The love of money is the root of all kinds of evil. — Jesus

Wall Street has three major players — pharmaceuticals, oil and banking. The first is the only one that has been growing at 20% a year in the last one decade or so. The pharmaceuticals lobby is thrice as big and powerful as that of oil, although oil is much bigger than drugs in total turnover! To understand how the industry works one must read the new book by two French medical specialists appointed by the former French President Nicolas Sarkozy to study the working of the drugs lobby in the country. Although the book is in French, Kim Wilsher of the The Guardian has written about this book and the interview with the authors on September 14, 2012.

The best part of the interview was the answer given by the first author: “There is nothing revolutionary in this book. This has all been known for some time.” I was happy as I was writing about this in India, the U.K. and the U.S. for at least four decades but to no avail. The powers that be do not seem to take notice, at least in India. The two authors, Professor Philippe Even, director of the prestigious Necker Institute, and Bernard Debré, a doctor and member of Parliament, feel that removing what they describe as superfluous and hazardous drugs from the list of those paid for by the French health service would save up to €10bn (£8bn) a year. It would also prevent up to 20,000 deaths linked to the medication and reduce hospital admissions by up to 1,00,000, they claim.

The book, Guide to 4000 Useful, Useless or Dangerous Medicines, in all its 900 pages, looked at the effectiveness, risk, and the prohibitively high cost of the drugs. Among those which were completely useless the first rank was taken by STATINS, the most fashionable and doctor-friendly anti-cholesterol drug. The authors blacklisted a total of 58 drugs which included anti-inflammatory drugs, painkillers; cardiovascular drugs many of which are useless, anti-diabetics — many of them are dangerous to say the least — and the useless drugs for osteoporosis, contraception, muscular cramps and tobacco addiction! According to these specialists, roughly one half of the drugs prescribed by doctors in France are useless and many of them downright dangerous. The authors feel that the powerful companies keep these drugs moving for their own benefit.

Most of these drugs are produced in France. Professor Evans felt that the companies push these drugs on doctors who then push them on to patients. “The pharmaceutical industry is the most lucrative, the most cynical and the least ethical of all the industries,” he said. “It is like an octopus with tentacles that has infiltrated all the decision-making bodies, world health organisations, governments, parliaments, high administrations in health and hospitals and the medical profession,” he felt. “For the last 40 years, patients have been told that medicines are necessary for them, so they ask for them. Today, we have doctors who want to give people medicines and sick people asking for medicines. There’s nothing objective or realistic about this.”

The story is the same in India. The only difference is that the number of useless drugs sold here will run into hundreds, if not thousands. The Indian public have shown lukewarm response to my writings on the subject in the last four decades. Now that the information comes from the West, people might sit up and take note. That would be good for mankind as Oliver Wendell Holmes put it succinctly thus: “If the whole pharmacopeia were to be sunk to the bottom of the seas, that will be that much good for people and that much worse for the fishes.” How true indeed? There is no pill for every ill but there is definitely an ill following every pill!

How can we change all these? One would shudder to see this report in a recent issue of the prestigious The New England Journal of Medicine: “The global pharmaceutical industry has racked up fines of more than $11billion in the past three years for criminal wrongdoing, including withholding safety data and promoting drugs for use beyond their licensed conditions.

In all, 26 companies, including eight of the 10 top players in the global industry, have been found to be acting dishonestly. The scale of the wrongdoing, revealed for the first time, has undermined public and professional trust in the industry and is holding back clinical progress.”

A fine of $3 billion, imposed on the U.K.-based GlaxoSmithKline in July after it admitted to three counts of criminal behaviour in U.S. courts, was probably the highest paid so far in the history of pharmaceuticals. Nine other companies have had fines imposed, ranging from $420m on Novartis to $2.3bn on Pfizer since 2009, totalling over $11bn.

The be-all and end-all of life should not be to get rich, but to enrich the world. — B.C. Forbes

(The writer is a former Professor of Cardiology, Middlesex Medical School, London, and former Vice-Chancellor, Manipal University. Email: hegdebm@gmail.com)