Bad Medicine: On Big Pharma’s Cozy Relationship With Docs

Written by David Michaelis

Legal settlements now available on Pro Publica reveal some of the financial details tying pharmaceutical companies and doctors. Here’s a closer look.

aNewDomain commentary — Physicians and pharmaceutical companies have always been linked somewhat, but thanks to legal settlements now available on Pro Publica, details on how they are financially linked are beginning to emerge.

The details are troubling, to say the least.

Let’s take a closer look.

pills big pharmaWhat Drug Companies Give The Most to Doctors?

As of 2014, 17 drug companies published information on the payments they make to doctors and other health professionals for promotional talks, research and consulting.

You, too, can search companies and doctors with this Pro Publica tool.

Here are 10 companies who have given the most to physicians, according to the newly released information:

  • Genentech, Inc. — $388 million
  • DePuy Synthes Products LLC — $94.7 million
  • Topera, Inc. — $93.1 million
  • AstraZeneca Pharmaceuticals LP — $90.9 million
  • Stryker Corporation — $90.8 million
  • Medtronic Sofamor Danek USA, Inc. — $85 million
  • Pfizer Inc. — $82.1 million
  • Allergan Inc. — $70.7 million
  • Zimmer Holding Inc. — $70.5 million
  • Arthrex, Inc. — $58.9 million

Patients aren’t the only people alarmed by this trend. A number of doctors say they think the system needs to change, too.

“A Growing Intrusion”

Dr. Philip A. Pizza of the Standford University Medical Center wrote a post, “A Categorical No-Thank-You,” that highlights his disgust with the current system. He writes:

During the past 10 to 20 years, there has been a growing intrusion of pharmaceutical companies and medical device makers into the day-to-day practice of medicine. Industry gifts—pads, pens, logo bags, and the like—have grown commonplace. In many doctors’ offices, hospitals, and medical centers, the free lunch, courtesy of industry sponsors, has turned into an accepted way of life. And these gifts can also include dinners at expensive restaurants (to hear a lecture by a physician also being compensated by industry) or free travel to meetings at fancy resorts (to participate in a medical education event sponsored by industry).”

Pizza is one of many who realize the institution has sold out. He wants the profession to develop guidelines for physician participation in “speakers bureaus,” which offer generous honoraria from companies for taking part in presentations related to company products.

According to John Oliver’s “Last Week Tonight,” nine of the top 10 drug makers spend more money on marketing than they do on research. And most of that money is spent marketing to doctors, rather than consumers. The episode is an insightful and hilarious take on the topic at hand — watch it below.

Video — Last Week Tonight with John Oliver: Marketing to Doctors (HBO)

Seriously, ask your doctor if they would wear a lab coat with their sponsors embroidered on. See what they say.

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Featured image: Courtesy dcincome

Body image: Assorted Pills via Wikimedia Commons

 

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  • ……………The New Corporate America Business Model

    Creating Foundations to Move Their Ideals…and Products

    By Pam Parker

    There’s a new and dangerous business strategy being employed in the United States. Corporations are creating Foundations who give grants to non-profits who push for laws that move their products. One thing the corporations, foundations and non-profits all share is profitability. One such corporation is Johnson and Johnson. Those who share in the profits are their partners.

    The Robert Wood Johnson Foundation was created by the founder of Johnson & Johnson with over ten million shares of Johnson and Johnson (JnJ stock)[i]. In 1972, it was established as a national foundation worth $1.2 billion [ii]. In 2009, the Foundation’s investment portfolio increased $1 billion to $8,379,808,000[iii]. RWJF’s mission today: to help society transform itself for the better. Noble sounding, until you delve into the fact that it’s what RWJF considers “for the better”, foregoing what we want for ourselves or for society. The horrifying truth is RWJF profits from what it wants for society.

    The RWJF Anthology “Taking on Tobacco: The Robert Wood Johnson Foundation’s Assault on Smoking” publication [iv] outlines how they gave $99 million in grants to fund coalitions “housed in organizations” such as the American Cancer Society (ACS), American Lung Association (ALA) and American Heart Association (AHA). This publication outlines all the organizations who received over $446 million in grants just through January, 2008. In the beginning, grants were given to organizations to promote tobacco education. Once organizations were used to receiving funding, if they did not move on to tobacco “control”, their funding was cut off. The Foundation makes it perfectly clear in their publications that as a Foundation, their grant money cannot be used for lobbying. However, to quote Julia Roberts in Pretty Woman, that’s just geography. It’s just moving money from point A to point B while accomplishing lobbying, with smoking cessation as RWJF’s ultimate goal. Over $99,000 in grant money was invested in Evaluating an Innovative Communications Campaign Designed to Increase Consumer Demand for Tobacco Dependence Treatment by Medicaid Recipients [v]. Nearly $97,000 in grant money was invested for Individual and Policy Level Influences on the Use of Various Cessation Strategies and Abstinence from Cigarettes Among Adult Smokers [vi].

    RWJF points out repeatedly that coalition building is the key. Here are but a few.

    O The Center for Disease Control has received grant money from RWJF [vii].

    o RWJF provides funding to TFK for polls used to influence lawmakers, such as an Ohio poll [viii] on raising cigarette taxes.

    o RWJF is a major funder of the Tobacco Control Legal Consortium [ix] who helps works with communities with tobacco law-related issues such as smoke-free policies (smoking bans) and tobacco control funding laws.

    o Steven Schroeder, former CEO of RWJF, returned to the University of California, San Francisco, with a $10 million RWJF grant for the Smoking Cessation Leadership Center[x].

    o GSK, marketer of Nicorette, Nicoderm, Nicoderm CQ, is quoted in this article as applauding two organizations for their efforts to improve the regulation of smoking cessation aides. The two organizations, Association for the Treatment of Tobacco Use and Dependence (ATTUD) and the Society for Research on Nicotine and Tobacco (SNRT) both urged the FDA to adopt more flexible regulatory approaches to expand access to and the use of NRT products. ATTUD’s FDA petition drive [xi] was funded, in part, by RWJF. SNRT is funded [xii], in part, by RWJF, Johnson & Johnson, Glaxo Smith Kline, and McNeil.

    o Professor Stanton Glantz, University of California, San Francisco, received grants over $1,071,000 to create Tobacco Scam to claim smoking bans don’t hurt the Hospitality Industry. It’s been proven that most bars are hurt by smoking bans, but Glantz combines restaurants with bars (restaurants outnumber bars 5:1 while restaurant employees outnumber bar employees 10:1). (RWJF Grants 52810 and 36173). Glantz’ job? To say it’s all a Big Tobacco lie and that’s what his website claims [xiii].

    If a group doesn’t exist, then RWJF just creates and funds it. For example – Tobacco-Free Kids. A brilliant marketing strategy. After all, who wouldn’t want kids to be tobacco-free? RWJF created and funded Tobacco-Free Kids [xiv] (TFK) with $84,000,000 in start-up money. In 2000, TFK drafted the core principles for the World Health Organization’s Framework Convention on Tobacco Control. In fact, interveners for the Master Settlement Agreement [xv] have all received funding from RWJF (ACS, AHA, ALA, Americans for Nonsmokers’ Rights [xvi][xvii], the National African American Tobacco Prevention Network [xviii]). The Master Settlement Agreement was originally to settle states’ Medicaid lawsuits against the tobacco industry for recovery of tobacco-related health care costs [xix]. It has evolved into lobbying states to spend the money on smoking cessation, quit lines and giveaways of nicotine replacement products, such as patches and gum.

    For decades, RWJF has financed a fellowship program, paying up to $165,000 each. These fellows are then assigned to highly influential Congressional Committees and members. This year[xx], there are six RWJF fellows, assigned free of charge to: Senator John D. Rockefeller (C), Senator Orin Hatch (R), Senator Kent Conrad (D), one is assigned to the Senate Committee on Finance, two are assigned to Health and Human Services, Office of the Secretary.

    With the exception of one FDA employee and three tobacco industry representatives, every member of the newly created FDA Tobacco Products Scientific Advisory Committee has received direct funding from RWJF.

    The latest (2008) Tobacco Cessation Guidelines were updated by a panel of tobacco control “experts”, seventy-one percent of whom directly received RWJF grants and/or awards.

    Consumers are now being told that using more than one type of NRT can triple quit rates [xxi].

    RWJF’s funding of tobacco control all links back to smoking cessation. Why is this important? As noted in this article, Glaxo Smith Kline markets Nicorette, Nicoderm, Nicoderm CQ, but these are Johnson & Johnson products, as well as Nicotrol which belongs to J&J’s McNeil Company. In fact, J&J has pretty much cornered the market on over-the-counter nicotine replacement products. The lobbying for payment of NRT, increased taxes on cigarettes, lobbying for smoking bans (excuse me, “advocating”) all increase not only J&J’s profits, but because RWJF owns millions of shares of JnJ stock, so does RWJF profit.

    Their partners also pull in a pretty penny. The ACS’ IRS 990 form on-line shows the ACS brought in over $9,009,812 in revenue from Quit Lines [xxii]. The ACS is a Quit Line vendor. The same 990 form shows the ACS claiming $0 [xxiii] in lobbying expenditures, yet they claim $11,662,010 in grants to others for lobbying purposes [xxiv]. Interesting how no one seems to claim money for lobbying purposes but claims to give millions and millions away to others for the others to lobby. The ACS published a report in 2003 that showed that 91.4% of former smokers quit Cold Turkey [xxv], yet they not only push NRT, they’ve been paid for the use of their logo on Nicorette, according to a 1996 US Attorneys General report. According to the report, the ACS entered into a licensing agreement in August, 1996 for annual payments of $1 million for the use of their logo on Nicoderm CQ and Nicorette. The same report claims the American Heart Association entered into an agreement with Johnson & Johnson for their logo to be used on McNeil’s Nicotrol for the price of $2.5 million annually.

    They serve on each other’s boards of directors. John Seffrin, CEO, ACS sits on the Board of Directors of Tobacco-Free Kids [xxvi].

    Public Library of Science Medicine (PLoS) this month published an article titled Global Health Philanthropy and Institutional Relationships: How should Conflicts of Interest Be Addressed?[xxvii] which states “the Robert Wood Johnson Foundation has played a leading role in promoting anti-tobacco products and maintains Smoking Cessation Leadership Centers and programs, although its endowment is mainly invested in Johnson & Johnson, a leading manufacturer of cessation products, and some board members have been represented on both the Foundation’s and the company’s boards”

    The British Medical Journal, April 14, 2011, published “WHO (World Health Organization) Warns Anti-Smoking Campaigners Not to Become Too Close to Drug Firms[xxviii], ironically at a conference in Madrid sponsored by Glaxo Smith Kline, Pfizer and McNeil who market or own NRT.

    Unfortunately, RWJF has used this footprint as a roadmap to further control of our behaviors and bans of what they deem unhealthy. RWJF has given over half a billion dollars in obesity grants. First Lady Michelle Obama is the spokesperson for Childhood Obesity. RWJF fellow Shale Wong was assigned to the First Lady [xxix] (free of charge) 2009-2010. Experts Argue for Tax on Sugar-Sweetened Beverages, a RWJF publication [xxx]. Kelly Brownell, one of the experts of the two cited, claims taxing sugar sweetened beverages would yield a 13% reduction while raising taxes. Ms. Brownell is with Rudd Center. The Rudd Center for Food Policy and Obesity is a RWJF grant recipient of $5,842,740[xxxi]. What really results from these types of bans and taxation is industries and businesses fail and consumers are driven to alternative sweeteners, such as Johnson & Johnson’s McNeil Company’s SPLENDA.

    This is the same playbook as their tobacco control playbook. I would look for RWJF to create and fund Sugar-Free Kids. Who will be hurt are bakeries, restaurants, bars (who can only sell “diet” pop with mixed drinks), and more. People will quit going to these businesses and will instead bake at home. Just like the smoking ban in Ohio cause 14.6 million more bottles of liquor to be sold for home and social gathering consumption. Johnson & Johnson and RWJF get even richer from the sales of their products they’ve guaranteed the sales of through the laws they buy with their grants, fellows, and partnerships. The more they make, the more money they have to buy more control of our lives. The word “lobbyist” may have a negative connotation, however they have to register and be known. “Fellows” assigned to influential Congressional Members and Committees are virtually unknown to the common American citizen.

    Foundations and corporations do not get to make laws, especially when they profit from those laws. Ohio lawmakers work for us, not these profitable non-profits. WE have the power to vote lawmakers out, not foundations and NGOs. God gave us rights over ourselves and He gave us the power to make decisions for ourselves. That includes deciding whether to drink a sugary drink or patronize a smoking bar. The more these people try to rule our lives, the more resistance they’ll get and from larger and larger and larger groups of people.

    Twenty-one people in nine states have filed complaints with Congressional Committees asking for an investigation into RWJF/J&J. J&J just settled for small fines rather than do prison time for bribery charges in a foreign country. I think what they’ve done to free-market enterprise, artificial stock manipulation, insider trading; violation of the Sherman Act, violation of the RICO Act, legislative rent-seeking and violation of the False Claims Act should no longer have the blind eye of Congress turned away. This article only barely touches on what we’ve discovered (including the 98.4% failure rate of NRT patches, the highly addictive properties of NRT gum). We look forward to the Ohio Supreme Court hearing the Zeno’s case. Ohio’s Constitution is much more protective of property rights than the U.S. Constitution. We can’t wait to have our properties returned to their rightful owners! We want you, our state legislators, to know that you’ve supported these special interest groups over us mom and pop business owners. You’ve forgotten to protect the minority. You’ve forgotten that our properties are to be held forever inviolate. That’s “forever”, not ignored when it suits special interests. No one is forced to work for us and no one is forced to enter our properties. We want to be profitable once again. And we want you to know that we know who’s behind controlling our behaviors for profit. Now…do you want to side with them? Or us, the people who vote?