Nobody begrudges a profit to individuals and companies that produce and sell the things we need and want – least of all this author. I do what I do best, and sell it to you. You do what you do best and sell it to me. We both make a profit, and we use that profit to buy what we need.
But when the profit motive assumes more importance than ethics, we have a damaging aberration – like cancer cells that grow much like normal cells, except they’re out of control and they don’t know when to quit – until they kill the organism.
One organism that’s about to be swallowed up in its own cancerous appetite for money is Big Pharma. This industry is the Robber Baron business of this century – much like the financiers who earned that title by ripping off Americans a hundred years ago.
Perhaps the reason the dark side of this activity is so hard to confront is because like cancer, it doesn’t make sense. Why would major pharmaceutical corporations, already among the world’s richest industries, want more and more even at the expense of human life; without regard for the consequences?
Increasingly, drug companies aren’t just selling cures. They’re also marketing disease, according to Bradford Plumer in the most recent edition of Mother Jones. The result is accelerating health care costs, and the primary beneficiary of this increased outlay is Big Pharma and the medical support structure that supports it.
But don’t confuse this with the medical doctors who work in this system. They aren’t getting the money. In fact, doctors make less and less and are being sued more and more – creating a shortage of physicians, actually, as young people enter the medical profession at startlingly decreasing rates. Hospitals are importing doctors from foreign countries to fill their needs, and still don’t have enough. This works in the favor of Big Pharma. They don’t need doctors. Doctors might cure something. Big Pharma would rather have patients who need pills – lots of them, and ongoing, with no end in sight. A quick prescription takes no time at all for a harried doctor. Instead of examining a kid to see whether he is diabetic or hypoglycemic or underslept or allergic, a quick slip of paper and he’s out the door. The pay to the doctor is the same. But Big Pharma gets a drug addict with a habit sanctioned by and supported by the state. That’s worth a lot of money. And if the people at Big Pharma have any trouble sleeping nights, they have a drug for that too.
The craziest practice is the contorted procedures drug companies go through to save a profit that would be lost at the end of a patent period when a drug goes generic. The Plumer story in Mother Jones describes how Big Pharma handles this situation with a damaging subterfuge we all pay for. An example is Prozac. The patent for Prozac was expiring in 1998. Woops! There goes a lot of profit! But wait – if the drug were found to be useful for handling some disease other than the one it was originally marketed for, it would be eligible for an extended patent period!!
What happens after that sound like something from Saturday Night Live. If Peter Sellers were alive today it would be a quaint English movie – something in the Inspector Clousseau vein. Imagine Sellers working the boardroom. “We need a new disorder. I need ideas here!”
“We need a psychological disease, something that doesn’t presently exist and something that can’t be proven scientifically,” says one wizened advisor. “Why would that be?” says the new kid who just ascended to the board because of his family connections.
“Don’t be silly!” says the older man, “If we call it a mental disease, then nobody can argue with us! There’s no way to prove anything! So they will take us at our word. If we name a real illness that can be scientifically proven, we will then have to scientifically prove that Prozac cures it. Prozac doesn’t actually cure anything, so that option is out.”
The end of the story (this part is not satire, it’s actually true) is that Lilly dug up a controversial new disease nobody had ever heard of, and drummed up interest in it until it became a legitimate accepted condition, then said the drug solved it – and extended their cash cow patent. Read the story. It’s fantastic.
But it doesn’t stop there. What do you do when you need some “authority” for a story in a large respected medical publication? You plant the story in little insignificant medical publications, then you quote those publications as sources for the story in the big influential publication. The American Medical Association and the American Psychiatric Association were doing this regularly in the 1950s when they were on a rampage attacking medical practices that fell outside their purview, such as Chiropractics. Huge lawsuit recoveries were made toward the end of the century when this sleazy practice finally caught up with them. But the drug companies still do it.
A question arises about whether there are unacceptable side effects to the drug when it is used for this newly discovered unprovable condition? All you have to do is plant a story in some small medical magazines saying that the fears are unfounded, then in the big magazine you publish that articles in many small magazines report that the fears are unfounded. It’s beyond fantastic.
There is more about this incredible business in the book Selling Sickness by Moynihan and Cassels.
It’s time to look at the ethics of Big Pharma. And it’s time to hold their feet to the fire. It’s time to say, “You made plenty of money ethically. Now you’ve been making excess profits. And they’re not excess because they are too much money, they’re excess because they’re being made unethically, on the backs of people who are being treated for non-existent diseases, and whose lives are damaged or ruined by the use of drugs that have extreme and violent side effects, including increased likelihood of homicide and suicide and real addiction that makes getting off them more difficult, in the opinion of some, than kicking heroin.
The lawsuits are accelerating. That’s good. But when do we start talking criminal responsibility? How many people have to die before some individuals are guilty of manslaughter?