Industry Corruption is Wide-Spread and Disgusting
This website documents the tens of billions of dollars of money wasted by physicians in the U.S. alone every year prescribing expensive patented medications after being brainwashed by massive industry advertising and bribery. The pharmaceutical industry has a powerful control of many university researchers, effectively control the annual meetings of the American Psychiatric Association and the annual meetings of virtually every other major medical specialty. Even DSM-IV's diagnostic manual is primarily designed by psychiatrists working for the pharmaceutical industry. The Bush Food and Drug Administration is a very corrupt enterprise. Top staffers who are good to drug companies get invited to give very well paid lectures at industry gatherings and some will get lucrative jobs with drug companies after they leave the FDA paying 2-3 times as much as they made at the FDA.
In most medical practices, drug sales representatives routinely bring free lunch for all of the staff several times a month. This is even true in some mental health centers. Almost all office notes are written on drug advertising pads. The only starter samples stocked are those placed there by drug sales agents promoting their extremely expensive patented medications. Many large programs use the drug reps as their primary or only form of continuing education. Paper weights, calendars, hand soap, bags for patients, prescription pads, and on and on.
In State College, PA, as in most of the U.S., psychiatrists have all expenses paid dinner and drinks every month at the best restaurant in town in a very attractive private conference room. Pennsylvania mental health prison employees were treated to free drinks at a local bar in May of 2005. Pennsylvania prison psychiatrists were given a lecture on February 23, 2005, on how to treat Bipolar Disorder by a Connecticut psychiatrist who was head of a medical school department of psychiatry. The expenses of the psychiatrist along with a lucrative stipend was totally covered by Abbott Pharmaceuticals. The psychiatrist put a strong plug in his talk for the new long-acting Depakote ER made by Abbott. Omaha psychiatrists even have it better. In 2004, they were taking turns lecturing to each other at their monthly free dinners and probably still are. The lecturer received a generous check from the drug companies footing the bill. Drug reps are able to track exactly how many prescriptions each psychiatrist writes for their favored drug. While all of the above blatant bribes such be criminal, they are standard practice across the U.S.
The sad thing is that almost no one cares. Physicians happily take the free handouts. Both political parties are bought off by the pharmaceutical industry. HMOs and PPOs don't seem to care at all so long as they make their money. It is apparently easier for them to suppress the income of individual physicians than to counter the corruption of prescribing practices by massively wealthy multinational pharmaceutical companies. Patients don't care so long as the government or their employer is paying the bill. Those paying their own bills usually just don't know better.
Corruption in the American Psychiatric Association: Every year, the APA's annual meeting is heavily subsidized by the pharmaceutical industry whose free breakfasts and dinners are another added heavy attraction to doctors attending. The APA American Journal of Psychiatry is also heavily dependent on funding from ads for various patented drugs. In a new article, "Financial ties between DSM-IV panel members and the pharmaceutical industry." Cosgrave L, et al, of the University of Massachusetts exposes that of 170 APA panel members who contributed to the diagnostic criteria produced for the DSM-IV, 56% had one or more financial associations with companies in the pharmaceutical industry: research funding (42%), consultancies (22%) and speakers bureau (16%). Researchers conclude that there are strong financial ties between the industry and those who are responsible for developing and modifying the diagnostic criteria for mental illness. The connections are especially strong in those diagnostic areas where drugs are the first line of treatment for mental disorders. Psychother Psychosom 2006;75(3):154-60. Ed: While the authors make only the mildest of recommendations (required revealing of ties), such biased individuals should not be allowed to serve on diagnostic committees in any capacity.
Corruption On-Going and Proven in the FDA: After accusations that some government scientists used their official positions for private gain, the National Institutes of Health announced rules on August 25th that ban FDA scientists from consulting for drug companies. The rules were issued after disclosures that FDA scientists had leveraged their positions to land lucrative consulting contracts that seemed to conflict or at least overlap with their official duties. Those contracts caused some critics to worry that research by the agency could be tainted. An investigation by the FDA concluded that 44 of its 1,200 senior scientists appeared to have violated rules governing consulting and that nine might have violated criminal laws. The conflicts were first reported by the Los Angeles Times. Sidney Wolfe, director of the health research group at Public Citizen, the consumer advocacy group, noted that the new rules still let employees deliver medical education lectures paid by drug companies. Although no strings are supposed to be attached to the financing, Wolfe noted that scientists who disagreed with the positions of the drug industry were rarely invited to give such lectures. Gardiner Harris, New York Times, Washington 8/26/05. Ed: Since the FDA only investigated after they were caught, you wonder what other corrupt schemes are still going on. Of course, the revolving door is still legal and very powerful. Many high ranking FDA officials stay with the FDA a few years and then take much higher paying jobs with the drug industry shortly after leaving the FDA. This strongly influences work at the FDA, since many hope to land these lucrative positions.
Cochrane Review Might Reduce Corruption of Its Reviews: Fierce opposition to industry funding of Cochrane reviews has caused the organization’s leadership to draft a set of proposals that will, if accepted, dramatically restrict commercial funding. The proposed policy will forbid for-profit companies to fund a Cochrane review if they have a real or potential vested interest in the findings of the review. It would additionally forbid commercial entities to fund the review groups themselves. The new proposals do not forbid industry sponsorship of other Cochrane entities, but suggest creating a "firewall" between commercial sources and review groups. Nor do they restrict funding by not-for-profit organizations. This is worrying some researchers as a "third party" strategy—in which industry funds or even creates not-for-profit professional or lay organizations that promote certain medicines—is increasingly being used by drug companies to influence prescribing. Recently, the Pfizer drug company funded of a Cochrane review of two migraine drugs. Pfizer manufactures one of the drugs reviewed, which was favored in the review. Corrupt university physician reviewers have been getting around previous regulations which prohibited total industry funding of the influential Cochrane reviews by claiming that their participation in the review was a contribution by the university since the university was paying their salaries and thus the review was not totally funded by the drug companies! BMJ 2/14/2004;328:366
PMDD Diagnosis Controversial in Europe; Drug Company Behind Corruption of FDA: In June 2003, as part of European harmonization of product information, the Committee for Proprietary Medicinal Products found that "PMDD is not a well-established disease entity across Europe." It said that the disorder was not listed in the international classification of diseases and was listed only as a research diagnosis in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. The committee strongly criticized two key trials of fluoxetine for premenstrual dysphoric disorder, noting that in one study almost half of the participants dropped out and that in the other little attempt was made to distinguish between mild and severe health problems. Fluoxetine was first approved for PMDD by the US Food and Drug Administration in 2000, after an influential 1998 "round table discussion" of experts supported by Lilly and attended by at least four Lilly representatives. The disorder was characterized by anger, irritability, and tension triggered by the menstrual cycle. An aggressive promotional campaign quickly followed, including television advertisements featuring a frustrated woman with a shopping trolley outside a shop and accompanied by the line, "Think its PMS? It could be PMDD." The campaign was criticized by some women's groups and was found by the Food and Drug Administration to be unbalanced and misleading because it "broadens the indication" and played down side effects. BMJ 2/14/2004;328:365
Yale Psychiatrist Protests Pharmaceutical Industry's Pushing of Psychiatric Medications: The rapid growth in sales of psychotropic medications during the late 1980s and 1990s, reaching $20 billion/year, including the increased use of seritonin reuptake inhibitors for depression, and atypical antipsychotics for schizophrenia (and stimulants for children and adults). Recently, some of the therapeutic claims for these medications have been challenged, and under-appreciated risks have turned out to be significant liabilities. Drug manufacturers increasingly dominate clinical trials research and evidence suggests that study designs and data presentations have been slanted to show products in a favorable light while unfavorable data were suppressed. The extensive financial ties between the pharmaceutical industry and academic researchers, professional associations, and consumer groups has discouraged expression of critical views. The narrow legal mandate of the FDA to evaluate the safety and efficacy of new drugs only in comparison to placebo (rather than in comparison to other treatments) has limited its contribution. In the absence of reliable, impartial research on the risk and benefits of psychotropic medications, both before and after they are brought to market, pharmacy benefits management cannot achieve its goal of maximizing health care benefits per dollar spent. Further institutional support is needed for independent research, either conducted or funded by the federal government. The growth of psychopharmacology in the 1990s: Evidence-based practice or irrational exuberance. Rosenheck R. Yale Medical School. Int J Law Psychiatry. 2005 Aug 25. Ed: Add to this the pushing of drugs in direct to consumer advertising, the widespread bribing of policians and political parties by the drug pushers, and the conflict of interest of psychiatrists who make money by prescribing drugs. Even add school teachers who would rather have their students drugged on stimulants so they will sit in their chairs rather than change the way the classrooms are run by eliminating "open classroom" features. In my experience, most patients who come to me are being overmedicated. It's even worse with children.