Here was my Big PhARMA forecast from 2002

I regret to say much of it has become manifest
I think we see indictments soon against CEOs

“Major Trouble ahead for Pharmaceutical firms”

1)Classical example of how greed and arrogance and the excesses of the free market takes something that is truly miraculous (life saving drugs/vaccines) and moves it to excess which then "backfires" See Teller -"When Technology Bites Back" or Dutton “ Worse Than The Disease"

2)Direct marketing to consumers on TV is a real debacle- the pharm companies come across as bone-fide drug pushers which they have become!

3)Science will show an increasing number of pharm products do more harm than good. They may be "efficacious" BUT THEY ARE NOT SAFE- grossly underestimated as contributing to cancer for example-see prempro story recently

4)Polypharmacy is running rampant- too many drugs for too many conditions in an individual- will get MUCH WORSE as naive boomers age and take more and more mixed meds

5) Psychotropics, analgesics and sedating antihistamines are contributing to serious safety problems on America’s highways and workplaces and who knows what other errors in judgment by leaders with this stuff swirling around their brains

6)Medications, especially psychotropics and analgesics are migrating in alarmingly large quantities to illicit market (eg. Oxycotin)

7)Yet politically, denying NEEDED drugs to elderly is hottest political issue going-another one is denying affordable drugs to millions dying of aids especially in Africa. So some populations are UNDERMEDICATED. Many in US are OVERMEDICATED

8)In high density populations there is the issue of ultimate ENVIRONMENTAL FATE in soil and water of human excreted medicines and/or their metabolites

9)Congressional Hearings ahead with tone of Tobacco and Asbestos

Rick Lippin, MD
Forecast published-July 2002
Southampton,Pa
Health Sector forecaster
http://medicalcrises.blogspot.com

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A good group has existed for some time addressing this very issue. It's No Free Lunch.org

"We are health care providers who believe that pharmaceutical promotion should not guide clinical practice. Our mission is to encourage health care providers to practice medicine on the basis of scientific evidence rather than on the basis of pharmaceutical promotion. We discourage the acceptance of all gifts from industry by health care providers, trainees, and students. Our goal is improved patient care.

No Free Lunch has initiated its "Drug Free Practitioners" Listing. This listing will be made up of health care
providers who have pledged to be "Drug company free," that is, free of drug company money and influence
in their clinical practice, teaching, and research. Among the objectives of the listing are:

To provide a mechanism for patients to find health care providers who practice medicine on the basis of evidence, rather than promotion.
To raise awareness of this issue both among the public and the medical profession, thereby maintaining
pressure on the profession to mend its ways, as well as individual practitioners (or researchers) to
mend theirs.

The pledge is as follows:

"I, __________________, am committed to practicing medicine in the best interest of my patients and on the basis of the best available evidence, rather than on the basis of advertising or promotion.

I therefore pledge to accept no money, gifts, or hospitality from the pharmaceutical industry; to seek unbiased sources of information and not rely on information disseminated by drug companies; and to avoid conflicts of interest in my practice, teaching, and/or research."

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Is the thing I find awful. I guess its a 'freedom of speech' issue but its troubling to advertise drug so much. The adverts themselves are awful and often embarassing (having to watch erectile disfunction, diarreah, and incontinence adversts is awful.) There also is a weird phenomena of getting perfectly healthy people to 'ask their doctor' for specific meds. This can't be good. Of course, doctors need to know about new drugs but this is best up to journals and, I guess, sales people. We should ban them but, unfortunately, the only speech we are outlawed to outlaw is political speech on television and radio.

As for sales tactics (pretty salespeople, free pens, notepads, golf trips) it sometimes is sleasy but everyone does it (almost) from computer, cars, real estate, insurance, even government agencies and programs. The point of the sales to doctors isn't so much to use a new drug as to use that particular companies drug, usually. Similarily to computers or other things, some drugs will treat the same disease so it becomes an issue of price (but since docs aren't paying) so it might come down to face time with a pretty, perky ex-Kentucky cheerleader that makes the sale.

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Looking at pharmacy invoice numbers on my monthly medication purchases from a local pharmacy, I find an annual increase of 30 to 50% for the past 5 years. The population of the neighborhood that they serve has not changed during that time. Something really bad is happening or marketing has been very effective.

Big Pharma is a corporate system. Corporate systems are limited only by laws, not by moral constraints. Corporations are required to do everything that is legal to increase profit, or the leadership can be held accountable. Therefore, profit is placed above human need. Congress is owned by corporate 'donors' who have only one goal, maximize profits by expanding markets. We should not be surprized that they have been successful at the expense of people who are suffering from illnesses that may or may not be well-managed by the medications that Big Pharma sells, and sells well. By the way, NIH pays for the basic research that leads to the new treatments that make Big Pharma all of its money. Big Pharma only pays for safety testing in clinical trials and manufacturing. So, when they advertize that they have to recoup their costs for developing a profitable drug, they are not telling the truth.

To profit from human suffering is reprehensable and Big Pharma is the worst. However, it is our fault for allowing our government to make such abuse of the most vulnerable among us possible. Corporations will always produce this sort of result as long as we allow them to do so. It is time to put people before corporate profit within a national universal health care system.

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It is sad that we have reached a point where something as critical and potentially dangerous as the chemicals we put into our body, is controlled so much by money and political influence. I intend to buy the DVD and tell as many people about it as I can. The additional issue that is important is that, we now know that medication errors cause 1.5 million patient injuries every year, and there are 700,000 emergency room visits that result from medication reactions, yet the pharmaceutical companies and their insurance companies are still trying to get immunity from suit when their products cause death or disability. Most people go not know that the pharma lobbyists have persisted in their efforts to pass laws that state that they can't be sued when a drug causes harm if the FDA has found the drug to be safe. The problem is that every drug that is on the market has already been found to be save, but we know that many of them are not. Michael Townes Watson, author of America's Tunnel Vision--How Insurance Companies' Propaganda Is Corrupting Medicine and Law.. www.StopMedicalError.com.

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One morning while waiting for an appointment, I took refuge in a crowded coffee shop nearby. The only seat was next to a beautiful and heavily made-up young woman who had taken two chairs—one for herself and the other for her designer coat—and set up her laptop on the table between. Her cellphone rang, and she was immediately in loud conversation, somewhat on the defensive I thought. "I did that! I told him that! But he..." Oblivious that she was broadcasting to all around her, she went into a play-by-play of a sales call she had just paid on a psychiatrist. "He says it's effective," she bellowed,"but doesn't he know I can monitor how many scripts her writes?!" I was astounded. It had never occurred to me that drug companies had access to the prescriptions individual doctors write. I never managed to learn the name of the resiliant doctor or the pharmaceutical company, and the drug name was unfamiliar. Nothing on her bulging wheeled case bore the name of the company, but I remember thinking that they had invested a lot in this rep, and it was clear what they expected.

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I am a practicing neurologist in a relatively poor Southern state. I see about 6-10 drug reps a week, and as one commentator above stated, a visit from a drug rep (actually just as many males as females) is a not unpleasant break in my routine and an excuse for a coffee break. Drug reps are like TV commercials. They interrupt your "program" to tell you about their products, but you certainly don't have to buy them.
In my practice I use the drugs that benefit my patients, not the ones with the prettiest reps in the shortest skirts (that mode of dress is nonsense; all reps dress very professionally). I also welcome their leaving samples: the more the better. Many of may patients can't afford medications and samples do help.
As to cost, I strongly complain to reps about the costs of their drugs, but I understand that the cost of getting a new drug on the market is extreme, due to the testing required by the FDA. But if Big Pharma doesn't make a profit, they can't continue to do research and development to find safe, effective drugs for the many problems that plague our fragile bodies and minds. And many of my poorer patients actually get their drugs free from the manufacturers through their patient assist programs, and numerous others get rebates and special deals that help defray the costs. I also use generic drugs at every opportunity, even if a pretty drug rep urges me with her "Rembrandt smile" to use her much more expensive brand.
One last thing: Unlike many physicians I favor Medicare for all Americans, so that everyone can afford quality healthcare. If our government would take that bold step, none of this discussion would be necessary.

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I remember reading a couple years ago about pharmaceutical companies actively recruiting college cheerleaders for sales and marketing positions paying six figure incomes. Not unlike recruiting athletes.

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ITA with the no-free-lunch folks. A psychiatrist friend of mine has a policy re: pharma reps. They are only allowed onto his practice's property during one hour each day. Upon arrival they have to sign in, leave all their samples, leave their scientific lit. but no sales crap but their card. They have to sign out and leave. Any rep who doesn't comply or spends more the five minutes (between sign in and sign out) is sent a form letter uninviting them in the future, this is cc'd to the CEO of the drug company and the marketing VP.

The practice uses the free samples for poor patients who need a bridge between scrips and so on. But under no circumstances do they make prescription decisions on the basis of marketing and they only accept free meds they actually use with patients. All other free shit is not permitted on site. It's the only practice I've ever encountered that doesn't have a zillion Prilosec notepads and Adderall pens all over the place. It's actually a very nice office suite to visit because it looks normal and not like a 4-walled advert-on-crack. If only more docs would do that. Oh, I've been there during the "drop hour" and I have to say some of those girls need a lesson in what constitutes "professional" or "business attire". Does it take a five inch heel to sell drugs? Hmmm... has anyone ever told that bouncy 20-somepin about her feet in ten years from wearing such footwear all day? Maybe the fine Doc from the south doesn't see short skirts but here in socal it's da norm, baby. Completely inappropriate.

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The creepiest thing I have ever seen is Dr Jarvic (inventer of the artificial heart) doing a commercial for some stupid drug - - he even does the disclaimer. He should be ashamed of himself. Ed Graham

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This information about the pharmaceutical firms' methods of selling drugs is just the tip of the iceberg. The entire medical system is corrupt.

Those who think they're protected by the Hippocratic Oath would be horrified to know that "First do no evil, " is NOT the primary point of the oath. Its primary purpose is to protect doctors, and the first part of the oath is that doctors are to protect and support other doctors, not patients. In this, the medical system has been entirely too successful.

Has anyone noted how doctors are nearly always incorporated? What does this say about their primary concerns? By incorporating, a doctor is making clear that income is the most important issue in his/her practice, not patients.

As a person who has suffered hugely at the hands of the medical system and who has seen others suffer, too, I am horrified at the attitude of most doctors. They treat their patients abominably, especially if their conditions are severe, so that have no options (at least, within the medical system) other than accepting such abuse. Pain patients are often forced into exceedingly dangerous procedures - often ones that are considered contraindicated for their conditions - by doctors who say that they'll refuse to provide pain meds if they don't go along with it. What could possibly be the motive for this, other than money?

Why don't doctors routinely inform patients of the real risks of the medications and procedures they perform. If people were aware of the risks, most would say, "No thanks," to a large percentage of drugs and procedures.

But the medical system has taken control and is answerable to no one but themselves, a well-designed outcome of self-policing, which they do not do, and a direct result of the Hippocratic Oath.

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I'm a retired psychologist who spent 30+ years in the practice of psychology here in the good ol' USofA; 10 years in community mental health centers and then Thank GOD-or-Whatever ; I escaped those insane-asylums- pretending- to-be-treatment- centers-while- reaping-hundreds -of-BILLIONS- of-tax-dollars- over-the- past-40-years and entered private practice in 1978.
Though it only took me about 10 minutes after I left graduate school in Fayetteville, Arkansas back in 1968; degrees in hand , to discover that 90% of mental health science is bogus; it was a few years later that I concluded that about 90% of its activity is destructive, dangerous and unconscionable and carried out by either sickos or sociopaths or idiots or, more likely, all the above.
The entire mental health effort began to be usurped by big pharma back in the 1950s when Miltown began to be universally prescribed as " moma's little helper " and quickly our mothers and grandmothers became addicted. Today, the progression from miltown to valium to tofranil to elevil to triavil to prozac to zoloft to paxil to..... has addicted a huge percentage of our population.. ..how else to explain the elections of idiots and crazies like Nixon, Reagan, Bush 1, ...and culminated by
the colossally inexplicable election of George Dumbya twice!?
The Prozac-Zoloft- Paxil made me do it is the only viable answer to that enigma.
I was present at the earliest dawning of the biological explanation for all the woes of parenting challenges and the easy " sales pitch " that the problem lies not in the stars or poor parenting skills but in the synapses of the children. In fact the movement was birthed at the Child Study Center in Little Rock, Arkansas in the mid-1960s. Back then the condition of ADD to morph into ADHD was labeled MBD: Minimal Brain Dysfunction which, I suspect was a far too ominous label to market and thus quickly became the SLD industry-Specific Learning Disability.
The beauty of all this was it took the burden and ,better still, the guilt off the parents so they'd become much more willing to enter and stay with treatment of "their little darlings ".
The drug industry, of course, rushed into the scam likkety split!
Since all difficult children's distractions ( meaning male behavior mostly ) was now organic; it was only logical that medicine was the treatment of choice. Enter Tegretol! Tegretol is an anti-convulsant used to help control seizures and since the original diagnosis nonsense was called Minimal Brain Damage/ More palatably,Minimal Brain Dysfunction; a drug related to treatment of actual brain dysfunction was a solution, administered at a lower level...but the idea suffered a minor glitch ...it didn't work.

NOT TO BE DISCOURAGED :

An unintended consequence of stimulants in children was noted along about this time. Children exhibited a paradoxical reaction to stimulants in that it seemed to sedate them rather than excite them. Voilla! " Let's give the antsy-pantsy kids some SPEED.....i. e. RITALIN ", an amphetamine derivative. 30+ years later we now have an epidemic of Crystal Methamphetamine addiction running amuck in the USofA and it is so devastating it is actually beginning to threaten the fabric of our society, which can tolerate scarcely little threat as it is. Suppose there's a connection between Ritalin abuse and the societal ills of ' speed '?
Before parents of the rare child who actually might truly benefit from stimulants begin screaming like gut shot panthers, please note I did occassionally bump into a child with demonstable ADHD......I repeat.....I did OCCASSIONALLY BUMP INTO AN AUTHENTIC CASE.
Drug cocktailing is the latest practice of criminals calling themselves psychiatrists; a lethal progression for the PROFOUNDLY TOXIC MENTAL HEALTH MOVEMENT!

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And I still can't understand why the general public think these guys are all hardworking, very smart and self-sacrifcing. They are in fact of mostly average intelligence, always very well paid, live in a bubble where you are constantly given free things, and that does extend to sex. They love conferences and what goes on there does not need saying on Alternet. And yes they do it all for the lfatery of company reps.

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