最近被揭发的一个广为人知的骗局就是全球暖化，世界上一帮最顶尖的气候科学家相互之间通讯的电邮被揭露公开，原来这帮顶级科学家一直在伪造数据，为了证明人类社会过度的发展的确在造成全球暖化这个臆象中的崇高目标，竟然长期以来在修改科学数据，尽管数据根本就表明没有全球暖化这回事。这事情很多媒体都已经广泛报道过，读者有兴趣的自己可以去谷歌搜索一下。

现在我要和各位读者说说另外一个同样数量级的全球性伪科学的医学骗局，那就是特敏福，或者是特敏服，英文名叫Tamiflu。自从1999年瑞士罗氏药厂研制出这个以中国的花椒八角为原料的抗病毒药后，一直寂寂无名，没有人注意。但自从2003年的SARS疫情爆发后，特敏福一下子被吹捧为仙丹，禽流感要用它，现在这甲流感也要用它。仅仅是美国政府就囤积了15亿美元价值的特敏福，而全世界各国政府总计则囤积了30亿美元的特敏服。这瑞士罗氏药厂从此名声大振，牛气冲天。但是上个星期英国的医学杂志（British Medical Journal，BMJ）公布了一个联合调查报告指出，并没有任何科学证据证明特敏服能够预防由甲流感所引起的严重并发症，及住院，和死亡。报告并指出，这罗氏药厂有意误导世界各国政府及卫生组织。

这个骗局其实是无意中发现的。原来这个世界上有一个叫Cochrane Collaboration（以下简称CC）的国际组织，是由一帮国际知名学者组成的联盟，定期检查医学界里各种医学治疗的实际疗效，看看是否真的名符其实。结果他们就发现出破绽。罗氏药厂是引用十个关键的研究结果来支持特敏服的疗效，但是这次CC的检查却发现这十个关键的研究成果只有两个被公开刊登在医学杂志上，更奇怪的是这两个公开的研究成果却表明特敏服相比起安慰剂来说只有微不足道的区别。就是说吃不吃都是一样的结果。于是这个CC组织就打算自己亲自去查看原始数据，看看到底是怎么回事。

这个CC先去联系这些研究报告的第一第二作者，就是我们说的学术带头人。这时候，奇怪的事情发生了，第一作者说，他以前搬过办公室，所以这些原始数据好像丢失了，不见了。那好，再找第二作者吧，更奇怪的事情再次发生了，这个第二作者竟然说他从来就没有见过这些原始数据，并且说有什么事情你们直接去联系罗氏药厂好了。

经过四个月反复的联系和要求（等世界各国下的订单都来齐了，钱都收到了之后），这罗氏药厂终于有所回应了，送来了一大堆林林总总的数据和资料。其中呢，有两个研究证明这特敏服是完全无效的，但是罗氏药厂却从来就没有公开发表过。另外还有一个更加庞大的研究，涵盖1447个年龄由13到80岁的男女老少，是这个特敏服所做过的最大型的研究，问题是，因为资料不齐全，就连CC自己也搞不清这个大型研究到底想研究什么。

更刺激的事情还在后头，有两个罗氏药厂所聘请的公关公司的原职员出来自首，出示了文件证明他们是撰写其中几个研究报告的替枪，写手。他们说，我们有一大串的关键字要确保写进研究报告里，。。。这是由罗氏药厂市场部负责的专案，我们要对他们言听计从。。。。在开头介绍的那一部分，我们要强调这流感的严重，最后我们要确保得出结论：特敏服就是这流感的不二选择。

最终，CC得出结论，特敏服对甲流感的效果是微乎其微。而这也正是美国食物药管局（FDA）和英国医疗品质管理局的结论。FDA 指令罗氏药厂在商标上标明，特敏服并没有被证实对流感所带来的后果有正面的效果。一个FDA的发言人说，临床试验证实无论是特敏服还是安慰剂都对流感没有任何积极作用。

荒唐的是，美国的国家疾病控制中心（ＣＤＣ）似乎完全生活在另外一个世界里，对特敏服的疗效毫不怀疑，完全对罗氏药厂的种种夸大言辞照单全收，无论FDA对特敏服的研究发现和完全没有证据证实特敏服的疗效。更荒唐的是，无论是ＦＤＡ还是ＣＤＣ都没有或者是拒绝要求罗氏药厂做特敏服的安慰剂对比试验，就是一半人服用特敏服，另一半人服用安慰剂，看看效果到底如何。CDC的发言人说，特敏服的疗效已经被证明了，不用做了。唯一的问题是这个已经被证明的疗效是基于虚假的研究报告的基础上。

罗氏药厂对英国医学杂志的这个联合调查的回应是，我们从未隐瞒或者试图隐瞒研究数据。仅此而已，罗氏药厂并没有义正言辞的反击说“特敏服是完全有效的”，而只是“从未隐瞒数据”。

大家如果要看原文，请看这里：http://www.theatlantic.com/magazine/archive/2009/12/the-truth-about-tamiflu/7801/

wanshi补充：

罗氏制药的控股人是著名的罗斯切尔德家族，犹太共济会的核心家族。全球变暖项目的幕后支持者是共济会下属的基金会，将其列入全球议题的是彼得伯格俱乐部。

The Atlantic Home

THURSDAY, JULY 21, 2011

The Truth About Tamiflu

Has the U.S. wasted $1.5 billion on an ineffective drug?

By SHANNON BROWNLEE and JEANNE LENZER

Two months ago, we pointed out in our story on flu in The Atlantic that the antiviral drug Tamiflu might not be as effective or safe as many patients, doctors, and governments think. The drug has been widely prescribed since the first cases of H1N1 flu surfaced last spring, and the U.S. government has spent more than $1.5 billion stockpiling it since 2005 as part of the nation’s pandemic preparedness plan.

Now it looks as if our concerns were correct, and the nation may have put more than a billion dollars into the medical equivalent of a mirage. This week, the British medical journal BMJ published a multi-part investigation that confirms that the scientific evidence just isn’t there to show that Tamiflu prevents serious complications, hospitalization, or death in people that have the flu. The BMJ goes further to suggest that Roche, the Swiss company that manufactures and markets Tamiflu, may have misled governments and physicians. In its defense, Roche stated that the company “has never concealed (or had the intention to conceal) any pertinent data.”

The BMJ’s investigation began innocently enough, with an update of a review by the Cochrane Collaboration, a widely-respected international consortium of researchers who periodically examine the medical literature to assess the safety and effectiveness of various treatments. Roche has claimed that its drug reduces hospital admissions by 61% in patients who were otherwise healthy before they got the flu. It has also said that Tamiflu reduces such complications as bronchitis, pneumonia, and sinusitis by 67%, and lower respiratory tract infections requiring antibiotics by 55%. A 2006 Cochrane review of Tamiflu came to similar conclusions—based largely on a paper that looked at ten studies, all of them funded by the company.

The dog ate my homework 

But when the Cochrane team, led by Chris Del Mar, from Bond University in Australia, re-examined the studies they had previously used in 2006, they found some discrepancies. It turned out that only two of the ten studies had ever been published in medical journals, and those two showed the drug had very little effect on complications compared to a dummy pill, or placebo. So the Cochrane reviewers decided to look at the data for themselves.

First they went to the lead authors of the published studies—the researchers who were supposed to have access to all of the data. One author said he had lost track of the data when he moved offices and the files appeared to have been discarded. The other said he’d never actually seen the data himself, and directed the Cochrane team to go directly to the company.

Four months and multiple requests later, the Cochrane researchers had a hodgepodge of data from the company, including two studies that showed the drug was ineffective, but which the company had never published. Roche also provided data from a third study, which involved 1,447 adults and adolescents aged 13-80, the largest study of the drug ever conducted. Yet the company never published that one either. (A summary of this and other studies is available at www.roche-trials.com). But with only partial data, the Cochrane team couldn’t even figure out what the study had been intended to measure.

In the meantime, two former employees of Adis International, a large communications company, came forward with documents showing they had ghostwritten some of the published studies of Tamiflu. One of the ghostwriters told the BMJ, “The Tamiflu accounts had a list of key messages that you had to get in. It was run by the [Roche] marketing department and you were answerable to them. In the introduction . . . I had to say what a big problem influenza is. I’d also have to come to the conclusion that Tamiflu was the answer.”

Stockpiling 

The Cochrane team eventually concluded that the evidence that Tamiflu reduces complications, hospitalizations, or deaths is weak at best, and if the drug does offer any benefit, it is slight indeed. This is precisely the conclusion of the U.S. Food and Drug Administration (FDA), and the UK’s National Institute for Health and Clinical Excellence (NICE). As we reported in our story in The Atlantic, the FDA directed Roche to state on the drug’s label the following caveat: “Tamiflu has not been proven to have a positive impact on the potential consequences (such as hospitalizations, mortality, or economic impact) of seasonal, avian, or pandemic influenza.” An FDA spokesperson told the BMJ, "The clinical trials . . . failed to demonstrate any significant difference in rates of hospitalization, complications, or mortality in patients receiving either Tamiflu or placebo.” Yet in the wake of the H1N1 pandemic, the FDA gave temporary approval for the drug to be given to hospitalized flu patients, who are at risk of dying.

Another big unknown is just how safe—or dangerous—Tamiflu may be. According to an FDA spokesperson, side effects may include potentially fatal heart problems. If the drug is going to be used to prevent death, it seems reasonable to ask whether or not its potentially deadly side effects are outweighed by potential benefits. We asked the FDA whether it had required Roche to conduct an additional trial or trials looking at whether or not, on balance, the drug reduces more serious complications than it causes. This week, a spokesperson reported back that there has been no such request made to Roche.

All of which leaves open the question of why governments around the world have invested so much—on the order of $3 billion since the emergence of H1N1 last spring, according to investment bank, JP Morgan—in a drug that appears to do so little.

The answer may lie in the politics of disease. Far from a commercial success when it was initially approved by the FDA in 1999, Tamiflu’s fortunes began to look up in 2003, after the SARS outbreak and the emergence of bird flu. Then Hurricane Katrina hit. In the wake of criticism over its handling of the disaster in New Orleans, the Bush Administration announced a multi-billion-dollar pandemic and bioterrorism preparedness strategy, which included stockpiling millions of doses of Tamiflu.

As the nation’s lead public health agency, the Centers for Disease Control and Prevention appears to be operating in some alternative universe, where valid science no longer matters to public policy. The agency’s flu recommendations are in lockstep with Roche’s claims that the drug can be life-saving—despite the FDA’s findings and despite the lack of studies to prove such a claim. What’s more, neither the CDC nor the FDA has demanded the types of scientific studies that could definitively determine whether or not the company’s claims are true: that Tamiflu reduces the risk of serious complications and saves lives. Nancy Cox, who heads the CDC’s flu program, told us earlier this year she opposes a placebo-controlled study (in which one half of patients would be given Tamiflu and the other half would be given placebo), because the drug’s benefits are already proven.

There are a couple of take-home messages here. One is pretty obvious: Tamiflu may not be doing much good for patients with the flu who take it, and it might be causing harm. The more important issue, however, involves the need for trust in science and medicine. Governments, public health agencies, and international bodies such as the World Health Organization, have all based their decisions to recommend and stockpile Tamiflu on studies that had seemed independent, but had in fact been funded by the company and were authored almost entirely by Roche employees or paid academic consultants. So did the Cochrane Collaboration, at least in its earlier assessments of Tamiflu. Millions of flu patients have taken the drug as a result.

That trust appears to have been misplaced, and a drug touted as beneficial on the basis of flimsy evidence has by now become so entrenched that no one appears willing to conduct the sort of study needed to prove whether or not it can, in fact, save lives.

Shannon Brownlee is a senior research fellow at the New America Foundation and the author of Overtreated (2007). Jeanne Lenzer is an investigative journalist and a frequent contributor to the British medical journal BMJ.