Posted by : Ed Lott, Ph.D., M.B.A.
Joe Rogan delivered a New Year’s eve present to his millions of fans – a two and a half hour tutorial on corporate crime in the pharmaceutical industry.
Rogan’s guest – John Abramson, author of the new book Sickening: How Big Pharma Broke American Health Care and How We Can Repair It (Mariner Books, February 2022).
Abramson is lecturer at Harvard Medical School and author of a 2004 book Overdosed America: The Broken Promise of American Medicine.
Abramson argues in Sickening that America’s health care system is unique in prioritizing corporate interests over the public good.
“At the heart of the problem is Big Pharma, which controls the medical research agenda, holds the real data from its clinical trials as corporate secrets, and shapes the information available to health care professionals to maximize its profits,” Abramson writes.
Rogan opened his interview with Abramson with his favorite corporate criminal – Pfizer.
Rogan raised Pfizer’s 2009 payment of $2.3 billion to settle criminal charges of misbranding Bextra with the intent to defraud or mislead. Bextra was an anti-inflammatory drug that Pfizer pulled from the market in 2005.
“What exactly did they do?” Rogan asked Abramson.
“I can’t tell you,” Abramson said. “I know, but I can’t tell you. I spent a little more than ten years in litigation as an expert in the national drug cases. And when I served as an expert, I got to see all the documents. There would be like twenty million documents in a case. I could see the science. If I needed a statistician to do a reanalysis of the primary data, I got that. I got to see how the marketing people strategized to exploit the science to create the most profit. I got to see how they marketed to doctors, how they wrote the articles in the medical journals.”
“I did that in the case of Pfizer. Plaintiffs’ attorneys hired me to analyze the situation. So I wrote a report and it got submitted to the court. Pfizer’s behavior was in my opinion so outrageous that I picked up the phone and called the Department of Justice. And I said – I know a lot about this drug. But I can’t tell you because I’ve signed a confidentiality agreement as an expert.”
“The Department of Justice and the FBI sent me a subpoena and said – you must come with your computer and tell us what they did wrong. And I did. That was the end of it. They keep their cards close to their chest.”
“And six months later I read in the newspaper that the Department of Justice found that the company had committed a felony and they were dealt the largest criminal fine in U.S. history.”
“So, I know what happened, but I can’t tell you.”
“We can read it, can’t we?” Rogan asked.
“No,” Abramson said. “You can read the Department of Justice press release on Bextra.”
“But none of the real data about what they lied about?” Rogan asked.
“Nope,” Abramson said. “Nada.”
“How is that possible?” Rogan asked. “There was an agreement to pay the fine and the details of it would not be divulged?”
“That’s correct,” Abramson said.
“Do you remember the drug Vioxx?” Abramson asked Rogan about Merck’s anti-inflammatory drug.
“Yes,” Rogan said. “I had a friend who had a stroke after taking Vioxx.”
“The issue is the size of the trial?” Rogan said. “You can have ten people and none of them can have a problem. Or you can have 10,000 people and you could have quite a few problems. You have to make the study as large as possible so you can get all of this biological variation between human beings?”
“That’s part of it,” Abramson answered. “But you can have a study of 8,000 people where you leave out three heart attacks and you flip the statistics and claim there is not a cardiovascular risk.”
“It was fraud,” Abramson said. “There was enough data on an Food and Drug Administration web site to see that Merck had been fraudulent about the heart attacks. And when I saw that, I said – I’m going to leave practice and figure this out.”
“I worked for two years on a book called Overdosed America. It was published in 2004. And it had the Vioxx story in it. A week after that book was published, Vioxx was pulled from the market. It wasn’t my doing. Merck had done another study that showed the same thing – that the risks of strokes, heart attacks and blood clots were doubled. At that point they had to pull it.”
Vioxx was on the market for four and a half years.
“Between twenty million and twenty five million Americans had taken Vioxx and between 40,000 and 60,000 Americans had died from the cardiovascular consequences of Vioxx. That was the same ballpark on the number of Americans who died in Vietnam. They died from taking a drug that was no more effective in treating arthritis or aches and pains than non-steroidal anti-inflammatories and caused 40,000 to 60,000 deaths.”
“And what was the punishment for Merck?” Rogan asked.
“There were 27,000 plaintiffs in the litigation and they were awarded $4.7 billion,” Abramson said. “Merck sold $12 billion worth of Vioxx in the four and a half years it was on the market. The Department of Justice fined them a little bit under $1 billion. And nobody went to jail.”
“They still made a profit?” Rogan asked.
“They took in $12 billion. They had research and marketing costs. Maybe they made a billion.”
Abramson quotes an internal email from Merck’s research chief saying there is always a hazard to drugs but the drug will “do well and so will we.”
“And no one went to jail for that?” Rogan asked. “That is insane. There are no consequences?”
“There are fines,” Abramson said. “But usually when the fines are announced by the Department of Justice, the stock goes up because the shareholders are happy to have this burden off.”
“It’s very rare that someone goes to jail. But even when the company pleads guilty to a felony, the Department of Justice allows a subsidiary of the parent company to take the hit so if there is another flagrant foul, the subsidiary gets excluded from the Medicare program. The parent company doesn’t get the legal foul counted against them.”
“In 1952, Milton Friedman wrote a book called Capitalism and Freedom,” Abramson said. “Friedman said there are only three legitimate functions of government. To preserve law and order, to enforce private contracts, and to ensure that private markets work.”
“That was radical at the time. But we are failing on all three. We are not enforcing law and order. When the drug companies commit fraud and felonies, they pay a price, take their slap on the hand and move along.”
“Is the fear that if you punish Pfizer and these drug companies that they are going to go under and they will not make medicine anymore?” Rogan asked.
“That is what Pfizer would like you to believe,” Abramson said. “But there is plenty of money to be made honestly. If Pfizer wanted to be a responsible corporation, they would say – let’s have a health technology assessment so that our drugs are tested fairly and are used appropriately. If the medical journals want to be responsible players, they would say – let’s insist that the data from the clinical trials is available to the peer reviewers.”
“What if when Vioxx went down the people who knew the data went to jail for 25 to 30 years?” Rogan asked. “What if the company was stripped of all of its assets? What if all of that money was funneled to the victims? What if they made a public display of real punitive damages? Would that have changed the way pharmaceuticals operate in this country?”
“A hundred percent,” Abramson said. “Absolutely it would have changed behavior. And if the people who masterminded the oxycontin scandal were at risk not just of losing their last $8 billion, but also going to jail, that too would change behavior. But now there are no consequences. There is not what Milton Friedman said – the government needs to maintain law and order.”
The post Joe Rogan New Year’s Eve Tutorial on Corporate Crime in the Pharmaceutical Industry appeared first on Corporate Crime Reporter.
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