This Is Your Country on Drugs

[marmar]

from In These Times:



This Is Your Country on Drugs
Melody Petersen talks about how we’re hooked on Big Pharma.

By George Kenney


Melody Petersen has been writing about the pharmaceutical industry for more than 10 years, including as a staff reporter for the New York Times. Her recent book, Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines and Hooked the Nation on Prescription Drugs (Farrar, Straus and Giroux, 2008), should be required reading for anyone who’s serious about healthcare reform.


What is the most outrageous thing you have seen while covering the drug industry?

I went to a conference where the title of one talk that jumped out at me was “Creating a Disease.” A drug company executive got up on stage with a PowerPoint presentation and explained how his company had created a disease—overactive bladder. The company owned a pill for incontinence, but the market for incontinence is very low because mostly elderly people suffer from it, and doctors try to manage this in a non-pharmaceutical way. Even though this drug works on your bladder, it is very hard on your brain. It can cause severe memory problems. But the company wanted to expand the market so it created this disease called “overactive bladder” or “OAB,” which it defined as needing to go to the bathroom more than nine times a day. And now you see ads for this drug, Detrol, for overactive bladders. It became a blockbuster.

As you say in the title of your book, it’s all a huge marketing machine. In Europe and Canada they pay less for drugs and take fewer.

Two-thirds of men, women and children in the United States take at least one prescription drug. And children in the United States are three times more likely to take anti-depressants and psychiatric drugs as children in Europe. We spend at least $300 billion a year on prescription drugs. That is about twice than what we spend on higher education.

The United States ranks 50th in life expectancy, according to the CIA. Today a 65-year-old Mexican man will live longer than a 65-year-old American man. How important are those international comparisons?

We are paying more in healthcare per person than any other country. In our economy, almost one out of every five dollars is spent on healthcare, and it continues to rise at a rate greater than inflation. You would think that with us spending so much, we would be at the top of the life expectancy ranking.

The implicit argument is that in addition to all the other problems, we are suffering from an excess dosage of drugs. This goes back to the marketing. What does the bulk of the marketing go into?

Most of the marketing dollars are spent on physicians. When the drug ads on television say, “Ask your doctor about this drug,” the drug companies have already been to your physician and made sure he or she was ready to prescribe it. A survey of physicians a couple years ago found that more than nine out of ten had recently taken some sort of gift or cash from the drug companies. And many doctors are taking hundreds of thousands of dollars a year from these drug companies, working as consultants and advisers. ...........(more)

The complete piece is at: http://www.inthesetimes.com/article/5316/this_is_your_country_on_drugs

[AzDar]

1. K & R

[rgbecker]

2. The Other War on Drugs! Time to open another front. n/t

[kcass1954]

3. Just wait till the pharma execs find out about asset forfeiture. n/t

[DCKit]

6. This time, it could be justified. n/t

[fascisthunter]

20. corruption is corruption

or does that get a price tag too? Does everything have to? Should everything have to?

[havocmom]

4. REAL HCR would include means of turning McMedician back into Health Care

Tinkering to make the world safe for insurance companies and Wall Street does NOT make real health care any more likely for anyone. The whole system is broken because it has the wrong goals/aims/focus.

[arustynail]

5. Legal drugs appear to be dangerous to your health. Not nearly

so much so with ILLegal drugs. Marijuana, for example, has no history in all of recorded history, of causing even a single death, yet
we allow and encourage the arrest and incarceration of more than half a million citizens year in and year out...thereby
destroying not only THEIR lives but also the lives of many of their family members.

I was hoping that maybe Obama might speak out about this crime against American humanity. I fear a long wait awaits.

[yankee2]

44. MJ has numerous benefits and virtually no dangerous side effects

Marijuana is such a stand-out case of a cheap drug with many beneficial effects, which is also pleasurable to use, and which produces virtually no dangerous side effects, that the fact that it is prohibited is absurd, but which can be understood. Marijuana has been called "safe to use on the highway" by the US DOT, does not cause any disease more dangerous than bronchitis, is NOT addictive, does not cause "anti-motivational syndrome," and is NOT a "gate-way drug." These facts are well known.

Marijuana was prohibited for a variety of reasons, none of which the DEA tells you about. It was prohibited because it (hemp, actually) would compete with the DuPont's new synthetic fibers, used for rope, fabric, paper and many other products. Prohibition was aided by forces which wanted to insult and harm Blacks and Mexicans, the principal users at the time. And of course the same Puritanical moralists who wanted to prohibit alcohol, since that failed, have joined the debate about MJ. Then there is the lucrative industry that is the drug war, in which about $50billion are handed out annually to its soldiers (police, jailers, lawyers, rehab operators, the propaganda media, etc.) Finally, the pharmas oppose it because it cannot be patented, and so it not only cannot become anyone's cash-cow, but it might very well compete with their established drug business. In that multi-$trillion dollar industry, THAT would be most unwelcome. None of these reasons have anything to do with public health or safety, or motivation or getting people addicted to hard drugs or anything else legitimate. The REAL reasons are very selfish.

If anyone has any doubt, consider this: if the negative effects of marijuana use are so severe, as some drug warriors would have us believe, why are they so difficult to demonstrate? The drug-war establishment has been telling wild and crazy lies about MJ for decades, and have funded hundreds if not thousands of research projects, the stated purpose of which has been to uncover harms which could justify prohibition. After decades of trying, they have failed utterly. The upshot of those and every other research project on marijuana has been that marijuana is nearly if not completely harmless. It is certainly MUCH less harmful than the cash-cows that are the legal drugs (one reason it IS prohibited is that it lacks potential to be anybody's cash-cow). It may produce risks similar to those of some OTC drugs, but unlike those, MJ has NEVER caused a single death or even a single case of serious illness.

Marijuana MUST be legalized in the next few years, Obama or no Obama. Just keep on keepin' on, truckin', and writing lots of letters telling truth to power. If we NEVER give up, success should be assured. They cannot forever continue to prohibit the least harmful drug of all.

[Name removed]

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[BakedAtAMileHigh]

8. Thank You!

I just finished watching about 20 minutes of Melody Petersen w/ Bill Moyers: it is chilling information. I found the second part particularly interesting: one of the things Ms. Petersen learned in her eight years of research was the variety of methods Big Pharma uses to manipulate their "independent" safety and efficacy studies including dosage alteration, the purposeful increase of side effects of "outdated" drugs, etc. There is a moment in the interview when she describes searching for an expert on a specific new drug through the AMA: there were none available without direct ties to the industry....anywhere.

[bpcmxr]

10. Do you have a link for that conversation?

Would love to see it. Thanks!

[chimpyisstillsatan]

29. most health experts make their skills available

to people who develop drugs. That's one of the reasons they became experts, to have an impact on disease.

Taken to its logical cnclusion, your complaint sounds like the Palin for President argument that people who are skilled in governance are by definition disqualified from governing, so let's hire the ignorant to run the show.

[JoeyT]

32. The way they manipulate the adverse effects is pretty terrible too.

The most glaring example, which I won't name because I'm not sure of site policy in regards to that, used seven or eight different acronyms to split the "Makes you dumber than a bag of hammers" category. So instead of admitting that roughly half of the people that take it have cognitive problems, it looks like 6-8% of the people had serious cognitive problems while everyone else suffered no impairment.

[Name removed]

9. Deleted message

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[KittyWampus]

11. Hopefully DU'ers will read the whole article- doctors prescribing meds the FDA didn't sign off on,

pharmaceutical cos inventing diseases, in passing at the end she does mention side effects making people sicker than they started out.

[hedgehog]

12. It's all the fault of Frederick Banting! He developed insulin as

a treatment for diabetes instead of developing a cure, the bastard!

[KittyWampus]

13. there were huge pharmaceuticals buying off doctors and the FDA and Congress in the 30's?

do you think he'd have gone on to work on a drug to "manage" restless leg syndrome if he were still alive today?

[hedgehog]

14. Restless leg syndrome sounds trivial - to people who don't have it

or who don't share a bed with someone who has it. As for overactive bladder - imagine going to the bathroom every hour or so all day and several times during the night. Sounds trivial, but you would end up planning your life around bathroom stops.

There are many chronic conditions out there that don't kill but do make people miserable. I don't object to treating a chronic illness until someone figures out a cure. I am concerned about all the people being treated for high cholesterol. I think evidence is emerging to indicate that high cholesterol is caused by whatever causes heart disease. In other words, lowering cholesterol may have nothing at all to do with preventing heart disease. It's the equivalent of silencing an alarm without fixing the problem. Some anti-cholesterol drugs have been shown to reduce heart disease, but i suspect that those drugs are getting to the root of the problem.

[wildflower]

15. Thanks

I too know people with restless leg syndrome, as well as chronic dry eye, another condition I hear being made fun of. I also agree with your thoughts on cholesterol.

I do worry that there is more money to be made in treatments than in cures, so I'm torn; I think a balance needs to be struck somehow with pharmaceuticals.

[walldude]

16. Well I for one would rather have to pee 9 times a day than loose my memory

the cure is worse than the disease. Lots of people have to "plan their life" around things. Start losing your memory and you'll have to plan your life around remembering where you are supposed to be going or finding your car keys.

[hedgehog]

19. Every drug has to be considered for its potential risks and advantages

for that particular person. Usually, only a few people suffer from the side effects and have to stop using a medication.

[chimpyisstillsatan]

27. memory loss

is a consequence of stress and lack of sleep. Trivializing another's suffering is inhumane.

[HiFructosePronSyrup]

31. Tell you what. Start an addiction to heroin.

Get really, really addicted to it.

Then quit presumably, presumably in some sort of clinic where they keep you locked in the room.

Then, as you're suffering from withdrawal symptoms, thrashing around because you can't keep your self still due to Restless Leg Syndrome- then tell us you wouldn't take a drug to solve the problem.

You see, it's pretty fucking easy to say you wouldn't take a drug when you don't have the problem it cures.

[mopinko]

18. thank you. sleep disorders are not a joke.

got a kid with restless leg, and it starts a cascade that has serious consequences.

[Goldstein1984]

21. Statin drugs for cholesterol can have terrible side effects

I had to be taken off of statins because I was experiencing the side effects.

There is evidence that atherosclerosis is cause by inflammation, not by cholesterol. Statin drugs do have anti-inflammatory effects, and at 1/10th the does for cholesterol management. There is a good chance that the link between cholesterol and heart disease is mere correlation. Blaming cholesterol for heart disease may make as much sense as blaming bricks for walls.

When I was pulled off of statins, I was prescribed another set of medications. They don't block key metabolic pathways like statins, but I had had my fill, and I'm just treating myself with niacin and a healthier diet now.

[Odin2005]

22. No use arguing with the anti-medication people.

I've run into posters that want the Paxil I take for anxiety, panic disorder, and depression banned. These people are nuts.

[chimpyisstillsatan]

26. statins work

Check out the decades of research from Framingham heart study. Granted, diet and exercise would work for most people, but among those with familial hypercholesterolemia, there is only substitute for a statin. Death.

[Hannah Bell]

33. there's actually a type of familial hypercholesterolemia where the risk of

heart disease is super-low, rather than super-high.

interesting stuff.

[chimpyisstillsatan]

37. got references handy?

that sounds really interesting. Are there complementary mutations that prevent cholesterol uptake or something?

[Overseas]

17. K&R. Medicine for Profit can cross ethical lines.

I always wondered whether a drug with a side-effect like making it more difficult to urinate would then be marketed anew as a cure for incontinence, just shuffle the side-effect language around.

The Bush Crash of 2008 was the great occasion to have ushered nonprofit healthcare back in to the US landscape. Bailed out Big Finance, so bailing Big People (Millions of Citizens)out of national health insecurity was so apropos right then. Desperate situation. 44,000 dieing early.

Second wave too though. Still appropriate to open up Medicare to help out millions of pre-seniors during the tightest job market we've seen. Along with the mega jobs programs we need doing valuable, practical things that support our national priorities--

>> Address the GOP-administered heap of deferred maintenance projects left to be done.

>> Green jobs retrofitting homes to save each ounce of old energy, and build up alternative sources of energy to give the citizens more national security by relying less on dirty old petroleum. We will still need billions of barrels, but if we can reduce that, that would go a long way to supporting our national security too.

Somehow our society needs to transition toward more green/sustainable business practices. We would like to do it carefully and cooperatively, rather than waiting for desperate emergencies.

That's my chess. The green thing could have many beautiful dimensions. Doing more with less. Savoring more.

And medicine would be encouraged to become more practical. Low key. Tough transition.

[Odin2005]

23. Right, and I bet my anxiety disorder is "all in my head" and there is no such thing as ADHD.

Sorry if I am skeptical, but I have run into way too many insulting "pharma is evil" rants decrying the evils of the Ritalin and SSRIs I take.

[depakid]

24. One reason why almost no other western country allows drug ads on TV

Disease mongering.

We can thank Bill Clinton for that....

[Echo In Light]

35. +1

[chimpyisstillsatan]

25. I've heard this "made up disease" crap

about my restless leg syndrome. Nobody who says it has ever watched me lose sleep or kick the shit out of my wife in the middle of the night when I fail to take my mirapex.

They used to say PMS was a fallacy, and anxiety, and PTSD, and erectile dysfuntion. They still say it about Fibromyalgia, and apparently bladder control problems. I know adults in their 30's who can't be in a car for more than 20-30 minutes because of bladder problems. I guess they don't DESERVE treatment because a Pharma company raised awareness of their disease, reducing their reluctance to speak about it, and encouraged patients to seek help, right?

I'll further bet there is considerable context missing from Ms. Peterson's "make-believe disease" powerpoint story than the ITT article lets on.

[lastliberalintexas]

40. Mirapex can have some nasty side effects

I am certainly not advising you to get off the meds, but just making sure you know. A friend's relative was taking it for a neuro disease and experienced some of them, which her doctor had failed to warn her about.

I wish you the best with your legs. Night cramps (unrelated to potassium intake) tend to run in my family. Thankfully I don't have them very frequently at all, but when I do get one, it is debilitating.

[chimpyisstillsatan]

41. not for me

requip, OTOH made me hallucinate and get nauseous. Not a good combo.

[iris27]

28. I'm willing to bet a large chunk of that "2/3 of all adults" are women

on the Pill. That's the only prescription I take, anyway, and it's cheaper to spend $18 on a 3-month supply at Costco than the comparable cost of condoms.

[windbreeze]

30. What's wrong with, in all things, moderation?

I know several people who take hands full of pills at least twice a day...I have seen it with my own eyes...along with other pills they take, randomly, for various things, in between the doses of multiple pills they take...I've been literally horrified to see the amount of pills being taken...and I know people who take every damned pill they do, just because the doctor said I should...w/o taking any control of their own lives....I also know of one child in particular who, by the age of 10 was on so many drugs for adhd/add, etc...that I worried for his brain/liver/his future...and for anyone who came into contact with him, as he was uncontrollable...guess what? They took him from his home, put him into foster care, and proceeded to take him off all the prescribed medications...so quess what?? He is a totally changed kid, now at the age of 13..I would have never believed I would see him like he is today...the medications were the problem....all those years, I kept trying to warn them that medications could be what was wrong with him..but...the doctor said so, so they medicated him excessively for years...I know a woman who takes a statin drug, because the doctor said so, even though she has never had a problem with cholesterol, and doesn't understand why she's taking it..hell, she received a medication by mail order, took it, and when she went to get it refilled, discovered that the pills were put into the wrong mailbox. They belonged to the neighbor man...3 months she took a prescription that wasn't hers, because she didn't pay attention to the name on the envelope they came in, (both of them belong to group health)and because she just figured group health sent them, so she must need them, (same pill she takes for cholesterol, that she doesn't need, she took a double dose of for 3 solid months)

I'm not saying all drugs are bad, or that no one should ever take any, what I am saying is that way too many people take way too many drugs...A lot of times taking drugs that they/we really don't need, and would be better off without...To the point that we are contaminating our ground water supply....We ARE a drugged society, and prescription drugs are just as dangerous as illegal drugs, if not more so...

How many times have drugs been on the market, and been prescribed to millions of people...then just as suddenly been pulled off the market because of some terrible consequences suffered by the people who took them?

People need to be actively involved in medical decisions...Don't take something just because the doctor said so...make sure you read the fine print on the inserts that come with prescriptions, or go on the web and check it out...many times the side effects, or allergic reactions can be/or are worse than the condition we suffer from to begin with..then after doing our research, we need to use our heads and act accordingly...wb

[midnight]

34. This is a good example of why our Insurance delivery system is not working.

The United States ranks 50th in life expectancy, according to the CIA. Today a 65-year-old Mexican man will live longer than a 65-year-old American man. How important are those international comparisons?

We are paying more in healthcare per person than any other country. In our economy, almost one out of every five dollars is spent on healthcare, and it continues to rise at a rate greater than inflation. You would think that with us spending so much, we would be at the top of the life expectancy ranking.

[waronbanks]

36. I dont think the jest of the article

is that people should not get relief from chronic ailments. I think it is the unscrupulous means the drug companies use to squeeze every dime they can out of Americans, how they pay off the FDA to get their "poisons" released to the masses and refusal by our government to do a damn thing about it.

Its the absolute profit motive...profits above all else...that is the sickening aspect of Pharma. Advertising on TV should never have been allowed. Our government should insist on price regulation...not be making deals with them to maintain status quo.

When a doctor tells you need an antidepressant, oh and you need Ambien to help you sleep because the Lexapro keeps you awake, and you should take a little Valium to offset the anxiety of the Ambien...well you see where that goes. THAT is the problem.

We need to regulate these bastards or they will pay off the FDA, charge outrageous prices for their questionable poisons, kill 50,000 people and then move on to the next scheme if we dont firmly regulate them.

I would never minimize anyones problems whether its bladder control or the "jimmy legs" (sorry...had to get a Seinfeld joke in there) or whatever. but getting these drug companies under control should be a number one priority of any health reform. Sadly...our president dealt that away.

[chimpyisstillsatan]

38. this isn't a Rorshach test

You seem to be projecting your own agendas and opinions on the article.

The gist of the article is that there's a person of alleged repute who claims that the drug companies are manufacturing diseases to sell drugs that otherwise have no apparent value. In doing so, this person delegitimizes the suffering of patients with those diseases.

You've identified several other potential themes in the health care discussion (profit margins-presumably for legitimate diseases; TV advertising, allegedly lax enforcement and outright corruption; pricing; and physician overprescribing). None of those are the focus of the article cited by the OP.

[debbierlus]

39. Fascinating and disturbing...

[truedelphi]

42. Here is an important implication of this topic -

We not only have a Big Pharma Industry that "creates" diseases (Like the overactive bladder
disease that is mentioned in this article.)

But with Big Pharma's control over the FDA, we don't have inexpensive drugs or remedies that can prevent and or cure various nasty conditions. Friends of mine are taking black walnut extract - two tablespoons a day. And this is relieving many of their fibromyalgia symptoms. Cost of this extract -nothing. The women go out and gather the black walnuts in the suburban style housing tracts - the homeowners don't like the walnuts as they aren't edible and also they leave black spots on their lawns come autumn.

It is known that marijuana oils and extracts can shrink tumors. Yet our Federal Government continues to rely on the Big Pharrma people who make statements to the press that in the history of medicine, marijuana had never ever been known to aid people with health problems.

Patently untrue - you go back five thousand years, and Chinese doctors were using marijuana to help women with heavy menses and cramps. In the early days of our country, marijuana was known to help with asthma. And the Big Pharma people don't want marijuana eliminated - just kept illegal for the private individual. They already are working on patents of various cannibinoids such that various health journals discuss how these cannibinoids will assist multiple sclerosis patients. These cannibinoids, once patented, will be sold at huge profits to those people, because Big Pharma is doing everything it can to see that people cannot grow their own.

[yankee2]

43. Pharmas make products, not drugs per se

One major problem with every Capitalist enterprise is that because profit is the primary objective, corporations do not make goods, they make products. That is, if any part of a product can be expected to be as good as it can be, it is its function as a product, i.e. as a device to make money, NOT its function as a tool to accomplish some kind of work.

This is particularly evident in the case of pharmaceutical drugs. I worked for a major Swiss Pharmaceutical company for several years, and became aware that pharmas, as well as smaller biotechs, often buy up or otherwise acquire promising patents for new drugs - and SIT ON THEM. And that is NOT because they hold low potential, in fact, it is often just the opposite - because they have the potential to compete effectively with their OTHER drugs, which are very profitable.

So they prevent new, alternative drugs from coming onto the market, despite the likelihood that they may prevent much suffering and even loss of life - because they would reduce the pharma's profits. Just as a single automobile company would not want to produce 2 similar, competing automobiles, pharmas resist producing 2 drugs that would compete with each other. You might ask "what difference does that make, since the 1st drug is effective?" The difference is that different people respond differently to different drugs, so some might respond better to the newer one, and - the new drug (which is not being produced) may in fact be the much better of the two.

Another reason a company might acquire and deep-six a drug is to prevent a competitor from getting its hands on it. The bottom line is that modern corporations, if they serve the common good at all, serve it purely as an incidental consequence of making profits. Making profits comes first, and if that end can be accomplished WITHOUT doing anyone else any good, that is fine with them. As a result, we often do NOT get the best of much of anything for our money, but we DO get exploited to the max. Every corporation is dedicated to getting as much for their products as possible, i.e. to maximizing profits, regardless of the cost of production. Corporations may provide some desirable products, but seldom offer them at "a fair profit," i.e. they charge the maximum price the market will bear.

Capitalism is a very poor model for promoting the common good, be it in health care or any other area of production.