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 ...
2 Planting Shills Everywhere
You can't read any product label nowadays without discovering that it's been endorsed by the American Society of Whatever, recommended by the National Center for Stuff, or enjoyed by the International Institute of Things.
As it turns out, most of these groups are pharmaceutical industry shills recommending medication based not on rigorous research, but rather the name that appears on their checks. Take the American Acne and Rosacea Society, for example. It's a theoretically impartial organization that's factually funded almost entirely by manufacturers of acne medication like Galderma, which has 13 of the 15 AARS experts on its payroll. So when AARS recommended a treatment for acne, it was no surprise that they went with Galderma's $2,500-a-year plan, instead of the equally effective $120-a-year generic alternative.
"Anything is possible!"
According to a study from the Journal Sentinel, among 20 clinical guidelines for the top-selling drugs in the U.S. (including Nexium, Lipitor, and Oxycontin), 16 were drafted by doctors with clear ties to drug companies. Case in point: GlaxoSmithKline's asthma medication Advair was America's fifth best-selling drug of 2011, thanks to a recommendation by the National Heart, Lung, and Blood Institute, which might have come about because 12 of the institute's 18 panel members were being paid by GSK.
But it's one thing when a bunch of professionals basically recommend brushing your teeth with dog food just because they're sponsored by Purina. It's a whole other thing when their shilling can kill you.
"When you think about it, what is 'death' really?"
Let's take what drug giant Wyeth did in 2002, after discovering that their hormone therapy drugs for menopause increased risk of breast cancer, heart disease, stroke, and blood clots. The problem was that the drugs Prempro and Premarin were already on the market, so instead of recalling them, the company spent $12 million forming the Council on Hormone Education, 85 percent of whose members were working for Wyeth. They then spent the next six years conducting an online course "educating" thousands of doctors about how totally awesome hormone therapy is, and how all that cancer/stroke business was probably due to something the patients did in their free time.
And in some cases they can take a, well, more direct approach ...