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Film "Side Effects" Exposes Pharmaceutical Secrets

The Associated Press
Thursday, March 10, 2005; 6:39 PM

NEW YORK - Hailed as a blockbuster drug, Vivexx is an antidepressant that its maker claims is so effective it will make standard bearer Prozac seem like “penny candy.”

There’s one hitch: Vivexx has been linked to liver problems that can cause death. But its manufacturer believes that pesky detail can be circumvented by stifling doctors who know about the problem and forbidding its sales representatives to raise the issue with physicians.

Sounds like real life, right?

But this is the plot of “Side Effects” a fictionalized account of the life of former drug sales representative Kathleen Slattery-Moschkau, the film’s writer and director.

After events like the withdrawal of pain reliever Vioxx and revelations that pharmaceutical companies squelched negative studies of their drugs, the film can seem like a documentary. That is, until the Hollywood ending when a drug representative, previously seduced by her impressive salary, exposes Vivexx’s side effects at a big industry meeting.

”Side Effects” debuts at the Cinequest Film Festival in San Jose, Calif. this weekend, and hits the Wisconsin Film Festival later this month. Distribution deals are pending.

Discomfort over the problems she saw with her former profession’s ethics drove Slattery-Moschkau to leave the business after about nine years in 2002 and to create a film about how she believes companies’ financial motives corrupt the marketing process.

”The marketing tactics were more about making money than patient safety,” said Slattery-Moschkau, who raised the $190,000 from investors to make the independent film which was shot in 16 days. “It got hard to look in the mirror.”

”Side Effects” is part of a larger trend of portraying the members of the medical establishment as monsters in popular culture, said Jim Farrelly, director of film studies at the University of Dayton. Rising health care costs, the growing number of uninsured and drug safety concerns have made portrayals of money-hungry managed care executives, shoddy doctors, and greedy pharmaceutical executives into TV staples. They turn up in movies and books, too.

A new book by a former Pfizer Inc. sales representative is on the way. And Michael Moore, who recently skewered U.S. President George Bush in his movie “Fahrenheit 9/11”, is working on a film about the health care industry.

Slattery-Moschkau opted for fiction instead of a documentary to send her message because she thought it would reach a wider audience.

”I felt through fiction I could get people to laugh, be shocked and get educated at the same time,” said Slattery-Moschkau.

”The movie sounds like fiction,” said Jeff Trewhitt, spokesman for the Pharmaceutical Research and Manufacturers of America. He said sales reps are well-trained, hardworking professionals who help educate doctors.

There are numerous similarities between Slattery-Moschkau and the movie’s heroine Karly Hert. Both can’t believe such a highly specialized industry would hire a liberal arts major.

Hert catapults to success in the same manner that Slattery-Moschkau said worked for her: Talking honestly about the company’s drugs, warts and all. In one scene Hert tells a doctor that her competitors’ drugs work well while her product is more expensive and causes constipation for a week.

Slattery-Moschkau grew accustomed to a hefty paycheck.

”Every time I wanted to leave, I got a raise” said Slattery-Moschkau, who was making around $100,000 a year and enjoying a company car and corporate credit card before she left the industry.

Other similarities exist. Slattery-Moschkau worked for Johnson & Johnson as well as Bristol-Myers Squibb Co., which sold an antidepressant called Serzone that was linked to liver problems. Both Bristol-Myers and J&J declined comment.

Bristol-Myers stopped selling Serzone last year but said the decision was based on sagging sales not safety issues.

”There were reports about the drug (Serzone) but I never thought it was that dangerous,” she said, stressing the story is fictional.

Her employers never instructed her to lie, Slattery-Moschkau said, but expanding beyond a narrow script wasn’t encouraged either. Sometimes, she said she worried she didn’t know enough about the drugs.

At one point in the film, Hert tells her boyfriend that sales reps are all one sentence away from negligence.

Keeping the eye on sales’ goals was an obsession in the industry, Slattery-Moschkau said.

In one movie scene, a sales manager chastises sales representatives for a lackluster week. Hert points out market share rose over the past month. The manager responds that such attitudes won’t help meet the company target of doubling market share in a year.

The pharmaceutical industry is concerned about films like “Side Effects” because they feed negative perceptions. High prices, government investigations, lawsuits, and recalls have savaged the industry’s image. A recent study by the Kaiser Family Foundation found that 70 percent of Americans believe the industry puts profits ahead of people

In his new book, “Hard Sell: The Evolution of a Viagra Salesman,” Jamie Reidy boasts a scant work schedule and an abundant paycheck. Pfizer declined comment, but Reidy believes his story may cause backlash against the industry if people equate high drug prices with highly compensated sales reps.

”People may wonder if that (high-priced sales reps) is why their copays are so high,” said Reidy, who now works sales for another drug company he doesn’t wish to name.

Said Trewhitt, “Clearly we need to do a better job of getting out our story.”