My #1 Super Crazy Fact about Big Pharma
I’m currently reading a book called Sickening. It’s a no-holds-barred exposé on the lies and deceptions of Big Pharma.
In the book Dr. John Abramson, a physician, Harvard faculty member, and the world’s most notable expert on the drug industry’s deceptive tactics, reveals how the financial interests of Big Pharma have become the main factor that influences the way we practice medicine.
Okay, so what? We all know that Big Pharma doesn’t always play by the rules and is primarily driven by profit. What’s new?
Well, this mind-blowing fact that I’m about to share is something that most people—including your family doctor—have no idea about. Let me quote from Dr. Abramson’s book:
“One of the best-kept secrets in all of health care—understood by few doctors—is that the peer reviewers, medical-journal editors, and guideline writers, who are assumed to be performing due diligence to ensure the accuracy and completeness of the data reported from company-sponsored studies, do not have access to the real data from these trials. The published reports that doctors accept as fully vetted scientific evidence can be more accurately described as unverified data summaries prepared largely by or for the sponsoring drug companies.”
Say what?! The people who are supposed to be protecting us—the editors, peer reviewers and journals—don’t actually have access to the real data from pharmaceutical clinical trials? Instead they are reliant on Big Pharma’s interpretation of their own data, which leaves an incredible amount of room for deception, misdirection, and trickery? 🤯 🤯 🤯
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Now let’s get back to this week’s Try This newsletter.
My #2 Super Crazy Fact about Big Pharma
Here’s another mind-blowing fact about Big Pharma that will knock your socks off.
One of the ways that pharmaceutical companies trick doctors into recommending new and expensive drugs is by running very large studies that are looking for even the tiniest of improvements. And as long as they can show some statistical significance, the FDA will let them say what they want to say, even if their drug doesn’t really make us any healthier compared to cheaper options that might be available. Here’s a great story about an expensive diabetes drug called Trulicity from Dr. Abramson:
“A recent ad for Trulicity, a non-insulin injectable drug to treat type 2 diabetes discussed in a previous chapter, provides an excellent example. The ad makes three claims:
“‘Most people taking Trulicity reached an HgbA1c under 7%,’ but the FDA-approved label shows that glucose control is no better than that achieved with metformin, and Trulicity costs as much as 170 times more than metformin.”
“‘Trulicity may help you lose up to 10 lbs,’ but the FDA-approved label shows weight loss is no greater with Trulicity than with metformin.”
“And ‘Trulicity may also help lower your risk of cardiovascular events,’ but this doesn’t inform viewers that the FDA-approved labels show the benefit is so small that 99.7 percent of the people treated with Trulicity each year will not receive this benefit. None of the claims in the Trulicity ad are false, but all are misleading. They create an exaggerated appearance of superiority for the expensive new drug.”
And our doctors, who of course have the best of intentions, see these ads and read the clinical guidelines that often follow and think they are doing right by their patients by recommending expensive treatment options that are supposedly better for them. But they often aren’t.
My #3 Super Crazy Fact about Big Pharma
One of the questions that’s being left out of the conversation when it comes to pharmaceutical research is, “How does this drug intervention compare to lifestyle recommendations?”
Because the FDA doesn’t require drug companies to explore this question, many doctors walk away with the notion that a drug intervention is often the best option, and “soft” interventions like eating healthy and exercise don’t work. Many doctors also develop the false belief that patients have zero interest in doing the hard work and are only interested in quick fixes. But this may not be the case according to Dr. Abramson:
“The definitive study showing how best to reduce the incidence of diabetes was done in the 1990s. The Diabetes Prevention Program Research Group, publicly rather than commercially funded, randomly assigned more than three thousand people at high risk of developing diabetes to one of three groups: standard lifestyle recommendations plus placebo; standard lifestyle recommendations plus metformin (a blood-sugar-lowering medication); or intensive counseling about healthy diet, exercise, and behavior modification plus placebo. The primary outcome was the difference in the percentage of people who developed diabetes in each group after three years.
“The study was highly unusual in that its goal was to determine the best way to decrease the risk of diabetes, instead of just trying to prove the efficacy of a particular drug. Its unusual design tested the widely held belief that people can’t be helped to adopt and sustain lifestyle habits. Indeed, the participants, all of whom had prediabetes and two-thirds of whom were obese, would have been expected to have significant difficulty with making lasting lifestyle changes.
“The results were stunning. First, they resoundingly debunked the conventional wisdom that people won’t change their habits and that physicians’ efforts to get them to do so are a waste of time. At the end of three years, the people assigned to the intensive-life-style-modification group had lost an average of twelve pounds and significantly increased their physical exercise compared to the two other groups. And second, the study showed that by far the best way to prevent diabetes is through positive lifestyle changes. Intensive counseling on lifestyle modification reduced the risk of developing diabetes by 58 percent compared to the placebo group and by 39 percent compared to the group treated with metformin.”
Dr. Abramson continues by saying…
“Looked at another way, the lifestyle-modification program delayed diabetes by an average of eleven years in this high-risk population, and the cost for each year of healthy life gained was only $1,100. Compared to what other therapeutic interventions typically cost in America to provide a year of healthy life—up to $150,000 or more for each year gained—the cost of the health benefit of intensive lifestyle modification is an enormous bargain.”
What a powerful reminder that not only are patients motivated when the right program is offered to them, but lifestyle modifications in many cases significantly outperform pharmaceutical interventions—and they can be cheaper too
I’m not going to lie, I got a little pissed off reading Dr. John Abramson’s book. But I think it’s okay to get a little pissed here and there as long as that energy turns into positive action.
Seriously, what would our world look like if society demanded that the FDA and Big Pharma actually focused on helping the population get healthier
Profit will always be the goal of for-profit companies, and I have no issue with that, but that doesn’t mean we shouldn’t have some checks and balances to make sure that these organizations are serving the taxpayers who are often paying for their drug research and development in the first place.
If you want to go deeper into this topic I’d highly recommend listening to my interview with Dr. Abramson here. And if you want to support the folks who are fighting the good fight, might I suggest you buy a copy of Dr. Abramson’s book? He’s a man dedicated to raising awareness around this important topic, and he needs all the help we can give him. You can find his book on Amazon or (hopefully) at your local bookstore.
Here’s to your health,