Our Daily Meds

Sample Q & A with Melody Petersen

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Why did you write this book?
From my work as a reporter at the New York Times covering the pharmaceutical industry, I could see that far too many people were dying needlessly from the drug industry’s aggressive and secretive promotional tactics. When people are dying, it’s very hard not to want to do something about it. 

What kinds of tactics do the drug companies use?
The drug companies do most of their promotion from behind the scenes, using tactics that are almost impossible to recognize as promotion. Everyone is familiar with all of those ads on television that are meant to get us to ask our doctors if the advertised drug is right for us. But the kind of promotion I’m talking about is far more dangerous. I wanted to detail how the companies did this so that people could see through the misinformation and protect themselves.

Can you give a couple of examples of this behind-the-scenes promotion?
For instance, when a company wants a group of patients to be advocates for a new medicine, some companies have simply created a group that looks like a heart association or a cancer society, but is little more than a creation of a public relations firm working to sell that drug.

Another standard technique is paying physicians to talk to other doctors about why they should prescribe the company’s drug. Physicians believe the message because it comes from one of their peers. But often that doctor has been trained to speak by the drug company’s ad agency. The drug companies are experts at finding ways to put their words in someone else’s mouth. They don’t want us to see that it is nothing more than an advertisement.

But can’t medicines help us? 
They absolutely can – if you get the right drug at the right time. The problem is not the medicines. The problem is the industry’s relentless marketing.

Marketing is all about selling as much of a product as you can, whether the customer really needs that product or not. This might be okay if you’re selling soup or soap, but it’s not okay if you’re selling medicines. Every medicine comes with life-threatening risks.

What evidence do you have that shows people are dying from their prescription drugs?
Let’s start with the pain reliever called Vioxx. It was one of the most aggressively promoted drugs in history. After many millions of Americans took it, we learned that it doubled a person’s risk of heart attack or stroke. A government scientist estimated that this one drug may have killed more than 40,000 Americans.

The truth is we have no idea how many thousands of Americans are dying. A study often cited by the government estimated that more than 100,000 Americans die every year from prescription drugs taken just as the doctor recommended. These aren’t cases where a doctor or pharmacist made a mistake. They aren’t cases where the patient accidentally took too much. These are deaths that happened when everything supposedly went right.

But why aren’t doctors protecting us from these dangerous drugs?
Doctors were once independent gatekeepers who helped keep us safe from drugs we didn’t need. But today’s doctors have grown dependent on the drug industry. A survey in 2007 found that virtually all physicians – 94 percent – take gifts or cash from the drug companies. Some doctors take hundreds of thousands of dollars a year. Most of them see nothing wrong with this. They don’t believe a gift will change what prescriptions – or how many prescriptions – they write. The industry knows better. 

What about the Food and Drug Administration? Isn’t the government protecting us?
I think the public misunderstands what the FDA can do under the law. The agency does no independent tests of medicines before approving them. Almost all clinical trials of medicines are performed by the companies selling the drugs. And, the FDA does not regulate the practice of medicine. It lets doctors prescribe whatever medicines they see fit to prescribe.

What do you find most frightening about what you found?
So many things are frightening about how drugs are marketed in the United States.  But I would have to say that the one thing I find most disturbing is how the industry’s aggressive salesmanship has corrupted medical science. I detail case after case in my book where the drug companies have manipulated the design of studies to generate data that makes their products look better and safer than they actually are.

They’ve also figured out how to publish that data in scientific journals to make it look as if it’s being endorsed by academic experts.  I think that Dr. Richard Smith, the former editor of the British Medical Journal, said it best when he wrote that our medical journals have become “a marketing arm” of the drug industry. This is horrifying. It means that doctors who have thrown the sales reps out of their offices and vowed to read scientific journals to find what medicines are best for patients are still getting a marketing pitch and information that could be dangerously biased to favor a drug.


 

Additional questions you can ask Melody:

  1. How did you become interested in the pharmaceutical industry?
  2. When did you realize that the problems are systemic and pervasive?
  3. What evidence have you found that Americans are taking too many medicines?
  4. How has the aggressive promotion of medicines harmed even those who don’t take them?
  5. What can I do as a patient to protect myself and my children from drugs we don’t need or drugs that may do more harm than good?
  6. What can we do to rein in the drug companies and put the practice of medicine back on track?