Stumble It!
Good Pills, Bad Pills, False Pills and True Pills
Alan Rubin is author of “Diabetes for Dummies,” the very first book I ever read on the topic. That kind of makes him my hero and mentor, at least in my mind. He’s not only well-informed; he also sports a healthy dose of cynicism, just like me 
A Guest Post by Alan L. Rubin, M. D.
In early June 2008 I stood in this vast hall at Moscone Convention Center in San Francisco, California at the 68th Scientific Sessions of the American Diabetes Association. I marveled at the huge exhibits that surrounded me, each representing one
or another of the enormous companies that produce products for the person with diabetes. Some of the largest were companies that make pills or injections that can make the difference between control of the blood glucose and a future of complications such as eye disease, kidney disease, nerve disease and heart disease. I can’t show you a picture of these exhibits because no photography is allowed. I couldn’t help but wonder, what are they trying to hide?
The last 20 years have produced a litany of revelations about how the drug companies convince you and me of the value of a drug and the need for us to have it, regardless of its true value or even its potential to do harm. Some of the books and articles that have convinced me of this include the following:
“Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines and Hooked the Nation on Prescription Drugs” by Melody Petersen. Farrar, Straus and Giroux, March 18, 2008.
“The Truth About the Drug Companies: How They Deceive Us and What to Do About It” by Marcia Angell, Random House, August 9, 2005.
“On the Take: How Medicine’s Complicity With Big Business Can Endanger Your Health” by Jerome Kassirer, Oxford University Press, October 20, 2005.
“Dangerous Deception—Hiding the Evidence of Adverse Drug Effects” by Jerry Avorn, M. D. , New England Journal of Medicine, November 23, 2006, page 2169.
“Investigators Find Repeated Deception in Ads for Drugs” by Robert Pear, New York Times, December 4, 2002.
“Revealed: How Drug Firms ‘Hoodwink’ Medical Journals” by Antony Barnett, The Observer, December 7, 2003.
For an avid reader of the New York Times, it seems like there are daily revelations about the obfuscation, lying, cheating, bribing, and stealing by the health industry. And it’s not just on the side of the companies. Unfortunately, they could not succeed without the complicity of the doctors.
Some of the allegations include the following:
• Renowned medical researchers have hidden the payment of large sums of money by drug companies whose drugs they have highly recommended.
• Drug companies have failed to publish studies that don’t support use of their drugs, while publishing only those that do.
• Drug companies have paid “ghostwriters” to write articles that are then signed by researchers who have had nothing to do with the research.
• Celebrities who are interviewed give glowing reports of how a certain medication helped them, without mentioning they are on the payroll of the maker of the drug.
• Drug companies pay travel agents to warn of disease that their drug treats.
• Drug companies promote their drugs to children by having video games and books written without mentioning they are the sponsors.
• Drug companies that make antidepressants sponsor “depression screenings” at colleges without noting they are the sponsor.
• Drug companies sponsor all kinds of sporting events.
• Drug companies pay for continuing education for doctors, where the drugs they make are recommended.
• Drug companies pay “thought leader” physicians to give presentations to doctors.
• Almost every physician who presents a discussion of a drug or device at a medical meeting is on the payroll of a drug company in one way or another, as a speaker, as a consultant, on a medical board, as a researcher or adviser. This includes not just private physicians but government researchers as well.
Does this suggest some conflict of interest? You bet it does. Even the best of the medical journals like the New England Journal of Medicine, the Journal of the American Medical Association, the Lancet and many others have found themselves the victims of these practices.
One thing you can depend on. You will never find a product recommended in any of my five books because I have been paid by the maker. I do recommend some products, but only because they are the best available, not because the manufacturer has paid me.
Stay tuned: In a subsequent article, I will tell you how to protect yourself from these dangers.
****
Dr. Rubin is author of Diabetes For Dummies, Diabetes Cookbook for Dummies, and Type 1 Diabetes for Dummies, among other titles. Visit him at www.drrubin.com.
Explore posts in the same categories: Books & Resources, D-News Examined, Miscellaneous
“Drug companies promote their drugs to children by having video games and books written without mentioning they are the sponsors.”
Can you furnish any examples of video games that promote these drugs?
Posted by: Mike | August 14th, 2008 at 7:00 amIn response to Mike,
How about Glucoboy, or the much ridiculed Captain Novolin as examples of video games which promote diabetes drugs?
Posted by: Scott | August 14th, 2008 at 7:27 amThis is rather ironic. You trash drug company’s for promoting their products cloaked in the form of education, and then you subtly suggest that you are somehow different while plugging your books, or at least you as an author, at the end of your “educational” article here on diabetesmine.com.
We cannot do away with conflict of interest and have the drugs we want at the same time. If drug companies did not pay for research and pay for influential people to promote their products, then they would not discover the products we want or make us aware of the existence of their products. I think it is important to condemn false advertising and demand full disclosure. But, we should to be cautious of, but not outright condemn simple conflicts of interest.
Posted by: Nelson | August 14th, 2008 at 7:42 amGlucoboy was an effort to try to create a meter that plugged into a popular device and then sell expensive strips (sadly, why don’t meters have games?). I actually contacted the Glucoboy people at one point to see if they had any updates for US release. They released in Australia and no date for the US. From what I can tell, Nintendo didn’t see it as a threat.
Captain N was on Super Nintendo so not really new. But you win.
With Nelson’s reply, I do agree that the conflicts between book promotion and drug promotion are similar but rarely do books come with side effects like low-blood sugar, potential heart issues, etc.
I have a friend who works at a big name drug company (who makes drugs for type 2 patients) and he’s a t1. He says that even without blogs, games or other media-esque venues, companies know what we want already. Hence the creation of designer ailments that seem to suddenly have “syndromes” or other non-disease type names. They see what people complain about, look in their catalogs to see if one of their drugs can help and then then market the drug for it. New revenue stream, no drug dev cost, they win, people complain less.
Sadly, people aren’t immune to hype (snake oil just got a new name). I remember thinking that Lantus was “the stuff” and every doc saying that it worked for 24 hours. Did it? Hardly… everyone got hyped, few diabetics got paid, many diabetics paid out loads. Oddly, no lawsuits.
Posted by: Mike | August 14th, 2008 at 9:29 amI have no problem with the drug companies and agree with Nelson. Nor do I have a problem with Alan’s article. It is curious that, in this day of age, they can’t come up with a single device that can monitor and regulate blood sugar. I mean really, if I can do it….?
Posted by: David | August 14th, 2008 at 2:17 pmMike’s comment (9:29 am) kind of made me uneasy. What is wrong with Lantus? I take it along with Humalog. I don’t get why there are sooo many diferent types. Long lasting and quick fix, I get. But wtf?
If the information that is presented at a medical conference is accurate, I don’t care if the presenter is being compensated by a product manufacturer. If the information is inaccurate or incomplete, then compensation is also a tangential issue…it’s the validity of the presentation that’s critical.
The same applies to the use of a ghost writer. When a physician or researcher allows his or her name to be attached to a paper, he’s taking responsibility for it’s content. The actual wordsmith who wrote the paper is irrelevant.
What to me is of far greater concern is the advertising to the general public of prescription drugs. Not only is the cost of all that advertising built into the cost of the drugs (and thus paid by our health insurance premiums) but the usage of those drugs increases at the expense of lower cost alternatives…which further increases health insurance premiums.
Posted by: Bill | August 14th, 2008 at 3:08 pmI think that if something is underwritten or put forth by a company, then if it is stated beforehand, I would be more comfortable. I know that most of the business world works in a similar manner. Big sponsors support organizations and research that supports their products. I’m ok with that….if it becomes inaccurate or jaded, then just like with anything that is untrue….I lose trust.
Posted by: Bob Hawkinson | August 17th, 2008 at 2:57 amDr Rubin has done the readers of this blog a service by publishing the evidence that BIg Pharma in particular but Medicine in general has been corrupted by the pursuit of profit.
All he did was tell the well documented truth.
Ever hear of shills? How about Snake Oil salesmen? Same same.
The use of shills to push their product at every conceivable point along the Big Pharma chain has completely undermined the intrigrity of the scientific process and calls into question the accuracy, honesty and trustworthiness of the information the medical physicians are told and thus what they rely upon to prescribe medications to patients.
Here’s the bottomline, the drugs of today are oversold and are in too many cases a clear and present danger to the patients who take them.
It is totally inappropriate to question Dr Rubin’s ethics for writing this particular blog entry on DiabetesMine.com since the information, as he mentioned, is widely and freely available to all Online, especially from the NY Times.
He only opened your eyes to the truth.
Posted by: im1dc | August 18th, 2008 at 1:23 pmDrug companies have paid “ghostwriters” to write articles that are then signed by researchers who have had nothing to do with the research.
I’m really sad about this but it’s the truth . There are so many people telling something on topics that they have’nt even research before .
Posted by: freediabeteshelp@gmail.com | October 23rd, 2008 at 10:48 amI’ve bookmarked dr.robin’s website , thanks for such a great share.