You Get What You Reward - Part Two

You Get What You Reward - Part Two

Last week we discussed how the “You Get What You Reward” principle applied to the practice of medicine ( Part One). In this week’s newsletter we are going to discuss how the application of this principle relates to the actions of the pharmaceutical companies that manufacture and distribute prescription and over-the-counter drugs. They look just like the rest of us. They are loving parents. They take care of their parents. They help their neighbors. They go to work every morning and do their jobs. Then they return home at night and sleep peacefully. These words could have been written to describe the life of a Nazi prison guard during World War II.

They could also be written to describe the life of tobacco executives in the 1950’s-1970’s when they did everything they could to hide the health-destroying aspects of their products and likely killed or severely affected the health of millions. They could also be written to describe the Ford Motor Company executives who decided that it would be more profitable pay the lawsuits rather than spend the money to relocate the gas tanks of their Pinto model that they knew were likely to explode in car crashes. They could also be written today to describe many drug company executives and drug salespeople.

They attempt to conceal from physicians and the public any clinical study of a drug that implies that it is not really more effective than a placebo (sugar pill). They try to dismiss any reports of their drug causing any harmful side effects—like diabetes, heart problems, impotency or even death. How could people who could be your neighbors or the parents of kids that go to the same school as your kids be as uncaring as the Nazi prison guards or the tobacco executives or the Ford executives? The answer is simple. These executives are rewarded for one thing—the profits they make for their employers and for themselves. If questioned, they will tell you:

  • Their job is to maximize the sales of their drugs;
  • Their company spent millions of dollars getting their drugs approved and marketing them;
  • There is no perfect drug that never causes problems;
  • Even if a drug creates harmful side effects for some, it is still ok to market it because it helps some people;
  • The decision to give their drug is up to the medical doctors, not them;
  • The FDA approved the drug label and that is all that they have to tell doctors;
  • There is nothing wrong with their drug salespeople only telling the positive things about their drugs and not telling about any negatives because this is done by all salespeople of every product;
  • If the drug companies were not profitable, how could they continue researching new drugs that will save more lives?
The list of justifications could continue but the truth is that these drug company executives and employees are rewarded for one thing—the sales of their drugs. This is why a stock market analyst who rates the drug company stocks was heard to say about clinical trials of new drugs, “There are two things that the drug companies don’t want when they start clinical trials on new drugs. The first is that someone dies. This could prevent the drug from being approved. The second is that the drug actually cures the disease it is treating. This will make the drug much less profitable.” If you are selling a product, then it is much more valuable if the product is purchased over and over again. If you can make people afraid to not take your product, then it is a perfect product. On top of this, if you can convince insurance companies or the government that they should pay for most or all of the cost of the product so that the consumer pays little—this is the best. This is why these executives see no problem:
  • Paying millions of dollars to doctors like psychiatrist Joseph Biederman of Harvard, without disclosing this to other doctors, to conduct studies of their drugs and to conclude that their drugs are great for uses not approved by the FDA (off-label uses) so they can convince other doctors to sell more of their drugs even if an unbiased review of the study would show that the drug was unsafe or ineffective for the new use;
  • Paying doctors to sign their names to medical papers actually written by the drug company and for which the signing doctors have done little to no investigation or verification;
  • Spending twice as much on marketing as on research;
  • Training their sales representatives to violate the law by promoting off-label uses of their drugs;
  • Paying other doctors to make presentations to their colleagues at fancy dinners about the benefits of their drugs, again without making disclosures of these payments;
  • Paying for continuing education for doctors, but ensuring that all the speakers promote the drugs of the company;
  • Discontinuing any studies that indicate that their drug is dangerous or ineffective;
  • Ensure that the results of the studies of their drugs conclude that their drug is safe and effective regardless of the actual results of the study;
  • Making settlements with victims that actually bring a suit rather than telling doctors and patients the truth;

Keep their drugs on the market and stall requests from the FDA for as long as possible so that they can sell more drugs before they take a dangerous drug off the market. You see, even when Purdue Pharma executives pled guilty to criminal charges relating to their concealing and actually falsifying the addictive effects of OxyContin, or when Eli Lilly executives pled guilty to criminal charges that they illegally promoted the off-label use of Zyprexa and this use killed and harmed countless numbers of people, their companies paid a fine that was only a small portion of the money their company made from the sales accomplished through these criminal acts.

The responsible executives not only paid no fines personally but also served no jail time. Sure, tens of thousands are harmed and many die, but none of these executives are jailed. If someone seriously hurts or kills someone else because they are negligently operating a vehicle, they often serve time in jail. However, these criminal executives not only get to keep the bonuses they earned from their criminal acts, but they are free to move on to other executive jobs at other companies who will often hire them because they produced profits.

In life, we get what we reward. If we continue to reward these drug company executives who make profits at all costs, how can we expect not to get drug company executives who will distort any truth or cause any harm to make profits? If we rewarded these executives and the people who carry out their directives by not only making them personally pay but also sending the truly culpable ones to jail, very quickly we would get drug company executives and employees who were concerned about the safety and efficacy of their drugs and who insisted on full disclosures of the risks being made known to doctors and the public. The prospect of personal fines and jail will largely stop drug company executives and employees from making the same remarks that have been heard through the centuries to justify immoral and disgusting behavior—“I was only doing my job”.


At Novus Medical Detox Center, we reward people who have made the decision to be free of drugs by helping them safely and comfortably accomplish their dreams. We have developed a protocol that allows people who once felt they were forever trapped on methadone become free of methadone. We take pride in seeing people come to us addicted to OxyContin, Percocet, Vicodin, methadone, Xanax or many other drugs and leave clearheaded, happy and no longer needing the drugs to keep from getting sick. They can then take their next step, whether it be returning to their life free of dependency or going to a rehab program to become free of their addiction.

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