Our Daily Meds: Navigating the Polypharmacy

In the 1970s, Professor J. Scott Armstrong put forth a conundrum to close to 2,000 business school students and executive trainees. Intrigued by the corporatizing of the pharmaceutical industry, he created a scenario (based on an actual 1969 incident) in which a company has a new drug with a projected $20 million profit. The catch: For each million the company nets, there is one death from side effects. The first twenty million meant twenty deaths, and so on thereafter.

Students and trainees were given five options, ranging from immediately pulling the drug from shelves--regulators stated cheaper, more effective pills without such grave side effects exist--to downplaying risks and promoting the drug heavily, creating a media-driven whitewash in which consumers could not discern problems, and therefore readily open their pockets.

The results? Zero took the first option; 79% chose the latter. As former NY Times journalist Melody Petersen writes in her new book, Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines and Hooked the Nation on Prescription Drugs (Sarah Chrichton Books), "For these students and trainees, who were playing the roles of the executives they would soon become, profits took precedence over patients."

As one can imagine by the book's subtitle, the above is not an isolated case study. In fact, it shows how the drive to maximize profits at any expense is built into the educational system by which students become executives. Petersen spends the majority of her book citing such examples, moving from hard facts and statistical data to personal interviews with people who have fallen victim to the marketing of pharmaceutical companies or, worse, have lost loved ones during the same process.

The varied and often disguised layers of pharmaceutical marketing and maneuvering begin at the outset, when Petersen reminds us that Americans spent $250 billion in 2005 on prescription drugs -- twice as much as we paid for higher education or new cars. This total is also greater than the population of "Japan, Germany, France, Italy, Spain, the United Kingdom, Australia, New Zealand, Canada, Mexico, Brazil, and Argentina combined." Sadly, this is due in part because our federal government is the only office in the developed world that does not control prescription drug prices. It leaves that to the companies themselves, a process that belittles the integrity of the medical profession--which is supposed to be about healing--by sticking to the idea that "the few the options, the higher the price; the greater the desperation, the greater the suffering, the higher the price."

Even more depressing are corporate payouts to doctors, the men and women who are supposed to represent the pinnacle of the healthcare profession. Petersen cites numerous examples of doctors receiving payola for prescribing certain drugs, like Dr. B.J. Wilder, who received a $401,350 check from Warner-Lambert to send himself and 125 medical residents to a luxury resort in Florida, or Dr. Ilo Leppik, who received a stipend of $303,600 to publish his book on epilepsy. Both were awarded those sums for the support they gave to Neurontin -- a drug that Pfizer (which came to own Warner-Lambert) had to pay $430 million in court fees for illegally marketing. An estimated 90% of prescriptions of the drug were for uses that the drug was not approved to treat, including attention deficit disorder and sexual dysfunction. Originally developed to combat epilepsy (and even then, not very well), it became a hit for the company for a variety of other "illnesses" which it did nothing for.

Again, this is not an isolated case by any means. Buying off doctors to promote prescriptions -- a practice which takes numerous forms, including "scientific" reports written by marketing companies and signed off by supposedly respected professionals, as well as partnering with them to help create diseases that don't necessarily exist--affects the majority of the industry. As Petersen often reminds us, paying off DJs to play music was regulated thanks to governmental intervention. When dealing with substances that can, and are, killing hundreds of thousands of Americans (the healthcare industry is the third biggest killer in the country, behind heart failure and cancer), however, the government and FDA remain mute.

I found myself getting angry at each page I turned. Yet it was an empowering rage, one based in knowledge. The book is like lifting the veil of ignorance that hangs over a country inundated with bright, colorful advertisements with perky stuffed animals and light violet skies promising us peace, equanimity and fun. The reality is anything but. In 2003, an executive from GlaxoSmithKline said that more than 90% of drugs "only work in 30 or 50 percent of the people," and their own tests found that certain drugs were only 25% effective. To maximize profits, though, they've encouraged the creation of a polypharmacy, where a person is on multiple prescriptions.

Often people are given one drug to battle one problem, and then another to counter the side effects of the first pill, and so on. This is bad enough when pushed on seniors, who rely on their doctors to help them enjoy their later years in as good of health as possible (and who, by the way, Petersen points out, are rarely if ever tested clinically when companies are trying out new drugs; these tests are almost always on young and healthy men and women). When our children became the focus of such marketing--between 2000-2004, prescriptions for sleeping pills in children age 10-19 increased 85% -- it is inexcusable.

Tragically, a drug often works no better than a sugar pill, yet the pharmaceutical industry is driving -- let's make that dominating -- our economy. Petersen projects that by 2015 one in every five dollars we earn will be feed back into healthcare. This might be justifiable if it meant that our health was getting better. To the contrary, we're actually declining in health as a nation, as our life expectancy rates have fallen far from the top of the list of "developed" worlds. How developed a nation can be when a small percentage of business executives is knowingly and purposefully promoting drugs that are killing fellow humans remains a question that Petersen does not, and cannot, answer. Thankfully, with this elucidating book, we can take that question into our own hands, and decide for ourselves how hooked on their tether we remain.

Follow Derek Beres on Twitter: www.twitter.com/derekberes

Comments

[maggiemae656]

If you think it's bad now, just wait until the United States of Corporations gets involved in managing your health. NO NATIONAL HEALTHCARE, PLEASE!!!!!!!

[mbaty]

"An ounce of prevention..." as they say, and yet alternative therapies aren't available through most insurance agencies, only these strange patented pills for things like "restless leg syndrome," and "Carbohydrate Craving Syndrome," which I made up--but which is equally plausible and could very well become "something to ask your doctor about"--including a pill that goes with it...and here's some pens and pads of paper and a tote bag with the name of the drug on it.
We spend more GDP on healthcare than any other developed country, and this is what we have to show for it? We have the war on drugs and simultaneously an endless barrage of marketing for chemical compounds that are barely studied--or the studies are skewed, and still many people have no coverage or have to pay large sums of money for what amounts to a multivitamin without the vitamins or a sugar pill that's not even as good for you as sugar and does even less.
Let's put the Health back in Health care.