Why Drug Companies Are Afraid of a Cartoon Man in a Silly Hat
Astellas, an American a Japanese drug company, is suing a medical journal in Paris in part because it used a cartoon of a man in a silly hat to criticize one of its drugs, the eczma skin cream Protopic. The case -- in which Astellas is bizarrely arguing that criticism of Protopic must be automatically invalid because it was approved for sale in Europe -- is part of a worrying pattern of drug companies suing doctors and research writers who publish things they don't like about drugs.
Other drug industry organizations that have sued their critics include GE Healthcare, NMT Medical, the vitamin entrepreneur Matthias Rath and the British Chiropractic Association.
In the Astellas case, the company objects to a 2010 article in which the French journal Prescrire described Protopic as having "a clearly unfavorable benefit-risk ratio" for use of the ointment "for prevention" of eczema.
The article was one of a series on Protopic, which the journal rated "not acceptable" in 2003. Although Prescrire is a respected publication, it has a sense of humor. The paper's mascot is the "pie-faced" researcher Gaspard Bonhomme, whose "childlike countenance expresses honesty and open-mindedness," the journal says. Bonhomme wears a 17th Century's French doctor's hat, similar to that worn by the physician in Moliere's Imaginary Invalid.
Bonhomme functions as Prescrire's rating system. Protopic received Prescrire's worst rating, "not acceptable," meaning "without evident benefit but with real or potential disadvantages." Drugs receiving that rating get a picture of Bonhomme contemptuously kicking a pill. Other ratings include "nothing new," "possibly helpful," "a real advantage," and its highest honor, "La Pilule d'Or" (the golden pill), in which Bonhomme's demeanour progressively improves. In 2009, Prescrire rated 19 percent of new drugs not acceptable.
It's informative that Astellas chose to bring its libel case in Europe and not in the U.S., even though Prescrire's English web site is available for American readers. European defamation laws are infamously medieval, designed to protect the ruling classes against criticism from their underlings, and usually require the defendant to prove the article was true. Such cases would rarely be brought in the U.S., where the burden of proof requires the plaintiff to show actual damages from false allegations.
Prescrire's worries over Protopic are almost certainly not false. The FDA warned in 2005 that Protopic may cause skin cancer and the drug itself carries a "black box" warning against the same.
The good news is that the tide may be turning against drug companies who want to use Europe's antiquated laws to silence their detractors. NMT, GE, the BCA and Rath all lost their cases, and the U.K. government has recently shown signs of reforming its libel laws.
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