If you go by their portrayal in movies and TV shows, you'd think that huge pharmaceutical corporations make all their money by turning children into zombies and having them steal grandma's heart medication, or whatever the plot of Resident Evil was. But the truth is that Big Pharma (as hippies and crackpots call it) isn't a modern-day Legion of Doom. They're businesses focused on making money, just like every other company out there ... which isn't to say they aren't capable of evil. They totally are. It's just that their evil usually involves less illegal genetic experiments and more down-to-earth dick moves like ...
#5. Repackaging Medication to Trick You into Taking It
The name of a drug is a crucial part of its marketing. The antidepressant Prozac, for example, is meant to sound sciency, while the drug Sarafem, which is targeted at women, sounds distinctly feminine. (It's also pink, because ... vaginas, we suppose?) However, the only differences between these supposedly very different drugs are their names and colors: Sarafem is actually just Prozac, because Eli Lilly, the drug company behind both medications, wanted women to take the drug without telling them what it was.
Warner Chilcott/Eli Lilly
"But it says 'fluoxetine' right on the label. How can you not immediately know what that is?!"
Sarafem was marketed as the cure for an ailment called premenstrual dysphoric disorder -- essentially, all the unpleasantness that goes along with menstruation, plus horrible panic attacks, anxiety, and souped-up mood swings. And we're not saying that Prozac doesn't treat those symptoms; it might (we're not doctors). We just think that tricking people into taking drugs they wouldn't otherwise take is a moral gray area, although it could be forgiven if it was done for noble intentions. Like, say, if women suffering from PMDD really needed to take Prozac but were avoiding it due to its negative association with depression. That, however, is not what happened here.
Prozac was a huge money maker for Eli Lilly, and Sarafem was released only a few months before their patent on Prozac was set to expire. When a drug patent expires, its price drops sharply, as competitors start releasing their own generic versions. But by releasing a new drug identical to Prozac, Eli Lilly managed to extend their patent by a few years, allowing the price of Prozac to remain nice and high.
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Depressing, huh? Don't worry -- Eli Lilly has the cure!
In 1997, GlaxoSmithKline did something similar when they released the well-known antidepressant Wellbutrin as a pill that helps you quit smoking, but only after rebranding it as Zyban. Again, the science behind the drug might have actually been sound, but it doesn't change the fact that deceiving people into taking mind-altering drugs is something you usually expect to end with James Bond blowing up a skull-shaped island fortress in the middle of the Pacific.
#4. Flooding the World With Bad Research
All right, so how exactly do doctors know what medication to give you, when new stuff is coming out all the time?
Well, they read medical journals, which are full of studies telling them what's working these days. Unfortunately, pharmaceutical companies know that, so when they roll out a new product that they know occasionally gives patients uncontrollable diarrhea, they first release an overwhelming number of falsified studies that replace the word "diarrhea" with "kittens."
The kittens have diarrhea, but it's adorable.
OK, the actual practice is a little more subtle than the kitten thing. In one real case, drug company Medtronic paid $210 million to dozens of surgeons to sign their names to medical articles that were drafted and edited with the help of Medtronic marketers to advertise the company's bone-growth product Infuse ... the same Infuse that was later linked to cancer and infertility in men, which might have affected any of the million people who were prescribed it. The warnings were always there in the fine print, but the marketers were able to tweak the wording to play up the benefits and brush off the horrifying risks and side effects. The authors who went along with it could later be seen wearing lab coats made of solid gold.
But even when drug companies go to the effort of conducting genuine scientific studies, oftentimes they simply don't publish the unfavorable results. In one experiment, a number of studies of an antidepressant medication were submitted to a drug regulatory authority, and in the end, only the studies that yielded favorable results were released to the public. Oh, did we forget to mention that the studies were funded by huge pharmaceutical conglomerates? This is why some researchers believe that the vast majority of studies on antidepressants are unreliable at best and complete horseshit at worst.
Personally, we prefer the trial-and-error method.
But what about independent studies that aren't paid for by big businesses? Sure, they exist, but many of the researchers end up getting sued, and the studies are kept from publication by the drug company lawyers. Remember, the companies don't even need to win their suits -- all they need to do is keep bringing the scientists back to court until they run out of money and resort to burning their research notes for warmth.
#3. Deploying an Army of Lying Sales Representatives
Other than medical journals, the other way for doctors to stay informed about drugs is through sales reps, who visit medical professionals and tell them about the newest pill-magic their company has come up with. Sales representative visits are basically the medical education equivalent of a pizza delivery in a porno, by which we mean that they are quick and convenient and usually end with someone getting fucked. The bad news? That someone is usually us.
"On the plus side, we've got plenty of birth control options for you to use while we do it."
In most countries, drug sales reps are legally required to disclose all relevant information about a drug they are promoting to the doctor, not just the fun stuff. But in the U.S., Canada, and France, it's been found that they only mention serious drug risks 6 percent of the time. Because, you know, they're in sales. Their goal isn't to inform; their goal is to get the doctors to sign on the dotted line -- and your doctor is just as susceptible to slick sales techniques as anybody else.
So what's the risk here? Well, more than half of the drugs whose downsides aren't mentioned carry the most severe warning that can be issued -- we're talking "may cause death" territory here. And that's just for the risks -- things that might go horribly wrong when someone takes the drug. This is not to be confused with side effects, which are things that will almost definitely go horribly right if you take the drug. But again, sales reps won't even mention side effects in 59 percent of the cases.
"When you think about it, what is 'anal bleeding' really?"
Part of the problem is that some hospitals might be greeting over a dozen sales reps a day. The doctors want to listen just long enough to get the merchandise and free samples, but not a moment longer than they have to. This leads to super condensed sales pitches, and if something's going to get cut, it'll be the downsides. A far larger part of the problem, however, is that despite the law being pretty clear on these points, there's practically no oversight or enforcement of it whatsoever.
Meanwhile, the drug companies are spending billions on TV ads telling patients to demand these drugs from their physician. So, the doctors are getting pressured from all sides. But really, why should they worry about it when they just read that informative journal article talking about how safe the drug is?
And if we're making it sound like there are paid shills everywhere, well, that's because drug companies are ...