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from the September 20, 2004 edition -
http://www.csmonitor.com/2004/0920/p11s02-ussc.html

A new corporate villain - drugmakers?
A number of charges against the pharmaceutical industry damages its
credibility and further erodes public support.
By Gregory M. Lamb | Staff writer of The Christian Science Monitor

Big Pharma is in danger of joining Big Oil and Big Tobacco as one of the
bad
boys of American industry. A slew of revelations have stung drugmakers in
recent months - from charges of hiding unflattering clinical trials to
studies showing a link between the use of antidepressants in children and
suicidal thoughts. The companies' stance against allowing Americans to buy
cheaper drugs in Canada has further eroded public support.

Now, a steady stream of critical books - with titles such as "On The Take"
and "The $800 Million Pill" - lambastes the way the companies do business.

"It's obviously frustrating," says Jeff Trewhitt, a spokesman for the
Pharmaceutical Research and Manufacturers of America (PhRMA), the industry
trade group. "We think it's the result of a barrage of distorted
allegations, and we are trying to fight back." The charges have "obscured
the fact that the US pharmaceutical and biotechnology research industry is
the most innovative ... in the world," he says, supplying 60 to 70 percent
of the world's new medicines.

Nevertheless, the charges keep coming. In June, New York's attorney general
sued GlaxoSmithKline for, among other things, suppressing clinical findings
that its antidepressant drug was ineffective in children and teens and
possibly could cause suicidal behavior. The drug industry has since
announced it will establish a voluntary database of clinical studies. But
some in Congress, as well as the American Medical Association and medical
journal editors, are calling for a mandatory registry that would make
public
all clinical trials, even the ones where the drugs failed to work.

Then last week, advisory panels to the federal Food and Drug Administration
(FDA) urged the strongest possible warnings on the use of antidepressants
in
children.

What's more, the current publicity about antidepressants "almost certainly"
will lead to more lawsuits against drug manufacturers, says Richard
Daynard,
an expert in product liability and consumer protection who teaches at
Northeastern University in Boston. People will say "these guys did know
[about the problems]. They should have told me," Professor Daynard says.

The drumbeat of revelations has damaged the industry's credibility. A
majority of Americans (55 percent) now think drug companies should be more
closely regulated and two-thirds of Americans say drug prices are
unreasonably high, according to Harris polls this year. Most significantly,
only 44 percent say pharmaceutical companies serve their customers well.
That's down 35 percentage points since 1997, the biggest drop in approval
among any of the 15 industries the poll tracks. Only four industries -
health insurance (36 percent), oil (32 percent), managed care or HMOs (30
percent), and tobacco (30 percent) - now rank lower.

Big Pharma is not the first industry to enter the doghouse of American
public opinion. The 1970s gasoline shortages and the infamous 1989 spill
from the oil tanker Exxon Valdez off the Alaskan coast have made Big Oil a
longtime member of the bad boys club.

Big Tobacco has an even longer history, although many Americans assume it
got its comeuppance in 1998 when US state attorneys general won a gigantic
$206 billion settlement against cigarettemakers.

Drugmakers do have a stronger case to make than the tobacco industry, says
Daynard, who has led efforts to make that industry legally responsible for
tobacco-induced deaths, diseases, and disabilities. "What the drug industry
can always do is say, 'Well, that was a bad product. We're sorry about that
one. And we should have put a somewhat different label on this other one.
But all our other stuff is fabulous and, you know, you need it."

"It's big industry, and people are prejudiced against large industries like
the oil industry," says Mel Harkrader Pine, a veteran public-relations
expert in Purcell-ville, Va., who has represented both Mobil and the
treated-wood industry when they were under attack.

Part of the problem is that drug companies are a victim of their own
success, he says. "We went through this in the '70s and early '80s [in the
oil industry] until business went down the tubes," Mr. Pine says. "People
liked us better when we weren't making as much money."

But critics say it's practices not profits that has gotten Big Pharma into
trouble.

"[C]ontrary to its public relations, this is not a very innovative
industry," writes Marcia Angell, a former editor in chief of the New
England
Journal of Medicine (NEJM) and author of "The Truth About the Drug
Companies," in an e-mail. "[T]he notion that the pharmaceutical companies
discover lifesaving drugs is largely myth. Of the 487 drugs they brought to
market in the past six years, 78 percent were classified by the FDA as not
likely to represent improvements over drugs already on the market, and 68
percent didn't even contain new chemical compounds (just old drugs in new
combinations or formulations)."

The current patch of criticism that has come upon PhRMA is "deserved," adds
Dr. Jerome Kassirer, another former editor in chief of NEJM and author of
"On The Take: How Medicine's Complicity with Big Business Can Endanger Your
Health." "[T]hey exaggerate the amount of money that's used to produce new
products. They are producing too many drugs that don't have any special
added value, a bunch of 'me too' drugs."

"Obviously, it's hard for someone to understand what's wrong with going
across the border into Canada and getting a needed drug for a lower price,"
says PR guru Pine. He says Big Pharma would benefit from the same advice he
gives all his clients: "Be authentic and sympathetic."

Critical books about the drug industry
• "The Truth About the Drug Companies: How They Deceive Us and What to Do
About It," by Dr. Marcia Angell.

• "On The Take: How Medicine's Complicity with Big Business Can Endanger
Your Health," by Dr. Jerome Kassirer.

• "Powerful Medicines: The Benefits, Risks, and Costs of Prescription
Drugs," by Dr. Jerry Avorn.

• "Overdo$ed America: The Broken Promise of American Medicine," by Dr.
John
Abramson.

• "Critical Condition: How Health Care in America Became Big Business -
and
Bad Medicine," by investigative reporters Donald Barlett and James Steele.

• "The $800 Million Pill: The Truth Behind the Cost of New Drugs," by
Merrill Goozner