pharma payouts

drug money

Big Pharma Is America’s New Mafia

Daniela Drake, M.D., M.B.A.

What Doctors Know For Sure

Pharmaceutical companies have more power than ever, and the American people are paying the price—too often with our lives. Prescription drugs are the nation’s third largest killer.

America is the most medicated nation on earth, with some 70 percent of Americans taking prescription drugs—yet we have worse health outcomes than other industrialized countries. As Slate’s devastating expose on the fraud in clinical drug trials shows us: We don’t know much about the drugs we prescribe.

Are Doctors Given Good Information?

As physicians, we have very little good information to go on. Even our most prestigious journals publish research based on falsified studies, according to Charles Seife, a journalism professor whose class spent a semester trying to figure out why the data don’t get corrected once research fraud comes to light.  “As a result,” Seife writes, “nobody ever finds out which data is bogus, which experiments are tainted, and which drugs might be on the market under false pretenses.”

If no one knows which data is bogus, we obviously have a big problem in conventional medicine. Standard of care is driven by “research.”

How are the Guidelines Made?

How something becomes part of a recommended guideline is not obvious—and has a lot to do with pharmaceutical money paid to academic physicians in research and consulting fees.

Many of these “experts” then get to influence prescribing practices. Consider the 2004 Cholesterol guidelines that resulted in an explosion in the use of statin drugs—eight out of nine of the doctors who wrote those guidelines were in receipt of money from statin manufacturers.

The Money Trail

The Harvard psychiatrist credited with hyping the use of stimulant drugs for ADHD—that has resulted in nearly 15 percent of our youth being medicated—received $1.6 million from producers of stimulant drugs. Prestigious medical journals—the ones that often define medical guidelines—allow physicians consulting for pharmaceutical companies or paid medical writers to extol the virtues of the drugs they are selling.

What the Doctors See

Practicing physicians are influenced far more by guidelines, esteemed academic physicians, and opinion pieces in prestigious journals than we are by a deli platter and a smiling drug rep. Pharmaceutical companies know this and have worked hard to sway the leadership.

The heavy influence of pharmaceutical dollars inspired the former editor-in-chief of the New England Journal of Medicine, Dr. Marcia Angell, to conclude, “It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines.”

That’s why so many practicing physicians and patients alike were relieved that Obamacare would force pharmaceutical companies to come clean about how much money they’re throwing at some doctors.  But while $90 million went to drug-company sponsored meals in 2013, according to the Open Payments database, at least $1.4 Billion went to research.  If we can believe that doctors can be bought with a slice of pizza pie, then we cannot underrate the influence of research monies.

Pharma’s Billion Dollar Investments

And by the way, that $1.4 billion is probably a fraction of what is spent on researchers. Obamacare allows a four-year delay in the reporting of research grants.

The Cochrane Collaboration was formed in the 1990s to perform systematic reviews of the literature. Dr. Peter Gotzsche, the Director of the Nordic Cochrane Center in Copenhagen, has seen enough over the last two decades to sum up his findings in a book whose title says it all: Deadly Medicines and Organised Crime: How Big Pharma has Corrupted Healthcare.

Their Activity Parallels Organised Crime

“Much of what the drug industry does fulfills the criteria for organized crime in US law,” Dr. Gotzsche said in a recent interview. “The drug industry buys the professors first, then chiefs of departments, then other chief physicians…”

Gotzsche isn’t the only one accusing pharmaceutical companies of wrongdoing beyond the marketing malfeasance they’re famous for. In Australia, during the Vioxx class action suit brought against Merck, company emails were released revealing that Merck employees planned to “neutralize” and “discredit” doctors who criticized the drug. “We may need to seek them out and destroy them where they live,” a Merck employee wrote, according to The Australian. Apparently, uncooperative physicians were targeted to lose academic appointments and research funding for telling the truth about the negative side effects they observed.

Even Approved Drugs Not Safe

This is troubling—but even more so in light of the fact that it’s now widely accepted that prescription drugs can be dangerous and over the years dozens have been recalled. “Our prescription drugs are the third leading cause of death after heart disease and cancer.” Drugs kill around 200,000 people in America every year,  because of the side-effects, said Dr. Gotzsche in his recent interview. “The other half die because of errors—and it’s often the doctors that make the errors because any drug may come with 20, 30 or 40 warnings, contraindications, precautions…and then the patients die.”

This is a hard pill for any of us to swallow. We should be able to trust our doctors, who should in turn be able to trust “the science.” Patients need more transparency—not just about the money, but about the drugs we are putting in our bodies.

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