I just watched the movie "The Constant Gardener," and I was disappointed. Don't get me wrong, the acting is great, the art direction marvelous and it is a movie filled with deep emotions. But the basic concept is that pharmaceutical companies would rather murder their patients than develop safe drugs, and to cover this up they will then happily hire crude killers who literally crucify and bludgeon the opposition to death with blunt weapons. The premise is simply too unsophisticated and brutish to do the industry justice.
And to make matters worse, all this takes place in Africa; a region which no pharmaceutical company worries about, since it accounts for less than one percent of sales, which certainly doesn't make it worth risking murder of a diplomat's wife. I realize that John Le Carré is one of our finest authors, but there's no question that this kind of one-dimensional story line is pretty outdated.
The truth is that the pharmaceutical industry has saved millions of lives, yet it is also an industry which has caused a lot of grief and pain when it hasn't handled its new drugs appropriately or when it has covered up fatal side-effects. Merck is the latest villain, and David Graham from the FDA claims that Vioxx has killed about 60,000 patients, or as many Americans that died in the Vietnam War. Among those who disagree with Dr. Graham are his bosses at the FDA, however, unfortunately for them, American jurors appear to agree with Dr. Graham and Merck is now getting killed in our courtrooms because of the company's alleged misdeeds.
A thriller needs killings but in real life the men who run the drug industry know that cutting off someone's genitalia and putting them into the victim's mouth while he's still alive (the way this is done in the movie), is counterproductive. After all, they might get caught. So they employ more sophisticated methods.
One of the most important methods the industry uses is to discredit anyone who doesn't agree with them. For instance, when Pfizer terminated my employment, they thought this was such big news that they called the New York Times and other major newspapers; they even left a message with "60 Minutes," about their strategic corporate decision to fire Peter Rost. I guess Pfizer really, really wanted to make sure that everyone knew that I was fired, just to assist me in my job search. (Disclosure for Pfizer lawyers; I'm using sarcasm.)
A few weeks later I found myself named "Whiny Whistleblower of the Year" by the American Council on Science and Health. In his nomination, Gilbert Ross, M.D., Executive and Medical Director of the ACSH stated that the biggest "Whiny Whistleblower" for 2005 was "the person who most outrageously defied his or her employer, regardless of loyalty, science, or even common sense." Dr. Ross concluded "I vote for ex-Pfizer V.P. Dr. Peter Rost, an inept exec but a pretty good whistleblower. He provoked a federal investigation of his own company in 2003, alleging that Pfizer was responsible for the improper marketing of the synthetic growth hormone Genotropin."
It didn't take long for me to find out that one of the donors to ACSH was the employer that had just fired me--Pfizer. But perhaps that was just a coincidence.
And it took even less time to learn that Dr. Ross "spent all of 1996 at a federal prison camp in Schuylkill, Pennsylvania, having being sentenced to 46 months in prison for his participation in a scheme that ultimately defrauded New York's Medicaid program of approximately $8 million." I guess that part reminds me of the brutes in the movie, so perhaps the film isn't entirely off base . . .
So am I nervous?
My wife tells me I should be. After I did my first press conference in U.S. Congress in support of lower drug prices and reimportation (you can view the press conference here with Realplayer), she told me to make sure no one had loosened the wheel nuts or done anything else to my car before I drove off.
But I just don't see something like that as realistic. Few planned murders are committed by really smart people because the risk/reward ratio simply isn't there. And if there's anything pharmaceutical executives are good at, it is to evaluate those ratios and come out ahead.
And because they are so good at this, when pharmaceutical companies break the law, they usually end up winning. Reality is that civil and criminal fines rarely make even a dent in the earnings a drug has brought in. Take Pfizer's Neurontin, for example. According to the New York Times, Neurontin had "become one of the biggest-selling drugs in the world, with sales last year of $2.7 billion. Nearly 90 percent of the drug's sales continue to be for ailments for which the drug is not an approved treatment, according to recent surveys." Pfizer ended up paying $430 million criminal and civil fine. That sounds like a lot of money until you realize this is how much money they made off this drug in just two months of sales.
With such profits, and such fines, of course the drug industry doesn't have much to worry about.
To show just how out of touch our legal system is when it comes to dealing with cheating corporations the Office of the Inspector General also forced Pfizer to sign a Corporate Integrity Agreement. Since the government can't put a corporation in jail, they make them sign an agreement in which the company promises to never again commit the same crime. Now here's the interesting part, guess how much Pfizer has to pay if they fail to comply with this agreement?
$1,000 per day.
If I was one of the Pfizer lawyers who signed that agreement I would have been laughing my head off as soon as the OIG lawyers left the room with that "agreement." (Please note Pfizer makes $50 billion per year). If you don't believe me, check out the agreement here.
So here's the situation. Imagine you could rob a bank and drive off with a million dollars a year, each year for ten years, then you have to pay a fine of $50,000 and you have to promise never to do it again, and if you don't comply, you'll pay another fine of 1 cent per day. Everybody would be robbing banks if those were the rules for ordinary citizens!
OK, before all the Pfizer lawyers read this and have heart attacks and blame me for their ailments; I'm being facetious.
So now I'll be fair and balanced. Of course I'm not implying that selling Neurontin for off-label use is the same as robbing a bank, nor that it is Pfizer's fault that most of the prescriptions for Neurontin were for off-label purposes. They obviously knew nothing; they had no idea what was going on and if they did it wasn't their fault anyway. And by the way, Pfizer already blamed the crooked executives at Warner-Lambert who put the honest Pfizer executives in a position in which they had to pay that fine; Warner-Lambert was the company from whom they got the drug. But Pfizer sure as heck made a lot of money off those unfortunate circumstances. I should probably also state that the evil Justice Department probably just blackmailed Pfizer to pay that big, big fine, anyway. That's the position Forbes took in a recent cover article.
In conclusion, there's far too much money to be made in the drug industry without killing a single critic.
But then again, I could be wrong. If so, feel free to make these lines part of my eulogy.
I'll end with a quote from one of my readers: Here is what Thomas Jefferson said about corporations. "I hope we shall . . . crush in its birth the aristocracy of our moneyed corporations, which dare already to challenge our government to a trial of strength and to bid defiance to the laws of their country."
- Thomas Jefferson, letter to George Logan. November 12, 1816.
IMPORTANT LEGAL DISCLAIMER HERE