David Horrobin
Encyclopedia
David Frederick Horrobin (6 October 1939 – 1 April 2003) was an entrepreneur, medical researcher, author and editor. He is best known as the founder of the biotechnology company Scotia Holdings and as a promoter of evening primrose oil as a medical treatment, Horrobin was founder and editor of the journals
Medical Hypotheses
and Prostaglandins, Leukotrienes and Essential Fatty Acids.
Horrobin believed that many diseases involve a lack of fatty acid precursors and might be alleviated by supplementing with the appropriate fatty acid. Horrobin's efforts focused on evening primrose
oil, which contains gamma-linolenic acid
. In the 1980s, Horrobin sold primrose oil in the United States without legally demonstrating its safety and efficacy, leading to government confiscations and felony indictments of his associates. Horrobin was later accused of withholding research data and suppressing the reports of scientists who questioned his claims. During Horrobin's tenure as chief executive, Scotia Pharmaceuticals obtained licences for several drugs based on evening primrose oil, but these licenses were withdrawn for lack of efficacy. Amidst charges of mismanagement and research fraud, Horrobin was ousted as CEO by a unanimous vote of the board and left the company in 1998. In 2001, Scotia, one of the first publicly-traded biotechnology companies in the United Kingdom
, also became the first to collapse. After Horrobin's departure from Scotia, he founded Laxdale Ltd., a company that investigated omega-3 fatty acid
s as possible treatments for schizophrenia
and neurodegenerative diseases.
Horrobin died of pneumonia as a complication of mantle cell lymphoma
in 2003. Obituaries noted his contributions to the biotechnology industry, intellectual acumen, original thinking and adventurousness, while some criticised his promotion of primrose oil and other questionable claims. Notably controversial obituaries in The Independent
and the British Medical Journal
angered Horrobin's friends and family by also portraying negative aspects of Horrobin's life, with the BMJ obituary stating that Horrobin "may prove to be the greatest snake oil salesman of his age".
, a town near Manchester
, England
, Horrobin attended Queen Elizabeth's Grammar School, Blackburn
and King's College
in Wimbledon
. He studied medicine on scholarship at Balliol College, Oxford
, obtaining degrees in both medicine and surgery, and during the same period earned a doctorate in neurophysiology and neuroendocrinology. On completing his pre-clinical work, Horrobin became a fellow of Magdalen College
in 1963. At Magdalen, he was strongly influenced by the nutritionist Hugh Macdonald Sinclair
and his hypotheses on essential fatty acids and degenerative disease.
Following participation in the Flying Doctor Service in east Africa, Horrobin was appointed as professor
and chairman of medical physiology at Nairobi University in Kenya
. In 1972, he moved to the University of Newcastle upon Tyne, where he was appointed as a reader
in medical physiology. In 1975, he became professor of medicine at the University of Montreal
.
"after trying it on the son of a librarian from his college". Horrobin planned to use the profits from Efamol to fund research and development of drugs containing EPO fatty acids. Efamol, renamed Scotia Pharmaceuticals in 1987, was active in Nova Scotia
, Surrey
and Scotland
. In 1993, under Horrobin's leadership, Scotia was one of the first biotechnology companies to be floated on the London Stock Exchange. Scotia spent heavily on research, being ranked 79th among all UK companies in 1993, and reached a peak market capitalisation of about £600m in 1996. As a major shareholder of Scotia, Horrobin rose to number 212 in 1996 on the list of the wealthiest people in the United Kingdom
.
to process Efamol into capsules in California; it would then be sold to General Nutrition and relabeled for resale under a different brand name. According to an FDA investigation, Horrobin suggested marketing strategies to circumvent the laws, including coaching retail representatives on making oral claims to customers, "planting articles on their research in the media, deploying researchers to make claims on their behalf, using radio phone-ins" and other tactics. Horrobin wrote to General Nutrition, "Obviously you could not advertise Efamol for these purposes but equally obviously there are ways of getting the information across". As a result, the FDA began to seize shipments of EPO and handed down felony indictments to General Nutrition, several executives and store managers for "conspiring to defraud the FDA and violating provisions of the Food, Drug, and Cosmetic Act". General Nutrition and its president entered guilty pleas and paid fines, but Horrobin was not prosecuted.
Efamol continued to ship EPO into the United States and to market its products. In a 1989 article on "health food frauds", the New York Times reported on the FDA's seizure of "more than $1 milion worth" of illegal EPO. The FDA again accused Efamol of marketing the oil "with unsubstantiated claims of treating a wide variety of illnesses". Efamol's lawyers responded that the product was not dangerous and that it had not made unsubstantiated claims. The American Dietetic Association, representing over 50,000 nutritionists, questioned the value of Horrobin's product since "one-tenth of a teaspoon of ordinary corn oil has as much of the fatty acids as a capsule of Evening Primrose Oil, at a fraction of the cost". In 1989, the FDA commissioned a report by investigator Stephen Barrett
, a medical doctor and consumer protection advocate. Barrett advised the FDA that Horrobin's marketing of Efamol was done in "a transparent attempt to evade the food and drug laws". In a report on the incident published by the consumer information organisation Quackwatch
, Barrett also questions Horrobin's research ethics: "Would someone that contemptuous of the law have any qualms about faking data?"
suggested that Horrobin had also actively suppressed research findings contradicting his claims about EPO. Horrobin wrote a meta-analysis of EPO research on eczema
in 1989, concluding that EPO was effective. Horrobin excluded the negative results of the largest published study to date but included purported results of seven of his own unpublished studies that remained unpublished as of 2006. When several scientists asked to see the unpublished data, Horrobin's legal team convinced the journal to refuse the request. In 1997, Horrobin's team successfully halted the publication of another meta-analysis commissioned by the Department of Health. Research published after Horrobin's death indicates that fatty acids are no more effective than a placebo
against eczema; Scotia's medicines licences for evening primrose oil drugs was withdrawn.
However, the initial successes of Scotia on the stock markets and Horrobin's reassurances were undermined by what investors perceived as long-standing and systemic problems at the company, and they saw their fears confirmed with the rejection in March 1997 of regulatory approval for Scotia's drug Tarabetic. Also known as Efamol, the product contained evening primrose oil and was intended to treat diabetic peripheral neuropathy. Scotia immediately lost one quarter of its value. Licences for several evening primrose oil-containing drugs were later withdrawn. A Scotia product, Epogam, was reportedly the first drug to have its licence withdrawn as a result of "evidence that it didn't work".
By the end of 1997, Scotia was nearly broke and did not have enough money to fund another year of research. Investors worried that Horrobin had spread the company and its resources too thinly, a state described by The Guardian as "woolly, sprawling and lacking in focus". They also questioned Horrobin's judgement in promoting his wife to research manager of the company despite her lack of scientific or business training; her highest qualification was a BA in English and women's studies. Investors were restive about Horrobin's emphasis on products related to evening primrose oil, which they considered a "hippy" project, "outmoded and of questionable scientific validity". When it was found that borage
contained a higher percentage of gamma-linolenic acid
than did the evening primrose, rival companies had begun to take market share of the supplement. In 1996, The Independent described Scotia's supplement business as "struggling". Horrobin responded to the borage competition by accusing his rivals of “duping women, selling pigs in pokes and marketing 'unstable and potentially toxic products'.”
Findings of fraud associated with Scotia trials also weighed on Horrobin's company. Goran Jamal, a doctor who had participated in developing Efamol, was found guilty of research fraud by the General Medical Council
in 2003. The Council ruled that Jamal had committed "serious professional misconduct for falsifying his results", manipulating the supposed randomisation of the clinical trial conducted over a decade earlier. Scotia was faulted by industry observers for what was called a "highly unusual" compensation scheme, as it had offered the doctor a portion of profits from future sales, although the Council suggested that Jamal was prompted to commit fraud by his "belief" in the efficacy of the drug and not by his desire for financial gain.
and neurodegenerative diseases. The company was sold after his death to the Amarin Corporation and is now known as Amarin Neuroscience Ltd.
to be a waste of resources, and believed that large-scale clinical trials were unnecessary and unethical. However, in at least one case, he defended modern medicine by writing a critique of Ivan Illich
's famous attack on the medical establishment, Medical Nemesis.
system, which, he believed, stifled creativity and innovation in science. Horrobin founded and edited the journal Medical Hypotheses
to provide an outlet for unorthodox ideas and research that would not be evaluated by other scientists before publication. Horrobin envisioned the journal as a resort for thinkers who were "very good at generating ideas, but are complete klutzes in the field" and committed to publishing ideas based only on whether he or other reviewers considered them "interesting and reasonable".
Horrobin also founded the journal Prostaglandins, Leukotrienes and Essential Fatty Acids. Science writer Susan Allport, in her book on dietary fatty acids, states that Horrobin founded this journal to disseminate his ideas about evening primrose oil and fatty acids.
's The Universe in a Nutshell
). Reviews of the book were mixed, writing of a "useful contribution" that was also "highly partisan and selective"; an "engaging and plausible argument" that is "not so convincingly" argued; and a book "brightly written" but with "a huge hole in its central premise" Horrobin was somewhat critical of his theory, describing it as a "just-so story perhaps fed by my own personal delusions". The book was compared unfavorably to similar works by Kay Redfield Jamison
, who examines a possible link between bipolar disorder
and artistic creativity.
Tim Crow
, a professor of psychiatry at Oxford University who had proposed a similar theory in 1995, accused Horrobin of failing to acknowledge Crow's contributions to the development of his ideas. When novelist Sebastian Faulks
stated that Horrobin's ideas influenced his novel Human Traces
, published in 2005, Crow protested that "much of the credit for his theory has been misdirected by Faulks to the late maverick doctor and writer, David Horrobin".
. He died of pneumonia as a complication of this cancer in 2003. Horrobin was survived by his wife, Sherri Clarkson, and two children from a previous marriage. A number of obituaries were published, both in medical journals such as The Lancet
and Horrobin's Prostaglandins, Leukotrienes and Essential Fatty Acids, and in the popular press. Most obituaries referred to Horrobin as a highly intelligent, creative and persuasive individual. According to The Telegraph, Horrobin was "a founding father of the biotechnology industry and regarded by some as one of Britain's finest original thinkers in medicine", but the same obituary also noted that Horrobin's implication of fatty acid metabolism in schizophrenia was not accepted by other scientists; that his approach was "unorthodox" and unpopular; and that his major business venture failed. The many problems at Scotia under Horrobin's leadership, which led to the company's eventual collapse, were a theme in several obituaries including two highly critical and controversial accounts written by former Horrobin colleague Caroline Richmond and published in the British Medical Journal
(BMJ) and The Independent
.
The BMJ obituary sparked a months-long controversy. The obituary described Horrobin as "effortlessly prolific" and "one of the most persuasive people on earth", but also criticised him as excessively promoting evening primrose oil despite a lack of scientific evidence, noting that some critics questioned his ethics. It suggested that Horrobin "may prove to be the greatest snake oil salesman of his age", stating that his evening primrose oil would "go down in history as the remedy for which there is no disease" and reporting that several of Scotia's product licences were later withdrawn because the drugs were ineffective. The obituary generated the largest e-mail response to an obituary in the history of the BMJ. Respondents, including Horrobin's colleagues, friends and family, were largely critical of the negative tone of the obituary. On behalf of Horrobin's family, Horrobin's son-in-law, Adam Kelliher, filed a complaint with the British Press Complaints Commission
, alleging that the BMJ obituary was "inaccurate" and "intrusive at a time of grief" in violation of the Code of Practice. Kelliher was founder and at the time chief executive of Equazen, a company marketing fish and evening primrose oils including a formulation called eye q, said to improve scholastic ability in children. However, in his initial complaint to the BMJ Kelliher stated that he had no competing interests. In reaction, the BMJ published an apology to Horrobin's family expressing regret for any distress caused. The journal corrected what its editor considered several insignificant spelling and factual errors and published three further obituaries of Horrobin. However, the journal also defended its original obituary as fairly presenting "both the positive and negative aspects of its subject's life". Kelliher did not accept the BMJ apology as genuine and maintained that inaccuracies and "unjustified slander" remained, but the Press Complaints Commission declined to take any action against the journal, stating that the BMJ had offered "sufficient remedial action". According to the Commission, the journal was not obliged to omit negative information, including the journal's contention "that Dr Horrobin was 'in some ways a charlatan'".
, having acquired the journal Medical Hypotheses
, created an annual David Horrobin Prize for medical theory in his honour. He was posthumously awarded the Stephen S. Chang
Award by the American Oil Chemists' Society in 2003.
Medical journal
A public health journal is a scientific journal devoted to the field of public health, including epidemiology, biostatistics, and health care . Public health journals, like most scientific journals, are peer-reviewed...
Medical Hypotheses
Medical Hypotheses
Medical Hypotheses is a medical journal published by Elsevier. It was originally intended as a forum for unconventional ideas without the traditional filter of scientific peer review, "so long as are coherent and clearly expressed" in order to "foster the diversity and debate upon which the...
and Prostaglandins, Leukotrienes and Essential Fatty Acids.
Horrobin believed that many diseases involve a lack of fatty acid precursors and might be alleviated by supplementing with the appropriate fatty acid. Horrobin's efforts focused on evening primrose
Oenothera
Oenothera is a Genus of about 125 species of annual, biennial and perennial herbaceous flowering plants, native to North and South America. It is the type genus of the family Onagraceae, the Evening Primrose Family. Common names include evening-primrose, suncups, and sundrops.The species vary in...
oil, which contains gamma-linolenic acid
Gamma-Linolenic acid
γ-Linolenic acid is a fatty acid found primarily in vegetable oils...
. In the 1980s, Horrobin sold primrose oil in the United States without legally demonstrating its safety and efficacy, leading to government confiscations and felony indictments of his associates. Horrobin was later accused of withholding research data and suppressing the reports of scientists who questioned his claims. During Horrobin's tenure as chief executive, Scotia Pharmaceuticals obtained licences for several drugs based on evening primrose oil, but these licenses were withdrawn for lack of efficacy. Amidst charges of mismanagement and research fraud, Horrobin was ousted as CEO by a unanimous vote of the board and left the company in 1998. In 2001, Scotia, one of the first publicly-traded biotechnology companies in the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
, also became the first to collapse. After Horrobin's departure from Scotia, he founded Laxdale Ltd., a company that investigated omega-3 fatty acid
Omega-3 fatty acid
N−3 fatty acids are essential unsaturated fatty acids with a double bond starting after the third carbon atom from the end of the carbon chain....
s as possible treatments for schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
and neurodegenerative diseases.
Horrobin died of pneumonia as a complication of mantle cell lymphoma
Mantle cell lymphoma
Mantle cell lymphoma is one of the rarest of the non-Hodgkin's lymphomas , comprising about 6% of NHL cases. There are only about 15,000 patients presently in the U.S. While it is difficult to treat and seldom considered cured, investigations into better treatments are actively pursued worldwide...
in 2003. Obituaries noted his contributions to the biotechnology industry, intellectual acumen, original thinking and adventurousness, while some criticised his promotion of primrose oil and other questionable claims. Notably controversial obituaries in The Independent
The Independent
The Independent is a British national morning newspaper published in London by Independent Print Limited, owned by Alexander Lebedev since 2010. It is nicknamed the Indy, while the Sunday edition, The Independent on Sunday, is the Sindy. Launched in 1986, it is one of the youngest UK national daily...
and the British Medical Journal
BMJ
BMJ is a partially open-access peer-reviewed medical journal. Originally called the British Medical Journal, the title was officially shortened to BMJ in 1988. The journal is published by the BMJ Group, a wholly owned subsidiary of the British Medical Association...
angered Horrobin's friends and family by also portraying negative aspects of Horrobin's life, with the BMJ obituary stating that Horrobin "may prove to be the greatest snake oil salesman of his age".
Education and academic career
Born in BoltonBolton
Bolton is a town in Greater Manchester, in the North West of England. Close to the West Pennine Moors, it is north west of the city of Manchester. Bolton is surrounded by several smaller towns and villages which together form the Metropolitan Borough of Bolton, of which Bolton is the...
, a town near Manchester
Manchester
Manchester is a city and metropolitan borough in Greater Manchester, England. According to the Office for National Statistics, the 2010 mid-year population estimate for Manchester was 498,800. Manchester lies within one of the UK's largest metropolitan areas, the metropolitan county of Greater...
, England
England
England is a country that is part of the United Kingdom. It shares land borders with Scotland to the north and Wales to the west; the Irish Sea is to the north west, the Celtic Sea to the south west, with the North Sea to the east and the English Channel to the south separating it from continental...
, Horrobin attended Queen Elizabeth's Grammar School, Blackburn
Queen Elizabeth's Grammar School, Blackburn
Queen Elizabeth's Grammar School is a co-educational independent school in Blackburn, Lancashire, founded in 1509 as a boys' school. The term "school" is usually used to collectively refer to the following:...
and King's College
King's College School
King's College School, commonly referred to as KCS, King's, or KCS Wimbledon, is an independent school for day pupils in Wimbledon in south-west London. The school was founded as the junior department of King's College London and occupied part of its premises in Strand, before relocating to...
in Wimbledon
Wimbledon, London
Wimbledon is a district in the south west area of London, England, located south of Wandsworth, and east of Kingston upon Thames. It is situated within Greater London. It is home to the Wimbledon Tennis Championships and New Wimbledon Theatre, and contains Wimbledon Common, one of the largest areas...
. He studied medicine on scholarship at Balliol College, Oxford
Balliol College, Oxford
Balliol College , founded in 1263, is one of the constituent colleges of the University of Oxford in England but founded by a family with strong Scottish connections....
, obtaining degrees in both medicine and surgery, and during the same period earned a doctorate in neurophysiology and neuroendocrinology. On completing his pre-clinical work, Horrobin became a fellow of Magdalen College
Magdalen College, Oxford
Magdalen College is one of the constituent colleges of the University of Oxford in England. As of 2006 the college had an estimated financial endowment of £153 million. Magdalen is currently top of the Norrington Table after over half of its 2010 finalists received first-class degrees, a record...
in 1963. At Magdalen, he was strongly influenced by the nutritionist Hugh Macdonald Sinclair
Hugh Macdonald Sinclair
Hugh Macdonald Sinclair, FRCP was a doctor, medical researcher, and expert in human nutrition. He is most widely known for claiming that what he called "diseases of civilization" such as coronary heart disease, cancer, diabetes, inflammation, strokes and skin disease are worsened by "bad...
and his hypotheses on essential fatty acids and degenerative disease.
Following participation in the Flying Doctor Service in east Africa, Horrobin was appointed as professor
Professor
A professor is a scholarly teacher; the precise meaning of the term varies by country. Literally, professor derives from Latin as a "person who professes" being usually an expert in arts or sciences; a teacher of high rank...
and chairman of medical physiology at Nairobi University in Kenya
Kenya
Kenya , officially known as the Republic of Kenya, is a country in East Africa that lies on the equator, with the Indian Ocean to its south-east...
. In 1972, he moved to the University of Newcastle upon Tyne, where he was appointed as a reader
Reader (academic rank)
The title of Reader in the United Kingdom and some universities in the Commonwealth nations like Australia and New Zealand denotes an appointment for a senior academic with a distinguished international reputation in research or scholarship...
in medical physiology. In 1975, he became professor of medicine at the University of Montreal
Université de Montréal
The Université de Montréal is a public francophone research university in Montreal, Quebec, Canada. It comprises thirteen faculties, more than sixty departments and two affiliated schools: the École Polytechnique and HEC Montréal...
.
Founding of Efamol and Scotia
While working as an academic investigator, in Africa and later, Horrobin developed a theory implicating altered fatty acid metabolism in schizophrenia. The idea did not generate interest, and Horrobin failed to obtain funding. It was noted that Horrobin presented only circumstantial evidence and was unable to propose a mechanism underlying the hypothesised link. To raise money for his research, Horrobin left academia and in 1977 established a company called Efamol to sell evening primrose oil (EPO) as a proposed treatment for various ailments. For example, Horrobin considered EPO to be a treatment for eczemaEczema
Eczema is a form of dermatitis, or inflammation of the epidermis . In England, an estimated 5.7 million or about one in every nine people have been diagnosed with the disease by a clinician at some point in their lives.The term eczema is broadly applied to a range of persistent skin conditions...
"after trying it on the son of a librarian from his college". Horrobin planned to use the profits from Efamol to fund research and development of drugs containing EPO fatty acids. Efamol, renamed Scotia Pharmaceuticals in 1987, was active in Nova Scotia
Nova Scotia
Nova Scotia is one of Canada's three Maritime provinces and is the most populous province in Atlantic Canada. The name of the province is Latin for "New Scotland," but "Nova Scotia" is the recognized, English-language name of the province. The provincial capital is Halifax. Nova Scotia is the...
, Surrey
Surrey
Surrey is a county in the South East of England and is one of the Home Counties. The county borders Greater London, Kent, East Sussex, West Sussex, Hampshire and Berkshire. The historic county town is Guildford. Surrey County Council sits at Kingston upon Thames, although this has been part of...
and Scotland
Scotland
Scotland is a country that is part of the United Kingdom. Occupying the northern third of the island of Great Britain, it shares a border with England to the south and is bounded by the North Sea to the east, the Atlantic Ocean to the north and west, and the North Channel and Irish Sea to the...
. In 1993, under Horrobin's leadership, Scotia was one of the first biotechnology companies to be floated on the London Stock Exchange. Scotia spent heavily on research, being ranked 79th among all UK companies in 1993, and reached a peak market capitalisation of about £600m in 1996. As a major shareholder of Scotia, Horrobin rose to number 212 in 1996 on the list of the wealthiest people in the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
.
Legal and regulatory problems
Horrobin, within several years of founding Efamol, was selling EPO in more than 25 countries. He marketed the supplement as a treatment for "PMS, alcoholism, pregnancy-induced hypertension, atopic eczema, elevated cholesterol levels, hypertension, scleroderma, multiple sclerosis, rheumatoid arthritis, mastalgia (breast pain) and other problems", but according to the United States Food and Drug Administration (FDA), Horrobin did not satisfactorily demonstrate the efficacy and safety of his supplement. The FDA advised Efamol not to ship EPO to the United States without obtaining approval. Horrobin agreed, but began making shipments. Horrobin conspired with General Nutrition, Inc.General Nutrition Centers
General Nutrition Centers is a Pittsburgh, Pennsylvania-based American commercial enterprise focused on the retail sale of health and nutrition related products, including vitamins, supplements, minerals, herbs, sports nutrition, diet & energy products.-History:In 1935, David Shakarian opened a...
to process Efamol into capsules in California; it would then be sold to General Nutrition and relabeled for resale under a different brand name. According to an FDA investigation, Horrobin suggested marketing strategies to circumvent the laws, including coaching retail representatives on making oral claims to customers, "planting articles on their research in the media, deploying researchers to make claims on their behalf, using radio phone-ins" and other tactics. Horrobin wrote to General Nutrition, "Obviously you could not advertise Efamol for these purposes but equally obviously there are ways of getting the information across". As a result, the FDA began to seize shipments of EPO and handed down felony indictments to General Nutrition, several executives and store managers for "conspiring to defraud the FDA and violating provisions of the Food, Drug, and Cosmetic Act". General Nutrition and its president entered guilty pleas and paid fines, but Horrobin was not prosecuted.
Efamol continued to ship EPO into the United States and to market its products. In a 1989 article on "health food frauds", the New York Times reported on the FDA's seizure of "more than $1 milion worth" of illegal EPO. The FDA again accused Efamol of marketing the oil "with unsubstantiated claims of treating a wide variety of illnesses". Efamol's lawyers responded that the product was not dangerous and that it had not made unsubstantiated claims. The American Dietetic Association, representing over 50,000 nutritionists, questioned the value of Horrobin's product since "one-tenth of a teaspoon of ordinary corn oil has as much of the fatty acids as a capsule of Evening Primrose Oil, at a fraction of the cost". In 1989, the FDA commissioned a report by investigator Stephen Barrett
Stephen Barrett
Stephen Joel Barrett is a retired American psychiatrist, author, co-founder of the National Council Against Health Fraud , and the webmaster of Quackwatch. He runs a number of websites dealing with quackery and health fraud. He focuses on consumer protection, medical ethics, and scientific...
, a medical doctor and consumer protection advocate. Barrett advised the FDA that Horrobin's marketing of Efamol was done in "a transparent attempt to evade the food and drug laws". In a report on the incident published by the consumer information organisation Quackwatch
Quackwatch
Quackwatch is an American non-profit organization founded by Stephen Barrett with the stated aim being to "combat health-related frauds, myths, fads, fallacies, and misconduct" and with a primary focus on providing "quackery-related information that is difficult or impossible to get elsewhere."...
, Barrett also questions Horrobin's research ethics: "Would someone that contemptuous of the law have any qualms about faking data?"
Allegations of selective reporting and research suppression
In 2006, a column in The GuardianThe Guardian
The Guardian, formerly known as The Manchester Guardian , is a British national daily newspaper in the Berliner format...
suggested that Horrobin had also actively suppressed research findings contradicting his claims about EPO. Horrobin wrote a meta-analysis of EPO research on eczema
Eczema
Eczema is a form of dermatitis, or inflammation of the epidermis . In England, an estimated 5.7 million or about one in every nine people have been diagnosed with the disease by a clinician at some point in their lives.The term eczema is broadly applied to a range of persistent skin conditions...
in 1989, concluding that EPO was effective. Horrobin excluded the negative results of the largest published study to date but included purported results of seven of his own unpublished studies that remained unpublished as of 2006. When several scientists asked to see the unpublished data, Horrobin's legal team convinced the journal to refuse the request. In 1997, Horrobin's team successfully halted the publication of another meta-analysis commissioned by the Department of Health. Research published after Horrobin's death indicates that fatty acids are no more effective than a placebo
Placebo
A placebo is a simulated or otherwise medically ineffectual treatment for a disease or other medical condition intended to deceive the recipient...
against eczema; Scotia's medicines licences for evening primrose oil drugs was withdrawn.
Investor concerns about an "ailing company"
As the supplement sales generated revenue, Horrobin's company began work on numerous drugs, most of them containing evening primrose oil. In 1993, the company was floated and enjoyed several years of increasing capitalisation as Horrobin reassured investors who worried about the company's lack of success, operating losses and enigmatic nature. Horrobin stated that any of four products in Scotia's drugs pipeline could bring the company billions of pounds in revenue. In early 1995, Horrobin said that he hoped to receive approval in the "next 18 months to sell one or both" of two of these drugs. In late 1996, Horrobin predicted that he would receive approval for one of the drugs "in under two years". In 1997, Horrobin stated, "Scotia will be cash-positive by 2000".However, the initial successes of Scotia on the stock markets and Horrobin's reassurances were undermined by what investors perceived as long-standing and systemic problems at the company, and they saw their fears confirmed with the rejection in March 1997 of regulatory approval for Scotia's drug Tarabetic. Also known as Efamol, the product contained evening primrose oil and was intended to treat diabetic peripheral neuropathy. Scotia immediately lost one quarter of its value. Licences for several evening primrose oil-containing drugs were later withdrawn. A Scotia product, Epogam, was reportedly the first drug to have its licence withdrawn as a result of "evidence that it didn't work".
By the end of 1997, Scotia was nearly broke and did not have enough money to fund another year of research. Investors worried that Horrobin had spread the company and its resources too thinly, a state described by The Guardian as "woolly, sprawling and lacking in focus". They also questioned Horrobin's judgement in promoting his wife to research manager of the company despite her lack of scientific or business training; her highest qualification was a BA in English and women's studies. Investors were restive about Horrobin's emphasis on products related to evening primrose oil, which they considered a "hippy" project, "outmoded and of questionable scientific validity". When it was found that borage
Borage
Borage, , also known as a starflower, is an annual herb originating in Syria, but naturalized throughout the Mediterranean region, as well as Asia Minor, Europe, North Africa, and South America. It grows to a height of , and is bristly or hairy all over the stems and leaves; the leaves are...
contained a higher percentage of gamma-linolenic acid
Gamma-Linolenic acid
γ-Linolenic acid is a fatty acid found primarily in vegetable oils...
than did the evening primrose, rival companies had begun to take market share of the supplement. In 1996, The Independent described Scotia's supplement business as "struggling". Horrobin responded to the borage competition by accusing his rivals of “duping women, selling pigs in pokes and marketing 'unstable and potentially toxic products'.”
Findings of fraud associated with Scotia trials also weighed on Horrobin's company. Goran Jamal, a doctor who had participated in developing Efamol, was found guilty of research fraud by the General Medical Council
General Medical Council
The General Medical Council registers and regulates doctors practising in the United Kingdom. It has the power to revoke or restrict a doctor's registration if it deems them unfit to practise...
in 2003. The Council ruled that Jamal had committed "serious professional misconduct for falsifying his results", manipulating the supposed randomisation of the clinical trial conducted over a decade earlier. Scotia was faulted by industry observers for what was called a "highly unusual" compensation scheme, as it had offered the doctor a portion of profits from future sales, although the Council suggested that Jamal was prompted to commit fraud by his "belief" in the efficacy of the drug and not by his desire for financial gain.
Horrobin's ouster from Scotia
Horrobin was ousted as chief executive of Scotia by a unanimous vote of the board and was replaced on 1 January 1998 by Robert Dow, whom Horrobin had hired several months earlier to help with the company's business plan and investor relations. Horrobin remained until May 1998 as a non-executive director. When he tried to stage a "boardroom coup" to return himself to the executive position, the other directors refused to support him, and Horrobin resigned. As the company’s value fell from about £600m to £16m, Horrobin and his successor each blamed the other for the company's failure. Scotia went into administration in 2001.Laxdale Ltd
Following his departure from Scotia, Horrobin set up a new company, Laxdale Ltd, to examine the use of omega-3 essential fatty acids in treating schizophreniaSchizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
and neurodegenerative diseases. The company was sold after his death to the Amarin Corporation and is now known as Amarin Neuroscience Ltd.
Research, publications and editorships
Horrobin was a prolific writer of academic and popular works. He was also the founder and editor of two journals, and, with his brother, the co-founder of MTP Press.Scientific publications
Horrobin was an author on over 800 publications, including about 500 scientific papers, many of which appeared in journals he edited. Horrobin's belief in a connection between fatty acids and schizophrenia guided much of his career. From 1970, Horrobin was medical adviser to the Schizophrenia Society of Great Britain. He later served as the Society's president. Horrobin also wrote on other scientific issues. He considered research with animal models of human diseaseAnimal model
An animal model is a living, non-human animal used during the research and investigation of human disease, for the purpose of better understanding the disease without the added risk of causing harm to an actual human being during the process...
to be a waste of resources, and believed that large-scale clinical trials were unnecessary and unethical. However, in at least one case, he defended modern medicine by writing a critique of Ivan Illich
Ivan Illich
Ivan Illich was an Austrian philosopher, Roman Catholic priest, and "maverick social critic" of the institutions of contemporary western culture and their effects on the provenance and practice of education, medicine, work, energy use, transportation, and economic development.- Personal life...
's famous attack on the medical establishment, Medical Nemesis.
Journal editor
Horrobin was a longtime critic of the anonymous peer reviewPeer review
Peer review is a process of self-regulation by a profession or a process of evaluation involving qualified individuals within the relevant field. Peer review methods are employed to maintain standards, improve performance and provide credibility...
system, which, he believed, stifled creativity and innovation in science. Horrobin founded and edited the journal Medical Hypotheses
Medical Hypotheses
Medical Hypotheses is a medical journal published by Elsevier. It was originally intended as a forum for unconventional ideas without the traditional filter of scientific peer review, "so long as are coherent and clearly expressed" in order to "foster the diversity and debate upon which the...
to provide an outlet for unorthodox ideas and research that would not be evaluated by other scientists before publication. Horrobin envisioned the journal as a resort for thinkers who were "very good at generating ideas, but are complete klutzes in the field" and committed to publishing ideas based only on whether he or other reviewers considered them "interesting and reasonable".
Horrobin also founded the journal Prostaglandins, Leukotrienes and Essential Fatty Acids. Science writer Susan Allport, in her book on dietary fatty acids, states that Horrobin founded this journal to disseminate his ideas about evening primrose oil and fatty acids.
Popular science
In the popular science book The Madness of Adam and Eve (2001), Horrobin outlined his hypothesis that schizophrenia contributed to the evolution of modern humans. According to Horrobin, fat metabolism was altered as humans evolved from other primates, leading to early humans with schizophrenia. These humans were more creative and did not experience as much physical pain as others. Horrobin suggested that the "genes for schizophrenia are responsible for most of the religious sense, most of the technical and artistic creativity and most of the leadership qualities of modern human beings". The Madness of Adam and Eve was one of six books shortlisted for the 2002 Aventis Prize (now the Royal Society Prizes for Science Books; the prize was won that year by Stephen HawkingStephen Hawking
Stephen William Hawking, CH, CBE, FRS, FRSA is an English theoretical physicist and cosmologist, whose scientific books and public appearances have made him an academic celebrity...
's The Universe in a Nutshell
The Universe in a Nutshell
The Universe in a Nutshell is one of Stephen Hawking's books on theoretical physics. It explains to a general audience various matters relating to the Lucasian professor's work, such as Gödel's Incompleteness Theorem and P-branes . It tells the history and principles of modern physics...
). Reviews of the book were mixed, writing of a "useful contribution" that was also "highly partisan and selective"; an "engaging and plausible argument" that is "not so convincingly" argued; and a book "brightly written" but with "a huge hole in its central premise" Horrobin was somewhat critical of his theory, describing it as a "just-so story perhaps fed by my own personal delusions". The book was compared unfavorably to similar works by Kay Redfield Jamison
Kay Redfield Jamison
Kay Redfield Jamison is an American clinical psychologist and writer whose work has centered on bipolar disorder which she has suffered from since her early adulthood...
, who examines a possible link between bipolar disorder
Bipolar disorder
Bipolar disorder or bipolar affective disorder, historically known as manic–depressive disorder, is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated energy levels, cognition, and mood with or without one or...
and artistic creativity.
Tim Crow
Tim Crow
Tim Crow is a British psychiatrist and researcher from Oxford. Much of his research is related to the causes of schizophrenia. He also has an interest in neurology and the evolutionary theory. He is the Honorary Director of the Prince of Wales International Centre for Research into Schizophrenia...
, a professor of psychiatry at Oxford University who had proposed a similar theory in 1995, accused Horrobin of failing to acknowledge Crow's contributions to the development of his ideas. When novelist Sebastian Faulks
Sebastian Faulks
-Early life:Faulks was born on 20 April 1953 in Donnington, Berkshire to Peter Faulks and Pamela . Edward Faulks, Baron Faulks, is his older brother. He was educated at Elstree School, Reading and went on to Wellington College, Berkshire...
stated that Horrobin's ideas influenced his novel Human Traces
Human Traces
Human Traces is a 2005 novel by Sebastian Faulks, best known as the British author of Birdsong and Charlotte Gray. The novel took Faulks five years to write...
, published in 2005, Crow protested that "much of the credit for his theory has been misdirected by Faulks to the late maverick doctor and writer, David Horrobin".
Death and obituary controversy
In 2001, Horrobin was diagnosed with mantle cell lymphomaLymphoma
Lymphoma is a cancer in the lymphatic cells of the immune system. Typically, lymphomas present as a solid tumor of lymphoid cells. Treatment might involve chemotherapy and in some cases radiotherapy and/or bone marrow transplantation, and can be curable depending on the histology, type, and stage...
. He died of pneumonia as a complication of this cancer in 2003. Horrobin was survived by his wife, Sherri Clarkson, and two children from a previous marriage. A number of obituaries were published, both in medical journals such as The Lancet
The Lancet
The Lancet is a weekly peer-reviewed general medical journal. It is one of the world's best known, oldest, and most respected general medical journals...
and Horrobin's Prostaglandins, Leukotrienes and Essential Fatty Acids, and in the popular press. Most obituaries referred to Horrobin as a highly intelligent, creative and persuasive individual. According to The Telegraph, Horrobin was "a founding father of the biotechnology industry and regarded by some as one of Britain's finest original thinkers in medicine", but the same obituary also noted that Horrobin's implication of fatty acid metabolism in schizophrenia was not accepted by other scientists; that his approach was "unorthodox" and unpopular; and that his major business venture failed. The many problems at Scotia under Horrobin's leadership, which led to the company's eventual collapse, were a theme in several obituaries including two highly critical and controversial accounts written by former Horrobin colleague Caroline Richmond and published in the British Medical Journal
BMJ
BMJ is a partially open-access peer-reviewed medical journal. Originally called the British Medical Journal, the title was officially shortened to BMJ in 1988. The journal is published by the BMJ Group, a wholly owned subsidiary of the British Medical Association...
(BMJ) and The Independent
The Independent
The Independent is a British national morning newspaper published in London by Independent Print Limited, owned by Alexander Lebedev since 2010. It is nicknamed the Indy, while the Sunday edition, The Independent on Sunday, is the Sindy. Launched in 1986, it is one of the youngest UK national daily...
.
The BMJ obituary sparked a months-long controversy. The obituary described Horrobin as "effortlessly prolific" and "one of the most persuasive people on earth", but also criticised him as excessively promoting evening primrose oil despite a lack of scientific evidence, noting that some critics questioned his ethics. It suggested that Horrobin "may prove to be the greatest snake oil salesman of his age", stating that his evening primrose oil would "go down in history as the remedy for which there is no disease" and reporting that several of Scotia's product licences were later withdrawn because the drugs were ineffective. The obituary generated the largest e-mail response to an obituary in the history of the BMJ. Respondents, including Horrobin's colleagues, friends and family, were largely critical of the negative tone of the obituary. On behalf of Horrobin's family, Horrobin's son-in-law, Adam Kelliher, filed a complaint with the British Press Complaints Commission
Press Complaints Commission
The Press Complaints Commission is a voluntary regulatory body for British printed newspapers and magazines, consisting of representatives of the major publishers. The PCC is funded by the annual levy it charges newspapers and magazines...
, alleging that the BMJ obituary was "inaccurate" and "intrusive at a time of grief" in violation of the Code of Practice. Kelliher was founder and at the time chief executive of Equazen, a company marketing fish and evening primrose oils including a formulation called eye q, said to improve scholastic ability in children. However, in his initial complaint to the BMJ Kelliher stated that he had no competing interests. In reaction, the BMJ published an apology to Horrobin's family expressing regret for any distress caused. The journal corrected what its editor considered several insignificant spelling and factual errors and published three further obituaries of Horrobin. However, the journal also defended its original obituary as fairly presenting "both the positive and negative aspects of its subject's life". Kelliher did not accept the BMJ apology as genuine and maintained that inaccuracies and "unjustified slander" remained, but the Press Complaints Commission declined to take any action against the journal, stating that the BMJ had offered "sufficient remedial action". According to the Commission, the journal was not obliged to omit negative information, including the journal's contention "that Dr Horrobin was 'in some ways a charlatan'".
Posthumous honours
In June 2004, the scientific publisher ElsevierElsevier
Elsevier is a publishing company which publishes medical and scientific literature. It is a part of the Reed Elsevier group. Based in Amsterdam, the company has operations in the United Kingdom, USA and elsewhere....
, having acquired the journal Medical Hypotheses
Medical Hypotheses
Medical Hypotheses is a medical journal published by Elsevier. It was originally intended as a forum for unconventional ideas without the traditional filter of scientific peer review, "so long as are coherent and clearly expressed" in order to "foster the diversity and debate upon which the...
, created an annual David Horrobin Prize for medical theory in his honour. He was posthumously awarded the Stephen S. Chang
Stephen S. Chang
Stephen S. Chang was a Chinese-born, American food scientist who was involved in the research of lipid and flavors in food, including the development of technology transfer between the United States and Taiwan.-Early career:...
Award by the American Oil Chemists' Society in 2003.