The World of Drug Reps

In the previous article, Ask Your Doctor: The Marketing of Drugs, I showed a video of former drug rep and now filmmaker Kathleen Slattery-Moschkau speaking from her insider knowledge of how the drug companies market their wares.

Marketing drugs is the major part of a drug company’s expenses, far ahead of research and development of new product. And on the frontline of the marketing is the drug rep.

There are about 700,000 practicing physicians in the U.S., and drug companies spend about $60,000 per doctor, for a total of $57 billion, promoting their drugs. The majority of that expense is for the drug reps.

The reps are doing a good job, in that 40% of all drugs produced in the world are being consumed in the U.S. – that’s why I said in a previous article that the U.S. is a Drugged Out Nation.

Sadly, there’s a down side to all that drug use – adverse drug reactions are the fourth leading cause of death in the U.S.

And, because of all that pill popping, the U.S. ranks 24th in the world for life expectancy.

I thought today it would be best to hear from the drug reps themselves, or to learn more about how they work.

At the top of the page is a trailer from a film called Side Effects, which was directed by the above mentioned Kathleen Slattery-Moschkau, the former drug rep turned filmmaker.

And below are a few videos:

1) A report on CNBC about how drug reps work.

2) A spoof of drug reps, from the TV show Scrubs.

3) A former drug rep who peddled the anti-psychotic drug Zyprexa, talking about how they manipulated and hid information about the drug.

4) Gwen Olson, a former drug rep who wrote an expose about the drug industry, on how drug reps manipulate doctors.

Ask Your Doctor: The Marketing of Drugs

In yesterday’s article, Drug Ads on TV – A Brief History, I laid the blame for the epidemic of exponential growth in pharmaceutical consumption in the U.S. to August 1997, when the FDA allowed drug companies to begin advertising on TV.

The ubiquitous line you always hear in the ads, “Ask your doctor,” is the catchphrase to get you to mention that specific drug to your doctor, so that your doctor may prescribe that specific one, as opposed to a generic variation.

In the above video, Kathleen Slattery-Moschkau, a former pharmaceutical sales rep gives the inside dirt. Slattery-Moschkau, who since leaving the field has gone on to become a filmmaker, making the feature film Side Effects, starring Katherine Heigl as a pharmaceutical sales rep, discusses the billion dollar psycho/pharmaceutical marketing campaign designed to get millions of people on psychotropic drugs through slick drug ads and marketing campaigns that include ghost writing pro-drug articles for medical journals.

Meanwhile, you think advertising on TV is the final resting stop for the drug companies? Think again.

The newest fertile ground is the online marketing of drugs.

There’s been an explosive growth in online advertising: the pharmaceutical industry spent more than $1 billion on Internet ads last year and is projected to spend $1.7 billion on such marketing efforts in 2012.

And with that growth comes the potential for more unscrupulous advertising, because it’s much harder for the FDA to monitor all the websites that drug companies advertise on. Both Eli Lilly and Merck have received warning letters this year from the FDA accusing them of misleading online advertisements, but many more online ads escape the eyes of the FDA.

An increasing number of pharmaceutical firms are now using social media sites such as Facebook, YouTube, Twitter and MySpace, to market their products.

The drug company McNeil developed their own social media site called “ADHD Allies”—aimed at adults with ADHD—and on the site offer an online podcast on financial advice and an ADHD self-assessment tool.

What McNeil and many other drug companies are doing with their online advertising is slick and unscrupulous. The websites don’t mention the company’s product but rather market the disease, under the guise of attempting to share information and educate the public, especially those with the disease.

On these websites, the tone is educational, with the specific disease discussed, but the only options given are pharmaceutical ones. It’s not so easy to tell that a specific drug company is behind the website.

By doing things this way, drug companies can overcome fears of running afoul of FDA regulations that govern drug advertising and at the same time help brand and position their companies in a positive light with both the general public and doctors.

The top 10 drug companies using social media are: Pfizer, Johnson and Johnson, Novartis, Boehringer Ingelheim, AstraZeneca US, Bayer, GlaxoSmithKline, Sanofi-Aventis, Roche, and Merck.

So next time you hear the slogan “Ask Your Doctor,” remember that the slogan is not being used with your best interests in mind.

Drug Ads on TV – A Brief History

I started this series on drugs last week, stating that we are a drugged-out nation, and that when you take medications, it lessens your ability to achieve true health.

I’m not saying to quit taking your medications right now, as that may not be a wise thing to do. What I am saying is that you have to consider what your health goals are, and if it’s becoming healthy, then you have to start becoming proactive in getting off or at least cutting down on your medications.

Pharmaceutical drugs are not the answer to health, but it seems to be that people are being programmed to think they are.

That’s because the drug companies are doing a good job of making people think they are the savior.

A patient of mine recently told me she was on high blood pressure medication. Her blood pressure was 118/80 before she went on medication, and I told her that she does not have high blood pressure and shouldn’t be on a drug for it.

She went to see her doctor, who said that new regulations are stating that her blood pressure puts her in the pre-high blood pressure category, and that it’s now recommended that when people are in that category they should go on blood pressure medication.

I couldn’t believe when she told me this, and I told her that drug companies must have written that regulation, as the only one that serves is them.

She was wise enough to stop the medication, and she’s doing fine.

But how did we get to this point that drugs use is at such an epidemic level?

Blame it on drug ads on TV, which before August 1997 did not exist. It was at that point in time when everything changed. That’s when the FDA allowed it to happen.

Prior to 1997, the FDA rules said, “Advertisements promoting the medical use of prescription drugs must contain a ‘brief summary’ of all important information about the advertised drug, including its side effects, contraindications and effectiveness. In addition, advertisements broadcast over radio, TV or through telephone communications systems must include a ‘major statement’ prominently disclosing all of the major risks associated with the drug.”

Prior to August of 1997, print advertisements for prescription drugs were able to meet the “brief summary” requirement by including the risk-related sections of drug labeling together with the advertising copy. As the drug companies looked wistfully at the enormous marketing potential of television, they saw that there was no way to provide the required information about the drug in 30 second or one minute television ads.

Did Congress act? No, the FDA made the August 1997 rule change quietly and without consulting Congress or really anyone else. Their change allowed the drug companies to “…include information about any major risks, as well as instructions for how consumers can easily obtain more detailed information about the drug’s approved uses and risks.”

FDA Lead Deputy Commissioner Michael J. Friedman, M.D was one of the driving forces behind this change long sought by the drug companies. Dr. Friedman said in 1997, “Today’s action can help promote greater consumer awareness about prescription drugs. By describing realistic standards for television advertising of prescription drugs, we hope to end the uncertainty which has plagued both consumers and industry about the use of this medium. The FDA is committed to making sure that accurate and complete information is available to consumers.”

In the 1997 rule revision, the FDA “…presumes that the broadcast ad is truthful, not misleading, and contains information about the major health risks associated with the drug.

In lieu of providing a “brief summary,” the advertiser would have to provide a mechanism to ensure that consumers can easily obtain full product labeling.” In other words it is enough to quickly list some of the side effects along with a toll-free phone number or web address or advise the listener to speak with a physician.

Shortly after the FDA gave their blessing to the drug companies to advertise on TV, thanks to Dr. Michael Friedman, the good doctor left the agency. In 1998, President Clinton nominated Dr. Jane Henney to be the next commissioner of the FDA, and Dr. Friedman resigned to become a senior vice president at Searle, a subsidiary of Monsanto.

Which begs the question: In whose interests was Dr. Friedman looking after?

The United States and New Zealand are the only two industrial nations that allow the drug companies to advertise on television in this fashion.

As a result of being given the green light to advertise on TV, drug companies have quadrupled expenditures on ads aimed at consumers. Spending on direct-to-consumer advertising increased by 296.4% from 1997 to 2005, from $1 billion to $4 billion.

And the five single drugs with the highest expenditures for direct-to-consumer advertising were Nexium, Lunesta, Vytorin, Crestor, and Advair.

So next time you see an ad on TV, and you hear the famous tagline at the end to “ask your doctor,” remember that drug use in the U.S. has increased exponentially over the last 10 years, thanks in no small part to all that advertising on TV.

Bill Maher on Pharmaceutical Drugs

Bill Maher has a sharp wit, a sharp tongue and a sharp sense of what’s right.

And on the issue of pharmaceuticals and the drug companies, Bill Maher is one of the harshest critics around.

He doesn’t pull punches, and he speaks his mind. He’s funny, sarcastic, ironic, and knowledgeable.

Maher is a big advocate of healthy living, and feels the only way to truly reform the health care system is for people to learn how to be healthy.

Along with that, people need to learn how to resist the distorted message of the drug companies, in order that we can stop being a drugged-out nation.

So I invite you to watch the above video, and the videos below, to hear Bill Maher speak forcefully and forthrightly. You’ll find yourself laughing, while at the same time shaking your head in agreement, knowing that what he speaks is the truth.

And it might just make you angry at the drug companies and the way health care is practiced in the U.S.

The key is, if you do get angry, to do something about it. Like, just saying no – to taking pharmaceuticals.

Antidepressants: Widely Used, But Practically Useless?

In yesterday’s article entitled Drugged-Out Nation, I mentioned how antidepressants were the third most popular class of drugs dispensed in 2008, with over $9.5 billion in sales.

And over the last ten years, their use has nearly doubled in the U.S., while the use of psychotherapy by those prescribed antidepressants has declined.

Ten percent of the U.S. population is now being treated with an antidepressant during the course of a year, whereas ten years ago, five percent of the population was being treated with antidepressants.

One exception to the trend involved African-Americans. Ten years ago, 3.6% of African-Americans were on antidepressants and currently that number stands at 4.5%. The reason for this, according to some studies, is that African-Americans have lower rates of depression than whites.

In regards to psychotherapy, ten years ago 31% of people on antidepressants also took part in psychotherapy. Now the number of people both taking antidepressants and participating in psychotherapy is 20%.

There are a number of factors that explain the increasing use of antidepressants. One is that there has been broad and growing acceptance of antidepressant medicine in the U.S..

The other is that over the last ten years, several new antidepressants have come on the market, and they’re big money makers.

Unfortunately, it’s well-known that in mild to moderate depression, psychotherapy is as good as or better than medications. And in the population as a whole, most depression is mild or moderate.

Yet, antidepressant use has skyrocketed while psychotherapy use has declined.

And now new research has shown that half the people who take antidepressants for depression never get relief.

Why? Because the cause of depression has been oversimplified and drugs designed to treat it aim at the wrong target, according to new research from the Northwestern University Feinberg School of Medicine.

A study from the laboratory of long-time depression researcher Eva Redei has toppled two strongly held beliefs about depression. One is that stressful life events are a major cause of depression. The other is that an imbalance in neurotransmitters in the brain triggers depressive symptoms.

Both findings are significant because these beliefs were the basis for developing drugs currently used to treat depression.

Redei, the David Lawrence Stein Professor of Psychiatry at Northwestern’s Feinberg School, found powerful molecular evidence that quashes the long-held dogma that stress is generally a major cause of depression. Her new research reveals that there is almost no overlap between stress-related genes and depression-related gene.

And antidepressants treat stress, not depression. “That is one key reason why current antidepressants aren’t doing a great job,” Redei noted.

She said another reason current antidepressants are often ineffective is that they aim to boost neurotransmitters based on the popular molecular explanation of depression, which is that it’s the result of decreased levels of the neurotransmitters serotonin, norepinephrine and dopamine. But that’s wrong, Redei said.

“The medications have been focusing on the effect, not the cause,” she said. “That’s why it takes so long for them to work and why they aren’t effective for so many people.”

And so, in our drugged-out nation, we have so many people taking antidepressants, and yet the great percentage of people taking them should not be.

But why should the drug companies care? They’re making healthy profits off of depression.

Drugged-Out Nation

I start a new series as of today, on the topic of Drugs. The pharmaceutical kind, that is. You know, the stuff you go to the drug store to get.

I’m not anti-drugs. There’s a time and place for them. They can save lives. And sometimes they are necessary.

But the problem is that they should be used as a bridge, to be a stopgap measure while a person is working on getting healthier.

Instead, they are the only thing the great majority of people turn to when they are not feeling well.

As a result, drug use is at an epidemic level. In the U.S., per capita drug use is one dozen. Imagine that: on average, every man, woman and child in the U.S. is taking one dozen medications.

And I’m not taking any, so that means someone is picking up the slack for me.

The thing is: if you truly want to be healthy, you need to cut down and then cut out taking any medications.

Because taking medications is one of the surest ways to end up living a High Density Lifestyle, and with it, a very unhealthy and unhappy life.

Here’s the most ironic thing: in the U.S., every child is taught the slogan, “Just say no.” And yet, what kind of a lesson is being taught when the use of prescription medication is so rampant? Where’s the “Just say no” of that?

In 2008, overall drug sales in the U.S. were $291.5 billion. Lipitor, a statin used to control cholesterol, was the top-selling drug, followed by the acid reflux medication Nexium, and Plavix, an anti-platelet agent that reduces the risk of heart attack or stroke.

Sales of cardiovascular and gastroenterology medications, as well as ones that regulate central nervous system issues like seizures, depression, pain and Alzheimer’s, accounted for half of all drug sales in 2008.

Another big seller are antidepressants – they were the third most-popular type of drug dispensed in 2008, with $9.5 billion in sales.

It’s a boom time for the depression business, as long as you’re not a psychotherapist – fewer patients are seeing psychotherapists to resolve their mental health problems. Instead, says Dr. Mark Olfson, a professor of clinical psychiatry at Columbia University Medical Center, “there’s a greater emphasis on drugs.”

Over 3.5 billion prescriptions a year are written in the U.S. And as a consequence of all those prescriptions written, here’s no surprise – the 4th leading cause of death is medication side effects.

And the outlook for the future? With prescription volume growing exponentially year after year, it’s not good.

This is great news for the drug industry and insurance companies – drug costs are driving premiums through the roof – but not good for the rest of us.

Drugs have direct, powerful effects on human systems. Most of these effects are negative, and taking multiple drugs increases the risks. Psychologically, the growing attitude that drugs are the answer for every ache and angst is destructive for individuals and societies.

With drug advertising everywhere, what is the message being drummed into us and our children: that for every symptom and sensation the solution is a pill?

The drug industry has been the most profitable industry by far year after year, and they have no ethical problem with the totally unethical act of giving financial incentives to doctors to write prescriptions for their products.

And it goes both ways: many doctors have no ethical problem with the totally unethical act of taking financial incentives from drug companies to write prescriptions for their products.

This is a sad state of affairs, and until it changes, we are going to be stuck in the quagmire of High Density Lifestyle living.

Which means we’ll continue to have people getting sicker, with their medical needs and costs draining the system; health care costs and premiums will continue to skyrocket with less coverage and higher co-pays; and businesses will be strangled with the burden of trying to give employees health care coverage.

The answer – along with health care reform – is for people to learn how to be healthier, and one of the most important steps in seeing that happen is the reduction and elimination of prescription drug consumption.

Over the next few weeks, I’ll be delving into this more.

An Interview with Mimi Kirk, Part 3

Today is the last installment of the three-part exclusive interview I recently did with Mimi Kirk, the 71-year-old winner of PETA’s sexiest female vegetarian over 50 award.

Mimi has a lot of valid things to say about health and wellness, and she’s an incredible role model for anyone of any age. Just watching her in this and the previous two interviews can teach you a lot about being and becoming healthy.

Mimi’s interview fits in well with this series on Longevity, because, although Mimi is far younger than all of the other masters of longevity I have profiled in this series, what she discusses is clearly the secrets to living a long and vital life.

In case you missed the previous interviews I did with Mimi Kirk, you can click on the links below to see them:
An Interview with Mimi Kirk, Part 1
An Interview with Mimi Kirk, Part 2

As you watch the above video, you’ll hear Mimi talk about:

***why it’s not genes and family history that dictate whether you’ll be sick as you age

***why medications can be toxic to your health and why they’re not the answer to getting healthy

***why developing good health is simple

***why she loves eating a raw foods diet

***what her favorite creative pastimes are

***her upcoming book, “How to Be Healthy and Hot At Any Age.”

***why her sex drive is strong

***that she feels incredibly healthy and full of life

***what she does to keep her skin youthful and vital (hint: she’s never used botox or plastic surgery)

***how people can connect with her and find out what she’s up to. (here’s how to get to her Facebook page: Mimi Kirk’s Facebook page.)

So, I hope you enjoyed the interview I did with Mimi Kirk, and got a lot out of it. I surely did.

I’ll be back tomorrow with another article in this series on Longevity, so see you then.

An Interview with Mimi Kirk, Part 2

Today I continue with the second part of a three-part exclusive interview I recently did with Mimi Kirk, who is no ordinary 71 year old. In 2009, when she was 70, Mimi was voted by PETA as the sexiest vegetarian female over 50.

If you didn’t see the first part of the interview with Mimi Kirk, don’t forget to review it by clicking on this link:
An Interview with Mimi Kirk, Part 1

The interview was conducted over skype with only one technical snafu – about halfway through today’s interview Mimi’s screen froze, so you’ll see me wait about 10 seconds until Mimi’s screen unfroze. After that the interview continued without a hitch.

As you watch the above video, you’ll hear Mimi talk about:

***why to become healthy you need to become empowered and take responsibility for your health

***how she manages to wear out her boyfriend, who’s 19 years younger than she is

***why the way you think, your attitude about life, your happiness, and your ability to laugh are also crucial to health, along with diet

***what holds people back from changing their diet and making healthy lifestyle choices

***how she manages to live a stress-free life

***what the common threads are amongst people who live long lives

***how to start living a healthier lifestyle

***why eating meat and dairy is unhealthy

***that she takes no medications, and also takes no supplements

***why she shops primarily at farmer’s markets

Mimi Kirk has a lot to say, and all of it is valid. I think you’ll agree with me, as you watch this video, that Mimi is an incredible inspiration to all of us.

Tomorrow I’ll be back with the last installment of this three-part interview, so don’t forget to tune in tomorrow…

An Interview With Mimi Kirk, Part 1

A few months ago, I wrote an article on the Low Density Lifestyle site about Mimi Kirk, and today I present the first part of an exclusive three-part interview I did with her.

Mimi was voted in 2009 by PETA as the sexiest vegetarian female over 50, which is an honor of and by itself. What makes it even more amazing is that Mimi was 70 years old at the time! (She’s now 71.)

You may want to read the article again before watching the above video on Mimi Kirk, the sexiest vegetarian over 50.

Mimi and I conducted the interview over skype, and I recorded the video. I will give you the three-part interview one installment at a time, in order to give it to you in bite size chunks.

As you watch the above video, you’ll hear Mimi talk about:

***how she won the award

***why she became a vegetarian

***why she’s now a raw food vegan and how eating that way has made a dramatic improvement in her health

***a typical food day for her

***what she does if she goes out to dinner or travels

***her 52-year-old boyfriend’s eating habits and how she got him to change his ways

***her personal nutritional philosophy

Mimi is truly an inspiration, not only because she won the award, but because she is so healthy and vibrant. She’s a true model of longevity, and a model of someone living a Low Density Lifestyle.

Don’t forget to tune in next time for installment number two…

The 98-Year-Old Massage Therapist Grandmother

In today’s article on Longevity, meet Evelyn Blackburn: She’s a 98-year-old grandmother who is Britain’s oldest massage therapist, with 60 years in the profession.

Evelyn Blackburn was first granted her license to operate in 1949 and recently renewed it.

Mrs. Blackburn, of Pinner, north London, has treated tens of thousands of people since a friend’s sore neck prompted her to learn the techniques of massage six decades ago.

But she has kept abreast of developments, embracing alternative treatments such as cupping – made famous by celebrity enthusiast Gwyneth Paltrow – and radiesthesia, which treats people’s energy or auras.

Mrs Blackburn said, “I have massaged thousands of people over the years – from mothers and grandmothers to builders and scientists. Back when I started, I used iodine-based oil called Dragon’s Blood. Nowadays, I use the modern substitutes. You have to move with the times.

“I still maintain the best treatment is a pair of hands.

“I don’t think anything can replace massage. I have used lots of therapies and machines, but nothing is quite as effective.

“A massage is much better than all these advertised creams to put on your face and body, although the companies making the cream wouldn’t like to hear that – but it’s the truth.”

Mrs. Blackburn used to treat up to eight people a day at the clinic where she worked in Nower Hill, Harrow, but for the past 24 years has worked from home in a room adapted into a studio.

She stated that, “I started in 1949 and now I’m 98. It has been a long time but I enjoy my work because I help people feel better. I love the contact with people and sharing their problems.

“Now I take on work as it comes. I’m available seven days a week.”

Explaining how she has kept so active, she said: “While you cannot determine how long you live, I have been a vegetarian since I was 20 and never get angry and depressed. When you feel down in the dumps, you must pick yourself up.”

Evelyn Blackburn, the 98-year-old massage therapist grandmother, is another model of longevity, and a model of someone living a Low Density Lifestyle.

One of the common threads you may have noticed amongst all the people featured so far in these articles on longevity is diet: they have all either proclaimed that they are (or in the case of Joe Rollino, was) a vegetarian, or that they ate very little animal foods.

That really is a very important part of it, as eating an animal-food based diet will shorten your life, as the article I wrote not too long ago on The China Study pointed out.

Another thing all of these people have is a sense of purpose, and having a sense of purpose is something that has been shown to help contribute to longevity.

For Evelyn Blackburn, her sense of purpose is in helping people feel better, and she truly loves to be able to do so. As she said above, she’s available seven days a week.

So next time you find yourself in Pinner, in north London, give Evelyn Blackburn a call and make an appointment for a massage from her. You’ll learn a thing or two about longevity along the way.

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