Big Pharma holds all ages in its thrall

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Big Pharma holds all ages in its thrall

 

Reviewed by Julie Mayeda

 

Sunday, October 9, 2005

 

 

 

 

 

 

Generation Rx

 

How Prescription Drugs Are Altering American Lives, Minds and Bodies

 

By Greg Critser

 

HOUGHTON MIFFLIN; 308 PAGES; $24.95

 

Big Tobacco, you're done, it's Big Pharma's turn to fry.

 

Last year, the former editor in chief of the New England Journal of

Medicine, Dr. Marcia Angell, turned the heat on Big Pharma with the

publication of her measured yet scalding disclosure, " The Truth About

Drug Companies. " Then, in the wake of the Vioxx recall, Newsweek

published a brief article describing how such an unsafe drug slipped

through the Food and Drug Administration safety net and " left patients

confused, drug companies defensive and government officials at odds

over how to fix the problem. " And now, " Fatland " author Greg Critser

torches Big Pharma in his timely book, " Generation Rx: How

Prescription Drugs Are Altering American Lives, Minds and Bodies. "

 

Simply put, we are a nation on drugs; half of all Americans take at

least one prescription drug daily, and of that half, 1 of 6 pop three

or more per day. That statistic ought to have some shock value, but

the truth is, we all know several people taking one or more

prescriptions daily. How did we become a nation of pill poppers -- we,

whom Critser has aptly labeled Generation Rx?

 

Certainly, some of the blame must be affixed to America's work-based

culture. Americans sacrifice much at the altar of productivity and

performance, including health. In lieu of lifestyles more conducive to

health and well-being, Americans have come to rely upon pills to stay

in the game. Thanks and blame go to Big Pharma, marketer of the pills

that help fuel our culture's frenetic work pace and high expectations,

and in the process has elevated itself from a stodgy flat-lined

industry to Wall Street darling.

 

Critser investigates Big Pharma's rise and finds that its success

wasn't wholly earned by novel offerings of effective products or

caring for its customers. Its success had more to do with persuading

Washington bureaucrats to lower and sometimes obliterate barriers put

in place to keep consumers safe and protect them from being swindled.

First, Big Pharma persuaded policymakers to drop the requirement that

advertisements include a time-sapping list of all of a drug's side

effects. This ruling popped the cork off the genie's bottle and

released a swarm of drug commercials on television viewers. The

commercials worked; last year, 8.5 million Americans asked their

doctors for a drug by name.

 

Then, as Critser points out, the Bayh-Dole Act was passed by Congress

in 1981, which made it easier for companies to use research

discoveries originated from publicly funded laboratories. Thus,

instead of incurring research and development costs, Big Pharma now

enjoyed the option of buying patent rights from National Institutes of

Health scientists for lucrative drug discoveries. However, the savings

are rarely passed down. In fact, consumers are charged twice for R & D

costs: first as taxpayers funding NIH research and again as customers

for phantom R & D costs used to validate a drug's hefty price tag.

 

More such maneuverings followed that effectively " unbound " (as Critser

titles his first chapter) Big Pharma even as they hamstrung FDA

regulators. While Critser covers some of the same ground as does

Angell's 2004 book, he was able to include the recent Vioxx recall,

which makes for a perfect cautionary tale of Big Pharma greed at the

expense of consumer safety. But where Critser truly breaks new ground

is in the following chapterhat divulges Big Pharma's targeting of age

groups, or " pharmaceutical tribes. "

 

Members of " The Tribe of High Performance Youth " have no time for

feeling blue because in this day and age, competition heats up early

in life. So for kids and teenagers there's the " California Cocktail " :

Ritalin, Neurontin (an anti-epileptic prescribed off-label for bipolar

disorder) and Wellbutrin (an antidepressant). However, the brain's

frontal lobes aren't fully matured until age 30, a fact that raises

the question, will such drugs permanently affect a child's later

ability to think and feel? Critser quotes an expert on child

psychopharmacology, Dr. Glen Elliott. " 'The problem,' he said, 'is

that our usage has outstripped our knowledge base. Let's face it,

we're experimenting on these kids without tracking the results.' "

 

The " Middle-Year Tribe " members feel compelled to maintain or boost

productivity on the one hand while staving off the aging process on

the other. For us, Big Pharma proffers pills for heartburn, high

cholesterol, high blood pressure, depression or all of the above. Most

desperately, we fend off entering into the last tribe, the " Tribe of

High-Performance Aging. " Naturally, members of this final tribe strive

to maintain independence and to extend their lifespan. They continue

taking their " middle-year-tribe " pills, but they might also add

prescriptions for osteoporosis, prostate disorders, rheumatoid

arthritis and diabetes.

 

All these pills add up. Nothing is for free, and when it comes to

prescription drugs, we know that from the bottom of our pocketbooks.

But there's another, if somewhat hidden, cost to all these

prescriptions. Livers, kidneys, lungs and stomach all struggle to

process so many drugs, but they frequently get overwhelmed and begin

to fail. According to one expert on liver disease quoted by Critser,

" In the United States drug-induced liver disease is the most common

cause of acute liver failure. " As yet, there is no medical initiative

to deal with the serious and sometimes fatal problems associated with

taking multiple pills.

 

In light of last year's hormone therapy findings and the Vioxx

scandal, public outrage over FDA ineptitude and Big Pharma greed is

already on simmer, and " Generation Rx " might just be the incendiary

needed to bring it to a roiling boil. " The stakes are high, " Critser

concludes. " It's your money and your life. "

 

Julie Mayeda is a writer in Oregon.