Tuesday, February 5, 2008

Bitter Medicine: Pills, Profit and the Public Health

Bitter Medicine: Pills, Profit and the Public Health
ABC NEWS SPECIAL REPORT With Peter Jennings

Peter Jennings - ...Dr. Drummond Rennie is an editor at The
Journal of the American Medical Association. He says
researchers who are critical get attacked all the time. Do
you actually believe, Dr. Rennie, that drug companies are
intent on keeping the consumer on drugs, which are not as
good as older drugs, for the simple requirement of profit?

Dr. Drummond Rennie - Yes. Yes, very much so. Absolutely.
....They've got to be prevented.

Peter Jennings - ... The top 10 drug companies combined
made profits of more than $37 billion in the year 2001.
And you, the taxpayer, are subsidizing research that
benefits the drug industry.

...Nancy Chockley runs an institute funded by managed care
organizations...

Nancy Chockley - What we found is that over the last 12
years, that there's really been a shift in the type of new
drugs being approved by the FDA. And that we found that
most of the growth was really in drugs that did not show
any significant clinical improvement.

Peter Jennings - Eighty percent of the drugs which the FDA
approves are not significantly different from the ones on
the market already, and only 20 percent of the drugs are
significantly new. Do you think the public even knows
that? ...We're spending more on prescription drugs than we
did in 1995. And the majority of the drugs approved by the
FDA are simply modifications of old drugs...Consumers spend
$90 billion more on prescription drugs last year than was
spent just six years ago. And are we $90 billion
healthier? ...But what critics call this 'gaming of the
system' may have a much more damaging result.

Dr. Sharon Levine, Kaiser Permanente Medical Group - If I'm
a manufacturer, and I can change one molecule and get
another 20 years of patent life and convince physicians to
prescribe and consumers to demand ... then why would I be
spending money on a lot less certain endeavor, which is
looking for brand new drugs?

Peter Jennings - The pharmaceutical industry has more
registered lobbyists than the number of senators and
congressmen combined.

Dr. Jerry Avorn, Brigham and Women's Hospital - I think
there's a sense that, for example, when the FDA approves a
drug, everything that needs to be known about it is known.
I think patients believe that. I think doctors sometimes
believe that. And that is not true.

Peter Jennings - How do you explain the overwhelming
success of these drugs in a very short period of time?

Dr. Sharon Levine - I think the only explanation is the
amount of money, the amount of time and energy that was put
into promoting these drugs to doctors and advertising these
drugs to consumers.

Peter Jennings - You see television ads like this all the
time, including many on ABC News programs. They are part
of the drug industry's $15 billion effort to get you to ask
for particular drugs and to get doctors to prescribe those
particular drugs. ...The drug companies spend vast amounts
of money - nearly $3 billion selling to consumers, $5
billion marketing to doctors, $8 billion worth of free
samples. ...Doesn't it make sense for the drug companies to
at least educate the doctors about the prescription drugs
that are available?

Dr. Marcia Angell - Well, that's not their business,
education. Drug companies are not in the education
business. Medical schools and teaching hospitals are.
It's like expecting beer companies to educate people about
alcoholism. It is not what they do.

Dr. Matt Handley, Group Health Cooperative - It's almost
like a trade. You might not have the stomach problem, but
the studies suggest you might, instead, be equally likely
to have a more serious heart problem. ...I would personally
wait years for long-term safety from the FDA's monitoring
program before I'd consider taking them. If they were
free, I would do that same thing.

Peter Jennings - What does this say about the social
responsibility of the pharmaceutical industry? Or is the
pharmaceutical industry supposed to have a social
responsibility?

Dr. Sharon Levine - That's a very good question that the
American people need to answer, do we want to entrust
critical elements of the public health to an industry whose
purpose, whose mission is to earn return for shareholders?

Peter Jennings - Congress has never required the FDA to
routinely compare new drugs with older drugs. This is
costing consumers billions of dollars that we do not need
to spend. And in some cases, it could be costing lives.
...There is no law that says new drugs have to be proven
100 percent safe. ... The government says they must be
relatively safe, which means that every drug comes with
risks. And the result of that is that sometimes new drugs
turn out to be more dangerous than old drugs.

Dr. Jerry Avorn, Harvard Medical School - If patients were
aware of the limitations that all of us physicians have in
terms of what we know and what we wish we know and what we
don't know, they would be more scared than they are at
present. ...The saying that a lot of doctors use sometimes
in jest is, 'Always wait a year before prescribing a new
drug. And if it's for a family member, wait five years.'
And that's an awful thing to say, but it reveals a
perception that we really don't know as much as we would
like to know about a drug until it's been around.

Peter Jennings - The fact is, drugs can be used for years
before we really know how safe they are. ...Dr. Drummond
Rennie is an editor at The Journal of the American Medical
Association. He says researchers who are critical get
attacked all the time. Why do you think the industry is
able to get away with what you have in the past called
'bullying tactics?'

Dr. Drummond Rennie, Journal of the American Medical
Association - Money. Because if the shareholders are
happy, whom else do they have to answer for? These are
multinationals. They have no masters.

Peter Jennings - Can we trust studies funded by companies
that have a vested interest in the results? ...Will the
pharmaceutical industry do whatever it takes to get the
results it wants from research?

Dr. Drummond Rennie - The temptation to spin those results
is always there, and it's frequently used. Frequently.

Peter Jennings - For nearly every drug on the market,
doctors must wrestle with conFL icting and sometimes
inaccurate information.

Dr. Drummond Rennie - If only the good news about a drug is
published, and never the bad news, then a false impression
is given of the quality, effectiveness of that drug. It
may be entirely false.

Peter Jennings - Does the drug industry, on occasion or
regularly, suppress data?

Dr. Drummond Rennie - Oh, we suspect, and rather know, that
this happens all the time.

Peter Jennings - Does the drug industry ever suspend a
trial - a drug trial - because it believes the results will
be different than it wishes?

Dr. Drummond Rennie - Yes, that's happened.

Peter Jennings - Does a drug company ever not publish the
results of a trial because it doesn't like the results?

Dr. Drummond Rennie - Yes.

Peter Jennings - Do you actually believe, Dr. Rennie, that
drug companies are intent on keeping the consumer on drugs,
which are not as good as older drugs, for the simple
requirement of profit?

Dr. Drummond Rennie - Yes. Yes, very much so. Absolutely.
... They've got to be prevented.

Peter Jennings - There is one last thing this evening which
we believe is important for all of us. The questions about
what we are getting for our money cannot and must not be
answered only by the drug companies. Virtually everyone we
talked to for this broadcast agrees on that. The rules by
which this hugely profitable industry operates do not
always serve consumers adequately. And nothing is going to
happen, no matter how angry consumers get, unless the
Congress and the president decide that the time is come.
The country can do better. I'm Peter Jennings. Thank you
for joining us. Good night.


----------------------------------------------------
The subsequent interview segments were taken from the ABC
News Special Report - Bitter Medicine: Pills, Profit and
the Public Health. A video and complete transcript of the
report may be obtained by writing to: ABC News Videos,
55353 Lyon Industrial, New Hudson, MI 48165
http://www.doctorsaloe.com/abc-news.htm

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