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Confessions of a Drug Pusher

MEDICAL & BUSINESS ETHICS & GORILLAS

By Tom Braun, RPh.

In my business career as a pharmaceutical buyer and later as a Drug Marketing executive, I had nothing but the highest respect for Merck. They had an image of impeccable business and medical ethics and they ran their own show. This image was confirmed by trade surveys year after year. Somewhere along the way, they started to loose focus on healthcare and the focus shifted to the bottom line.

When Clinton was running for the presidency, he often showed up in the company of Merck. This week, Arianna Huffington wrote a biting article about Merck's fall from grace titled "You want a Moral Issue? How about drugs that don't kill". The theme is that the Democrats should come together and open the medicine chest and clean up the hidden mess that is inside.

The problem is that the Democratic Party has long shared in the money dole from the pharmaceutical manufacturers. It's somewhere around a 60-40 split, with the Republicans getting the bigger piece of the pumpkin pie. Big Pharma has always hedged their bets and it doesn't matter who is running this country because they have seduced most of the Congressman with money and junkets and the like.

Phil Crane from Illinois, one of Big Pharma's champions was not re-elected this fall. Abbott Laboratories in his former district has paid over $100 million dollars in fines for not following Good Manufacturing Practices. Total fines and judgments have been over $1,000,000,000 in the last five years for Abbott, the Champion fine payer. Another seven Pharmaceutical manufacturers accounted for an additional $1 billion-plus dollars in fines and penalties paid for fraudulent business practices over the last five years. The only way you recoup these losses is to raise your prices.

A 300-pound Gorilla has been let out of the cage called Vioxx. There is another Gorilla rocking his cage called Statin. Back in the early 1980's, time release Niacin (which is a vitamin) was beginning to gain acceptance by the physicians as a way to control high cholesterol. It worked. Was not expensive and if you didn't overdose on it, you were in great shape. Along comes a 10 patient study from the St. Louis VA hospital that claimed that Niacin caused liver damage. No one confirmed that the liver of these 10 VA patients was normal before the study began. Mysteriously, this small study got nation wide press and Niacin was discredited.

Within 90 days of the nationwide negative publicity on Niacin, the first prescription statin drug was marketed by none other than Merck. All those who were worried about their cholesterol levels were saved. The drug was called Mevacor. Would anyone suggest that Merck primed the pump for their new drug by discrediting Niacin? This was the first of a long line of cholesterol lowering drugs called Statins.

Today, the most popular ones are Merck's Mevacor and Pfizer's Lipitor. Baycol from Bayer was removed from the market due to its deadly side effects. Class Action law suits continue to this day. Crestor is under attack for it's high side effect profile and may be the next drug to be removed from the market. In the meantime, Statin drugs produce about $20 billion dollars in sales for the manufacturers and everyday these drugs remain on the market they are a power house of profit for them.

BAND-AID RESPONSE?

It still is an open question today that high cholesterol causes heart disease. Is it the cause or an effect? In some medical groups, the theory is that inflammation of the artery walls which is caused by unknown pathogens &/or immune system responses causes the body to send out cholesterol to repair the weakening wall of the artery. More of a Band-Aid response rather than a cause. This is why statin drugs that suppress the liver's cholesterol production is prescribed. All the consumer ads for these Statin drugs warn that there is a danger of liver damage. Sound Familiar?

In the process of creating the first statin drug, Merck discovered that an essential enzyme called Co Enzyme Q 10 is reduced in the body if you take a statin drug that suppresses your cholesterol. Every cell in your body requires Co Enzyme Q 10 as well as cholesterol, but medical researchers pushed on with the concept that high cholesterol is bad for you and has ignored the consequences of too little cholesterol or Q 10 in the body. Over the years the manufacturers have convinced the physicians that lower and lower values of cholesterol should be the norm. Pfizer has been promoting that 150 is the max. Profit motives surpass realistic medical guidelines.

In 1990, Merck received a patent for the combination drug of lovastatin and Co Enzyme Q 10. (Patent#'s 4929437 & 4933165). They have never marketed this combination drug and today, 14 years later, the NIH, FDA or no other Medical Institution has demanded that the way Statins are prescribed and patients are treated has to be changed to include the supplement Co Enzyme Q 10.

I would have thought that if they were not going to market this combination of drug, at least they would have told the prescribing physicians that a Q 10 supplement should be taken along with the statin drug. So much for patient concerns and medical ethics.

Medical Ethics has been relegated to the rear of the classroom and in many cases has never left academia. How else can you explain the lack of outcry from physicians for being convinced to prescribe a class of drugs that do harm not only to the liver but also the heart that requires adequate Co Enzyme Q 10 to function properly.

When this 1000-pound Gorilla called Statin comes out of his cage and his rampaging is heard, then maybe the Democrats and the Republicans will learn how to spell the word "Bipartisanship".

US Healthcare (really Sickcare) ranks 37th in the World and costs (almost 15% GDP) the majority of the citizens twice what it does in the other countries that deliver better healthcare to their citizens. There are 45 million Americans who can't afford healthcare...period. I can't understand why the physicians of this country don't demand complete and honest medical information and take back their profession from special interests. The way it is going it, the practice of medicine is regressing and becoming more of an art form than a science.

Restoring Medical & Business Ethics to the Pharmaceutical Arena would go along way in improving Healthcare in the US and reducing costs. It's going to take a healthcare crisis of an enormous magnitude to get any changes to take place. Bush is proposing Selfcare as the solution, which is what 45 million Americans have to practice as it is.

Let's not stop the medical carpetbaggers; it may be bad for politics.

Tom Braun RPh
Retired but not senile yet!

Copyright © 2004 Thomas Braun

T. Braun, Pharmacist, Buyer, Marketing Executive for a Major Drug Chain. Active for over 45 years in Pharmacy.

Legal Stuff: Disclaimer - This document is informational in nature. Medical advice should be secured through your physician.


TOM ASKS IN HIS MOST RECENT COLUMN, "DOESN'T THE FDA EVER LEARN FROM THEIR MISTAKES?"

READ HIS OTHER RECENT COLUMNS OF INTEREST, "WHY WE CAN'T WIN THE WAR ON CANCER" AND "OUR MEDICAL CRISIS & ITS IMPACT ON SENIOR."

ALSO HIS COLUMN ABOUT STATINS AND IMPOTENCY, "HOW PFIZER'S LIPITOR CAN BE DANGEROUS TO YOUR SEX LIFE, BUT PFIZER'S VIAGRA FIXES IT ALL UP."

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