The Book of the Week is “Pharma– Greed, Lies, and the Poisoning of America” by Gerald Posner, published in 2020.
In 2016, the “superbug” Enterobacteriaceae turned out to be resistant to 26 different antibiotics. About half of patients who contract it, die. There are a bunch of other similar bacteria in the world. The author warned that in the future, a bacterial pandemic was on the way, for which there would be no antibiotic cure. Apparently, there can be a viral pandemic, too– one that cannot be treated with antibiotics at all.
For, antibiotics kill only bacteria, if that. Yet, in the United States, for decades, antibiotics have been prescribed to treat (mild!) viral illnesses. That is one major reason that superbugs have become a trend. And there has been an epidemic of diabetes type II. And many other adverse consequences.
Anyway, the author recounted the history of big-name drug companies, which began selling morphine to soldiers during the American Civil War. In the second half of the 1800’s, Pfizer, Squibb, Wyeth, Parke-Davis, Eli Lilly, and Burroughs-Wellcome began mostly as family proprietorships that sold highly addictive, unregulated drugs. Bayer produced heroin in 1898. The twentieth century saw Merck put cocaine in its products; other companies jumped on the cocaine bandwagon.
In 1904, the head of the United States government’s Bureau of Chemistry, Harvey Wiley, was concerned about contaminants in the nation’s food supply. Consumers were being sickened by chemicals that were supposed to retard spoilage or enhance the appeal of foods. They included, but were far from limited to: borax, salicylic acid, formaldehyde, benzoate, copper sulfate and sulfites. Trendy patent medicines were also doing harm to consumers. The word “patent” gave the impression of approval or regulation of some kind, but actually meant nothing.
Through the first third of the twentieth century, the government continued categorizing, monitoring and taxing drugs, but the pharmaceutical companies continued using trade groups and legal strategists to protect their profits. The 1930’s saw the big drug companies start research laboratories. Finally in 1938, the government established the Food and Drug Administration, and began to require extensive product-testing and labeling, and factory inspections. That same year, the Wheeler-Lea Act prohibited false advertising of drugs, except for previously manufactured barbiturates and amphetamines.
After Pearl Harbor was attacked in December 1941, America sought to manufacture penicillin in volume. For, the newly introduced antibiotic would be very helpful to the war wounded. But the drug’s fermentation process required a rare ingredient. In spring 1942, one patient who had friends in high places was cured. That largely used up the penicillin supply in the entire country. Other kinds of antibiotics were produced in the next decade, but their profitability was hampered by the bureaucratic processes of patent applications and FDA approval applications.
In the late 1940’s, Arthur Sackler and his brothers founded a family drug-company dynasty. The author revealed excessive trivia from FBI files on them and other greedy characters whose tentacles pervaded all businesses that could help sell (translation: maximize profits of) the family’s healthcare goods and services. This meant consulting, advertising, publishing, charities, public relations, database services, etc. The parties failed to disclose countless conflicts of interest.
In the early 1950’s, drug companies successfully lobbied the U.S. Patent and Trademark Office to allow drugs with strikingly similar molecular structures to be deemed different so that they could be granted separate patents. A higher number of drugs could then be rushed to market sooner, and make the most money.
In 1952, farmers fed Pfizer’s antibiotics to their animals so that they grew bigger (both Pfizer and the animals). In the mid-1950’s, Pfizer, Lederle, Squibb, Bristol and Upjohn engaged in an illegal tetracycline price-fixing scheme. They reaped hundreds of millions of dollars in earnings. The FDA chief was in Sackler’s back pocket. So when violations came to light, the FTC and FDA gave the offenders a slap on the wrist. However, senator Estes Kefauver was a thorn in their side.
Kefauver led an investigation as to why America’s drug prices were so excessively high when compared with those in other nations. In fighting back, the drug industry smeared Kefauver as a liberal pinko, claiming he had designs on forcing socialized medicine on the United States. The nineteen drugmakers under the gun gave bogus excuses. The real reason is that America’s drug prices and patents are subjected to minimal or no regulation, unlike everywhere else.
In 1956, Americans were told they were stressed, but a wonder drug called “Miltown” would help calm them down. The mild tranquilizer became a best-seller, until it was counterfeited and appeared on the black market, and its adverse side effects gave it bad publicity. Oh, well.
Then in the 1960’s came the culture-changing birth control Pill, and Valium– also called “mother’s little helper” that was marketed as a weight-loss aid. The next game-changer was thalidomide. Kefauver used the worldwide backlash against this drug to push through some drug safety and effectiveness regulation in the United States in 1963. For a change. Even so, in 1972, when the U.S. Supreme Court confirmed certain regulatory powers conferred on the FDA, drugmakers merely sought additional markets for their products on other continents.
In 1976, there was a swine flu epidemic in America. Healthcare companies were reluctant to develop a vaccine for it, fearing an orgy of litigation from victims if any harm was done. So the government unwisely agreed to foot any legal bills. Sure enough, some vaccine recipients developed cases of Guillain Barre syndrome, and neurological complications. The (taxpayer-funded) Justice Department took the hit. Other parties piled on. “The CDC had exploited ‘Washington’s panic’ to ‘increase the size of its empire and multiply its budget.’ “
Moving on, the author told the whole sordid story of the “opioid crisis” in America. In a nutshell: in May 2002, Purdue Pharma, maker and unethical marketer of OxyContin, hired Rudy Giuliani’s firm to defend it against the firestorm from its host of illegal activities. The firm collected a $3 million fee per month. Purdue collected $30 million per week from OxyContin sales. To be fair, Purdue and the Sackler family were the poster-scapegoats of the crisis. Numerous other parties aided and abetted them: other pharmaceutical companies, doctors, FDA bureaucrats, and pain management “experts” and pharmacists. The far-reaching consequences have caused a lot of trouble for society as a whole in the areas of: increased healthcare costs, criminal justice, social services, drug rehabilitation services, lost productivity and earnings, etc.
Read the book to learn an additional wealth of details and the details of wealth of the healthcare industry’s evolution into a hegemonic legal behemoth / excessive profit center, in the form of a series of cautionary tales in various topic areas– drug advertising, blood donations, biotech, epidemics, pharmacy benefit managers– that wrought major good and bad (mostly bad) cultural and regulatory changes (including the Hatch-Waxman Act and the Orphan Drug Act); plus the family battles following the sudden death of Arthur Sackler.