By Daniela Perdomo, AlterNet
Prescription drugs taken as directed kill 100,000 Americans a year. That's one person every five minutes. How did we get here?
June 25, 2010 | How many people do you know who regularly use a prescription medication? If your social group is like most Americans', the answer is most. Sixty-five percent of the country takes a prescription drug these days. In 2005 alone, we spent $250 billion on them.
I recently caught up with Melody Petersen, author of Our Daily Meds, an in-depth look at the pharmaceutical companies that have taken the reins of our faltering health care system by cleverly hawking every kind of drug imaginable. We discussed how this powerful industry has our health in its hands.
Daniela Perdomo: Your book includes some staggering stats. For example, 100,000 Americans die each year from prescription drugs -- that's 270 per day, or, as you put it, more than twice as many who are killed in car accidents each day. Could you elaborate on this? Are these people abusing their prescription drugs or is this a sign of prescription meds gone bad?
Melody Petersen: The study estimating that 100,000 Americans die each year from their prescriptions looked only at deaths from known side effects. That is, those deaths didn't happen because the doctor made a mistake and prescribed the wrong drug, or the pharmacist made a mistake in filling the prescription, or the patient accidentally took too much. Unfortunately, thousands of patients die from such mistakes too, but this study looked only at deaths where our present medical system wouldn't fault anyone. Tens of thousands of people are dying every year from drugs they took just as the doctor directed. This shows you how dangerous medications are.
DP: You write about a growing market for drugs for children. You say we know little about the long-term effects of prescription meds on kids. Let's talk particularly about depression medications and ADHD meds, which seem to be what kids are mostly prescribed.
MP: In recent years, sales of drugs for children have been the industry's fastest growing business. Doctors now prescribe pills to children for all kinds of conditions -- from high cholesterol to anxiety. The market for ADHD drugs has long been a big opportunity for the industry. More recently, the companies have had their sales reps urge doctors to prescribe antidepressants, antipsychotics and other psychiatric meds to children. The result: our kids take more of those medicines than children in other countries. For example, a study last year found that American children take three times more attention deficit medications and antidepressants than children in Europe.
DP: Could you tell me how the prescription med industry is in bed with doctors?
MP: The industry spends hundreds of millions of dollars on physicians every year. In one survey, 9 out of 10 doctors said they had recently taken something of value from the drug industry. And some of those doctors take hundreds of thousands of dollars each year from the industry. The drug companies pay doctors to be their so-called consultants. They also pay them to sit on corporate advisory boards and to give lectures to other doctors. They pay for up to 80 percent of the continuing medical education that doctors need to maintain their licenses. If you ask a doctor if this is a problem, they will more than likely tell you no. But the studies show that even a small gift will sway doctors to write a prescription for a certain drug. The truth is that doctors are no longer independent gatekeepers who keep us safe from drugs we don't need. Far too many of them are financially tied to the industry. They are writing the prescriptions that their financial backers want them to write.
DP: We are the only developed country that doesn't control prescription drug prices. Could you tell me what that means, practically, for consumers?
MP: It means that the drug companies can charge whatever they want to -- even for drugs that don't work very well. One drug costs $400,000 a year. Some cancer drugs now cost $50,000, even though on average, they give the patient just a few weeks extra to live. It's clear that the drugs aren't worth these extreme prices, but the companies are taking advantage of patients who are desperate for a cure. The industry's unlimited hikes in prices have helped make health insurance unaffordable. This is also why wages of American workers have stagnated. When health premiums rise, employers must get the extra money from somewhere, and employee raises are one of the first things to go.
DP: You write about how companies are more interested in developing 'lifestyle drugs for rich Americans' rather than discovering cures for diseases that affect the majority of the world, like malaria. How many cholesterol drugs do we need? Sex drive meds? Hair loss meds?
MP: The answer is that we really don't need many of those kinds of drugs, those lifestyle drugs that don't save or lengthen lives. But the drug companies have discovered there are billions of dollars to be made by selling pills to Americans who worry about getting old, but are otherwise healthy. It's so easy to fall for the marketers' claim that a little pill will enhance our lives and keep us young forever.
DP: Could you tell me about drugs that are developed for one use but used for another. How often does this happen?
MP: It is a common sales tactic in the industry to have sales reps push doctors to prescribe a drug for many uses and patient conditions. The drug companies do this even though it is illegal to promote a drug for anything other than the condition the FDA has approved it for. I detail in my book how a lackluster drug for epilepsy - a drug called Neurontin -- was sold by a company for just about any condition that affects the brain. The company's sales representatives pushed doctors to prescribe Neurontin for children with attention problems, for adults with mania, for just about anyone with restless legs. They did this even though they had no scientific evidence that it helped people with these conditions. This is a very dangerous corporate fraud.
DP: How often are ailments created simply to fit a drug already created?
MP: The industry has proven that it is not beyond creating new diseases when it wants to expand the use of a drug. For example, I wrote in my book about how the company Pharmacia created the disease of overactive bladder to expand sales of a drug for incontinence. We don't know how often this is done because few companies are willing to tell the public how their marketers work behind the scenes.
DP: What do we prescribe drugs for that other countries don't? In other words, what ailments do Americans suffer from that other nations don't?
MP: The drug companies have made Americans believe that almost anything should be treated with a pill. Women can ask their doctors for a drug that will diminish their facial hair. Parents can ask for a stimulant to keep their children calm and focused. Even people who are shy are now told they have a disease that needs to be medicated. This is far less prevalent in other countries because the drug companies don't have as much power elsewhere. The U.S. and New Zealand are the only two developed countries in the world that allow the drug companies to aggressively advertise prescription drugs to consumers.
DP: Why do we rush to prescribe? Have we always been this way or was there a shift at some point?
MP: The prescriptions are driven by the promotional efforts of the industry. Today, the companies start promoting a drug years before it even goes to the FDA for approval. Some drugs have promotional campaigns funded by more than a billion dollars. It was around 1980 when the big drug companies learned that they could make far more profit by focusing their efforts on marketing rather than on the truly hard work of scientific research and finding new drugs.
DP: American life expectancy is low compared to other developed nations. What are they doing right? We're not the only ones with prescription drug companies within our borders.
MP: In America, if you're lucky enough to have health insurance, you can easily get too much medicine, too much health care. Many Americans don't understand that all of health care has risks and that too much of it can actually shorten your life. Is this one of the reasons why we're falling fast in the world rankings on life expectancy? No one knows for sure. But it's obvious that all that money we spend on prescriptions and doctors is not giving us an advantage.
DP: From a consumer/patient standpoint, are certain drug manufacturers better than others?
MP: No. There is not an ethically minded shining star. All the companies operate in a similar way. Fraud is rampant in this industry because there is so much money involved.
DP: How will the health care bill affect prescription drug use and the med industry?
MP: The drug companies and their lobbyists won big under the new health care law. The companies will get millions of new customers. At the same time, Congress agreed with the industry's lobbyists that there should be no limits on how much they can charge for medicines. We needed to make health insurance available to all Americans, but there should have been stronger cost controls and promotional limits in the law. Now, even more people will be at risk of getting dangerous and expensive drugs that they don't need.
DP: What do you make of theories that someday very soon we'll all be on smart drugs. Realistic? Already here?
MP: I recently spoke to a college student who told me he used Adderall, a drug for ADHD, to enhance his studies. He didn't have a prescription for the drug. He got the pills from friends. He knew this was dangerous and illegal, but he did it anyway. People no longer understand that every drug comes with risks. Adderall, for example, comes with a label warning that using it without a prescription can lead to addiction, and in rare cases, death. The marketers have made us believe that we can do just about anything with the help of a pill.
DP: What is the biggest issue relating to prescription drugs that the mainstream media misses?
MP: Overall, the biggest problem is that the news media is not objective when reporting on medicines. Much of the news coverage on prescription drugs exaggerates their potential benefits and glosses over their risks. Many news stories about new drugs don't even mention the side effects. People are getting distorted information on prescription drugs. Many of these news stories are little more than press releases that come straight out of the drug companies' marketing departments.
View this story online at: http://www.alternet.org/story/147318/