It's hard to read Our Daily Meds without thinking of Americans as shaven-head underground dwellers of THX-1138, shuffling through their twilight days in a prescription-drug-haze.
Our Daily MedsPublisher: Farrar, Straus and Giroux
Subtitle: How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines
Author: Melody Petersen
US publication date: 2008-03
Not long after 27-year-old Stephen Kazmierczak walked into a Northern Illinois University classroom and shot 19 people, five fatally, before committing suicide, it was revealed that he had been taking Xanax and Prozac, as well as Ambien. A couple weeks before he appeared in that classroom with a blank expression and four newly purchased firearms, Kazmierczak stopped those medications and began acting (as was universally described) “erratically”.
Although one can draw a comparison to other young male mass murderers taking antidepressants before their crime, in some of those cases, it can reasonably be argued that some of those would-be killers (Virginia Tech shooter Cho Seung Hui, for one, a socially maladjusted misfit who could barely hold a conversation) were on the drugs because they were troubled. The case of Kazmierczak could potentially be different, however, given that (if what is being said by many who knew him can be believed) he seemed a fairly stable and easygoing sort of person.
It is far from proven at this point (and may well never be), but there is something to the post-shooting chatter online and in the media where many conjectured that, far from curing his problems, the drugs Kazmierczak was taking (and the shock to his system that a sudden stoppage could have brought about) could possibly have been creating them.
It’s a theory that former New York Times pharmaceutical reporter Melody Petersen would certainly give a listen to, given the startling thesis she puts forward in her barn-burner of a book, Our Daily Meds. With barely controlled rage and cold hard data, Petersen identifies her target, the pharmaceutical industry (aka Big Pharma), and wastes no time piling up incriminating facts:
There is now one drug salesperson (many with entertaining and marketing budgets that would put a high-flying media conglomerate to shame) in America for every six physicians.
In 2004 Americans spent more on prescription drugs than they did on gas.
Between 1980 and 2003, the amount Americans spent on prescription drugs exploded from $12 billion to $197 billion.
What’s the big deal? If the drugs work, then those numbers show a thriving business that has managed to meet a need. New drugs to deal with old and new problems. The problem, as Petersen lays it out, is manifold.
To start with, Big Pharma now resembles Big Tobacco, another industry that once hooked customers on addictive and dangerous products that they didn’t need, and ended up so profitable they didn’t know what to do with all the cash. (Granted, Big Pharma does, for all its sins, still produce drugs that save lives and help millions, whereas Big Tobacco does nothing but sell cancer in a box.)
Petersen makes a strong case that many of the drugs that help fill the coffers of Big Pharma are in effect nothing more than slightly tweaked variations on or combinations of older drugs given zippy new names and snappy marketing. At best, these "new drugs" that increasingly pressured doctors have been prescribing in ever-higher numbers are just more expensive versions of the same (which is its own problem, of course, particularly in a worsening economy).
At worst, though, these aggressively marketed drugs are dangerous, having been pushed through a regulatory process that increasingly favors industry over the consumer. As Petersen notes: “The drug companies’ chain of influence is so complete that there are few people left to look objectively at the effects of their products on the nation’s health or at the consequences of their power on society.” As a result, patients are harmed; it’s that simple. Petersen estimates that prescription drugs kill about 270 Americans every single day.
Petersen reports on numerous examples of chicanery in the drug-pusher model used by Big Pharma to insert its new brands into the marketplace, though few more disturbing than the Sesame Street incident. Pfizer paid Children’s Television Workshop to produce a video in which Elmo had an ear infection but took the (Pfizer-produced) antibiotic Zithromax, and felt all better afterward.
The company continued pushing Zithromax even after pediatric experts and the federal government (stepping into the fray for once) advised doctors in 1999 that most children with ear infections don’t need drugs, and the few that do can just use the cheaper standard amoxicillin, which works just as well. Petersen boils down the inherent problems in corporations pushing pediatric drugs just as they would a box of sugary cereal: “When a doctor gives children prescriptions they do not need, they risk all its potentially serious side effects, but gain no benefit.” Not to mention the inherent sin of pimping out Elmo.
Given how much money Big Pharma pumps annually into consultant fees and gifts to doctors, grants to universities, and to their armies of government lobbyists, there is little incentive from the powers that be to do anything about the current state of affairs. If everybody’s making money, than who is left to care about the people being harmed?
In one particularly chilling detail, Petersen writes about a rare instance in 2004 when a pharmaceutical company was actually found guilty of what many do all day, everyday. Warner-Lambert (a Pfizer division at the time) had been pushing Neurontin as not just a great new epilepsy drug, but the new end-all, be-all cure for just about everything. Even though it is illegal for companies to promote prescribing drugs for illnesses they haven’t been tested for, Warner-Lambert (according to damning whistle-blower evidence) went about doing just that in an aggressive sales campaign that came down many times to handing out massive amounts of cash to doctors: physician payola.
According to Petersen, Warner-Lambert -- whose drug subsidiary Parke-Davis had been trying to convince doctors back in the 1880s that a great way to get morphine addicts clean was to give them the company’s cocaine-based elixir -- ultimately paid out $430 million in fines, “only a fraction of the profits that Pfizer was now earning from the drug.” With profits like that, it’s clear why Big Pharma no longer bothers with the low-profit vaccines and antibiotics of earlier years; why create the new penicillin when there’s more money to be made in convincing people they need a drug to help them sleep, have sex, or just plain be happy?
It's hard to read Our Daily Meds without thinking of Americans as shaven-head underground dwellers of THX-1138, shuffling through their twilight days in a prescription-drug-haze. Although the admirably plain-styled Petersen does her best by the end of the book to provide a way forward, in case any crusading legislator decides to stop riding the Big Pharma gravy train and get on the case (Ralph Nader, where are you?), it’s hard for stories like the one just described to not have a hope-draining effect on readers.
The problem, as Petersen reports it (in lengthy, occasionally deadening detail), is vast, with a country increasingly addicted to expensive drugs that often cause new problems when not helping cure existing ones (why else are there now chain drugstores on every corner if not to feed this habit?). And with a system so corrupted by high profit, it's difficult to imagine that much will change any time soon. For the brave reformer, though, Petersen has at least provided plentiful reason for a crusade.
It’s like the doctor says in Fernando Meirelles’ film version of John Le Carre’s novel, The Constant Gardener, “Big pharmaceuticals are right up there with the arms dealers.” It’s a hard point to argue, particularly when one thinks of Stephen Kazmierczak, and all his victims.