Same old duet: drug companies and psychiatry

Here’s more this month from investigative journalist Alison Bass, author of the book Side Effects: A Prosecutor, a Whistleblower, and A Bestselling Antidepressant on Trial:

“The same drug giants paying millions of dollars to settle claims that they engaged in illegal and improper marketing of anti-psychotic drugs in the U.S. are even now looking for new worlds to conquer. Consider the study published in the Archives of General Psychiatry. It surveyed more than 60,000 adults in 11 countries in Eastern Europe, Asia and South America and concludes that the treatment needs for people with bipolar disorder are “often unmet, particularly in low-income countries.”

“That may indeed be true. But I’d find this result a lot more believable if the study were not funded in large part by the same pharmaceutical companies who make the atypical anti-psychotics used to treat bipolar disorder: Eli Lilly (which makes Zyprexa), Janssen (the unit of Johnson & Johnson that brought us Risperdal), Pfizer (Geodon), Bristol Myers Squibb (Abilify), GlaxoSmithKline (Lamictal), and Novartis (Fanapt).  Continue reading

Does the medical profession need to wean itself from its “pervasive dependence” on Big Pharma money?

Judges do not hear cases in which they have a financial interest. Reporters do not write stories about companies in which they have a financial interest. By the same token, doctors should not have a financial interest in treatments they are evaluating, or accept gifts from the makers of drugs they prescribe.” 

That’s what Dr. Marcia Angell says, and she ought to know.  She spent over 20 years as editor of the prestigious New England Journal of Medicine. She wrote these words last January in a letter to Dr. Nada Stotland, president of the American Psychiatric Association in response to Stotland’s criticisms of her essay in the New York Review of Books.

Back then, the editorial board at the New York Times had decreed:

“The medical profession needs to wean itself almost entirely from its pervasive dependence on industry money.”

Dr. Angell agreed with the Times, adding:

“Pervasive conflicts of interest corrupt the medical profession, not in a criminal sense, but in the sense of undermining the impartiality that is essential both to medical research and clinical practice.” 

Dr. Angell disagreed strongly with psychiatrist Dr. Stotland’s assertion that very few drugs of any kind have been tested on children. Not so, claims Dr. Angell.  Continue reading

“Pay for Delay”- how off-patent brand name drugs fight off generics

Drug companies are acutely aware of what’s called the ‘patent cliff’, when their expensive brand name medications lose their patent protection, thus opening up the market for cheaper, identical generic competition. This is good news for consumers, but very bad news for Big Pharma. Lipitor*, for example, Pfizer’s blockbuster cholesterol medication, is set to fall off the patent cliff in 2011.

But even last year’s sales of the biggest selling drug on the planet already showed declines due to growing competition from other cholesterol drug manufacturers.  See also: Is Big Pharma Onboard the Titanic? Continue reading

Johnson & Johnson: “Welcome to your nursing home nightmare!”

When I visit my friend Ruth in her nursing home, I have to walk down a long corridor to get to her room. Along one wall of the long corridor sits a large aquarium. In front of the large aquarium, wheelchairs are lined up every day, eight or nine in a row facing the fish, their occupants slumped in semi-conscious stupor, rheumy eyes half-closed or glazed, with none of them paying any attention to the fish. It is distressing to me, this row of seniors. It reminds me that every one of them was once young and healthy.

They had families and careers and a social life.  And now here they are, lined up in front of an aquarium they do not see.

It also reminds me that this fate in front of the fish may well await me  – and you – one day, too, especially if drug companies like Eli Lilly or Johnson & Johnson have their way dispensing their anti-psychotic crowd control drugs to the frail elderly.

But these anti-psychotic drugs can raise the risk of death in dementia cases and are not approved to treat this, although that hasn’t stopped J&J from offering kickbacks in exchange for pushing its anti-psychotic, Risperdal.

According to a government news release, J&J paid kickbacks to a big nursing home pharmacy company, Omnicare, to get the company to prescribe more of its drugs, including Risperdal. And this is not the first time. Last year, Omnicare paid $98 million to settle allegations that it had solicited and received kickbacks from J&J in exchange for recommending Risperdal.  Some people just don’t get it.

U.S. Attorney Carmen Ortiz said in the news release:

“Kickbacks in the nursing home pharmacy context are particularly nefarious because they can result in excessive prescribing of strong drugs to patients who have little or no control over the medical care they are receiving. Pharmacists’ recommendations should not be a product of money that a drug company is paying to the pharmacy.”  Continue reading

Nice work if you can get it: same talk, same slides, week in, week out – at $1,500 a pop

speech purpleSince returning from Mayo Clinic and the annual WomenHeart Science & Leadership Symposium for Women with Heart Disease training, I’ve done many public presentations on the subject of heart disease – the #1 killer of women in North America. My talks are pretty well all the same. When I tell the story of my own heart attack misdiagnosis, it never changes.  When I talk about emerging research from Mayo and other experts on women’s risk factors for developing heart disease, it’s always the same list.  When I discuss surprising symptoms and signs that you might be having a heart attack – well, you get my drift.

This is a normal public speaking reality for those who have a specific message to deliver or a unique area of expertise to share.  Same talk, same slides, different audiences.

Just ask psychiatrist Dr. Manoj Waikar, adjunct professor at Stanford University, who moonlights as a public speaker for the largest American psychiatric drug maker, Eli Lilly.  Continue reading

What drug company sales reps wrote on their BlackBerries

 blackberry office

  • A psychiatrist, originally skeptical about prescribing the powerful anti-psychotic drug Seroquel to his patients, becomes a super-prescriber who is rewarded by the drug’s manufacturer with generous $1,500 speaking engagements.
  • a neurologist jokes that she doles out so much Seroquel for her migraine patients that the drug company probably thinks she’s a psychiatrist;  she is rewarded with free trips to Scotland and Spain by the company.
  • a  busy physician has no problem leaving patients to stew in the waiting room while he listens to a pitch about Seroquel from a drug rep. “Dr had 3 patients waiting but did sit down with me x 25 minutes,” the rep wrote in her daily call notes.  Continue reading