Thursday, March 13, 2014

Being Poor in Vancouver Requires A Fat Purse

A rose by any other name may still be a rose but if you change the definition of social housing you change the thing completely.

The proposed changes in the definition of social housing by the City of Vancouver are problematic. The essential component in the definition of 'social housing' is that it provide housing for those who cannot raise the means to house themselves. The definition of social housing must to be tied to income, ability and need.

The new proposed definition implies that social housing could be met in the City of Vancouver with accommodation and housing at market rates if the accommodation or housing is owned or operated by a non-profit, a co-op, or by the City. Under the proposed definition the City could claim 10,000 suites of 'social housing' in the inventory (as an example) even if the average rent is $1800 a month. People in BC receiving a Disability II pension (people permanently unable to work) receive about $980.00 a month and they are able to earn up to an additional $200 for a maximum monthly income of less than $1200. These are people who are dying, have advanced levels of MS, or other debilitating illnesses or conditions.

If your math and budget-making skills are like mine you can immediately see a problem.

If you think "co-op" housing is inherently affordable read this headline from Forbes March 2012, "Manhattan's $60 Million Apartment Will Be The Most Expensive Co-op Sale Ever.

And click here for a listing (as of March 13, 2014) in Vancouver, BC for a co-op unit ($209,000).

And if you think that "non-profits" are inherently social then consider that the Canadian Federation of Taxpayers is a,  "right-wing Canadian federally incorporated, non-profit political organization." A non-profit organizational structure can serve many different purposes and intentions, including housing for golf-loving millionaires (please let me join, please let me join, please, please, please).

See what The Mainlander says about the proposed change in the definition of social housing by the City of Vancouver by clicking here.  Check out Melissa Fong here.

The definition of social housing, for it to be a mitzvah, must be tied to income and need.

Thursday, April 05, 2012

I may not be entirely necessary

The blogosphere is apparently getting along well enough without me.

Thursday, April 01, 2010

Project Hero - reply from Joyce Green

I sent a letter to the professors at the University of Regina who signed an Open Letter to U of R President Timmons in regards to its Project Hero program. That open letter can be found here: .

This is the reply I received from Joyce Green, Professor of the Poli-Sci department at U of R:

Dear Mr. Van Lane:

Thanks for your note; we appreciate the support.

We are aware of several facebook groups, some of which appear to have the same creator, an individual involved with the Conservative and Saskatchewan parties.

Our position is as follows:

The letter we signed was intended neither to criticize individual soldiers, nor to deprive or deny anyone of financial support to pursue post-secondary education. The criticism was directed against one scholarship program, the “Project Hero” program, and not at any other support for, or scholarships targeted to, veterans or their families. We note that the federal government can and does provide for education assistance for families of soldiers, and thus, there is no policy need for Project Hero. The benefits provided under the "Children of Deceased Veterans Education Assistance Act C-28" provides for educational expenses. (Please consult Veterans’ Affairs Canada for more information.)

At issue here was our perception that “Project Hero” was designed for essentially partisan political purposes, as a way of using the Universities, as institutions, to endorse Canada’s current military presence in Afghanistan. As the “Project Hero” program requires the Universities themselves to bear the costs of the tuition waivers it offers (in contrast to privately or externally funded scholarship programs, in which the costs are borne by third parties), it requires the Universities to treat one particular subset of students as different from all others, including those students who are children of wounded soldiers, as well as the children of any number of other risky and honourable professions.

This compromises the political neutrality of the University; at its worst, it potentially makes the institution into a cheerleader for the policy of whichever government happens to be in power. It is our view that a distance should be maintained between universities and governments (whether conservative, liberal, or social democratic), and that this program compromises that distance, making it that much more difficult to have open and unconstrained conversations in our universities about Canadian foreign policies.


Joyce A. Green
Department of Political Science
University of Regina
Regina, Saskatchewan S4S 0A2

Thursday, July 30, 2009

2010 Vancouver Olympics - a Gift That Keeps On Taking

Thanks for the Olympics, Santa - but what I really wanted was a public daycare system

In May of 2007 the provincial government released a 'business plan' in which the ultimate cost of the Olympics to the public wasn't revealed.

As Chris Shaw wrote in his book, Five Ring Circus, the IOC refuses to allow any city to host the Olympics unless public money is guaranteed. This is because the Olympics are such a colossal business risk that no sensible business person would underwrite it.

So, public inputs are taken from hospitals, schools, and daycares so a few people can chase each other around an ice rink or zip down an icy course in a bobsled while thousands of others watch live and billions watch on TV.

Why spend money removing the 100 million landmines in the world or retooling the economies or fighting poverty when you can vicariously experience the thrill of victory or the agony of defeat. That kid in Afghanistan, who stepped one of those landmines and is now hopping around on one foot, is thinking the same thing. "Bobsledding, mom. Quick, quick, come look!"

Then why is the public taxpayer 'investing' in this fucking orgy? Because we were told that in the worst case scenario we'd 'break even' and in the best case scenario we'd make $200 million. Now, in my books (and remember I'm coming from a loonie left POV - you know, the people who couldn't manage a hot dog stand) 'breaking even' means the income is equal to the expense. So, if the expenses are $12 then the income is $12 and the result is no gain - but no loss either. When my mom breaks even in at the slots in Reno it's because she left home with $300 and she returned with $300, which doesn't happen very often such is the nature of gambling.

So, how do we the taxpayer recoup public money, or investment? Well, through taxes silly. And where do we collect taxes? We collect income tax and sales tax.

It appears the cost of the Olympics to taxpayers will be closer to $3 billion than to $600 million. The cost of security alone ballooned from $85 million to $1 billion - the same ratio as if I said "It's gonna cost you 85 bucks" and then once the contract was signed I revealed "plus another $915."

The Olympics span a period of 13 days.

The taxpayers don't share in any revenue from the broadcast rights or from the licensing of the games, etc. The public didn't make any money in the development of properties, etc.

Yes, we're going to collect taxes from ourselves, in the form of taxes on our income. If our income increases by massive amounts the taxes will reflect an increase in provincial revenue.

Mostly we hope to recoup our investment in the games from the visitors to Vancouver who come for the Olympic experience who will leave behind massive amounts of money in the form of sales taxes.

Now here are some basic calculations:

Let's say $3 billion is the target (our break even).

PST is 7%.

Therefore $3 billion represents 7% of the total expenditures during the 13 days. Thus the Olympic experience has to generate an extra $42,857,142, 857 in taxable sales. Or almost $3.2 billion dollars a day.

The population of the Metro Vancouver area is close to 2 million people. Let's assume that we'll get 2 million people during the 13 days visiting us. They will have to spend $1648 per day for the full 13 days. So a family of four will have to spend nearly $6600 a day (and that doesn't include food since it's not taxable).

You can massage the numbers by increasing the number of touristy days to a month or double the number of people or say the increase of income tax will account for greater revenues. On and on.

But if I came to you and said "I have a great business opportunity for you" and I gave you these numbers I'm sure it'd be a difficult moment for both of us. Unless, I wore a tie. Then you'd probably think, "he's got loads of experience and he wears a tie. And he says things like 'traction', 'inputs' and 'aggressive'".

And by the way, if we don't get the sales tax from those visitors, that means an increase in our property taxes (that $100 million bill we plopped into the developer's bank account for the Olympic Village means an increase of about $2000 in property tax for Vancouverites - and if you spread it over the several years there will be financing costs).

And doubling the population of Vancouver (2 million people i) is going to lead to massive delivery problems, consumption costs, etc.

Had we used the money to develop a public day care program each family would be relieved of between $8000 and $12000 per child per year in expenses and it would have employed about 64,000 people in good paying jobs and it would have done a lot of other things almost equal in goodness as bobsledding.



Tuesday, April 14, 2009

Old Barry Goldwater and the young me

What do we want? Freedom! When we do want it? Soon!

Ah, youth. The newness of life, the excitement of fresh ideas, the certainty. I was strolling recently amoung my book collection and came across an old friend and influence sitting there ignominiously nestled between Marx and Engels on one side and Trotsky on the other, Senator Barry Goldwater.

Goldwater was the Senator from Arizona and the Republican nominee for the US presidency in 1964. He was a true, state's rights, limited government conservative. He wrote a book in 1960 in the last days of Dwight Eisenhower's tenure in the White House called Conscience of a Conservative. This book, a manifesto of conservatism, introduced me to the ideas of the honest right; it explained a creed of freedom against an oppressive government, the principled position taken by the writers of the American constitution, and an individual's and state's rights vs. federal rights. Its language was clear, simple, direct. I read it at 15 and still remembered phrases as I reread them 30 years later.

"Conservatism...puts material things in their proper place - that has a structured view of the human being and human society, in which economics plays only a subsidiary role" he writes in his introduction. Socialism, he says, subordinates all other considerations to man's material well-being. People are social, creative and spiritual. Conservatism, he believes, understand this; socialism does not.

In those youthful days I read Ayn Rand, Barbera Amiel. I read Gary Allen's None Dare Call It Conspiracy and John Stormer's None Dare Call It Treason. The ideas were fresh and influential the first time I came across them and they stayed with me for years.

When Gov. Ronald Reagan entered the White House, he came to power speaking the words that Senator Barry Goldwater had written and campaigned on 16 years earlier (Reagan gave the keynote at the RNC 1964). I was 17 years old and steeped in the conservative philosophy.

Seeing Reagan in action for the next eight years, then four years of Bush, plus our own unctuous Prime Minister, Brian "Pay-Me-Cash" Mulroney, the AIDS crisis, and neo-conservatism disabused me of the certainty a better world would be made from the efforts of the honest right.

I began to see a 'marketplace' that, left to its own forces, brought infected milk to market, poisoned watersheds, gave thalidomide to pregnant mothers. The marketplace ignored (and lied about) smoking and cancer, about the contraindications of SSRIs. People would be forced to work at the lowest wage in the worst conditions possible using the strange Orwellian argument that it necessary to 'create wealth'. Moneymen lied about the true nature of the financial instruments they created and we're seeing the economic fallout of that. Poverty increased. The governments grew its military and had no hestitation of using it against its own citizens. I saw the war-on-drugs as an excuse to militarize the urban centres.

In short, the problem of keeping the individual, or classes of individuals, from cheating, lying and stealing became apparent. How do people exercise protection, keep themselves from being enslaved, abused or marginalized except through the powers of the state.

I came to realize that Barry Goldwater's politics let me down in every aspect. There isn't a page in Conscience of a Conservative with which I can now completely agree. Ayn Rand turned out to be a political philospher divorced from reality. Gary Allen and John Stormer were...well, they're fucking Birchers, man.

I have to say that, as I wistfully read Barry Goldwater again, the idea of a political philosophy in which the people, equal before the law, with clean hearts and honest minds come together to help each other as needed, who resist coercing or being coerced, still appealed to me. But the fact is the strong will kill and eat the weak because strength and decency are not always coincident in the same person, because we've created a society of 'getting our own' instead of helping each other. We don't think of the human wants and hurts of others when we make our choices. We're more Amway than St. Matthew.

Goldwater's political philosophy, despite his denial, is all about money in the end. His arguments for personal freedom never carried with it an equally forceful argument for responsibility. By removing responsibility from the equation he paved the way for deregulation, inaction, injustice and the 'redistribution of wealth' into the hands of the few instead of the many.

When one doesn't contribute to help the poor, to help the halt, to build community, or defend justice one can't enjoy freedom. We're all in this together. We live or die based on the decisions, great and small, we make towards each other.

Still, being young was fun, even if I was an idiotic, mouthy right-wing punk. And I loved Barry Goldwater so much I stole his glasses.



Thursday, February 12, 2009

I'll see your Milton Friedman and raise you four John Kenneth Galbraiths

Economic swordsmanship is sexy

John Kenneth Galbraith, Canadian born, Harvard professor, economist, advisor to President Kennedy, speechwriter for Adlai Stevenson. In the 20th century whenever something interesting was being done in the world of economics or public policy Galbraith was never too far away if he wasn't in the centre of things.

Of all intellectuals and public policy people I can't decide whether it is Keynes or Galbraith I like most.

Here are some JKG quotes from Wiki-quote (I went there to remind myself where I pulled a quote from):

Relevant for the these days of economic 'bailouts' and the nitpicking debates.

In the usual (though certainly not in every) public decision on economic policy, the choice is between courses that are almost equally good or equally bad. It is the narrowest decisions that are most ardently debated. If the world is lucky enough to enjoy peace, it may even one day make the discovery, to the horror of doctrinaire free-enterprisers and doctrinaire planners alike, that what is called capitalism and what is called socialism are both capable of working quite well. "The American Economy: Its Substance and Myth," quoted in Years of the Modern (1949), ed. J.W. Chase

A great response to the so-called 9/11 paradigm shift. The principle holds even if he was speaking specifically about economic models.

When you see reference to a new paradigm you should always, under all circumstances, take cover. Because ever since the great tulipmania in 1637, speculation has always been covered by a new paradigm. There was never a paradigm so new and so wonderful as the one that covered John Law and the South Sea Bubble — until the day of disaster. Quoted in Ben Laurance and William Keegan, "Galbraith on crashes, Japan and Walking Sticks", The Observer (1998-06-21)

A note to the doctrinaire left and, especially these days, the doctrinaire right. When you have 15 million children starving to death annually and a billion people hungry you should be looking for economies and public policies that work. To be deaf to the cries of the poor in order to keep your cherished beliefs from being contradicted is cruel.

I react to what is necessary. I would like to eschew any formula. There are some things where the government is absolutely inevitable, which we cannot get along without comprehensive state action. But there are many things — producing consumer goods, producing a wide range of entertainment, producing a wide level of cultural activity — where the market system, which independent activity is also important, so I react pragmatically. Where the market works, I'm for that. Where the government is necessary, I'm for that. I'm deeply suspicious of somebody who says, "I'm in favor of privatization," or, "I'm deeply in favor of public ownership." I'm in favor of whatever works in the particular case. from Bookends interview with Brian Lamb (1994)

From Age of Uncertainty (1977). This is one of my favourite quotes from a book that is almost completely quotable.

All of the great leaders have had one characteristic in common: it was the willingness to confront unequivocally the major anxiety of their people in their time. This, and not much else, is the essence of leadership.

A bonus quote from Money: Whence it came and Where it went. The first Galbraith book I read with chapters on John Law, coin sweating, gold standards, and paper money. It also has the best summary of American attitudes towards government and policy.

It is well-known that Americans are opposed to taxation without representation. It is equally true that Americans are also opposed to taxation with representation.



Monday, January 12, 2009

Pfizer and Off-label Marketing

Oh, no you didn't!

This article was pulled from the New England Journal of Medicine. It is reprinted in full. The text formatting is my own and was done on the fly.

The article's overview is this: Pfizer had an agressive marketing campaign to increase sales (use) of Neurontin for conditions for which it was not approved (off-label). They bumped Neurontin's US sales from $98 million to over $3 billion using these tactics.

The question is: if the Conservative government passes legislation that allows medical marketing like this (as they tried with C-51) then what restrictions will they put in place to protect public health and the public purse from being abused like this?

Pfizer settled part of the suit out of court with a $500 million payment.

It's a fairly easy read so I encourage you to dig into it.

These marketing methods were not found to be illegal in themselves; they were illegal insofar as they promoted off-label prescription.

Landefeld CS, Steinman MA.

The Neurontin Legacy - Marketing through
Misinformation and Manipulation. 2009; 360: 103-6 (8 January)

Old drugs usually fade away. Sometimes, however, they leave surprising legacies. In 1997, for example, a study comparing the effects of brand-name and generic formulations of levothyroxine led to an uproar over the discovery that the manufacturer of the brand-name product suppressed publication of the result that the two formulations were equivalent.

Recently, lawsuits alleging damages from illegal marketing of another old drug, gabapentin (Neurontin), have yielded remarkable discoveries about the structure and function of pharmaceutical marketing.

Patented in 1977 and approved by the Food and Drug Administration (FDA) in 1993 in doses of up to 1800 mg per day as adjunctive therapy for partial complex seizures, Neurontin became a surprise blockbuster for Parke-Davis, a division of Warner-Lambert, which was purchased by Pfizer in 2000.

U.S. sales rose from $98 million in 1995 to nearly $3 billion in 2004 before Neurontin faced generic competition and lost most U.S. sales.

The rise of Neurontin would have been unheralded except for a quirk of fate: a young biologist, David Franklin, went to work for Parke-Davis on April 1, 1996. Fresh out of postdoctoral training at Harvard, Franklin soon grew concerned that he was participating in illegal marketing. At a training seminar for "medical liaisons" on April 16, 1996, Franklin and his peers were told that FDA regulations required a fair and balanced presentation and prohibited promotion of a drug for off-label uses, selling by medical liaisons, and soliciting of inquiries from physicians. Six days later, a Parke-Davis executive reportedly told Franklin: I want you out there every day selling Neurontin. . . . We all know Neurontin's not growing for adjunctive therapy, besides that's not where the money is. Pain management, now that's money. Monotherapy [for epilepsy], that's money. . . . We can't wait for [physicians] to ask, we need [to] get out there and tell them up front. Dinner programs, CME programs, consultantships all work great but don't forget the one-on-one. That's where we need to be, holding their hand and whispering in their ear, Neurontin for pain, Neurontin for monotherapy, Neurontin for bipolar, Neurontin for everything. I don't want to see a single patient coming off Neurontin before they've been up to at least 4800 mg/day. I don't want to hear that safety crap either, have you tried Neurontin, every one of you should take one just to see there is nothing, it's a great drug.1

Three months later, Franklin left Parke-Davis and filed a suit (ultimately,United States of America ex rel. David Franklin vs. Pfizer, Inc., and Parke-Davis Division of Warner-Lambert Company) alleging that off-label marketing of Neurontin constituted "false claims" designed to elicit payments from the federal government. On May 13, 2004, Warner-Lambert agreed to plead guilty and to pay more than $430 million to resolve criminal charges and civil liabilities. A class-action suit was filed the next day in federal court on behalf of private parties who had paid for illegally marketed Neurontin; this case (now known as In Re: Neurontin Marketing, Sales Practices, and Products Liability Litigation) remains active.

The Franklin case placed more than 8000 pages of corporate documents in the public domain; these documents are now available in a searchable digital library at the University of California, San Francisco. The class-action suit also generated detailed testimony and reports that are available through the Federal Judiciary's Public Access to Court Electronic Records Service Center.

The Neurontin cases have revealed the mechanisms of action of a comprehensive marketing campaign - its goals and strategies, tactics and programs, and the participation of particular physicians and institutions.2 The campaign involved the systematic use of deception and misinformation to create a biased evidence base and manipulate physicians' beliefs and prescribing behaviors. These marketing methods were not found to be illegal in themselves; they were illegal insofar as they promoted off-label prescription. Thus, the importance of the cases lies largely in the light they shed on marketing methods that may be widespread but remain unseen because companies are rarely prosecuted for illegal marketing.

The Neurontin marketing plan consisted of both general strategies - such as the promotion of Neurontin use among high-prescribing physicians and cultivation of thought leaders - and tactical programs.2 Local physicians were recruited, trained, and paid to serve as speakers in "peer-to-peer selling" programs, which the company saw as "one of the most effective ways to communicate our message." Academic leaders were solicited with educational grants, research grants, and speaking opportunities; some received up to $158,250 over a 4-year period. Advisory boards and "consultants" were convened so that the firm could cultivate relationships with them and deliver "a hard-hitting message about Neurontin."

Marketing "tactics" included education, publications, and research whose promotional intent was disguised, in addition to more transparent activities, such as advertising and sales visits.2 "Educational programs" reflected the belief that "medical education drives this market!" Teleconferences involving practicing physicians were moderated by physicians who were paid as much as $176,100 over 4 years. Parke-Davis formed speakers bureaus and sought "strong Neurontin advocates and users to speak locally for Neurontin." "Unrestricted educational grants" were made to for-profit medical-education companies that produced programs to discuss unapproved uses of Neurontin and to grant credit approved by the Accreditation Council for Continuing Medical Education.

A "publication strategy" was designed to increase the use of Neurontin for neuropathic pain and bipolar disorder, off-label indications with great revenue potential. Parke-Davis contracted with medical-education companies to produce articles on prespecified topics, target journals, titles, potential authors to be "chosen at the discretion of Parke-Davis," and "a consistent message" in keeping with promotional goals; some articles were ghost-written.

"Research" was designed and commissioned specifically to promote Neurontin use. A large seeding trial was conducted to "teach physicians to titrate Neurontin to clinical effect" and "to give neurologists the opportunity to titrate to higher doses [up to twice the FDA-approved limit] when needed."

In a recently unsealed 318-page analysis of research sponsored by Parke-Davis, epidemiologist Kay Dickersin concluded that available documents demonstrate "a remarkable assemblage of evidence of reporting biases that amount to outright deception of the biomedical community, and suppression of scientific truth concerning the effectiveness of Neurontin for migraine, bipolar disorders, and pain."3 For example, publication was delayed for a report on a multicenter, placebo-controlled study that found no effect of Neurontin on the primary outcome measure for neuropathic pain because "we [Parke-Davis employees] should take care not to publish anything that damages neurontin's marketing success."

Ultimately, ghost-written manuscripts downplayed the lack of effect on the primary outcome and emphasized other outcomes and subgroup analyses that favored Neurontin. Although guest authorship and commercial bias in research are a well-recognized threat to scientific integrity, the documentation of comprehensive manipulation of research and publication related to Neurontin is remarkable.

What is Neurontin's legacy? First, we have learned that pharmaceutical marketing can be comprehensive, strategic, well financed, disguised as "education" and "research," influential, and very effective. Promotion of Neurontin was neither discrete, compartmentalized, nor readily apparent; instead, it was intercalated in nearly every aspect of physicians' professional lives, from the accoutrements of practice to lectures, professional meetings, and publications. Although some pharmaceutical marketing may be less opaque, deceptive, and manipulative, evidence indicates that drug promotion can corrupt the science, teaching, and practice of medicine.4

Second, such comprehensive marketing involved many people and institutions that apparently failed to recognize the serious ethical and legal problems with their actions. Employees of Parke-Davis, the medical-education companies it hired, and many physicians (consultants, advisors, educators, and researchers) all participated knowingly. Universities, hospitals, professional organizations, and foundations also participated, and oversight agencies such as the FDA and the Department of Justice did not intervene quickly. Apparently, there was a shared acceptance that Parke-Davis's marketing was simply business as usual.

Finally, these cases substantiate the emerging conviction that "drastic action is essential" to preserve the integrity of medical science and practice and to justify public trust.4 We believe that such action should include the routine placement of legally discovered documents in the public domain, the study of such documents to inform strategies for minimizing abuses, the establishment of penalties that eliminate the profit to be gained through illegal marketing, and the independent public funding of peer-reviewed pharmaceutical research through a National Institute for Pharmaceutical Research that might be funded by a tax on all drug sales.5

Will our profession soon feel compelled to advocate for such actions to preserve our integrity, our social contract, and ultimately our privileges? Neurontin's most important legacy may be promoting our discussion of these issues and perhaps pushing us beyond the tipping point to action.

Drs. Landefeld and Steinman report serving as unpaid consultants to the plaintiff's attorney in United States of America ex rel. David Franklin vs. Pfizer, Inc., and Parke-Davis Division of Warner-Lambert Company and participating in the creation of the Drug Industry Document Archive by the University of California, San Francisco, Kalmanovitz Library, an effort that was funded in part by Thomas Greene, whose law firm represented David Franklin in the case.

Dr. Steinman also reports receiving support from an educational grant funded by the Attorney General Settlement Fund that arose from the Franklin case. No other potential conflict of interest relevant to this article was reported.

The views expressed in this article are those of the authors and do not
necessarily reflect the official views of the Department of Veterans Affairs.

Source Information
Dr. Landefeld is a professor of medicine and chief of the Division of Geriatrics at the University of California, San Francisco (UCSF), San Francisco; associate chief of staff for geriatrics and extended care at the San Francisco Veterans Affairs Medical Center (SFVAMC), San Francisco; and a fellow at the Center for Advanced Study in the Behavioral Sciences, Stanford University, Stanford, CA.

Dr. Steinman is an assistant professor of medicine at UCSF and a staff physician at SFVAMC.


1. Disclosure of information by relator David P. Franklin pursuant to 31 U.S.C. 3730 b(2), page 11. (Accessed December 16, 2008, at

2. Steinman MA, Bero LA, Chren MM, Landefeld CS. The promotion of gabapentin: an analysis of internal industry documents. Ann Intern Med 2006;145:284-293. [Free Full Text]

3. Dickersin K. Reporting and other biases in studies of Neurontin for migraine, psychiatric/bipolar disorders, nociceptive pain, and neuropathic pain. August 10, 2008. (Accessed December 16, 2008, at

4. DeAngelis CD, Fontanarosa PB. Impugning the integrity of medical science: the adverse effects of industry influence. JAMA 2008;299:1833-1835. [Free Full Text]

5. Landefeld CS. Commercial support and bias in pharmaceutical research. Am J Med 2004;117:876-878.