Over time, the pharmaceutical industry has become an ever more for-profit oriented business. Sales and profits are increasing year after year and the top management is engaged in achieving that goal each year. In other words the pharmaceutical industry is no different from any other business. It has gained so much influence over the medical community and over patients that it is seriously damaging the global health system. People are often prescribed medicines they don’t really need and, because of that, they suffer from unpleasant largely avoidable side effects; the release of vaccines and medicines follows a for-profit model instead of ensuring health and minimizing the number of deaths around the world; patients are too often induced to buy expansive branded medicines instead of cheaper generic or over-the-counter versions of the same drugs. What’s in the words ‘Big Pharma?’ What are the ultimate consequences of an excessively for-profit oriented pharmaceutical system? And how is the internet levelling out the health conversation? In 2004 was written the book Big Pharma, by Jacky Law. Is since then the scenario changed? According to Jacky Law, Yes! And there is room for further improvements in the relations between the pharmaceutical companies and patients. Jacky Law, author of ‘Big Pharma,’ answered to these and other questions.
Jacky Law: Jacky Law is the author of ‘Big Pharma:.’ She is a well-recognized journalist on the topic of healthcare. In fact, Law has written about healthcare for 25 years, several of them as associate editor of Scrip Magazine, a once leading monthly magazine for the drugs industry. Now, among other engagements, she focuses on connecting healthcare thought leaders to support patient empowerment.
INTERVIEW - (December 2014)
Subject: The Pharmaceutical business; towards a better relations between the pharmaceutical companies and patients?
Question 1: You are the author of ‘Big Pharma:’ a book chronicling two drug safety scares in 2004. Can you tell us in poor words what is ‘Big Pharma?’ (who are the main actors involved in Big Pharma’s strategies?)
Big Pharma was coined to describe the enormous power of the top players in the pharma industry at a time when the key industry stakeholders were the medicines regulators, who make sure drugs work and are safe, the doctors who prescribe them and the people who pay the drugs bill. 2004 was a watershed year. The landscape has changed phenomenally since the book was written, not only because the internet has given patients a voice for the first time but also there are now requirements that medicines show value in the real world rather than the confines of a clinical trial which so rigorously deletes all the human aspects of medicine. It is also now a requirement that payments between drugs companies and doctors are made public in the US and soon in Europe.
Question 2: So, what are the ultimate consequences on the health of patients of an excessively empowered pharmaceutical system?
We saw that in my book. When an awful lot of money and jobs ride on a single product being successful, there will inevitably be strong forces at play to frame that product in the best possible light. One of the main lessons learned from the worldwide withdrawal of Vioxx in 2004 is that it is incredibly easy for people to not hear what is against their interests. Cardiologist Eric Topol, now director of the Scripps Translational Science Institute, saw rising numbers of adverse cardiac events in his clinic and tried to make his views heard months before the drug was withdrawn for precisely the reasons he was highlighting. Regulations on both sides of the Atlantic have been tightened and transparency rules introduced to try to control powerful interests that had not been sufficiently well monitored in the past.
Question 3: One of the main bad consequences of a ‘for-profit’ pharmaceutical system is that people are often prescribed medicines they don’t really need. As a result, patients are increasingly suffer from ‘side effects.’ What do you think about this phenomenon? Could you give us some figures about the number of deaths and injuries resulting from this trend?
I don’t have figures but it was a front-page item in the UK media this week (Interview made in December 2014) that half the population of England is on some prescription medication. I think it is important to stress that while it will always be in the interests of any ‘for-profit’ industry to present their products in the most attractive way, the current trends in pharma are most definitely to redress the previous balance of power in favor of the person who is sick. The internet is leveling out the health conversation as patients find they have a real voice that, for the first time, is being listened to. It is being listened to because companies are only reimbursed for their products if they can be shown to help people’s lives in a demonstrable way. Patients are being encouraged from several angles to speak up, challenge their doctor, and generally take greater responsibility for their lives.
Question 4: We live in a ‘quick fix’ culture (a culture that offers us all sorts of quick fixes for what are really complex problems). Ever more doctors do recognize the role of environmental, lifestyle and social issues on determining the health of people. Do you think that’s true? What should be done to really increase this knowledge among the population?
I definitely think it is true that environmental, lifestyle and social issues are rightly recognized as playing an important role in people’s health. People like to eat, drink and smoke for reasons that medicine cannot fathom but which account for the vast majority of the healthcare bill in treatments for obesity, diabetes, liver, lung and heart disorders and more. I think this knowledge is already rising among the general population. It can be seen, for example, in the quantified-self movement, which is gaining pace as people clearly have a desire to keep track of the biometrics that define their lifestyle. People now have the technology relatively cheaply to see the consequences of how they live, in other words. The trouble is it is mainly the already fit who use it.