So tired of the drug companies


Category : Medical Rants

I love the pharmaceutical industry; I hate the pharmaceutical industry. I love the research that brings us new drugs, especially new drugs classes. I hate the attitude that sales outweigh ethics.

Earlier this morning I thought about the Zyprexa articles. I was considering how to approach this issue in a rant. retired doc relieves me of the need to type a long angry rant. He nails it – More accusations of big pharma behaving very badly

I know that physicians must share the blame. When we listen to drug reps we are acting irresponsibly. We should know that they are trying to deceive us. We should know better, but we too often believe what drug reps say.

The ethics of business is not the same as the ethics of medicine but if recent accusations against Lilly are true you might conclude that in regard to some businesses the word does not even apply. I have quoted Dr. Patricia Illingworth before:

…some commonly accepted principles of business ethics are fundamentally incompatible with traditional medical ethics…,

These practices include spinning and playing down the negative aspects of your product and intentionally misleading customers and maybe that is why we have laws against deceptive trade practices.

I am so tired of these stories. The drug companies influence inappropriate use of new expensive drugs, and ignore side effects. Our only defense is to refuse to see drug reps, even when they are cheerleaders.

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Comments (7)

I personally don’t interact with too many drug reps but my wife is a Pharm.D working in a hospital. We’ve discussed drug reps a few times and the dynamic between prescribers and reps and pharmacists. The conclusions that we both have come to is that drug reps do provide a valuable service. However, as retired doc said “The ethics of business is not the same as the ethics of medicine”. I remember a story in which a drug rep was telling my wife that their new drug hit an extra receptor (3 instead of 2) that their competitor’s did not. However, in the study of the drug, it was no more effective than their competitor’s that only hit 2 receptors.

So, is there a solution to this other than asking physicians to spend more time keeping up with new drugs and how they compare?

To be honest I am a little confused. In today’s WSJ there is a full page color ad by Roche titled “Conducting Research to Bring NEW BLOOD to Renal Anemia Care”. The ad then goes on to describe Roche’s partnership with doctors and patients in this important field etc.

This ad is not directed towards the medical community but the general public and investors. What is the point other than the obvious of driving demand for their product from the bottom up?

Steve Lucas

I am going to agree with DB on 1 point and disagree on 2.

First I agree with: “I know that physicians must share the blame”. Too often we take drug rep info as “truth”. We (physicians) are half, if not more, of the blame. We write the prescriptions, not the drug reps. We must make sure the info we are given is correct.

What I dont agree with are the following 2 points DB makes:
DB writes: “When we listen to drug reps we are acting irresponsibly”.- I dont agree with this statement. I think if we listen to them uncritically we are acting irresponsibly. They serve a purpose to give us info (be it likely biased) on new drugs or new uses (approved) of old drugs. It is our job to critically appraise and challenge the info directly with the drug rep or by searching for information on our own and critically appraising it. I agree that we dont have to talk with them but if we do our job is to be critical.

DB writes: “Our only defense is to refuse to see drug reps”. Information is our best defense. If you see them, hear them out but then you must look at the information for yourself and critically appraise it.

“Our only defense is to refuse to see drug reps”. Information is our best defense. If you see them, hear them out ”

Refusal to see them, at least in Japan, means losing out on all the goodies they bring–chocolates, whiskey, discount airline ticket coupons, lunch ‘obento’ boxes, etc.

Eli Lilly Zyprexa scandal

Zyprexa off label promotion scandal is all over the news now.
Lilly drug reps are alleged to have called their marketing ploy,”Viva zyprexa”.

Eli Lilly zyprexa cost me over $250.00 a month supply out of my own pocket X 4 years and has up to ten times the risk (over non users) of causing diabetes and severe weight gain.

Zyprexa which is only FDA approved for schizophrenia (.5-1% of pop) and some bipolar (2% pop) and then an even smaller percentage of theses two groups.
So how does Zyprexa get to be the 7th largest drug sale in the world?
Eli Lilly is in deep trouble for using their drug reps to ‘encourage’ doctors to write zyprexa for non-FDA approved ‘off label’ uses.

The drug causes increased diabetes risk,and medicare picks up all the expensive fallout.There are now 7 states (and counting) going after Lilly for fraud and restitution.

Only 9 percent of adult Americans think the pharmaceutical industry can be trusted right around the same rating as big tobacco.

Daniel Haszard

So lets see, car salesmen are immoral—they often sell their products by making exaggerated claims for them, right? Therefore, our “best defense” is not to listen to car salesmen. Convenient if one doesn’t need a new car…..of course one could simply go to consumer reports, but many don’t bother and one also gets useful information from the salesmen—such that the market for cars performs better with such advertising than it would without it.

What DB cannot bring himself to acknowledge is that the production and consumption of drugs is organized as a market, and behaves similarly (when relevant differences are accounted for) to other markets. In which advertising plays an important part, both for good and evil but, in most markets, on balance for good.

Perhaps we ought to interpret his screeds against big pharma as a wish that the industry be organized differently, for instance as a government cartel. But until it is, there is a prima facia case that advertising is beneficial. The burden is on DB to show that it isn’t—and he has never provided a shred of evidence to that effect. That is, that the beneficial effect of physicians learning about new drugs and getting them to those that can benefit from them more quickly than would be the case otherwise is exceeded by the bad effect of physicians using new drugs harmfully.

Big pharma behaves like other major industries; that is, sometimes disgracefully. And they should be held to account for such behavior. But the practice of advertising by drug reps is not in that category. And we should listen to them and make use of useful information while rejecting the rest.

I was prescribed zyprexa for ocd and depression (off-label uses). Prior to taking zyprexa for 7 months, I was in perfect physical health. I have just been diagnosed with diabetes and hyperglycemia. No one else in my family has diabetes.

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