Yesterday, I was scanning a file I keep of books people on discussion lists have mentioned. Scanning the books at the indie book store, I spied a book on my list: Our Daily Meds by Christine Petersen.
I just finished the first couple of chapters and this book is awesome. It's about the way the pharmaceutical industry and physicians end up creating maladies that can be treated with drugs that are not proven to be especially effective -- sometimes depression medication is no more effective than the placebo, which I've heard before.
I had heard plenty about the ridiculous marketing that goes on, and even understood it first hand. (snipped story for brevity) Petersen's book focuses mainly on the era after the late 80s/early 90s, when the HMOs emerged to rein in medical spending. Everyone at the time wondered what would happen, sociologically speaking, to physicians who were being treated as if they were no more than worker cogs in the vast HMO machine. There were horror stories of HMOs deciding treatment plans, undermining physicians' treatment plans, and one outraged physician after another.
What no one wondered in sociological circles that I traveled was what would happen once doctor's paychecks declined b/c of the HMO effect. (there was some naive assumption that doctors with their ethics code and professionalism would fight HMOs so they could treat people properly. Apparently: fat chance to that.)
Instead, what happened was that physicians became targets of big pharma. They started paying them 'consulting fees' to become consultants for the company, traveling to conferences, small gatherings, wherever doctor's gathered in order to pitch their sponsor's drugs. They were rewarded on the basis of their prescription rates, with some companies outright paying for things like brand new offices for a doctor just because he had a great prescription track record and indicated there was more where that came from.
Petersen writes about the crappy testing procedures where you don't have to prove anything much to get a drug approved. Oh, they worry about side effects, but apparently it is cake to get a drug approved even if only 30% of patients are actually helped by the drug. Even if all they do is show it's better than a sugar pills, they can do enough testing to find the 2 clinical trials that show that the drug is better than the placebo. Whee!
One drug, for over active bladder -- a malady Petersen convincingly argues was wholly fabricated by the pharma companies -- was well known for causing people to hallucinate and, basically, lose their minds. Some people were diagnosed with Alzheimer's. Turns out that, especially in elderly folks (who happen to be more incontinent), the drug causes the onset of Alzheimer's-like disease.
Nice, huh?
so, the pharmaceutical industry creates maladies and diseases, treats them with drugs that are ineffective and/or repackaged and higher priced versions of one that already exists or offers no improvements on drugs that already exist. Then, those drugs actually cause new problems. People who take heartburn medication end up having high blood pressure which gets treated with statin drugs which have still more side effects.
Christ, I thought it was a crime when my mother in law was prescribed 17 different kinds of meds. Apparently, that was old school Today, the elderly have an average of 30 prescriptions each year.
This is a fucked up country. These pharma companies are making something like an 18% profit. This is unheard of in other industries. I have forgotten the stats, but the cost of actually creating a drug is something like 15% of the cost of the drug. And then she ran some numbers to indicate that even after r&d, marketing, etc. they still had plenty of money.
I will continue to read this book and report more, but give a shot. It will be hard to read I suppose if you are on medication. It can be scary to learn how many side effects there are. It will also be controversial because so many people feel they have been helped by drugs that have been found to be ineffective for most people or found to be horribly over-prescribed.
E.g., ambien is really dangerous. It can cause people to do crazy things like walk in their sleep, eat an entire loaf of bread in their sleep, even get in their cars and drive -- and not remember any of it. It also causes some people to lose their memories and slowly lose their minds. It is also wicked addictive and should never been taken for more than a few days at a time. And yet the marketing downplays this and even subverts this knowledge, which is provided in the adverts and commercials -- but is, again, subverted by the very text and mis en scene of the commercial. It can also cause withdrawal insomnia, worse than the insomnia the person had that was the impetus for the 'script in the first place.
Crazy!
I'm going to go read more, but do enjoy this book if you get a chance.