There have been a number of posts/threads in the past few weeks about the election, the influence of lobbyists on politicians, and wholesale corporate greed (Tired of Evangelicals, Disaster Capitalists, What Do Lobbyists Do?, and my own Sexism+Capitalism) that I thought I would share some additional portion of my experience.
A few years ago, I was employed by a company that produced software used by the pharmaceutical industry and provided venture capital to clinical trial/research organizations. It was a very small company, and my job duties were necessarily diverse. Besides managing corporate communications and creating software manuals, I was sent to a number of conferences to research potential investment opportunities.
As a result, I basically got to hang around slobbering pharmaceutical executives, including one of their biggest conferences. I received an intensive education on sleazy Republican lobbyists, the Russian mafia, third world corruption, Medicare D and everything else scary and bad about the industry.
In 2005, I attended the Drug Information Association’s annual meeting in Washington, DC. To a certain degree it was fun. My job was to talk to people, and I enjoy learning what people have to say as much as it seems people like to talk to me. The fact that I represented a rich vein of American investment dollars did not hurt my popularity either. One of several reasons I am good at assessing important information is that my expressions do not give away my reactions, and I avoid passing judgment, which occasionally results in some people telling me more than they should.
Consider a group of clinical researchers I met among the many booths of the DIA. I was looking for a group that had access to a drug naïve European population for phase I, II and III trials. Why? The investors I represented already had partnered with a CTO in Asia, but their Asian population, although drug-naïve (meaning not already taking a bunch of meds like us ‘Mericans), was not sufficiently physiologically representative to the market as a whole. Asians are, in general, smaller, which affects how pharmaceuticals are processed by the body. At the time of the conference, European, especially Eastern European trials, were the new hotness.
I was in a booth for a Russian CTO, looking at their brochure. One of their representatives, a lead physician, approached me to ask if I had any questions. Before I could answer he spied my nametag.
“Ah, Dobkowski! You must be Polish!” Several other reps swarmed around me in excitement. I responded in jest, that being a Pole surrounded by Russians was instinctually discomfiting. The doctor laughed, and so did I. He was charming, warm, and clearly knowledgeable. When I told him why I was at DIA, his eyes brightened and he offered to give me whatever information I needed. I thanked him, and after taking a few notes, visited several more booths.
Later, when I had evaluated a number of options, the Russians were at the top of my list. I arranged an evening meeting between the doctor and my boss. The Russians have a similar manner of advancing drugs through to trial as we do, except where our pharmaceutical companies have lobbyists, the Russians have the mafia. I learned from the friendly doctor that he could exert pressure on the government to advance drugs to trials twice as fast as his competitors because he had a family member who held a high position within “The Organization”.
That he affiliated so nonchalantly with a criminal underworld surprised me, but not my boss, who seemed to think it was a good thing—for business. Later, the doctor confided in me that he had come to the US to escape that lifestyle and practice legitimate medicine. He seemed genuinely perturbed by some of the activities of his associates, but did not seem to think there was any other option. “I do good work,” he said, “but I could never do it without my connections.” He continued, “Besides, doing trials in Russia gives many people access to medications that they could otherwise never afford.” This is an excellent point, repeated by many other CROs I spoke with. But it was difficult not to ask why people could not afford life-saving and improving medicine.
At the end of the conference, the larger drug companies threw a number of parties. Compared to them, the company I worked for represented an insignificant amount of money, but without small investment companies, many drugs profitable to them would never come to market. I was invited to their parties, all of which were held in a different Smithsonian museum building. You heard correct: several drug companies each rented out an entire building. The one held at the National Air and Space Museum was said to be the largest, but one of the most interesting was the one held by Pharmanet at the then-brand new Museum of the American Indian.
It was disorienting: piles of smoked salmon, shrimp and lobster. Cascades of fruit so large they resembled Whole Foods displays. Multiple open bars serving premium liquor and champagne. A hokey, but talented band. Free tours of the museum. For a long time, I stood at the rail of the second level, overlooking the huge, semi-tipsy crowd. I walked slowly through the museum, appreciating the art and artifacts of a population so oppressed by poverty that it is almost as extinct as the Mastodons in the nearby Museum of Natural History. Did no one see the obscenity of this juxtaposition? I could not help but think of the people who funded this decadence: those who scrimp and save to peel off twenty or forty or a hundred dollars for the damn co-pay for their heart medicine. And that’s the lucky stiff with insurance. I felt like a spy, and perhaps, in writing this, I have become one.
I don’t think medicine should be given away, and like most people, I appreciate the science that goes into developing life-saving or improving drugs. But there is a vast spectrum of economic reward that precedes the life of Midas (especially when it seems the useless VPs talking about pipelines and cost-effectiveness are the ones reaping those rewards, not the scientists who exert grueling efforts in discovery and research).
While reading the literature piled in drifts on the conference floor, one of the loudest refrains I kept hearing was one of an image problem: Michael Pucci of GlaxoSmithKline was quoted by the FDA’s Drug Safety Advisor as complaining about the public that “they don’t view us as human.” Because using divisive terminology like “us” and “they” really helps. He later goes on to say that a message that can overcome that view is that the industry “cares”. The quotes are his. Picture him making them with his fingers, the prick.
Do I have advice for the pharmaceutical industry? You bet I do: if you, as a pharmaceutical company want to change public perception, you will only do so through genuine action, even if it means a cut in profits. Charge for drugs, but stop charging so damn much for drugs. Do more for sick people. Don’t, for god’s sake, drag your feet on AIDS research and on providing meds to populations who can’t afford them. Do pay your scientists better. Don’t push drugs on doctors, do make sure drugs are safe, or at least give adequate warnings and risk assessment.
Drug companies can develop the cure for cancer, AIDS, and the common cold, but as long as the perception is that the primary motivation is profit, profit, profit—nothing “they” sell is or should be viewed with anything but suspicion, especially given their track record so far.
Still, these points are so damn obvious to anyone who is human that I can’t help but think the doubts behind Big Pharma’s humanity have merit, and nothing I have heard on many pharmaceutical investment calls since has convinced me otherwise.