The accepted “progressive” version of the story about drug companies is this: the company glosses and twists data then a slick, often attractive, sales person seduces a doctor with misleading information derived from partial publications. Without pharma’s wicked ways, fashionable writers say, doctors could read scientific publications and make scientific decisions about the right medicines to use. Doctor-writers such as Ben Goldacre have made a living from saying these kinds of things.

How astonishing then to read a piece by a senior professor at the ultra-politically correct London School of Hygiene and Tropical Medicine in the most read of British left-wing magazines, The New Statesman. The  sin of the pharma industry according to this piece: that it has failed to approach the US Food & Drug Administration for permission to market tranexamic acid as a way to stop bleeding in cases of traumatic injury. Tranexamic acid is freely available in the US and widely used in other conditions but the product is not licensed for use in traumatic injury so Ferring (or other producers) are forbidden to promote this use to doctors.

“Spectacular” data on the drug’s potential were published in 2010 in The Lancet and, Professor Ian Roberts says,  “the use of tranexamic acid to treat bleeding trauma patients in US hospitals could prevent more than 3,500 premature deaths each year.”  But, “trial investigators have had to take over the role of a pharmaceutical marketing department” and they are finding that it is not as easy as it looked: “art students have been  enlisted to create informational cartoons that might go viral but might not,” as he puts it.

Here is Professor Roberts on what he would like to happen:

“If we do manage to raise the profile of this lifesaving treatment, the drug company will pay the FDA the license application fee, the FDA might give them permission to tell US doctors about tranexamic acid, the company will make some money and a few thousand Americans will not die.”

And there is the truth about how the practice of medicine works. Doctors cannot keep up. Without pharma company filtering of reams of data, vital studies go ignored. Without pharmaceutical representatives, even medical  specialists do not find out about innovation. Without sales reps, patients die. Don’t take it from me; Professor Ian Roberts of the LSHTM said it in the New Statesman