The Problem with Big Pharma, Part II

Alright, this is part II of my longwinded ranting about big pharma. Strap on your seat-belts, because here I go again.

When last we spoke, I left you with the question of how my doctor had been so mind-booglingly stupid as to confuse the staph infection I had on my leg with fleas; the only real commonalities are 1. they itch and 2. they look funky. My answer is a little tongue in cheek, but not altogether absurd.

Big Pharma and Med Students

There's a developing trend in med schools that's a little scary for those of us who want out doctors to be reliable, unbiased, and well-studied. That trend is drug manufacturers sponsoring lectures and professors, and "educating" those enrolled in med schools.

In 2005, University of Minnesota students complained that PowerPoint slides for a lecture on erectile dysfunction were watermarked with the logo for Cialis (a drug for erectile dysfunction manufactured by Eli Lilly). Moreover, it was found that the professor giving the lecture was on the advisory board for Cialis and, hence, had a vested interest in the company.

How can we expect that these students are getting the full story of so-called "erectile dysfunction" (which many say can be improved by adding a little chili to your diet) if their lectures are being given by a specific drug company with aims towards profit?

Another example of the biased condition of med schools is made clear in the story of David Healy; Healy was offered a position at the Centre for Addiction and Mental Health (CAMH), which is a U of T affiliate. Shortly after the offer was made, he gave a lecture at the CAMH in which he raised concerns about new anti-psychotic drugs, saying the had the potential to do a great deal of harm in some patients and should be perscribed carefully. The physcian-in-chief of the CAMH, Dr. David Goldbloom, was extremely angered by the lecture and withdrew the job offer.

Even though the audience present had ranked Healy's lecture as the best of the day, he was still punished for speaking out against drug companies (specifically, the manufacturers of Prozac, which has a patient suicide rate of 10/1000 as opposed to the average 1.5/1000). So, it seems the best lecturers are being turned away, if they don't agree with pushing pharmaceuticals.

Maybe this doesn't exactly explain the kind of ineptitude my doctor exhibited, but it certainly does explain (what I would call) the declining quality of doctors overall. The real facts are being made secondary to the facts that are going to sell a higher number of drugs.

Revising Guidelines

Another point I want to quickly speak to is the revision of cholesterol guidelines and what constitutes "high cholesterol." Once upon a time, the cut-off for high cholesterol was much higher than it is today: it's moved from blood cholesterol levels of 280mm per deciliter all the way down to below 100. Why the drastic change?

In 2003 it was found that eight of the nine major experts who wrote the 2003 cholesterol guidelines were employed by major drug companies. Hence, a lower cut-off means more people have "high cholesterol," which means more people need drugs. In 2005 the guidelines changed so that 500,000 more people would be advised to take statin medication. That meant $250 million more in profit for drug companies.

To put things in perspective: a middle-aged man who takes statins for 10 years reduces his risk of heart attack by 2%, on average. However, napping about 3 times a week for 30 minutes reduces your risk of heart-attack by about 37%. So, why are we paying for these drugs, again?

Moreover, people who do not have evidence of occlusive vascular disease SHOULD NOT BE TAKING STATINS. That means that 3/4 of the people who are currently on them, should not, in fact, be. This means that the doctors that we put so much faith in are frequently perscribing drugs to people who don't need them!

You've got to ask yourself, have the risks of cholesterol over 100mm really changed that much, or is there something else going on here? Who's benefitting?

The drug industry, though it does a lot of good for a lot of people, does not deserve the kind of power and authority that we give to it. One of the things that we so often forget is that we are consumers, dealing with businesses. The pharmaceutical industry is a business. The media exists, businesses exist, drug commercials exist to sell us products. They are not parents, or gods, or protectors of mankind. The are a bunch of folks who are out to make money. And there's nothing wrong with that. The problems start when they start deceiving us and we don't look take responsibility for ourselves and look into the deceit.

Amber Pinsonneault's Feed Your Head is a great place to starting learning about natural health alternatives and what works. Again, the facts found in this post were taken from James Winter's "Lies the Media Tells Us" and the documentary "Big Bucks, Big Pharma."

posted by Ashley Girty @ 3:30 PM, ,


Big Pharma: Do You Often Experience Pain, Dizziness, or the Urge to Take Drugs You Don't Need?

Those of you who know me are probably aware of my long-standing hatred of doctors. I think it started when one looked down his nose at me, diagnosed me with fleas (when I really had a fever, mild blood-poisoning, and staph infection) and told I ought to take better care of my cats (to this day I have never owned even one cat). This was before ushering me out the door with a perscription for flea cream. Thanks, doc. There have been various -- indeed much worse -- incidents since, but it was at that moment that I realized that being doctor doesn't necessarily mean you can tell the difference between a sick person and plain old itchy one. So, it wasn't shocking when, a few years later, I discovered that all the faith I'd had in pharmaceuticals was equally unfounded.

Mostly, the realization came through seeing too many ads on tv, getting curious, and looking into what was going on. What I found out was that there's a lot of ground to cover when you're talking about big pharma and why they are more-or-less evil incarnate, so I will try to break it down as best I can. Moreover, I think I have found the reason why Dr. McFleas was so vastly insipid as to imagine I had a common feline ailment, but I'll explain that in an upcoming post (this subject will be basis for a few posts because of the volume of information).

But, for now, let's start with the obvious:

Advertising to the Public

Alright, so you're sitting at home, watching some Grey's, or whatever shameful innocuous drama it is that you watch, and we cut to commercial. Suddenly: Are you too fat? Are you too thin? Does something on you hurt? Do you occasionally experience emotion?!!? There's a pill for that!

There's a reason why for most of the 90s and early 2000s the combined profits of the top ten pharmaceutical companies exceeded the combined profits of the other 490 Fortune 500 companies. There's a reason why big American drug companies have a profit margin of about 17%, where 3.1% is considered high. There's a reason why in Germany today a typical glass of drinking water contains anywhere between 30 and 60 antibiotics, hormones, pain killers, chemo chemicals, etc. Why?

Because, overwhelmingly, our global society believes that pills are a cure-all answer. And a big part of the reason we think that is advertising. Every year, 4.2 billion dollars are spent on advertising drugs directly to consumers. Mostly, the money is spent on advertisements which "brand" pills, or create an emotional bond between the consumer and the product. For example, let's look at this Nexium ad:



Alright, so, for the first 15 seconds of this 1 minute ad, we have no indication that we're being offered a pill. We've got an all-American dad, "the Finisher" who runs his family, gets things done, lives the upper-middle class ideal. The way he bursts down the hall with a puffed out chest is more than a little reminiscient of Superman. The first thing that's being sold isn't a pill, it's a persona, a lifestyle. Nexium isn't just about heartburn, then. It's about being a successful man and a good dad.

Then we find out about what the pill supposedly does. And the side effects: his doctor did say that headache, diarrhea, and abdominal pain could be side effects of Nexium. But let's not dwell on this for too long! We quickly move on to a picture of him and the kids are hanging out on the immaculate lawn in front of a picture perfect treehouse. (And, p.s., did any of you have a treehouse like that growing up? I mean, I wasn't the only one with a structurally unsound hodgepodge of 2" by 4"s in a tree, was I?)

So basically, we have viable ad for a pill sandwiched between two montages that have absolutely nothing to do with medicine. They are there to create a brand identity and sell a lifestyle.

It's an effective tool, because every year hundreds of people walk into their doctor's office with a list of meds that they're interested in. The way we are told to feel about Nexium is as much about fatherhood as it is about acid reflux. Whether or not we actually NEED these drugs becomes irrelevant: I mean, women have apparently asked for Viagra and Cialis. Not the way that works, ladies!

But there's a lot more going on than just the obvious branding advertisements we see everyday.

Other forms of advertising

Let's talk about the other stuff, the advertising we don't know about. There's a lot of stuff we just don't see, but, make no mistake about it, it's there, it's impacting our lives, and drug companies are spending a truckload of money on it. The target? Doctors.

Ghostwriting

Somewhere between 11% and 50% of the articles in any given major medical journal will be written by, you guessed it, big pharma. Industry workers write articles and then pay doctors to submit these articles to journals under their names, as if they had written them. These articles are more favourable toward the drug in question by an 8:1 margin. "Cialis is so badass! Medically speaking, this is the most badass drug of all time. 100% guarenteed to increase badassitude with no ill effects. Perscribing this drug means that your badass too!" Other doctors then read these articles and perscribe the drug, not being fully aware of its success rates, side effects, etc. The result? The world gets screwed.

Making Laws

Big Pharma doesn't merely obey laws; they make them too. This is because they can afford to hire lobbyists. In 2003, big pharma had 675 lobbyists in Washington, which is more than 1 per congressman. Moreover, in 1992 the Perscription Drug User Fee Act was passed, which allowed drug companies to pay the FDA in order to speed up drug approval (I'm not saying the FDA couldn't speed things up a little, or a lot, but in such a way that they agree to do a lousy job in order to pad their pockets). Drug companies and the current forms of government making friends = no good for consumers.

"Educating" Medical Students and Doctors

This is a HUGE issue in the pharmaceutical industry. You know when you walk into the doctor's office, and he or she looks like a pharmaceutical float? The Ambien pen, the Septra pad, the Xanax lancer, the Lipitor coat? Yes? That's the result of sales reps! Yes, there are sales reps who visit your doctor in order to pump their companies drugs.

Overwhelmingly, the reps are young, flirty, good-looking women. These reps are employed to bring doctors lunch, remember the names of their wives and kids, their birthdays... Basically, it's all about making the doctor feel special. What's more, these reps have huge expense accounts; friendly bribes are commonplace.

One example: a former drug rep, Phyllis Adams, arranged a $35,000 "unrestricted educational grant" for a doctor... it was used to put a swimming pool in his backyard. No joke.

According to another former rep, ten minutes with a doctor means that your market share is going to go through the roof. In other words, that doctor is going to start perscribing your drug a lot more, because gee, aren't those people at GlaxoSmithKline nice? That's great for the company, but not necessarily great for the people who are being put on meds that they don't need, or meds that they could get for cheaper, or these meds instead of those meds, which would actually work better for them.

But it doesn't stop with the wisened old doctors; now big pharma has moved in on med students... I'll be talking about that and other facets of big pharma in my next post.

Also, fyi, most of the facts for this post are coming from James Winter's "Lies the Media tell Us" and the documentary "Big Bucks, Big Pharma," which is available to watch at FreeDocumentaries.org.

posted by Ashley Girty @ 2:41 PM, ,


Here, Have a Nerdy Past Time!

Alright, everyone, I come to you this week bearing exciting news -- especially if you are a fellow media-nerd. I have found a way in which to expend virtually no effort while similtaniously improving my media literacy! Sound too good to be true? I assure you, it's not! (Alright, I probably sound sort of like an infomercial here, but I'm still fairly geeked about it.)

The source of my newfound knowledge and glee is FreeDocumentaries.org. This website hosts about a hundred full-length documentaries, most of which provide altnernative media perspectives on exciting issues such as Cuba, Nicaragua, US interventions, democracy... You name it and they've probably got it.

Basically, I have combined this website with my extraordingary powers of facebooking, twittering, and general online time-wasting in order to create a fabulous situation of passive learning. Simply put one of these films on in the background while you browse and you'll probably learn something that will blow your mind without even having to do anything!

Here are a few of my favourites:
Next up, I have my eye on the uber-corny sounding Secrets of the CIA (though I'm sure it will be better than it sounds). It might even be good enough to warrent my full-attention and a bag of popcorn...!

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posted by Ashley Girty @ 3:59 PM, ,