Feature Drug industry

Health camps and surveys: marketing an unproved, unapproved drug in India

BMJ 2016; 355 doi: https://doi.org/10.1136/bmj.i6573 (Published 20 December 2016) Cite this as: BMJ 2016;355:i6573
  1. Frederik Joelving, freelance journalist
  1. Copenhagen, Denmark
  1. fcjoelving{at}gmail.com

A US drug maker encouraged Indian doctors to prescribe a drug unproven for diabetic neuropathy that until recently lacked central government approval. Frederik Joelving investigates

It was an attractive invitation: outside doctors’ offices throughout India, where hundreds of millions of people struggle to afford basic healthcare, posters from a subsidiary of the US drug company Abbott Laboratories advertised free neuropathy tests for anyone with symptoms such as tingling or numbness in the feet.

But those who took up the offer may have spent their money on a product useless for treating neuropathy.

According to internal Abbott communications, published by the New York Times in August,1 people who tested positive at the drug maker’s “neuropathy camps” were prescribed Abbott India’s Surbex Star, a mix of antioxidants, minerals, and B vitamins that the company promotes for the treatment of diabetic neuropathy. The BMJ was unable to find any evidence that this product had been clinically tested, much less proved effective for this indication.

“These combination supplements, unless you’re deficient in something, they really don’t do anything,” said Christopher Gibbons, head of the neuropathy clinic at the Joslin Diabetes Center in Boston. The one possible exception is the antioxidant α-lipoic acid in Surbex Star, he told The BMJ. Studies show that it can improve neuropathic pain when given intravenously, though oral therapy (Surbex Star is taken orally) may not have clinically significant benefits.2

An Abbott spokesman declined to discuss the science behind Surbex Star, which in India is considered a drug because it is marketed to treat a disease.

The lack of evidence did not deter the drug maker. In March 2015 an email from an Abbott India sales representative to his manager described a neuropathy camp as a “big success,” noting that all 30 patients with positive neuropathy tests …

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