Know anyone taking prescription drugs? The odds are enormous you do. And it’s likely they are taking drugs they don’t need because their doctors are too quick to fall under the influence of Big Pharma’s aggressive drug sales reps.
Consider these statistics: almost half of all Americans are currently diagnosed with a chronic condition and 40 percent of those older than 60 taking five or more medications. Is it really possible that many people in the U.S. have illnesses that need to be treated with multiple drugs?
This question obviously raises issues about the nature of the relationship between the expanding definition of chronic illness and the explosion of prescription drug use in the U.S. — issues Michigan State University anthropologist Linda M. Hunt, PhD., decided to research.
Dr. Hunt looked into dramatic increases in the diagnosis of common, chronic conditions and the use of prescription drugs to treat these health woes . She specifically looked at two conditions which can often be relieved with lifestyle changes — type 2 diabetes and hypertension — that were treated in 44 primary care clinics.
Her research team interviewed 58 clinicians and 70 of their patients, and observed 107 clinical consultations in order to assess the doctors’ treatment strategies and the factors influencing their treatment decisions. They found that doctors usually prescribed at least two or more drugs per condition.
More than half of the patients studied were taking five or more drugs. Interviews with these people showed the cost of the drugs was often a hardship and the patients were often made sicker because of adverse side-effects.
So why are so many people taking so many drugs? The new study, just published in The Annals of Internal Medicine, concludes more drugs are prescribed because the threshold for what constitutes an “illness” keeps getting lower and lower, thanks in large part to Big Pharma’s influence. For example, what was once normal blood pressure is now too high or, if approaching high, is called “pre-hypertension” and Big Pharma recommends treatment. And instead of telling someone with high blood sugar to lose weight and exercise and eventually they could improve or normalize their condition, it’s likely a doctor will emphasize that a person found to have type 2 diabetes will need to rely on medication for life.
Dr. Hunt points out in her study that physicians are caught up in an “auditing and reward system.” That means doctors are rewarded by drug companies for prescribing more and more drugs. Perhaps most disturbing is what Hunt calls a “prescribing cascade.” Simply put, drugs are prescribed to help relieve side effects caused by other drugs. Then still more drugs can be prescribed to relieve any new side-effects from the recently prescribed drugs.
The truth about how the drug industry operates is not nearly as innocent and noble as it’s bright and cheery drug commercials might lead you to believe. The drug industry accounts for more than a half trillion dollars of revenue per year and has grown to be so powerful and influential that it might as well be a branch of government.
Because of this tremendous influence, millions of Americans are taking potentially dangerous medications that they don’t need. To avoid being one of them, it’s important that you understand how this powerful industry operates.
Buying the Partnership of Doctors and Politicians
Starting with the first day of medical school, doctors are treated like royalty by the big drug companies. They are given all kinds of free products, and in some cases, are even given bonuses, vacations, and a number of other incentives. Pfizer, the world’s largest drug manufacturer, was recently fined a record breaking $2.4 billion for this type of behavior.
Doctors and drug companies claim that these activities have no influence on prescriptions, but if this were the case, the drug industry wouldn’t be spending billions of dollars to promote their products to doctors. Furthermore, research has shown that doctors are indeed influenced by these marketing efforts and drug companies know this because they track prescription records. Drug companies put such an emphasis on this type of promotion that the ratio of drug representatives to doctors is nearly 1 to 4.
Medical professionals aren’t the only people that the drug industry is befriending. They have deep political connections as well and contribute more money to political campaigns than any other industry. Perhaps this is why the FDA’s regulation of the drug industry is so lax.
Research that’s Biased and Deceitful
As unbelievable as it sounds, the FDA actually expects drug companies to research the safety of their own drugs. The drug industry takes advantage of this by selectively publishing favorable research, discarding unfavorable research, and even manipulating results. Because the drug industry also has a significant influence on medical journals, research is typically published without the data which makes it difficult to verify the conclusions that were drawn. Some medical journal publications are even ghostwritten and published under another name.
One of the most unsettling examples of this type of biased research is with the drug Vioxx which is a nonsteroidal anti-inflammatory (NSAID) that was primarily intended to treat arthritis. Despite research indicating that Vioxx wasn’t any more effective than Aleve and had the added risk of cardiovascular side effects, Merck concealed this information and pushed the drug heavily. As a result, approximately 100,000 people suffered from heart attacks prior to the drug finally being pulled off the market.
Sneaky Marketing Tactics
The drug industry often claims that the high cost of their drugs is necessary to pay for the extensive amount of research that’s needed to create them, but this isn’t the truth. The drug industry actually spends twice as much on marketing as it does on research. During the year 2000, more money was spent on marketing Vioxx than Budweiser and Pepsi.
Drug companies are also clever about manipulating commercial rights. As long as they have a patent on a particular drug, they have exclusive rights to it and can charge a high price. Because the FDA only requires that new versions of an existing drug be tested against a placebo, there’s no need to prove that the new version provides any improvement, and as a result, it’s easy to obtain a new patent for an existing drug by changing it ever so slightly. More than three quarters of new drugs are a byproduct of this type of strategy and aren’t any different than what’s already on the market. To make matters worse, the limited amount of money that drug companies dedicate to research is often used to support this type of trickery.
AstraZeneca’s Nexium, a popular medication for acid reflux, is an excellent example of this. By the time that AstraZeneca’s patent on Prilosec was about to run out and they were at risk of losing $6 billion in revenue per year, they created and patented Nexium which is almost identical to Prilosec and isn’t any more effective. During this process, doctors were encouraged to prescribe Nexium instead of Prilosec even though Nexium is up to 7 times as expensive as Prilosec and no more effective.
Targeting Patients Directly
A relatively new marketing tactic for the drug industry, which has been quite effective, is to advertise directly to the general public through the influence of television. You’ve probably seen countless drug commercials that associate a wonderful scenario of happiness and health with a particular drug. They conclude by telling you to ask your doctor about the drug, and according to a number of doctors, many people are following orders. In fact, some people are belligerently demanding prescriptions for drugs that they saw on television without even knowing their purpose or risk. There have even been cases of women requesting Viagra and Cialis.
Unfortunately, the FDA doesn’t require drug commercials to be approved before they air, and when an issue arises regarding deceptive advertising, it takes an average of 4 to 6 months for them to respond which is much too late. Sadly, the FDA even defends drug commercials claiming that they educate the public and get people to their doctors. How’s that for influence?
Inventing and Selling Illness
The drug industry has a significant influence on research, medical journals, physicians, patients, and even our government. Drug representatives have physicians wanting to prescribe the latest medications, and television commercials have patients requesting them. It’s a very successful and profitable business model.
As if the existing amount of influence weren’t enough, drug companies create even more by making the common challenges of every day life seem like a disorder that requires medication. When a drug company receives approval to promote an existing drug for the treatment of a new condition, it makes the drug eligible for a patent extension. As such, drug companies have a tremendous incentive to find new conditions to treat with existing drugs, and when they can’t, they invent them.
For example, the drug Sarafem is really Prozac with a different name and a different color capsule. It’s patented, approved, and promoted for the treatment of “Premenstrual Dysphoric Disorder” which is defined as the sadness, irritability, tension, and moodiness that might occur prior to menstruation. Even though this drug isn’t any more effective at treating these symptoms than generic Prozac, it’s up to three times as expensive.
Another common tactic is to change the definition of existing diseases. For example, changes to blood pressure and cholesterol level guidelines could qualify millions of new people for prescription medication literally overnight. When this happens, it’s not uncommon for the supporters of such changes to have financial ties to the drug companies that would benefit most. Learn about Drug and Alcohol Testing Compliance Services and what you can do to prevent drug abuse in your home and place of work.