prescription drugs the only ovals that
can bring people in the Seattle area joy
anymore to put it mildly to put it
mildly America takes a lot of these
things 70% of Americans take at least
one prescription drug more than half of
us take two researchers say a record
four billion prescriptions were written
in 2011 total drug spending jumped last
year by 3% to nearly three hundred and
thirty billion dollars with a B Wow
that works out to $1,000 per person on
prescription drugs kind of makes you
feel like Walter White could have made
more money cooking up rheumatoid
arthritis medication but but should this
really beat that surprising cuz it's
impossible to escape pharmaceutical ads
you can't turn on the TV without being
subjected to an endless stream of
sleep-inducing moths old men getting
boners while varnishing chairs this if
your bladder is calling the shots you
may have a medical condition called
overactive bladder or OAB okay okay what
that woman really needs is a pill to
stop her hallucinating anthropomorphic
pilatus you've looked inside the prison
of your own mind Susan can't even
bladder be job but that's only one small
part of pharmaceutical marketing you see
drugs aren't like most other products
because you need someone's permission to
buy them which is why all drug ads end
with the same catchy phrase ask your
doctor if lunesta is right for you ask
your doctor about mere Bedrich ask your
doctor ask your doctor ask your doctor
ask your doctor three words you're
either hearing in a commercial or sang
to your coworker when he asks you if the
mole on his back looks cancerous
I don't know gene ask your doctor all I
said was how was your weekend
it's probably fine drug companies know
that doctors hold all the real power in
the prescription drug business which is
why while they spend nearly 4 billion
dollars a year marketing directly to us
they spent an estimated twenty four
billion dollars a year marketing
directly to doctors in fact one analysis
claimed that in 2013 nine out of the top
ten drug makers spent more on marketing
than they did on research drug companies
are a bit like high school boyfriends
they're much more concerned with getting
inside you than being effective once
they're in there we take a look at how
all that marketing money gets spent
which turns out to be surprisingly
difficult it's a pretty secretive world
you you usually only get tantalizing
glimpses into during lawsuits years
after the fact for instance in 2012 the
government settled a case with the
makers of asthma medication advair /
allegedly irresponsible marketing
practices which meant for the first time
we were able to see this video of a 2001
adverse sales meeting ladies and
gentlemen please welcome Darryl Baker's
Simon Jones
rob judge and cyber that was for an
asthma medication and then we're
treating it like an NBA pregame show
please welcome he's 59 whitey likes
turkey sandwiches this wife's name is
Karen ladies and gentlemen say hello to
Darryl boom boom baker the audience in
that room were pharmaceutical reps the
foot soldiers in every company's drug
marketing efforts now drug companies
will tell you their reps are there to
educate doctors but behind closed doors
that message can be a little different
there are people in this room who are
going to make an ungodly sum of money
selling aired their and you know who you
are ungodly that would barely be an
appropriate tone if they were trying to
get cereal into people's bodies let
alone drugs now no you don't you don't
need to see the people whooping in that
room to know what they look like because
pharmaceutical sales reps are famously
young attractive people in fact this is
so widely known it's become a sitcom
punchline for years today's the day the
pharmaceutical reps show up to peddle
their new drugs and the sacred heart
that means one thing Julie's here
[Music]
if something is a joke on Scrubs you
know it's common knowledge that show did
not do a lot of arcane what is it with
phlebotomist and french cuisine
am i right you are right Terk we're
great friends the problem comes the
problem comes if those reps don't
understand the effects of the drugs
they're pushing listen to one former rep
describe his first training session I
was in a room with 21 classmates and two
trainers and I was the only one with a
science background in fact on the first
day of training I taught my class and my
instructors the very basic process by
which two brain cells communicate
so essentially former reps are like the
cast of Grey's Anatomy they're young
they're hot and they have virtually no
medical training whatsoever now to be
fair most doctors will probably take
that into consideration the problem
comes when some don't I even had one
physician who would often bring out a
patient chart if she was having a
difficult patient or whatever the case
is she'd bring out a patient chart and
be like okay Kathleen I've tried this
I've tried this what do you recommend
here in terms of tweaking and I'm
sitting here thinking I'm a political
science major you're asking me you know
what to prescribe for this patient yeah
exactly
because the only question a poli-sci
major is really qualified to answer is
was it worth having to move back in with
your parents after college
[Applause]
if you're thinking why do doctors let
drug reps into their offices at all well
they don't comment II hand it they'll
often show up with free samples and even
better free chicken palm whoever said
there's no such thing as a free lunch
hasn't worked in a doctor's office there
are some offices that advertise in the
front desk job description free lunch
every day not because the doctors are
paying for it because the drug reps are
bringing in every day free lunch every
day now that might not seem like a big
deal but think about it
lunch is awesome if Charlie Manson
brought me a free lunch every day but at
least listen to his sales pitch on
forehead swastikas so I don't think it's
for me charlie but keep talking that's
delicious
drug companies don't do this to be
friendly they do it because they know it
works
in fact they know a terrifying amount
about nearly every prescription coming
out of a doctor's office every time a
patient goes into a pharmacy to get a
prescription filled the information is
sold to drug companies who send it to
laptops out in the field so we see
everything that the doctor does how many
prescriptions he prescribes have our
medication and the competitors
medication if the computer shows that
doctors not prescribing as promised all
you have to do is say hey you're banging
out a lot of prescriptions for the
competitors drug and not mine what's
going on yeah what's going on Carl you
seem to be making medical decisions
based on your best judgment I brought
you a meatball sub with chips Carl
dumped me on this
witness with this level of preference
unsurprisingly drug companies have in
the past crossed the line pushing
doctors to prescribe pills for
non-fda-approved uses that's called
going off-label and here is a horrifying
example involving Astra Zeneca the
government charged were going off label
with seroquel and antipsychotic with
dangerous side effects the allegations
which were very troubling were that they
were taking a drug that was really
approved for fairly narrow uses bipolar
disorders and schizophrenia end up
marketing it for everything from
sleeplessness to depression and dementia
here's the thing you can't just give
people potentially dangerous drugs and
see what happens you're a fortune 500
company not a white guy with dreadlocks
at Burning Man
AstraZeneca denied any wrongdoing but it
paid half a billion dollars to settle
the lawsuits and if you're thinking well
look that's just one company with one
drug you should know that just about
every major drug company has paid money
to settle similar charges johnson and
johnson paid 2.2 billion Eli Lilly paid
1.4 billion
Pfizer and its subsidiary paid 2.3
billion and GlaxoSmithKline paid out a
record three billion dollars to settle
accusations that it had among other
things pushed wellbutrin an
antidepressant as a cure for weight gain
and sexual dysfunction or as one former
drug rep describes the pitch it was a
quick Zenor for your doc to tell your
doctor hey Doc remember wellbutrin it's
the happy horny skinny drug okay that's
not just irresponsible that's copyright
infringement
because there was only one happy horny
skinny drug and that is crystal meth so
that that's a fact right there
for the increasing number of doctors who
will refuse even to see drug reps the
companies have one other trick up their
sleeve simply paying doctors to talk to
other doctors about their products over
dinner and that sounds ridiculous but
not as ridiculous as the special ego
boosting title they use I essentially
say to a doctor hey our company has
identified you to be a thought leader
would you like to be a thought leader
for our company the doctor were normally
almost every time say yes of course they
say yes that's an appealing phrase
doctors like to be called thought
leaders the same way that Brendan Fraser
likes being called two-time Academy
Award winner Brendan Fraser thanks it's
clearly not true but it's got a lovely
ring to it and look how happy it makes
it for a position described as thought
leader not a lot of thought goes into
the job in many cases these slides and
the content and the script are actually
prepared by the drug company it's not
always clear the audience that this is
material that was really scripted
completely by the drug company that was
paying the doctor to give the talk okay
so if you're a doctor just regurgitating
a script you're not really a thought
leader so much as you are a thought
Sayer Abraham Lincoln was a thought
leader you're more like the animatronic
Lincoln at Disneyland yeah to be fair
again GlaxoSmithKline will no longer pay
for thought leaders and the industry in
general claims they're reforming in fact
a spokeswoman for pharma the drug
industry's trade group has even bragged
about the tough new restrictions they
put in place in our Pharma code we say
that pharmaceutical representatives
could can bring an occasional meal a
modest meal turkey sandwiches pizza I
don't want to just focus on Turkey maybe
we could have ham sandwiches
but modest meals not steak in a
restaurant oh no no not in a restaurant
although we probably allow a steak and
an Outback Steakhouse because come on
that's not a great steak that's
basically a chunk of horse meat with
grill marks drawn on it with a sharpie
so no one's getting epically compromised
by that that's what we're saying this
voluntary farmer code is I guess a step
in the right direction so let's see how
one of their members have been a voice
abiding by it the Justice Department
filed a civil fraud lawsuit against a
Swiss drug maker Novartis accusing it of
paying kickbacks and lavishly spending
on doctors including taking some out to
Hooters in exchange for prescribing its
drugs don't worry
researches show the best medical
decisions are always made with an
Arizona State College football game
blasting in the background but at least
Hooters qualifies as a modest meal that
they allegedly also pay doctors to speak
at places like l200 in Chicago a
restaurant whose Zagat review reads and
I quote tabs may bring tears to your
eyes so many sakes for special occasions
only unless of course you go on someone
else's diet I'm guessing at the end of
the meal the waiter came over and asked
separate checks or is one person buying
your influence just what is it oh that's
very nice of him there you go and at
least they were there for that one that
the suit says many doctors took payments
for speeches they never even gave all of
which Novartis has denied saying that
everything they did had a legitimate
business purpose and besides speaker
programs like theirs are an accepted and
customary practice in the industry which
is kind of the whole point even in its
best form hiring doctors as paid
spokesmen seems like a conflict of
interest and notable reports have found
that many drugs top prescribers are also
often getting money from that drugs
company which is worrying because we
trust doctors when you see Rihanna
trying to get you to drink coconut water
you know she's getting money to do that
and you take that into account you think
to yourself I'm glad you're getting paid
RiRi but I'm actually not going to drink
that because you and I both know that
coconut water tastes like cereal milk
mixed with bull semen so we both know
that so I'm going to take that into
account when I make this decision for
myself I know this is all being
disheartening but luckily there is
actually some good news here
a new clause and the Affordable Care Act
will for the first time ever allow
average citizens to search a federal
website to see all of the perks given to
physicians by pharmaceutical companies
now I know what you're thinking what a
federal website made up of a list of
doctors hold on let me come ante up a
new tab right now this website is
actually kind of fascinating that the
first batch of numbers are now online
covering the last five months of 2013
and you can and absolutely should go
online and look up your doctor at this
address and see what you find maybe
you'll find your doctor didn't a little
research for a drug company which is
probably fine or maybe as Pro Publica
did when they looked at Pharma payments
you'll find a doctor who's earned more
than a million dollars delivering
promotional talks and consulting or
maybe like we did you'll find a doctor
who got food and beverages one day worth
four cents I have to know what that meal
was because the only way a four cent
meal makes sense is if that doctor is a
mouse that's the only way anything the
point is there is information on this
database you should know and this should
really be just the beginning
if drug companies really want to regain
our trust maybe they should let us know
the effect that their money has on
doctors in the only way they know how
have you noticed anything strange about
your doctor does he seem happier than
usual these days is he quick to
prescribe drugs you think you might not
need know that one more actually Justice
waiting-room frequently features
surprisingly attractive not sick looking
people well that may be because your
doctors been taking pharmaceutical money
pharmaceutical money takes many forms
from free lunches to speaking fees
here's how it works
money combines with the cash receptors
in your doctor's wallet to create
fast-acting financial relief so your
doctor can rest easy and enjoy life
common side effects of doctors taking
money may include chronic
over-prescription unusually heavy cash
flow dependency on free samples
inflammation of confidence affluenza and
an increased tendency to suggest
off-label prescriptions which in turn
can cause heart attack stroke loss of
feeling in arms and legs seizures
blurred vision
grinding of the teeth temporary deafness
total blindness numbness sudden bursts
of rage reduction of trust angry
erections lasting over 17 hours
and ask a doctor today if he's taking
pharmaceutical company money then ask
your doctor what the money is for ask
your doctor if he's taken any money from
the companies who make the drugs he just
prescribed for you then ask yourself if
you're satisfied with that answer
pharmaceutical money ask your doctor if
he's taking it is right for you
you