ABC
NEWS SPECIAL REPORT
With Peter Jennings
Bitter Medicine: Pills, Profit and the
Public Health
Peter Jennings – …Dr. Drummond Rennie
is an editor at The Journal of the American Medical
Association. He says researchers who are critical
get attacked all the time.
Do you actually believe, Dr. Rennie, that drug
companies are intent on keeping the consumer on
drugs, which are not as good as older drugs, for
the simple requirement of profit?
Dr. Drummond Rennie – Yes. Yes, very much
so. Absolutely. ….They’ve got to be
prevented.
Peter Jennings – … The top 10 drug
companies combined made profits of more than $37
billion in the year 2001. And you, the taxpayer,
are subsidizing research that benefits the drug
industry.
…Nancy Chockley runs an institute funded
by managed care organizations…
Nancy Chockley – What we found is that over
the last 12 years, that there’s really been
a shift in the type of new drugs being approved
by the FDA. And that we found that most of the
growth was really in drugs that did not show any
significant clinical improvement.
Peter Jennings – Eighty percent of the drugs,
which the FDA approves, are not significantly
different from the ones on the market already,
and only 20 percent of the drugs are significantly
new. Do you think the public even knows that?
…We’re spending more on prescription
drugs than we did in 1995. And the majority of
the drugs approved by the FDA are simply modifications
of old drugs…Consumers spend $90 billion
more on prescription drugs last year than was
spent just six years ago. And are we $90 billion
healthier? …But what critics call this ‘gaming
of the system’ may have a much more damaging
result.
Dr. Sharon Levine, Kaiser Permanente Medical Group
- If I’m a manufacturer, and I can change
one molecule and get another 20 years of patent
life and convince physicians to prescribe and
consumers to demand … then why would I be
spending money on a lot less certain endeavor,
which is looking for brand new drugs?
Peter Jennings – The pharmaceutical industry
has more registered lobbyists than the number
of senators and congressmen combined.
Dr. Jerry Avorn, Brigham and Women’s Hospital
– I think there’s a sense that, for
example, when the FDA approves a drug, everything
that needs to be known about it is known. I think
patients believe that. I think doctors sometimes
believe that. And that is not true.
Peter Jennings – How do you explain the
overwhelming success of these drugs in a very
short period of time?
Dr. Sharon Levine – I think the only explanation
is the amount of money, the amount of time and
energy that was put into promoting these drugs
to doctors and advertising these drugs to consumers.
Peter Jennings – You see television ads
like this all the time, including many on ABC
News programs. They are part of the drug industry’s
$15 billion effort to get you to ask for particular
drugs and to get doctors to prescribe those particular
drugs. …The drug companies spend vast amounts
of money – nearly $3 billion selling to
consumers, $5 billion marketing to doctors, $8
billion worth of free samples. …Doesn’t
it make sense for the drug companies to at least
educate the doctors about the prescription drugs
that are available?
Dr. Marcia Angell – Well, that’s not
their business, education. Drug companies are
not in the education business. Medical schools
and teaching hospitals are. It’s like expecting
beer companies to educate people about alcoholism.
It is not what they do.
Dr. Matt Handley, Group Health Cooperative –
It’s almost like a trade. You might not
have the stomach problem, but the studies suggest
you might, instead, be equally likely to have
a more serious heart problem.
…I would personally wait years for long-term
safety from the FDA’s monitoring program
before I’d consider taking them. If they
were free, I would do that same thing.
Peter Jennings – What does this say about
the social responsibility of the pharmaceutical
industry? Or is the pharmaceutical industry supposed
to have a social responsibility?
Dr. Sharon Levine – That’s a very
good question that the American people need to
answer, do we want to entrust critical elements
of the public health to an industry whose purpose,
whose mission is to earn return for shareholders?
Peter Jennings – Congress has never required
the FDA to routinely compare new drugs with older
drugs. This is costing consumers billions of dollars
that we do not need to spend. And in some cases,
it could be costing lives. …There is no
law that says new drugs have to be proven 100
percent safe. … The government says they
must be relatively safe, which means that every
drug comes with risks. And the result of that
is that sometimes new drugs turn out to be more
dangerous than old drugs.
Dr. Jerry Avorn, Harvard Medical School - If patients
were aware of the limitations that all of us physicians
have in terms of what we know and what we wish
we know and what we don’t know, they would
be more scared than they are at present. …The
saying that a lot of doctors use sometimes in
jest is, ‘Always wait a year before prescribing
a new drug. And if it’s for a family member,
wait five years.’ And that’s an awful
thing to say, but it reveals a perception that
we really don’t know as much as we would
like to know about a drug until it’s been
around. INSERT: In other words, tested on the
public. ...So, the assumption that there’s
somehow this wide body of knowledge that, A, exists
and, B, is at the tip of our tongues when we write
a prescription is actually a false sense of security.
Peter Jennings – The fact is, drugs can
be used for years before we really know how safe
they are. …Dr. Drummond Rennie is an editor
at The Journal of the American Medical Association.
He says researchers who are critical get attacked
all the time. Why do you think the industry is
able to get away with what you have in the past
called ‘bullying tactics?’
Dr. Drummond Rennie, Journal of the American Medical
Association – Money. Because if the shareholders
are happy, whom else do they have to answer for?
These are multinationals. They have no masters.
Peter Jennings – Can we trust studies funded
by companies that have a vested interest in the
results? …Will the pharmaceutical industry
do whatever it takes to get the results it wants
from research?
Dr. Drummond Rennie – The temptation to
spin those results is always there, and it’s
frequently used. Frequently.
Peter Jennings – For nearly every drug on
the market, doctors must wrestle with conflicting
and sometimes inaccurate information.
Dr. Drummond Rennie – If only the good news
about a drug is published, and never the bad news,
then a false impression is given of the quality,
effectiveness of that drug. It may be entirely
false.
Peter Jennings - Does the drug industry, on occasion
or regularly, suppress data?
Dr. Drummond Rennie – Oh, we suspect, and
rather know, that this happens all the time.
Peter Jennings - Does the drug industry ever suspend
a trial – a drug trial – because it
believes the results will be different than it
wishes?
Dr. Drummond Rennie – Yes, that’s
happened.
Peter Jennings – Does a drug company ever
not publish the results of a trial because it
doesn’t like the results?
Dr. Drummond Rennie – Yes.
Peter Jennings – Do you actually believe,
Dr. Rennie, that drug companies are intent on
keeping the consumer on drugs, which are not as
good as older drugs, for the simple requirement
of profit?
Dr. Drummond Rennie – Yes. Yes, very much
so. Absolutely. … They’ve got to be
prevented.
Peter Jennings – There is one last thing
this evening which we believe is important for
all of us. The questions about what we are getting
for our money cannot and must not be answered
only by the drug companies. Virtually everyone
we talked to for this broadcast agrees on that.
The rules by which this hugely profitable industry
operates do not always serve consumers adequately.
And nothing is going to happen, no matter how
angry consumers get, unless the Congress and the
president decide that the time is come. The country
can do better. I’m Peter Jennings. Thank
you for joining us. Good night.
