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Lunch in Modor Being used to the high energy of medical conferences and political activism events, I wondered what people would be like who work for the world’s second largest industry (after armaments). Strangely, only 35 people attended, including the speakers, technicians and me (the only reporter). Almost everybody was dressed in precisely tailored black, white, and grey suits with perfect hairdos and make-up, males and females equally represented, everybody focused and cool. But the mood was subdued to the point where I thought to myself, “They are either on Prozac or would like to be.” It quickly emerged from the power-point presentations’ pie-charts, graphs and statistics that the fever chart of world drug sales suggests ill health. Paul Getty, possibly the richest man ever, supposedly said, “A billion just doesn’t go as far as it used to” - exactly Big Pharma’s own diagnosis, as presented at this forum. Tough Times This drug habit is driven by shareholders’ interests, and this conference was devoted to them. So, presenters focused on obstacles to growth and how to generate more consumption (more sick people). The key-note speaker, Pierre Gaudrault, represented Pfizer which, incidentally, was rated 17th among the world’s top 100 corporate criminals (www.MotherJones.com). He identified the problem as: the limits of chemistry, governments frantic to reduce health costs, cheaper generic drugs, and popular pressure to change patent laws. As of 2004, only 3 new active substances have been submitted for patenting, as opposed to 10 in 1999 and 29 a couple of years earlier. Big Pharma calls that the “pipe-line problem” – no new potential blockbuster drugs in the works: synthetic chemistry is finite. The cost of research and development has simultaneously gone through the roof: in 1988 it cost US $ 150 million to bring a new drug to market, and now it’s about US $ 1 billion, and evidently, a few more billion are unlikely to produce a new blockbuster. His solution was to exhort everybody to “capture customer loyalty, enthusiasm, and commitment around the world”. He ended with an inspirational quote, known to all environmental activists, from the great Rene Dubois: “Act locally – think globally!” In 2002 in North America alone more than 100,000 drug reps were working the doctors’ offices, a three-fold increase from 1993, or 1 rep per every 5 doctors. The return on investment for every US dollar spent in 1996 was US $3.34, but by 1999 it had decreased to US $ 1.94. Marketing in 1996 cost US $ 6.1 billion, but only three years later Big Pharma was throwing US $ 9.4 billion at marketing and advertising (from Sawaya, 2002). So, dirty tricks increased: financing phony patient support groups (Toronto Star Feb.7, 2004); inventing new diseases (Pfizer’s “social anxiety disorder”, supposedly treatable by Zoloft, was invented by a Fred Nadjarian of Roche in Australia for which he faced a public disgracing); attempting to use Children’s Aid Society wards without their knowledge as human research subjects for antidepressants (Hamilton Spectator Dec. 11,2002); the widespread sale of doctors’ prescription patterns by pharmacies to Big Pharma in contravention of current privacy laws (see outraged editorial in the March 2, 2004, Canadian Medical Medical Association Journal ); and many more are told in Prescription Games. Almost every major drug is under legal challenge annually costing hundreds of millions of dollars in out-of-court settlements or fines (see the documentary The Corporation). Much of the discussions focused on that magical solution to a troubled market: DTCA! Various speakers described how it had increased sales by close to 70% annually in the US, and reading from a February 4th FDA memo, they noted that DTCA especially increases customer compliance! It lasts a little longer after the adverse effects emerge, especially on lucrative antidepressants and cholesterol-lowering drugs, but the speakers cautioned, Canadian activists are astonishingly successful in blocking DTCA. Most depressingly, even though Canada has the ultimate “industry-friendly” Health Minister, Monsieur Pettigrew, he told Big Pharma that there was no reason to introduce DTCA because there was “just no evidence to show that this enormous increase in drug consumption in the US had improved health overall.” Amazingly, nobody laughed! This was black humor of the finest vintage and nobody noticed. When the question of ads for vaccines was raised, audible sighs of relief were heard and everyone was reminded to take heart as, thankfully, those are exempt from Canadian DTCA rules. Vaccines are the new frontier of corporate medicine. Of course, there is a statistic, mentioning which in this meeting would have been equivalent to farting at a royal reception: The world’s most prestigious medical school, Johns Hopkins in Baltimore, published last year numbers indicating that drugs and doctors’ mistakes may be the primary leading cause of death in the US, costing the economy US$ 80 billion annually. (Full details and sources at www.mercola.com; view all research on www.garynull.com). Dr. Andre de Villiers was different. He reported on his medical biotech company which markets the technology and chemicals used to treat certain cancers and surgical transplants. This technology identifies cancer cells for targeted destruction while leaving healthy cells intact. Similarly, donor rejection can frequently be solved without killing the patient’s entire immune system with immuno-suppressant drugs by zeroing in on only those immune factors that are causing the rejection: high tech medicine that works for life. Having lost a daughter in 1986 to a disease this technology now routinely cures, I was deeply impressed. He pointed out, understandably smugly, that his was “good marketing because it’s a good product and good science.” Good point. Considering that the American Journal of Cardiology last August published findings indicating that heart disease and cholesterol may have no link at all, a finding supported by European research, the blockbuster drug Lipidor may soon prove that even blockbusters aren’t what they used to be as their supportive science winds up to be neither. “Ethics” – What's That? While conceding that many drugs are indispensable, they observed, (like a battered wife without a job might to her SOB husband), that research dollars today come virtually only from Big Pharma, and that this abusive relationship does not promote excellence. Shareholders need more and more sick people, while scientists want to cure sick people. Some serious efforts are being made to stop this abuse: McMaster Medical School teaches its students Ten Commandments for handling drug reps. The first being: “Physicians should maintain control” of the encounter. The rest focus on demanding scientific proof for every claim made, and the last insists the doctor may not “commit to the use of the product”, but merely indicate that “it will be given further consideration.” The ethicists also suggested that Big Pharma should consider self-restraint with all its coercive dirty tricks. What a concept! When the discussion was opened for questions from the floor, not even one was posed. Nobody appear to wonder why everybody is so ticked off, what might possibly be wrong with the products, prices or (God forbid) drug effectiveness, and what alternate marketing strategy should be considered. Imagine Mercedes, BMW, or Volvo being told their cars are dangerous to drive and that people are mad about their engineers lying and cheating about the physics involved in their manufacture resulting in many people driving crippled or killed. Since those cars are synonymous with excellence, this is unthinkable. With Big Pharma’s products and its Dark-Lord-business-practices this is what most people associate with this industry, yet not a single question was raised. At a book table Dr. Lou Sawaya of Ottawa sold his publications on drug rep education. His 2003 The Reader is not an Idiot – He is your Doctor, includes a joke (here abbreviated): the US president and the CEO of a pharmaceutical company consulted God. The US president asked, “Lord, when will our unemployment problem be solved?” God replies, “In the year 2020.” The president walked away, crying bitterly. Then the pharmaceutical CEO asked, “Lord, when will the public image of our industry become favorable again?” God thought for a long time, and then God walked away, crying bitterly. A Short Survival Guide for Dealing In Drugs As the ethics panel pointed out, US judges ruling on Big Pharma cases agree that this industry is the cause for the corruption of medical science, education and practice. So, whom do you trust and what can you believe? The simple rule of thumb is: look who paid for the study. But if sleuthing through journals is impossible when you have to make a quick decision, having just been handed a prescription, here are some suggestions on how to navigate the minefield of pharmacology:
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