CCompared to others In high-income countries, American health is in dire straits and has been declining for decades. Even before the Covid-19 pandemic accelerated health inequalities, the crisis, in addition to the crisis, exacerbated, creating even more devastating situations for more and more people, especially groups left behind by society. There is a crisis of diabetes, a crisis of obesity and, of course, a crisis of despair, including suicide, alcoholism and an increasing trend of drug overdose, killing an average of 70,000 people annually from 2005 to 2019. In the United States, it is below the average for the other 28 countries.
According to John Abramson, a medical policy instructor at Harvard Medical School, the sap of this poisonous tree is the so-called big pharma, a coalition of pharmaceutical companies that have structured American medical care into a money-making machine. In “Getting Sick: How Big Pharma Breaks and Repairs American Healthcare,” Abramson answers the “American Healthcare Paradox,” using the testimony of patients and former drug executives. Build his case.
Book review — — “Getting sick: how Big Pharma broke American health care and how it can be repaired,” by John Abramson (Mariner Books, p. 336).
In this book, Abramson reveals that doctors are regularly fooled into prescribing expensive drugs with extreme side effects while major pharmaceutical companies are making record profits. I am. But recent research shows that 46 million Americans can’t afford to pay for medical care. According to a 2020 survey, two-thirds of consumers live in fear of medical costs.
This book is a short-term intensive course of profit-driven systems built by Big Pharma, which dominates the U.S. healthcare industry, and has recently killed thousands of Americans while enriching large corporations. Starting with some pharmaceutical scandals, they can cause excessive distress.
Having worked as a family doctor for many years, Abramson has served as a legal expert in about 15 civil trials involving pharmaceutical companies, highlighting flawed research and clever marketing tactics in the pharmaceutical industry. His first few chapters are studded with dramatic court sequences, and for many years, as writer William Heisel described him as “a candid critic of the pharmaceutical industry” in 2009. Shows reputation.
“As a litigation expert, I had access to the manufacturer’s scientific data and its business and marketing plans,” Abramson wrote. “These are pieces of the puzzle, and in summary, let pharmaceutical companies prescribe expensive new drugs, even if they have little or no (and in some cases harm) added value compared to cheaper alternatives. It shows how to convince a doctor. ”
In one glorious scene, Abramson explained to the jury how Pfizer persuaded doctors to overprescribe neurontin (gabapentin), an off-label epilepsy drug for bipolar disorder. In the late 1990s, Pfizer sponsored a number of fashionable dinners and held conferences where pharmaceutical companies presented misleading data showing remarkable improvements. However, they withheld data that “showed that the drug was significantly worse than placebo,” Abramson wrote.
Pfizer later pleaded guilty to illegally selling their medicines, but only increased the company’s profits from neurontin. This example is far from anomalies in the field of biotechnology, how deeply corporate profits infect almost every aspect of the American healthcare system, and why it’s so difficult to fix. is showing.
At the heart of this issue, which this book repeatedly emphasizes, is a corrupt scientific process that requires significant reform. The peer-review process is inherently broken, Abramson writes. At least when it comes to drug development, mostly raw clinical trial data is kept secret from peer reviewers and medical journals.
And as more and more medical research is funded by pharmaceutical companies, it creates a perverse incentive to develop beneficial treatments rather than “determining optimal care,” he explains. increase. “Without this commitment, the results of clinical studies received by physicians and other healthcare professionals as valid scientific evidence are only marketing tools.”
It’s no wonder that drug costs are out of control. The federal government cannot negotiate low prices, so pharmaceutical companies can basically write blank checks. “The United States does not regulate drug prices and has no national program to determine whether new drugs provide added value that justifies higher costs,” Abramson wrote. According to a recent report by RAND Corporation, a non-profit think tank, Americans pay 256% more on medicines than in the other 32 countries. And obviously, based on the overall decline in our health, he argues, we don’t get much in return for these costs.
This equation can be fatal. One example used by Abramson is Vioxx, an analgesic similar to ibuprofen, which became the center of the largest drug recall in US history in 2004. Its manufacturer, Merck & Company, claimed that Vioxx can relieve the pain of arthritis without causing gastric ulcers. This is a potential side effect of non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen.
However, Merck masked the fact that Vioxx doubled the risk of a patient’s heart attack without providing better pain relief. Abramson claims to have done this with the help of the New England Journal of Medicine, which has made significant profits by publishing Merck’s data, and nearly a million misleading articles claiming that the drug is safe. Reprinting the department, “brought $ 697,000 to $ 836,000 to the journal’s vault.” The drug was later associated with an estimated 39,000 to 61,000 deaths.
Merck is well aware of this risk, and an internal email later revealed, but a specific medical history that “minimized the possibility of revealing the potential cardiovascular risk of Vioxx.” The study was designed in a way that excludes people with.
Merck also continued to put cash into Vioxx and “spent more money on selling medicines than any other company in history,” he said. In 2011, Merck pleaded guilty to illegal marketing and “false statements about the cardiovascular safety of drugs.” But Abramson claims that others were colluding, including medical journals that were waiting while misleading information was being used to boost sales.
“If NEJM knew the problem and immediately corrected the wrong article, it would have prevented many of these injuries and deaths,” he wrote. “Instead, it leaves the article uncorrected, allowing Merck to benefit from the drug blockbuster status for another three and a half years, and the journal itself sells a misleading reprint of the article to Merck. I was able to profit from that. ”
However, NEJM states that it “partially corrected the record” by issuing a statement about the article, but “still, editors act solely because the journal’s reputation is at stake. Did”.
Regulators are not without responsibility. Abramson said the FDA did not intervene in the ongoing public health emergency after the FDA took the family of one patient who took Vioxx “after the executive reports based on Merck’s data clearly identified the risks.” I wrote that it “failed”.
Examples like Vioxx are common in the industry because Abramson repeatedly lays them out. He argues that if we intend to get out of this turmoil, we need a “triple coalition” that can be “integrated into an effective force for reform.” This coalition includes health professionals, insurance companies and other people who pay for health care, and health care consumers: you and me. “These supporters can pool their influence and create formidable power,” says Abramson.
However, drug price cuts are a bipartisan issue, supported by 77% of voters, but Congress has failed to pass meaningful reforms. Abramson questioned this: “Why Pharma’s scientific distortion and exorbitant pricing are to balance commercial and public interests, especially in the context of such strong negative public opinion. Didn’t it trigger an effective policy? ”Changes are repeatedly stalled: Senator Bernie Sanders of Vermont’s recent attempt to force him to vote on a bill to lower drug costs is Mike of Idaho.・ It was blocked by Senator Kurapo.
Nevertheless, the United States may at least be approaching better drug testing and regulation. Robert Caliph’s recent appointment as head of the FDA was praised in an opinion piece by STAT News, emphasizing his support for “publishing data submitted to the FDA during the drug development process.” We hope this will make scientific accountability a little easier for medical research.
“Sickening” is written in an enhanced language backed by hard data and past examples to explain Big Pharma’s enrichment strategy. But “don’t hold your breath waiting for the big pharmaceutical companies to have an epiphany of social conscience and voluntarily give up their power and profitability to serve greater profits,” Abram said. Son concludes. “It’s not their job.”
Troy Farah is an independent journalist from southwestern California. His reports on science, drug policy, and public health have been published in Wired, The Guardian, Discover Magazine, Vice, and more. He co-sponsors the drug policy podcast Narcotica. Follow him on Twitter @filth_filler.
