Be warned: reading this book will make you angry. It will make you feel frustrated and, at times, simply discouraged. If you are someone who has taken any of the medicines detailed in its well-researched pages, you may even feel depressed and furious. But it is a book
which every American should read.
Melody Petersen is an experienced award-winning investigative reporter whose beat is the pharmaceutical industry. She begins by reminding us that Americans spend billions on medicines, outstripping the amounts spent on gas and fast food. And, shockingly, in many cases the meds they choose are ones that have been created to "cure" an ailment "invented" by the company that pushes the pills.
This was the case with Detrol, the first miracle cure for incontinence. Incontinence isn't something that most people have and those that do don't like to talk about it. So the first task of the sales team at Pharmacia, the company that marketed Detrol, was to make the drug seem like something we all need. The first step was to bribe doctors into coming up with the right set of symptoms. By wining and dining physicians at luxury resorts, pharmaceutical companies have been able to massage the medical community to bend to its will with extraordinary success. Detrol, the marketers claimed, would cure something called "overactive bladder." Overactive bladder, the American public was told, was crippling its citizens, forcing them to go to the bathroom up to nine times a day, forcing them to "map" their day to include familiar and acceptable bathroom locations, even keeping some people at home for fear of having to go when no bathroom was available. Insidiously, these ideas were planted not just in the minds of the public but in the minds of doctors, so that if anyone came to their office with some urinary symptoms, out came the Detrol. Since they'd been amply rewarded to give out samples and write prescriptions, they were willing pawns in the manufacturer's game. Amazingly, American doctors who have sworn to "do no harm" are quite easily swayed by flattery and bribery.
Americans now use drugs for everything - even, Petersen points out, the family dog takes
Prozac if he's barking too much. Brand-name appeals are made to children because it's been proven that children are very susceptible to this form of repetitious advertising: "When children begin talking, they begin asking for things by brand name..." Gives a different slant to ads featuring cute kids singing about "Band-aid brand," doesn't it? But it's far worse than that. One company pitched its anti-eczema drug to kids with coloring books and animated cartoon ads, and went on doing so after the drug cream in question had been shown to cause cancer.
One of the most distressing segments of the book deals with the drug Neurontin. The story is told from the viewpoint of a whistle-blower, David Franklin, who lived on the gravy train as a Neurontin rep for several years until he began to feel queasy about the way Walter-Lambert, a division of Pfizer, was pushing its best-selling med. Researched as a medicine for seizure control, Neurontin was, Franklin learned, being praised to doctors as a remedy for just about anything from headaches to ADHD. A PhD
himself, Franklin saw the lavish treatment of doctors encouraged to prescribe it and became part of the pernicious practice of touting the med to conventions of physicians: "...the company paid one doctor more than $300,000 over three years to give presentations about Neurontin." Franklin learned the behind-the-scenes practices of paper-shredding and the glib dismissals of any problem with the drug. Then reports began to trickle in, anecdotal at first, from doctors who found that the medicine simply wasn't helping their patients. The breaking point for Franklin came when a doctor to whom he was trying to promote the drug showed him a recent study in which patients, children, had been made worse by taking Neurontin - "the kids grew defiant and more hyperactive." At that point, Franklin began to record voice messages and save memos until he felt he had amassed sufficient evidence to approach a lawyer. In the end, Warner-Lambert pleaded guilty to criminal charges - they paid out
$430 million, after having earned ten billion dollars in profits by illegally marketing their product.
Petersen offers some suggestions for concerned consumers - and you will be one by the time you get to this part of the book, I assure you. All of us need to be more careful about what medicine we take. We need to understand the reasons why it was prescribed. Beware of free samples - these will be the most recent hand-outs from the zealous drug reps, and their purpose is to get you hooked on something that may not have been thoroughly researched, something your doctor has had only a few minutes to get a grasp on in a sales pitch designed to seduce rather than inform. Yes, you should use cost as a reason not to take a drug. Petersen advises, "Start a revolution. This is your medical system. You're paying dearly for it, whether you use it or not."