Category Archives: Big Pharma

1000 Words: And One Pill Makes You Small

Medicine is on my mind today. Or, more specifically, the weird ways Big Pharma and the Medical-Industrial Complex harass us to buy their products.

Big Pharma, like many facile terms, can mean a lot of things, many of which are either conspiratorial in nature or flat-out nonsense. As I use it here, it means pharmaceutical manufacturers and marketers that are for-profit corporations whose primary responsibility is to benefit shareholders. Every other stakeholder, including consumers, as well as the general notion of public health, occupy a less important position than the company’s investors. That’s the nature of any for-profit business in this era of late-stage global capitalism and it often comes into conflict with the needs of individuals and society at large.

Here we go: Why in this or any other world would pharmaceutical manufacturers and marketers want or need to advertise their drugs to us? It’s not as though we can try out this or that drug, as we do when trying to decide what our fave breakfast cereal should be.

Here are three drugs often (very often) advertised on YouTube before the video you want to see begins:

Stelara

Entyvio

Xeljanz

In each case, the entire ad consists of a pleasant, pastoral scene or a happy family get-together with the words “Ask Your Doctor About _______” superimposed. Each ad lasts five seconds. And the use and purpose of each drug is utterly unknown to me as well as, I assume, 99.99 percent of the populace.

To borrow a line from Tony Soprano, I ask you again, what da fuck?

Da fuck, acc’d’g to my digging, is this: The Food and Drug Administration began allowing prescription drug makers to advertise, direct-to-consumer, in 1997.

At first, they created ads they hoped would convince millions of viewers they had one or another heretofore unheard-of or rare-ish malady. Examples: ankylosing spondylitis, erectile dysfunction (as a pathology), etc. Then they followed up with ads for cures.

An article published by the USC Annenberg Center for Health Journalism and written by Martha Rosenberg contains this damning passage:

Many people when they hear a radio or TV announcement about depression or ankylosing spondylitis think it is from the Centers for Disease Control and Prevention or other medical group concerned with public health. Wrong. Most “disease awareness” messages are from Big Pharma trying to get people to diagnose themselves with a certain disease to churn “demand” for a new Pharma drug.

Ankylosing spondylitis, by the way, is a rare-ish autoimmune or auto inflammatory disease that affects the human spine, causing great pain. The disease has no cure as yet and treatment consists of some combination of pain relievers, exercise, physical therapy and, occasionally, surgery. In other words, doctors by and large throw spaghetti against the wall to see what sticks.

Perhaps as few as 0.1 percent of people actually contract the condition. That’s one of every thousand people. It’s a good bet you don’t know anybody who has it.

Yet pharmaceutical companies a few years back flooded the airwaves with dire warnings about the malady. The reason? Hell, pretty much everybody experiences back pain now and again. The makers of AS drugs hoped enough people would harass their primary care physicians about them — and, really, they only relieve pain — that sales would soar. And they did.

Big Pharma’s marketers saw that as a win. You and I shouldn’t.

An article in the online publication of the Harvard Medical School, headlined “Do Not Get Sold on Drug Advertising,” reported in 2017:

Many medical advocacy groups say that drug companies employ direct-to-consumer advertising in a way that puts consumers at a disadvantage. First, the FDA cannot limit the amount of money companies spend on advertising; nor can it ban ads for drugs that have serious risks. Companies don’t have to spell out exactly how the drug works, mention the cost, or note if there is a generic drug in the same class or a similar drug with fewer risks.

The ad blitz of expensive brand-name drugs is often cited as a factor for rising health care costs. Prescription drugs accounted for nearly 17% of total health care spending in 2015, up from about 7% in the 1990s before revised FDA guidelines went into effect.

Once Big Pharma squeezed as much mileage out of trying to convince you you had a certain disease, then it began marketing specific drugs. The drugs Prozac, Viagra, Cialis, and Celebrex were among the early brand names hammered home on TV, radio, and internet ads after the FDA’s relaxing of restrictions. Drug companies spent hundreds of millions of dollars yearly advertising each of them and many others.

People then began hectoring their doctors for them. Opioids, too. Doctors — many of them well-meaning but a certain percentage of them craven — got writer’s cramp penning scrips for opioids.

In recent years, the drug companies’ ad people decided it’d be even better to throw drug names out there w/o planting the disease in your mind first, reversing their earlier strategy. Ergo the three drugs I mention above.

The only possible line of reasoning, as I see it, goes like this: You’ll hear about the drug so many times that you’ll either look it up yourself or catch wind of it from somebody else who has looked it up. Then it’ll stew in your mind until, voila, you’re starting to feel symptoms. The ads’ end goal is for you to go to your doctor, harangue her or him about your symptoms, real or imagined, or pepper her/him with questions about this or that drug until s/he finally whips out pen and scrip pad just to get rid of you.

Doctors are only human and, as such, can take only so much bellyaching each day. If dashing off a scrip prevents endless patient carping and gets said patient out of the examination room quicker so the doc can see others, then what’s the harm?

One answer would be the opioid epidemic.

According to the Centers for Disease Control, more than 100,000 people died of opioid overdoses in the year ending in April, 2021.

As we’ve learned via the myriad lawsuits against the Sackler family’s Purdue Pharma, maker of OxyContin, its marketers and sales reps stood on their heads to get doctors to write prescriptions for the drug, even after it was determined it was highly addictive and being prescribed needlessly in hundreds of thousands of cases. Big consumer distributors like CVS, Walgreen’s and Walmart also have been named in the suits. As I said, it’s a medical-industrial complex.

So, like the military-industrial complex, the medical-industrial complex is a dangerous racket.

BTW: here’s what those three drugs advertised on YouTube do:

Stelara — generic name, ustekinutab; developer, Janssen Pharmaceuticals; used to treat Crohn’s disease, ulcerative colitis, psoriasis, and psoriatic arthritis.

Entyviogeneric name, vedolizumab; developer, Millennium Pharmaceuticals; used to treat ulcerative colitis and Crohn’s disease.

Xeljanz — generic name, tofacitiib; developer, a public-private partnership of Pfizer Inc. and the National Institutes of Health; used to treat rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis.

For the life of me, I can’t imagine too many people capable of accurately self-diagnosing these maladies. But, that’s what the advertisers want you to do. And then go harass your doctor.

The Pencil Today:

THE QUOTE

“I’m back.” — Michael Jordan

GOD, THE JERK

Can anyone dispute it?

Case in point.

The guy who performed the world’s first successful organ transplant, Dr. Joseph E. Murray, has died. Officials at Brigham & Women’s Hospital in Boston announced his death yesterday.

Murray (center) Performing The First Successful Organ Transplant

Surgeons had been trying to transplant organs for decades before Murray hit upon transplanting the kidney of an identical twin into his brother in 1954. That was the key. All previously transplanted organs had been rejected by the receiving body. Murray was the guy over whose head the light bulb snapped on.

He figured it was genetics that caused all the rejections. If only, he concluded, you could transplant an organ from a donor whose DNA precisely matched the receiver. Ergo, twins.

It Just Might Work

After that, doctors all over the world quickly learned how to transplant other organs and how to swap parts between non-kin. Now, of course, organ transplant is routine.

Anyway, Murray told an interviewer once that he faced a lot of heat when he was doing his groundbreaking work. People called him Doctor Frankenstein, natch, and other shook their fingers — and their Bibles — at him.

Yup. The pious of this holy land warned Murray in no uncertain terms that god was steamed over his work. It was unnatural to take the kidney from one human and place it in another. It violated god’s law.

Teed Off — As Usual

I, for one, am thrilled that Murray ignored them. “We were just doing our work,” he said.

Since that time some 600,000 people have had their lives extended by organ transplants. The figure surprises me; I would have imagined many, many more folks would have received new kidneys and hearts and skin.

Here’s another thing I can’t quite grasp: As long as we as a species have decided to invent a god — that is, the creator of the Universe and the guy who has given us a guidebook for our behavior — why did we have to invent such a jerk?

I’M TIRED — ERGO, TERRIBLY ILL

Let’s stick with medicine. Only this has to do with how that particular science too often can become little more than a tawdry business.

I drove my sister up to Indy yesterday afternoon so she could catch her flight back home to Florida (where it was expected to be sunny and in the low 70s; I hate her.) By the way, The Loved One and I handled Thanksgiving weekend’s Glabbie Invasion fairly well. In fact, the whole gang seemed on reasonably good behavior: no blood or weapons were drawn and Gov. Daniels was able to demobilize the National Guard units he’d put on alert Wednesday night just in case.

It’s Okay, Boys, You Can Go Home Now

On the way back, I flipped through the channels and was able to pick up 670 The Score, one of the sports stations out of Chicago. A commercial came on for something called Nuvigil® which, technically, is the generic pharmaceutical compound, armodafinil, and is produced by Cephalon Inc.

Armodafinil is prescribed for people who suffer the dread disease, Shift Work Disorder.

Yes, the mad scientists and captains of industry who run Big Pharma have now transformed the yawn into an ailment.

Quick, Call An Ambulance!

Shift Work Disorder has become so ingrained in the doctor’s office culture that it’s referred to almost affectionately as SWD. You know as well as I do that whenever something becomes an acronym, it has become part of our human genome.

So now the fact that people who work overnights and have trouble getting enough sleep are viewed as suffering from a horrible malady and — whaddya know?! — need these new, miraculous little pills.

In fact, there’s a mysterious symptom of SWD that bedevils its sad victims. It’s called ES. Lord above, please don’t ever let me have to bear the horrors of ES. Scientists, chemists, and doctors must work around the clock to battle this scourge.

Somehow the heroic folks of Cephalon who put out the outfit’s website have mustered the courage to actually define ES. Yes, they have steeled themselves to type the words Excessive Sleepiness.

He Needs Pills, Stat!

The marvels of modern science! Who would have though that if you work nights and aren’t able to get enough sleep you’d become, well, sleepy?

Now, the sane among us agree that the optimal cure for SWD and its little brother, ES, is to look for a day job but, of course, that would preclude the need for Cephalon Inc.’s new, miraculous little pills.

It’s funny. There’s a group of people who have long had to work late into the night and have had trouble getting to sleep after their work shifts. They’re called musicians.

Musicians are notorious for having drug problems. Read any rock or pop or country star’s autobiography and nine times out of ten it’ll include several chapters on the author’s mighty battle with substances.

And just as invariably, they ascribe their early propensity to self-medicate to the twin needs of getting themselves up for their performances and then getting themselves down so they can sleep. They take speed or cocaine to prepare for the night’s gig and then they gulp downers or smoke pot or drink Southern Comfort (the foulest spirit ever distilled, BTW) to lull themselves into the arms of Morpheus.

Dr. Richards, I Presume

It’s an ugly vicious cycle, brought on by the performer’s need to make piles of cash in the short period that they may be popular and to provide ongoing employment for the dozens of people who depend on them. This kind of drug-taking is frowned upon.

Yet Nuvigil is advertised all day long and doctors prescribe it by the bushel-full.

Yet another thing I can’t figure.

GO AWAY, WOULDJA?

As long as I’m harping on the imponderables, how about this?

Who does Grover Norquist think he is and why in the world should we pay an iota of attention to such a grim-visaged, rigid, morally superior ideologue?

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