JRE #1756 – John Abramson

This podcast dives into the complex and often controversial world of Big Pharma with John Abramson, a Harvard Medical School lecturer, drug litigation expert, and author of the book, “Sickening: How Big Pharma Broke American Health Care and How We Can Repair It.” Topics cover drug advertising, manipulation of data, questionable ethical practices, and the role of government oversight. The underlying themes explore the influence of unchecked capitalism on healthcare, the importance of transparency and accountability, and the need for a course correction to prioritize public health over profit.

Major Topics:

1. The Problematic Nature of Pharmaceutical Drug Advertising:

   • The United States is one of only two countries allowing pharmaceutical drug advertising.
   • Drug ads often utilize manipulative tactics, emotionally appealing imagery, and minimized side effects.
   • The podcast argues for greater transparency and accountability in drug advertising, requiring factual information regarding benefits, costs, and comparisons to alternative therapies.
   • The debate raises concerns about the ethical implications of marketing potentially addictive or harmful drugs through emotional appeals.

2. The Manipulation of Data by Pharmaceutical Companies:

3. John Abramson shares his personal experience as a drug litigation expert, revealing instances of data manipulation and suppression.
4. He highlights the practice of pharmaceutical companies controlling data from clinical trials, preventing independent review by medical journals and researchers.
5. The podcast exposes the potential for fraud and bias in the scientific information presented to doctors and patients, raising concerns about the reliability of peer-reviewed publications.
6. The discussion emphasizes the need for greater transparency and independent oversight in clinical trial data to ensure accurate and unbiased information reaches the medical community.

7. The Vioxx Case and Its Implications:

8. The Vioxx case serves as a striking example of pharmaceutical fraud and its devastating consequences.
9. The podcast reveals how Merck, the manufacturer of Vioxx, manipulated data and concealed the drug’s cardiovascular risks.
10. The episode highlights the inadequate consequences for Merck, with a significant financial settlement but no jail time for those responsible for the deaths caused by the drug.
11. This case exemplifies the need for more robust regulations and accountability to prevent similar incidents in the future.

12. The Neurontin Case and Off-Label Use:

13. The podcast examines the case of Neurontin (gabapentin), a drug initially approved for seizures and post-herpes zoster pain.
14. Pfizer, the manufacturer, allegedly engaged in fraudulent marketing practices, promoting off-label use for general pain and other conditions.
15. The case highlights the manipulation of data and misleading information presented to doctors to increase Neurontin’s market share.
16. This episode raises concerns about the influence of pharmaceutical companies on prescribing practices and the potential for off-label use to lead to inappropriate and potentially harmful treatments.

17. The Controversy Surrounding Ivermectin:

18. The podcast delves into the debate surrounding Ivermectin, a generic drug with potential antiviral properties.
19. It highlights the controversial use of Ivermectin for COVID-19, despite limited scientific evidence and the drug’s availability as a cheap generic.
20. The episode discusses the politicization of Ivermectin and the potential for financial motivations to influence the narrative.
21. The discussion calls for balanced and evidence-based assessments, recognizing the need for robust research while acknowledging potential benefits and risks.

22. The Role of Monoclonal Antibodies and Their Distribution:

23. The podcast explores the efficacy of monoclonal antibodies for COVID-19, highlighting their potential for effective treatment.
24. It raises concerns about the alleged blocking of distribution of monoclonal antibodies, suggesting potential political and financial motivations behind these actions.
25. The episode questions the rationale for restricting access to effective treatment options and the impact on public health.
26. The discussion emphasizes the need for transparent and evidence-based decision-making regarding the use and distribution of these valuable therapeutic options.

27. The CDC’s Data and Its Potential Biases:

28. The podcast examines the data released by the CDC, acknowledging its broad access but also highlighting potential biases.
29. It raises questions about the influence of pharmaceutical companies and political considerations on the CDC’s data collection and interpretation.
30. The episode encourages a critical approach to data analysis, acknowledging the importance of diverse sources and understanding potential biases.
31. The discussion emphasizes the importance of maintaining independent scientific institutions and transparent data practices to ensure trustworthy information.

32. The Influence of Pharmaceutical Companies on Medical Education and Research:

33. The podcast reveals how pharmaceutical companies exert influence on medical education and research.
34. It discusses the funding of medical journals, research studies, and continuing medical education programs by drug companies, creating potential for bias and conflicts of interest.
35. The episode explores how this influence can shape the information doctors receive and their prescribing practices.
36. The discussion emphasizes the importance of transparency and independent oversight to ensure accurate and unbiased information reaches healthcare professionals.

37. The 100% Effectiveness Claim and Data Manipulation:

38. The podcast addresses the controversial claim that COVID vaccines are 100% effective in preventing death, arguing that such claims are misleading and misinterpret data.
39. It explains the distinction between relative risk reduction and absolute risk reduction, emphasizing the importance of presenting accurate and contextually relevant data.
40. The episode exposes the potential for data manipulation and the need for critical thinking when evaluating information regarding vaccine efficacy.
41. The discussion highlights the importance of responsible communication and clear understanding of scientific data to prevent misinterpretations and misinformation.

42. The Disparity in Healthcare Outcomes and Costs:

43. The podcast highlights the significant disparities in healthcare outcomes and costs between the United States and other developed countries.
44. It discusses the higher mortality rates, lower healthy life expectancy, and higher healthcare spending in the US compared to countries with greater government oversight and regulations.
45. The episode emphasizes the need for a comprehensive approach to healthcare reform, addressing issues of cost, access, and preventative care.
46. The discussion explores the importance of prioritizing public health and implementing policies that promote equitable and affordable healthcare for all.

47. The Role of Economic Inequality and Social Determinants of Health:

48. The podcast explores the connection between economic inequality and health outcomes.
49. It highlights the concept of “diseases of despair” and their link to social pressures, economic hardship, and diminished quality of life.
50. The episode discusses the impact of wealth inequality on health disparities and the need for policies that address social determinants of health.
51. The discussion calls for a more equitable society, addressing economic disparities and promoting social programs that support individual health and well-being.

52. The Importance of Health Technology Assessments:

53. The podcast emphasizes the significance of health technology assessments (HTAs) in regulating drug prices and evaluating their value.
54. It describes how HTAs compare the medical and economic benefits of new drugs to existing treatments, informing coverage decisions and ensuring value for money.
55. The episode advocates for the implementation of HTAs in the United States to control drug prices, promote cost-effective therapies, and improve healthcare outcomes.
56. The discussion highlights the need for a more rational approach to healthcare, prioritizing evidence-based decision-making and value for money.

57. The Role of Pharmaceutical Benefits Managers (PBMs):

58. The podcast examines the role of PBMs in the pharmaceutical supply chain.
59. It explains how PBMs negotiate rebates and influence drug formulary placement, often prioritizing profitability over patient needs.
60. The episode raises concerns about the opaque nature of PBM operations and their potential for conflicts of interest.
61. The discussion highlights the need for greater transparency and accountability in the PBM industry to ensure fair and ethical practices.

62. The Importance of Lifestyle Choices and Preventative Care:

63. The podcast underscores the crucial role of lifestyle choices and preventative care in promoting health and well-being.
64. It highlights the evidence that lifestyle factors account for a significant portion of health outcomes, emphasizing the need for individual responsibility and societal support.
65. The episode encourages a shift in focus from solely relying on pharmaceutical solutions to embracing preventative measures like exercise, nutrition, and stress management.
66. The discussion calls for a more comprehensive and holistic approach to healthcare, encompassing both medical interventions and lifestyle interventions.

67. The Insulin Crisis and Price Manipulation:

68. The podcast discusses the ongoing insulin crisis, revealing how the price of insulin has skyrocketed despite its availability as a cheap generic.
69. It examines the historical context of insulin development and the transition from animal insulin to human recombinant insulin and then to insulin analogs.
70. The episode exposes the manipulation of standards and the creation of an artificial need for more expensive insulin analogs.
71. The discussion highlights the need for price controls, greater transparency in drug pricing, and a focus on cost-effective treatments.

72. The Case of Aduhelm and Questionable FDA Approval:

73. The podcast delves into the controversial approval of Aduhelm, an Alzheimer’s drug with limited efficacy and potential for serious side effects.
74. It exposes the potential for backroom deals and political influence in the FDA approval process.
75. The episode raises concerns about the financial motivations behind the drug’s approval and the potential for harm to patients.
76. The discussion emphasizes the importance of evidence-based decision-making, independent oversight, and patient safety in drug development and approval processes.

77. The Future of the Pharmaceutical Industry and the Need for Course Correction:

78. The podcast concludes with a discussion of the potential future of the pharmaceutical industry and the need for course correction.
79. It highlights the concerning trend of prioritizing profit over public health and the potential for further exploitation.
80. The episode calls for a fundamental shift in the industry’s approach, emphasizing transparency, accountability, and a commitment to serving patient needs.
81. The discussion emphasizes the importance of public engagement, political action, and a collective effort to reshape the healthcare landscape.

Memorable Quotes:

• “The primary function of the drug companies is to make money for their investors. And we’ve gotta get over the illusion that they’re somehow their purpose is to serve our health. The purpose is to make money.”
• “We don’t have what’s called health technology assessments. So we have no governmental or quasi governmental oversight of that compares the value of new drugs in terms of the therapeutic value and the economic value to old drugs, to older drugs, older other available therapies that inform coverage decisions and inform physicians about how best to apply the new therapeutics.”
• “In our largely unregulated system, unique unregulated healthcare system, pharmaceutical system amongst developed countries. We allow the drug companies to control the information that flows to doctors and patients. And that’s what has to change.”
• “The problem is unchecked capitalism, like unchecked profit, unchecked where where you have so much money that you can influence the way things are regulated. You can influence the way things are promoted by health officials where you just have full rein. with your ability to distort information and to cover up the damaging and detrimental effects of these drugs.”
• “If you believe in the market, you better get it to work. Milton Friedman, the conservative economist, wrote in 1962, he wrote a book called capitalism and freedom. And he said there’s only 3 legitimate functions of government to preserve law and order to enforce private contracts. And number 3, is to ensure that private markets work. Law and order and force contracts ensure that markets work.”