McGoldrick ’12: Profiting from medicine
Medicine — we love it, we praise it, we have faith in it, we take it, but should we trust it? Normally we think researchers, doctors and other health professionals have our best interests at heart, but all too often we forget how corrupting money can be, even in the most virtuous of professions. In recent years there has been a general growing concern about the ethical behavior of pharmaceutical companies and the universities that collaborate with them — unfortunately, Brown included.
In the 1990s, Professor of Psychiatry and Human Behavior Martin Keller conducted a study on paroxetine — a drug marketed as Paxil in the United States and as Seroxat in the U.K. — to see if the drug was a safe and effective treatment for depression in adolescents.
The study was funded by GlaxoSmithKline and the results, which concluded that paroxetine was safe and effective in adolescents, were published in 2001 in the Journal of the American Academy of Child and Adolescent Psychiatry. With this stamp of approval, the drug was prescribed to thousands of people of all age groups — including teens — for ailments from depression to dizziness. Though it was one of GSK’s most profitable drugs, paroxetine soon racked up stacks of side-effect complaints as serious as dependence and suicide.
According to The Herald, part of the controversy lies in the claim that Keller used selective reporting — he discarded negative findings — to come up with his positive results. But another ethical concern is the alleged claim that a GSK-affiliated employee ghostwrote the study’s results. In other words, the accusation is that Keller accepted money from the pharmaceutical company in exchange for allowing the study’s findings to be written by someone paid by GSK and published under his name. While the jury is still out on this case, it’s a reminder that we shouldn’t assume that money can’t influence the health profession.
In fact, the very structure of this industry consistently puts profits before patients. In 2010 alone, Americans spent more than $307 billion on prescription drugs. Many pharmaceutical company apologists argue that these tremendous revenues are necessary to pay for the costs of research and development.
Sure, research and development is costly, but that doesn’t explain the price of these drugs. The truth is that the major pharmaceutical companies — GSK, Pfizer and AstraZeneca, to name the biggest players — spend twice the amount on marketing and advertisement as they do on research and development. Apologists retort that marketing is necessary to educate health professionals and the public about the innovative drugs they produce in their labs. This ignores the fact that these companies are not producing innovative drugs, but imitation drugs.
Pharmaceutical companies have to spend more on marketing and advertisement because most prescriptions being introduced on the market are not new drugs, but merely imitations of already existing medicines. The lion’s share of this “research and development” either goes towards copying another company’s pill or tweaking the molecular formula of one of their own drugs that’s lost its patent. How many prescription nasal allergy sprays are advertised on television? Do we really need Pfizer’s Lipitor and AstraZeneca’s Crestor if both lower cholesterol? Or what about Nexium — the “healing purple pill” — that was introduced only after Prilosec lost its patent status and became available over the counter? The examples are endless.
Sometimes these copy-cat drugs are actually more dangerous than the ones they’re replacing. Vioxx, for instance, was a hugely profitable drug despite the fact that it was no more effective than aspirin and significantly more fatal.
These billion-dollar companies don’t market their drugs in order to educate us. They do it to secure their own piece of the lucrative drug market. Since there are a handful of other drugs on the market that do exactly the same thing, the aim of these marketing campaigns is to make their brand name and their pill the one that doctors are familiar with and prescribing. The pharmaceutical industry spends nearly $25 billion on things like pens, clocks, sporting event tickets and vacations that advertise to doctors and medical students. This calculated investment provides these mega-corporations enormous returns.
Additionally, pharmaceutical companies consistently seek to create lifestyle drugs — drugs that healthy people take to improve appearance or performance. Nearly every major pharmaceutical company is producing drugs for conditions like hair loss, acne, rosacea or erectile dysfunction. Pharmaceutical companies invest in prescriptions that Americans can afford and believe they need while neglecting to invest in cures and preventive treatments for diseases like malaria that are decimating the developing world.
It is absolutely unacceptable that this industry pushes people to believe that medicine is expensive because research and development is costly. These companies sweep negative clinical trial findings under the rug, invest in developing drugs that may be less effective and more dangerous than ones already on the market and care more about improving a patient’s self-esteem than saving lives.
Brown’s cozy friendship with pharmaceutical companies should concern every one of us. The University’s failure to launch a public investigation into Keller’s research threatens the integrity of other research coming from Brown. Not only does it discredit Brown’s integrity as a research university, but it also threatens patient safety since doctors are misinformed about the negative side-effects of drugs they are prescribing. The University should be devoted to researching medicine for the sake of benefiting humanity, not corporate profits.