Leroy has Social Phobia ? Everything fitted in with the criteria in DSM IV.” My junior plucked up courage to ask me during supervision.

It was good to keep oneself on one’s toes with juniors who had just arrived from London and who read up on everything.

“What’s wrong with shyness?” I joked, “Do you want me to put him on SSRI (Selective serotonin reuptake inhibitors)?”
“It is supposed to work.”
“If he starts taking SSRI at thirteen, what is he going to do for the rest of his life?!”
“The newer short acting ones are supposed to be better.”
“Take one advice from me; think the opposite, the opposite to what the big Pharmas tell you. In pharmacology, shorter acting drugs are more addictive. That was what I learned in Medical Schooland is still true if you think carefully about it.”

Today’s Times headline: No prosecution on suicide-risk drug.
“A report suggested that GlaxoSmithKline (GSK) knew about safety risks but failed to report them to the medicines safety watchdog for five years.”
The drug concerned is Paroxetine and in the UK marketed as Seroxat and in the US as Paxil.
“GSK submitted data from clinical trials to the MHRA in May 2003 showing that patients under 18 had a six or sevenfold increased risk of suicidal behaviour if they were treated with Seroxat than if they received a placebo. Data also showed that the drug was not effective for treating depression in children and adolescents. Leaked documents suggested that GSK had known about these results as early as 1998.”
Keen eyed bloggers would have noticed Paxil CR in a previous posting of mine about how GlaxoSmithKline had all their Paxil CR and Avandamet seized in the U.S.

Now the story of Ribena has to be one of those sweet (sorry) stories one remembers for a long, long time.


Wagner, it would seem is as up to date as ever.


Looks like the modern Rheinmaidens are male and collected their gold from GSK.



                                                                 Intermezzo
Four former GlaxoSmithKline employees will share up to $250m (£159m) after their evidence helped US authorities secure a record settlement with the UK drug company for mispromoting drugs.

Greg Thorpe, Blair Hamrick, Thomas Gerahty and Matthew Burke are in line to receive the payout under the Federal False Claims Act, a US law dating back to the Civil War that allows whistleblowers to receive a portion of money the government recovers when prosecuting fraud.

The dark side of the gods: (it is sometimes easier if one take GODS in the Ring to mean those in POWER. For the characters read here.) In fact, the gods need not work at all, the Nibelungs work almost all the time.

Disrespectful Wotan is hardly revered unanimously, and even he acknowledges higher authorities. Erda knows things he doesn't; his almost bureaucratic dominance derives solely from treaties engraved in runes on his spear, treaties to which he is subservient.

Born liarsCharacters lie as it suits them. Events are initiated by Wotan's spurious promise to the Giants to pay them by giving them Freia in exchange for building Valhalla, a promise he knows he cannot keep, as she is the indispensable symbol of love whose golden apples keep the gods alive. His shady ally, Loge, is defined as a double-dealing trickster. Brünnhilde breaks her promise to her father to allow Siegmund to be killed in combat. Mime makes dissembling a veritable life's work, ably carried forward by his nephew, Hagen, in Götterdämmerung. 

Contemptuous
Brünnhilde disobeys Wotan, and his grandson Siegfried destroys his power. Mime, who raises Siegfried from infancy and even makes him toys, is treated with disturbingly cruel contempt by the bumptious hero. Hagen, whom Alberich sired via gold-empowered lust as a tool to retrieve the Ring for him, mutters that if he succeeds he will keep it, not hand it over to his Nibelung father.

Thieving & Misappropriation 
……. misappropriation, of persons or of things, provides much of the plot machinery. First, Alberich plunders the Rhinegold, and afterward, theft of others' possessions, including the Ring, motivates action upon action. 


Incest and other illicit sexThe teasing of Alberich by the Rhinemaidens which leads to his abjuring love--love, not lust. The definitive heroine, Brünnhilde, and her Valkyrie sisters are the offspring of an adulterous liaison between Wotan and Erda; Wotan also illegitimately fathers the Wälsung twins by a mortal. Sieglinde's infidelity is excoriated by marriage-goddess Fricka, as is her violation with Siegmund of an even more basic taboo, incest. But Wotan defends the twins ("…those two are in love") and, like most audience members moved by the ardent love music, views both transgressions kindly. 

Homicidal
Fafner kills his brother Fasolt, the first victim of Alberich's curse, and we are off to the homicide races. Hunding slays Siegmund, only to be destroyed by Wotan's contempt. Siegfried kills Fafner, the Giant-turned-dragon, and then, after realizing that Mime is trying to poison him, kills him as well. By the time the gods' destiny climaxes, Hagen has murdered both Siegfried and Gunther and is himself drowned by the Rhinemaidens. Eventually Brünnhilde sets Valhalla ablaze as part of her self-immolation upon Siegfried's funeral pyre ("Thus do I hurl the torch into Valhalla's proud-standing stronghold") and all the gods die.
Greed, greed, greed! Finally, "coveting that which is your neighbor's" is pretty much the whole raison d'être for the Ring story, starting with Alberich's desire for the Rhinemaidens, then for the gold they guard. Thereafter everybody seems to want what doesn't belong to him or her: the Ring, a sword, a treasure, someone else's wife, sheer power. 

Yet in spite of Wagner's wholesale abandonment of the Decalogue, the bastion of Western morality, Der Ring des Nibelungen generates explosive ethical and metaphysical impact. He started with the absorption, fusion and reinvention of myriad legendary sources, and layered Schopenhauer's philosophy upon Feuerbach's. In Art and Climate Wagner wrote, "there is no true freedom except that which is common to all mankind... The redeemer is therefore love… starting with sexual love, [it] strides forward through love of children, brothers and friends, to universal love of humanity." The emphasis is his. Yet, some years later he wrote to Mathilde Wesendonck, "I can conceive of only one salvation. It is Rest! ...The stilling of every desire!" 

Wagner once wrote to Röckel, "I have come now to realize how much there is, owing to the whole weight of my poetic aim, that only becomes clear through the music." He later described the discontinuity between his "rationally formed ideas" and "the exquisite unconsciousness of artistic creation… guided by wholly different, infinitely more profound intuition."


Richard Wagner
Götterdämmerung

www.staatsoper.de 


Intermezzo Update: Just one of those Rings

 The world of Götterdämmerung is the 21st century corporation, featuring an anonymous mass of business-suited Gibichungs in a flashy glass and steel edifice.

Production photos can be seen hereherehere and here.


Thursday, June 26, 2014

Animal Farm: 2014 Special Meeting!


Looks like someone stole our idea at the 2012 special meeting:

There will be two kinds of CCGs. They may look the same, but in truth they are going to be different. In simple terms, the ones you people are going to run will be different to those run by non-supporters.

We have promise that there will be choice. Yes, there will be. Your choice!

You can choose the healthy patients and leave those in care homes or those with chronic illnesses to the others. We will make sure that the other CCGs cannot refuse.


Animal Farm: 2012 Special Meeting!

Reform is happening too down in the farm & the pig called a special meeting but only of supporters:
©2012 Am Ang Zhang

Dear Supporters, thanks for coming today. The dissenters did not realise the most important part of our plan.

There will be two kinds of CCGs. They may look the same, but in truth they are going to be different. In simple terms, the ones you people are going to run will be different to those run by non-supporters.

We have promise that there will be choice. Yes, there will be. Your choice!

You can choose the healthy patients and leave those in care homes or those with chronic illnesses to the others. We will make sure that the other CCGs cannot refuse.

There will be integration but here we really mean our kind of integration. Or was it your kind? Anyway, your kind of CCGs will run the special Hospitals that will have the help of great financiers from the City. Like Kaiser Permanente (which we should not mention outside these doors) we will not let other hospitals make money. No true competition, just think about airlinesutility companies and ADM.

Some hospital will fail and you can buy them up and run it profitably and we already have people that know about Real Estate helping you. Imagine a Central Luxury Apartment with easy access to the best hospitals in the world? World Class Real Estate and World Class Medicine!

Just in case you are worried about the few Hospital Consultants that did not agree, do not worry, we have people everywhere.

Run, get cracking!
    ©2012 Am Ang Zhang
20 years in the planning and we are nearly there.

“In the case of the consultants, a show was made of trying to make them accept much closer supervision by hospital managers, and cut back on their private work. But it soon came to seem that the real aim of doing this was to make them feel more disenchanted with working as salaried NHS employees and readier to go into business – to form doctors chambers, on the model of barristers, or other kinds of business, and sell their services to any employer, public or private, that offered them the best terms. A significant number began to plan to do so and some have begun to. And as the cuts begin to bite there will be unemployment among hospital doctors. As you will have read, consultants are among those scheduled to be laid off by St George’s hospital in Tooting, and elsewhere. Working for private providers will become normal again in a way it hasn’t been since 1948.”

                                                                                      The Plot Against the NHS

I think there is something fundamentally scary about our democracy…. Because I think people have a sense that the system is rigged, and it’s hard to argue that it isn’t.


Michael Lewis: The Big Short


Kaiser Permanente:
Animal Farm



Price competition links: airlinesutility companies and ADM.


Saturday, June 21, 2014

ADHD: WHY! WHY! WHY!

©2014 Am Ang Zhang

Thanks to the human heart by which we live,
Thanks to its tenderness, its joys, and fears,
To me the meanest flower that blows can give
Thoughts that do often lie too deep for tears.




William Wordsworth

Ode
Intimations of Immortality from Recollections of Early Childhood

I have in my travels met other psychiatrists who often ask why there is such a discrepancy in the diagnosis of ADHD in the US and the rest of the world.

WHY! 
Perhaps it is something they have in the diet.

Dietary causes have been popular for a while and we all know the kind of food American kids have.
Perhaps it is the television programmes they watch.            Scenes now change every few seconds – used to be every three minutes or so.

Perhaps it is something in their genetic make-up. But the US takes the gene pool from literally every country in the world.

Perhaps they have too many cars. But they took lead out before anybody even consider the harm lead can do.

What about vaccines? Please, we are not going there.

Up until recently American kids consume 90% of the world’s consumption of stimulants although Canada is now taking a bigger share.

The answer may not lie with environmental or genetic factors.

"Psychiatrists Top List in Drug Maker Gifts", reported the New York Times last year, citing disclosures by an unlikely state: Vermont.

©2005 Am Ang Zhang
I have been to Vermont and in the winter it is as beautiful as the photo shows.

“Vermont officials disclosed Tuesday that drug company payments to psychiatrists in the state more than doubled last year, to an average of $45,692 each from $20,835 in 2005.”

The Vermont Attorney General’s office’s report: Pharmaceutical Marketing Disclosures was issued recently (8th of July).
Here is their top 10 drugs list:
Two ADHD drugs top the list. 

Now we know.
I wrote in September 15, 2011


ADHD: Medical Morality!

“There’s a sense that greater powers, profit-driven and amoral, are pulling the strings in our children’s lives. There’s a sense that those who should best protect us — our government and our doctors — are so corrupted that they can no longer do the job. There’s a sense that childhood has, in many ways, been denatured, that youth has been stolen, that the range of human acceptability has been narrowed for our kids to a point that it has become soul-crushingly inhuman.”


                                                Judith Warner      New York Times



In my book The Cockroach Catcher, I told the story about this boy with hydrocephalous who was referred to me. He had just started school and his teacher considered him hyperactive and wondered if he had this new disease called ADD/ADHD and should he be on Ritalin. This is what I wrote about the ADHD phenomenon in that chapter:


“A treatment that had a history of over fifty years, starting life under fairly relaxed FDA rules, was approved for a different purpose in 1980 under fairly dubious circumstances, based on minimal research data on some very small samples. The treatment never caught the imagination of the child psychiatrists of the time and was so rarely used that in 1986 the drug was withdrawn from the British market. Then suddenly it took off and if I say anymore about my personal view on how and why it took off, I might be faced with libel action from the main parties concerned.

The drug concerned is still hardly prescribed in France, a country well endowed with child psychiatric services and the French are rather fond of their medicament. There is no market yet in China which has a fifth of the world’s population and presumably also roughly a fifth of the world’s child population. It probably would not take long for China to adopt it though. Contrary to popular belief, admiration for all things American is endemic in China if not epidemic. You may not think so considering the rhetoric of the leaders. On a recent visit, I noticed one of their bottled water advertisements proudly saying “using the latest US reverse osmosis technology”. For now there are countries both in the first world and in the developing world that have not found it necessary to use the drug.

Most research showed that Ritalin would eventually lead to addiction; but there are some who prefer to insist there is no truth in that. The U.S. is the world’s No.1 prescriber of Ritalin and is also the world’s No.1 consumer of Cocaine. The other listed use of Ritalin is for Cocaine withdrawal.

Why then is there such a renewed demand and interest in diagnosis and drug treatment of ADHD.


It is a sad reflection of our times that we demand fast responses. Being patient is no longer seen as a virtue. Have you not noticed that with faster and faster computers we still consider them slow and therefore manufacturers can continue to sell us “faster” ones? TV and computer games have conditioned kids so that they can rarely hold their concentration for more than three seconds. Even the term “three minute culture” is now out of date – no modern day television or film scene must last longer than ten seconds. How many children nowadays can withstand five hours of waiting at the fishing rod without catching anything? How many mothers have to cope with lines like: I am thirsty, mummy, I want my juice now, please. Are they really going to die of dehydration if mother makes them wait a bit?


Concentration like most other things in our modern society is no longer something that is packaged by our Maker. People need to acquire it and one way is by taking a stimulant such as Ritalin.


Ritalin has also become popular because it takes the blame away from those responsible for the child – the parents and often the teachers as well. Some parents who do not wish for their child to go on Ritalin are often put under tremendous pressure by the teachers. Very few have even bothered to find out if there is any non drug related method at all.”



“According to data obtained exclusively by Education Guardian under Freedom of Information legislation, there has been a 65% increase in spending on drugs to treat ADHD over the last four years. Such treatments now cost the taxpayer over £31m a year.”                          More>>>>





Related:
ADHD: To treat or not to treat?

Friday, June 20, 2014

GSK: Seroxat and Ribena!

Black current? Honest!

Black Currant Studies © 2012 Am Ang Zhang

© 2012 Am Ang Zhang

In The Cockroach Catcher, Dr Am Ang Zhang had an interesting discussion with his Junior who had just transferred from one of the top London teaching hospitals:

“Do you agree that Leroy has Social Phobia ? Everything fitted in with the criteria in DSM IV.” My junior plucked up courage to ask me during supervision.

It was good to keep oneself on one’s toes with juniors who had just arrived from London and who read up on everything.
“What’s wrong with shyness?” I joked, “Do you want me to put him on SSRI (Selective serotonin reuptake inhibitors)?”

“It is supposed to work.”

“If he starts taking SSRI at thirteen, what is he going to do for the rest of his life?!”

“The newer short acting ones are supposed to be better.”

“Take one advice from me; think the opposite, the opposite to what the big Pharmas tell you. In pharmacology, shorter acting drugs are more addictive. That was what I learned in Medical School and is still true if you think carefully about it.”


Times headline:        

No prosecution on suicide-risk drug.


“A report suggested that GlaxoSmithKline (GSK) knew about safety risks but failed to report them to the medicines safety watchdog for five years.”
The drug concerned is Paroxetine and in the UK marketed as Seroxat and in the US as Paxil.
“GSK submitted data from clinical trials to the MHRA in May 2003 showing that patients under 18 had a six or sevenfold increased risk of suicidal behaviour if they were treated with Seroxat than if they received a placebo. Data also showed that the drug was not effective for treating depression in children and adolescents. Leaked documents suggested that GSK had known about these results as early as 1998.”
Keen eyed bloggers would have noticed Paxil CR in a previous posting of mine about how GlaxoSmithKline had all their Paxil CR andAvandamet seized in the U.S.
Now the story of Ribena has to be one of those sweet (sorry) stories one remembers for a long, long time.
Anna Devathasan (left) and Jenny Suo, New Zealand
Photo by Martin Sykes

In 2004 a science experiment by two 14-year-old high school girls in New Zealand brought embarrassment to the world's second-largest food and pharmaceutical company, GlaxoSmithKline, whose Ribena sale is around $8 million a year.
"We thought we were doing it wrong, we thought we must have made a mistake," Anna said when they found negligible vitamin C level in the Ribena they tested. The company had promoted the product by claiming that blackcurrants had four times the vitamin C of oranges.
The girls got short shrift when they telephoned GlaxoSmithKline.
"They didn't even really answer our questions. They just said it's the blackcurrants that have it, then they hung up," Jenny said.
Well, that was very clever. Blackcurrants have it, but not Ribena. So, nobody is misleading the public. You can guess the “concentration” of blackcurrant in Ribena. Have you tried the Syrop de cassis from France? The flavour of blackcurrant just bursts in your mouth.
The question must be asked of the second largest pharmaceutical company in the world. If they did not know how to check for vitamin C level, what business did they have in producing drugs that are used by millions? If they knew about it then ……wow!
The 2007 New Zealand Commerce Commission Report did not mince their words:
"Health claims are big business in today’s market, and the Commission has targeted bogus health claims in recent years. It is very disappointing to see a major pharmaceutical and health products company like GlaxoSmithKline mislead the public in this way……….a massive breach of trust with the New Zealand public."

GSK pleaded guilty to 15 representative charges of breaching the Fair Trading Act by making misleading claims about the Vitamin C content of Ribena, was fined $227,500, and ordered to undertake a nationwide campaign of corrective advertising in newspapers to explain that some forms of Ribena contain no detectable level of vitamin C.
GSK were lucky that they did not get fined over Ribena in any other country including Australia. In Australia, they avoided the fine by undertaking to explain the true nutritional makeup of Ribena on its packaging, its website and in future advertising.
Knowledge is power and it is good to know that there are young Cockroach Catchers as far away as New Zealand.
The two girls must have the last words:
Every time I see the new Ribena ad, the one where they don't mention any vitamin C, I'm just like, "Oh, yeah".


Jul 07, 2012


Other teenage Paxil users were not so lucky. Jake Garrison, a 15-year-old who suffered from acne, was prescribed Paxil by his dermatologist for “body dysmorphic disorder,” a condition that leaves people feeling preoccupied with their own perceived physical defects. He took the medicine for a while, then stopped, and then, in September 2002, began taking it again. Three days later, he shot himself to death.

.....GSK also seemed to be manipulating data from its clinical trials to minimize the number of suicides or attempts that might be blamed on its pills—“cooking the books,” in the words of a former Navy lawyer who took on the British pharma giant.


As I read through company documents released by government lawyers, I began thinking about some of the victims I’ve interviewed during two decades of reporting on the pharmaceutical industry and its marketing of flawed, sometimes dangerous drugs—people like Angela Reich and the anguished parents of other children who died. I also thought about the statements made by Sir Andrew Witty, Glaxo’s chief executive officer, who expressed “regret,” said the company had learned from “the mistakes that were made” and asserted that under his leadership the company was now “putting patients first, acting transparently…and displaying integrity in everything we do.”