This commentary is by Dennis Miller, RPh. He is a retired chain store pharmacist. His book, The Shocking Truth About Pharmacy: A Pharmacist Reveals All the Disturbing Secrets, can be downloaded in its entirety at Amazon.
Why Pharma Makes Me Sick:
Price:
1. Pharma charges way too much for drugs that are very often just copy-cats of existing drugs
These “me-too” drugs are not a major therapeutic advancement in comparison to drugs that are already on the market. Each pharmaceutical company wants to have its own drug to compete in the lucrative blood pressure market, cholesterol market, type 2 diabetes market, cancer market, arthritis market, depression market, osteoporosis market, anxiety market, insomnia market, hyperactivity market, schizophrenia market, etc. Pharma sees modern medicine as primarily a market for goods and services.
Pharma spends more on advertising and promotion than on research for truly innovative drugs. Pharma marketing attempts to make these copy-cat drugs appear as though they are as important as insulin and penicillin, two genuine pharmacy superstars.
Ads:
2. Pharma’s direct-to-consumer advertising of prescription drugs promotes overmedication
By advertising prescription drugs directly to the public on TV and in magazines and newspapers, Pharma is encouraging excessive consumption of pharmaceuticals. Only the USA and New Zealand allow this practice. What does that tell you other than that our government is quite willing to allow big corporations to exploit the public for private gain?
In my opinion, the FDA should prohibit direct-to-consumer advertising of prescription drugs. There is a reason why these drugs require a prescription. It is because these are heavy duty substances which carry significant risks, some of which can be extremely serious.
At the very least, the FDA should prohibit images of dogs wagging their tails while the announcer breezes through a scary list of potential side effects. The compelling images of friends, family, and pets having fun on sunny days are clearly intended to divert viewers’ attention from these adverse drug effects.
Not too long ago, there existed quaint concepts known as “true” and “false.” In today’s world, a lie is increasingly seen as just another point of view.
In my opinion, Pharma’s strategy is to make lies indistinguishable from truth. Pharma marketing is a modern-day sophisticated version of the frontier snake oil salesman. In the view of the drug industry, pharmaceuticals are a blank canvas upon which any reality can be constructed. That’s because reality is a completely elastic concept in the eyes of Pharma. Even though marketing campaigns are much more sophisticated today compared to the past, human gullibility has perhaps remained constant.
Questions on Safety & Efficacy:
3. Pharma often lies about the safety and effectiveness of pharmaceuticals. Pharma wants you to think that FDA approval means that a drug is safe and effective. Pharma does not tell you that FDA’s definition of “safe and effective” is a far cry from the layman’s definition. How can drugs that include “death” as a possible side effect be considered “safe”?
Many drugs approved by the FDA show only marginal benefit in comparison to placebos. How can such drugs be considered “effective”? Indeed, in many cases, when one factors in the adverse effects of an active drug, the placebo could reasonably be viewed as the superior agent.
Of course, Pharma will never admit that no one really knows the true incidence of drug adverse effects. That’s evidenced by the fact that black box warnings are too often added to the labeling years after the FDA approved a drug. Moreover, drugs are sometimes withdrawn from the market due to safety concerns that were not discovered in clinical trials.
Drugs That May Cause Cancer:
One of the truly scary issues with pharmaceuticals is that commonly prescribed drugs are linked to tumors and cancers in lab animals and sometimes in humans. Pharma will not admit that no one knows what to do with the voluminous data on the potential carcinogenicity of pharmaceuticals. (Read this data yourself in the Carcinogenesis and Mutagenesis section in the official labeling).
The carcinogenicity and mutagenicity data in the official prescribing information is something that leaves a lot of health professionals scratching their heads. Why are so many commonly prescribed drugs associated with tumors in lab animals and, in many cases, humans?
Perhaps nothing illustrates the crudeness of pharmaceuticals more than the fact that “about half of prescription drugs are potentially carcinogenic,” according to Thomas J. Moore in Prescription for Disaster (New York: Simon & Schuster, 1998).
In my opinion, a drug’s potential carcinogenicity is the single most important fact that the pharmaceutical industry wants to hide from the public. The fact that a drug you’re taking can actually CAUSE cancer is something that Big Pharma would like to sweep under the rug. I have not read a clearer discussion of the potential carcinogenicity of drugs anywhere other than Moore’s book.
See Prescription for Disaster, p. 96:
“Despite the complexity of cancer causation, prescription drugs ought to be ranked second only to cigarette smoking as a cancer hazard. While certain industrial chemicals are more potent carcinogens than any drug, there are few chemical agents to which so many people are exposed at relatively high doses for great lengths of time. The evidence implicating drugs is based on both the results of animal studies and observations in humans.
“…evidence suggests about half of prescription drugs are potentially carcinogenic.”
Shady Marketing Practices:
4. Individual Pharma companies are very frequently fined huge sums for false claims, kickbacks, fraud, poor manufacturing practices, failure to disclose safety data, etc.
Drug companies have been fined hundreds of millions or billions of dollars for infractions such as: off label promotion, false claims, failure to disclose safety data, paying kickbacks to physicians, making false and misleading statements about safety, underpaying rebates, Medicare fraud, poor manufacturing practices, monopolistic practices, etc. See Wikipedia: “List of largest pharmaceutical settlements”
Year: 2012
Company: Glaxo-SmithKline
Fines: $3 billion
Drugs: Avandia, Wellbutrin, Paxil, Advair, Lamictal, Zofran, Imitrex, Lotronex, Flovent, Valtrex
Year: 2009
Company: Pfizer
Fines: $2.3 billion
Drugs: Bextra, Geodon, Zyvox, Lyrica
Year: 2013
Company: Johnson & Johnson
Fines: $2.2 billion
Drugs: Risperdal, Invega, Nesiritide
Year: 2012
Company: Abbott
Fine: $1.5 billion
Drug: Depakote
Year 2009
Company: Eli Lilly
Fine: $1.4 billion
Drug: Zyprexa
Misrepresentation:
5. Pharma mischaracterizes and misrepresents pharmaceuticals, the human body, and common medical conditions.
Pharma does not tell you that most pharmaceuticals are synthetic substances, never before seen during the long course of evolution, that overwhelm delicate biological processes which have been fine-tuned over hundreds of thousands or millions of years.
Pharma describes Homo sapiens as if we are nothing more than a collection of chemicals, and implies that the human body can be completely understood in terms of chemistry. Pharma therefore implies that chemical solutions are needed for everything. At other times, Pharma implies that the human body is the equivalent of a rickety old machine, constantly subject to breakdown, and constantly in need of shoring up with synthetic chemicals known as pharmaceuticals.
Pharma views the human body in completely mechanistic and reductionist terms and claims that human health requires a relentless assault against delicate biological processes with an endless array of drugs variously classified as blockers, inhibitors, and antagonists. This includes alpha blockers, beta blockers, calcium channel blockers, angiotensin receptor blockers, proton pump inhibitors, cholinesterase inhibitors, HMGCoA reductase inhibitors, H2 antagonists, etc. Pharma implies that Mother Nature has done a very poor job throughout evolution, resulting in massive defects in Homo sapiens which need to be corrected with Pharma’s synthetic chemicals.
Pharma will never acknowledge how miraculous, wondrous, and magical Homo sapiens is or, for that matter, all living things and all life forms. Pharma will never admit that humans are part of the natural world. Pharma will never concede that most of the prescriptions that pharmacists fill are to treat preventable diseases of modern civilization.
Regulatory Capture:
6. Pharma has captured the Food and Drug Administration.
The FDA is clearly not the watchdog that the public expects and hopes. The FDA represents a clear example of “regulatory capture.” That’s a situation in which an industry that is supposed to be regulated by a governmental entity ends up controlling the regulator. The governmental entity (FDA) which is supposed to guarantee the safety and effectiveness of drugs has in reality been captured by the pharmaceutical industry.
Sixty-five percent of the FDA’s drug regulatory budget comes from Pharma through user fees. According to an official FDA publication (“FDA At A Glance,” U.S. Food & Drug Administration, Office of the Commissioner, Nov, 2020), “Human drugs regulatory activities account for 33 percent of FDA’s budget; 65 percent of these activities are paid for by industry user fees.”
The public is not told that this leads to a situation where FDA employees might feel that they work for or are beholden to Pharma rather than the American people.
In my opinion, this explains why the FDA approved the Alzheimer’s drug Aduhelm despite the fact that 10 of 11 advisory committee members voted that there was insufficient evidence to demonstrate the drug slowed cognitive decline. (The 11th panelist voted “uncertain.”) Three members of the panel resigned as a result.
Medicalization:
7. Pharma medicalizes common human behaviors.
Pharma describes the following behaviors as medical conditions that need medication: social anxiety disorder (shyness), generalized anxiety disorder, attention deficit hyperactivity disorder, intermittent explosive disorder (example: road rage), seasonal affective disorder (winter blues), obsessive-compulsive disorder (example: excessive handwashing), body dysmorphic disorder (dissatisfaction with the appearance of one’s body), compulsive shopping disorder, compulsive gambling disorder, shift work sleep disorder (working the overnight shift can cause health problems), performance anxiety (speaking or playing a musical instrument in public), etc.
Treatment Preferred to Prevention:
8. Pharma prefers to treat disease rather than to prevent it.
Pharma will not admit that prevention is better than pills. That’s because there’s much more money in the treatment of disease than in prevention. Pharma claims that it does indeed promote prevention. But Pharma does not tell you that it promotes “medicalized” prevention (prevention in a pill), rather than prevention via dietary and lifestyle changes.
Pharma defines prevention as, for example, treating elevated blood pressure or cholesterol with pills to prevent progression to cardiovascular disease. In contrast, genuine (non-medicalized) prevention means preventing disease upstream before it occurs by employing significant dietary and lifestyle changes including weight loss, exercise, avoiding tobacco and alcohol, etc.
People don’t seem to realize just how radical the standard American diet is from the perspective of human evolution. That’s why I try to eat only whole foods as they exist in nature rather than processed foods. I’d never eat 95 percent of the products sold at a typical grocery store.
Pharma Manipulates Statistics:
9. Pharma plays games with statistics and clinical trial data to make drugs appear safer and more effective than they really are.
Pharma typically compares their drugs against placebos rather than against competing drugs in the same class.
Relative Risk:
Pharma uses “relative risk reduction” rather than the far more meaningful “absolute risk reduction.“
Surrogate Markers:
Pharma uses “surrogate endpoints” or “surrogate markers” like a favorable change in a lab value rather than use far more meaningful statistics like decrease in all-cause mortality. For example, a drug can bring about an improvement in a specific lab value but it causes such overall havoc in the human body that all-cause mortality actually increases with the active drug in comparison to another drug or a placebo.
Selecting Study Subjects:
Pharma uses younger and healthier people in clinical trials rather than use people who are more representative of the population that will take the drugs in the real world (most notably senior citizens). Younger people may be better able to tolerate side effects than seniors whose liver and kidney function is often diminished.
Seniors should be included in clinical trials in large numbers. But Pharma gets around that issue by pointing out that taking multiple drugs complicates assessment of the drug being tested. In my opinion, if a drug is going to be used primarily in senior citizens, then the clinical trials must be changed somehow to have senior citizens represented in proportion to the extent to which they take that drug in the real world.
Pharma Misrepresents Increased Life Expectancy:
10. Pharma implies that modern medicine is the primary reason for increases in life expectancy in the last 100 years
The biggest myth of modern medicine is that the increased life expectancy in the last hundred years is primarily due to physicians, drugs, and surgery. This misguided belief is the foundation for the exalted status of modern medicine.
In fact, the large increases in life expectancy in the last 100 years are primarily due to improvements in nutrition and changes in lifestyle and public health factors like cleaner drinking water, better sanitation, better protection from the elements (better housing), etc. Modern medicine has played a role in the increases in life expectancy, but that role has been modest in comparison to social, cultural, economic, dietary/nutritional, environmental and political factors. These increases in life expectancy (prior to Covid) are greatly affected by the wealth effect, i.e., as nations become wealthier, life expectancy increases.
To the delight of the medical profession, Big Pharma, Big Insurance, hospitals, drug stores and pharmacists, the belief that modern medicine is the primary reason for the increase in life expectancy is widespread. However the proposition that modern medicine is the primary reason is largely acknowledged as fiction in the medical literature.
In conclusion
Pharma has been successful beyond its wildest dreams in driving the narrative about health toward a narrow view which grossly exaggerates the value of pills and grossly diminishes the value of prevention. I’m disappointed but not really surprised that more pharmacists don’t acknowledge how absurd and corrupt our health care system is. A nice paycheck has the powerful ability to keep pharmacists from rocking the boat.
Dennis Miller, R.Ph. is a retired chain store pharmacist. His book, The Shocking Truth About Pharmacy: A Pharmacist Reveals All the Disturbing Secrets, can be downloaded in its entirety at Amazon for 99 cents.
The opinions expressed and the data that are cited are Dennis Miller’s alone.
