Conjoined Twins
Pharmaceutical Industry and Psychiatry
Conjoined Twins – Joined at the Wallet
By
K.L. Carlson, MBA
“Unlimited spending! Schedule all the programs you can.” That was the
management directive announced at the regional business meeting I attended
when I first became a pharmaceutical rep. When I heard the announcement I felt
like I was on an Enron train that was roaring down the tracks, and the company
expected everyone to be on board. The company was giving its sales force
unlimited funds to hire physicians as paid speakers, sometimes to influence
other physicians to prescribe the company’s drugs, at other times to simply
financially reward physicians who wrote high volumes of prescriptions every
month for the company’s drugs.
Former Merck regional sales manager, Gene Carbona, told the New York
Times that the only thing the company considered when selecting physicians to
provide presentations was “the volume or potential volume of prescribing that
the doctor could do.” This is true of all pharmaceutical companies. According to
The Wall Street Journal (August 31, 2009), Eli Lilly alone paid physicians $22
million dollars in just the first quarter of 2009.
The higher a physician is on the influential ladder, the greater the financial
rewards to be reaped. Pharmaceutical companies pay influential leaders who
can sway public opinion and influence research. And the area of medicine
receiving the greatest amount of pharmaceutical money is psychiatry. The
American Psychiatric Association (APA) is the most drug industry financially
supported medical association. In July 2008, Senator Charles Grassley’s
demands that the APA provide an accounting of its finances revealed that in
2006 the pharmaceutical industry accounted for about 30 percent of the APA’s
financing; more than $20 million dollars.
The New York Times found psychiatrists were paid more by drug
companies than any other medical specialty in Minnesota, the only state
requiring full reporting of financial relationships between physicians and drug
companies. Between 1997 and 2005 psychiatrists in Minnesota collected $6.7
million from drug companies. The New York Times also found drug companies
were not selective about psychiatrists paid to conduct clinical trials of drugs. At
least 103 of the physicians had been disciplined, criticized, or had their license to
practice revoked by the Minnesota state medical board. In the case of one
psychiatrist, the FDA concluded he had violated the protocols of every drug
study he led that the FDA had audited. The FDA found he had reported
inaccurate data to the drug makers. Despite all this, drug makers continue to hire
this psychiatrist.
Senator Grassley continues to investigate the strong financial ties between
the pharmaceutical industry and influential physicians. His efforts have
disclosed drug industry payments to individual psychiatrists in extremely
influential positions. Such as former Director of the National Institute of Mental
Health (NIMH) and former radio host, Dr. Frederick K. Goodwin, who was
taking money from drug companies and promoting their psychiatric drugs on
his weekly National Public Radio (NPR) program, “The Infinite Mind.” Dr.
Goodwin never warned the public about the extremely dangerous side effects of
psychiatric drugs. When the head of NPR learned of Dr. Goodwin’s financial
relationships to pharmaceutical companies, the program was ended.
Based on his investigations, Senator Grassley accused the APA current
president-elect, Alan F. Schatzberg, MD, chairman of psychiatry at Stanford
University, of failing to disclose ownership of about $6 million in shares in
Corcept Therapeutics. Dr. Schatzberg is listed as principal investigator of a
government-funded trial of a drug Corcept is trying to commercialize.
In October 2008, Sen. Grassley discovered that Charles Nemeroff, M.D.,
Chairman of Psychiatry at Emory University, had earned more than $2.8 million
in consulting fees from pharmaceutical companies from 2000 – 2007. During that
time Dr. Nemeroff was researching drugs with government money in the form of
NIH grants. He failed to report this income to Emory and violated federal
research rules.
Another influential psychiatrist at Emory Senator Grassley’s
investigations disclosed had strong relationships with drug companies is Dr.
Zachary Stowe. Senator Grassley uncovered an email that demonstrates the
degree of control that drug companies have with physicians in influential
positions. The email was sent to the pharmaceutical company GlaxoSmithKline
(GSK) from a public relations firm that worked for them. GSK is the
manufacturer of Paxil, an antidepressant drug with severe side effects, including
suicide. The email was titled “For Your Review/Paxil Breast Milk Press
Release.” The email states:
“Please review the attached press release and forward me any
comments/edits. As you may know, Dr. Stowe is on board
for publicity efforts and name withheld and I are coordinating
time to meet with him next week to arm him with the key
messages for this announcement, which is slated for early
February. We are sending the release for your review at the
same time in efforts to secure distribution on Emory letterhead
(as you know, would provide credibility to data for the media)”
GSK paid Dr. Stowe at least a quarter of a million dollars in 2007 and 2008
according to Sen. Grassley’s investigations. Dr. Stowe also received money to
promote psychiatric drugs from Eli Lilly, Bristol-Myers Squibb, Pfizer, and
Wyeth.
Two child psychiatrists from Harvard Medical School, Dr. Joseph
Biederman and Dr. Timothy E. Wilens, reported to Senator Grassley that they
each earned several hundred thousand dollars from drug companies from 2000
to 2007. However it was found they each earned at least $1.6 million. Dr.
Bierderman’s support of the use of powerful antipsychotic drugs in children led
to a sharp increase in the use of these dangerous drugs in children as young as
three years old.
While psychiatrists are being paid by pharmaceutical companies to
promote psychiatric drugs, people who are taking the drugs are dying. One in
145 adults died in clinical trials of those taking the antipsychotic drugs Zyprexa,
Risperdal, or Seroqual according to FDA data. Dr. Biederman has financial ties
with Johnson and Johnson, owners of the company that makes Risperdal.
“We know the drug companies are throwing huge amounts of money at
medical researchers, and there is no clear-cut way to know how much and
exactly where,” Senator Grassley said in a news release.
The public and practicing physicians cannot trust the research results and
the promotion of drugs by what appears to be eminent sources. The pervasive
financial control by the pharmaceutical industry has destroyed their credibility,
and left us in a position where:
Hearing the truth about drugs is like trying to
hear a mouse tap dance during a hurricane.
References:
“Eli Lilly’s Payments to Doctors Revealed” by Shirley S. Wang, The Wall Street Journal, July 31, 2009.
Minnesota psychiatrists is from “After Sanctions, Doctors Get Drug Company Pay,” by Gardiner Harris
and Janet Roberts, The New York Times, June 3, 2007.
“Radio Host Has Drug Company Ties” by Gardiner Harris, The New York Times, Nov. 21, 2008.
“Grassley Seeks More Info on Conflict of Interest Policies at Medical Schools” by Evelyn Pringle, website
lawyersandsettlements.com, June 25, 2009.
“Psychiatric Group Faces Scrutiny Over Drug Industry Ties,” by Benedict Carey and Gardiner Harris, The
New York Times, July 12, 2008.
FDA data for deaths in clinical trials is from Allen Jones’ whistle-blower article, http://psychrights.org.
