Captains of Pharma

It Could Be Different

Over the course of the last week or two, my husband and I have been watching the eight-part Hulu documentary series Dopesick exploring how Purdue Pharma, privately owned by the Sackler family, pushed its deadly narcotic OxyContin resulting in the addiction and deaths of tens of thousands of people. The Sacklers and Purdue deployed a specious propaganda campaign mendaciously touting OxyContin as less addictive than other opioids and claiming an addiction rate of less than 1% for patients.

You have to watch Dopesick or read the book upon which the series is based to really understand how evil these people are and how far they went to ensure their family made billions at the expense of innocent human beings.

In addition to claiming Oxy was less addictive, the Sacklers/Purdue dishonestly portrayed their drug as not suffering from the normal spikes in blood concentrations common to other opioids which result in euphoria and the crash that follows leaving patients begging for more. They claimed the time release coating on pills of Oxy eliminated those spikes. They manipulated the scale on the graphs in their promotional materials to mislead salespeople and doctors into believing the lie that Oxy did not result in the peaks and valleys which lead to addiction.

Purdue funded and organized Astroturf expert groups on pain management that extolled the virtues of Oxy and its ability to manage moderate pain, paid doctors to push the drug, and incentivized salespeople with volume-driven bonuses. They funded Astroturf citizens groups to control the conversation in the communities that were devastated by the drug and when that failed, they attempted to buy their silence.

When we finished the docu-series I was left feeling quite demoralized because not one of the executives nor one member of the Sackler family that led the company ever went to jail – which is exactly where they belong. No individual was even charged with a felony despite all their lies and deception. Yes, the company filed for bankruptcy, yes, the Sacklers lost the company, and yes, the company paid billions in fines but the family still enjoys extraordinary wealth despite the carnage of their deceptive OxyContin campaign.

If you or I committed the crimes they committed we certainly would have been charged with a felony and landed in prison for a lengthy term but the Sacklers and their underlings are part of the ruling class who seem to inhabit a sphere above our laws.

They are part of the revolving door between government and industry. Top brass at federal health agencies regularly complete government appointments then transition to high paying positions at the very corporations they once regulated. Perhaps this is just the way the world works but a more cynical interpretation is this is how industry rewards those who “carry their water” – and buy their silence.

It is no secret that former CDC head Dr. Julie Gerberding went to a cushy job at Merck vaccines a year after leaving her position. More recently, former FDA Commissioner Scott Gotlieb conveniently landed at Pfizer where he serves on the board earning a six-figure salary only a couple months after departing FDA.  In the case of Purdue, Curtis Wright, a director at FDA who led the agency’s approval of OxyContin took a cushy job at Purdue with a starting salary of $400,000 a year after his departure.

To a large extent, due to the Prescription Drug User Fee Act, the pharmaceutical industry effectively controls FDA via the “user fees” it pays directly to the agency amounting to $2.8 billion in 2021. FDA is, for all intents and purposes, a captured agency as user fees amount to roughly 65% of the drug approvers salaries for human drugs and 45% of FDA’s total budget.

But it’s not only federal agencies that suffer from conflicts of interest, as the series makes clear, our justice system is also plagued by a revolving door with industry.

Watching Dopesick left me feeling sad, depressed, helpless, angry, and perhaps worst of all, despairing because the Sackler family and Purdue Pharma story are not unique. They are not an isolated incident in the vast landscape of American medicine, drugs, and politics.

Rather, the Purdue Pharma story is par for the course.

I have firsthand experience of this modus operandi from my days on Wall Street. When the management team of one of the biggest drug companies in the world came to reassure us as one of their largest investors about the blockbuster drug in their pipeline, the CEO explained how despite a “Black Box Warning” on the packaging as ordered by FDA in response to some patients on the phase III clinical trials dying, he still thought the company would rake in billions of dollars in revenue and profits. He knew innocent and trusting but naïve people would die, but that was not part of the equation.

Through years of research, I later came to realize that injury and loss of life are a part of the equation, but not in the way a heartfelt human would imagine. Instead, these companies calculate the injuries and loss of life in terms of the cost of any lawsuits, penalties, and fines they’ll have to shoulder for harm caused as simply a cost of doing business. As the damages-related costs are dwarfed by the mountains of expected profits, the unfortunate human and financial damage are just a write-off.

According to the consumer watchdog Public Citizen, the drug industry has defrauded the federal government more than any other industry and paid $38.6 billion in settlements, fines, and penalties for hundreds of lawsuits including marketing fraud and other offenses. But for an industry that raked in $1.42 trillion in global revenues in 2021, a few billion in fines over 27 years is small potatoes.

Perhaps one of the most shocking and damaging aspects of the status quo in pharma is the admittedly risky standard vaccine program (apart from the Covid shots).

The whole system is set up against parents and Americans in general. The National Childhood Vaccine Injury Act of 1986 (NCVIA) was intended to protect grieving families from the nightmare of suing over vaccine injury. NCVIA created a National Vaccine Injury Compensation Program (NVCP) which was supposed to guarantee applicants with a “swift, flexible, and less adversarial alternative” to civil litigation. In exchange, the vaccine industry was bestowed with a financial and legal liability shield other industries can only dream about. In laymen’s terms, this means it is near impossible to sue the vaccine industry.

The NCVIA/NVCP acknowledged that vaccines injure and kill some recipients and set up a no-fault compensation program with a Vaccine Injury Table of recognized side-effects compensable through the trust fund established under the NVCP. Unfortunately, the Vaccine Injury Table has been gutted in the ensuing 35 years to the point that seeking justice in the purportedly quick, simple, no-fault program is a second nightmare for families who apply to it.

The Vaccine Injury Compensation Trust Fund pays out settlements to those who apply successfully to the program. The program is funded by a 75-cent tax on all CDC recommended vaccines and has paid out over $4.5 billion to victims since program inception despite only a small portion of applicants succeeding. As the vaccine makers have no liability and no role in funding the compensation program, they have no incentive to make safer products.

Vaccine claims are heard by the Office of Special Masters within the US Court of Federal Claims, a special court run by government-funded lawyers, administering a government program lacking due process or discovery.

It’s hard not see the system as a racket given the following facts: The CDC recommends the shots; the States mandate them; the federal government acts as the largest purchaser of vaccines in the nation through the Vaccines for Children Program; CDC both promotes vaccines and ensures their safety; vaccine recipients pay to compensate those who are injured, and the government protects the vaccine makers from liability.

The US vaccine programs constitute a convoluted and inherently conflicted mess over which Congress has failed to exercise oversight since the NCVIA program’s inception.

Unfortunately, this is just the status quo of the world we inhabit. Arthur Sackler testified to Congress in the 1960s that modern pharmaceuticals were the way of the future. We have experienced the impact of that prescient statement in recent decades - and the past 3 years.

Hard as it may be to stomach, it seems that the captains of the pharmaceutical industry possess a cavalier attitude regarding the tradeoff between people’s health and well-being on the one hand, and their corporate power and profits on the other.

As I sat contemplating this institutionalized hustle, I felt plainly dejected as I simply cannot comprehend that human beings can be so dishonest, so heartless, so craven, weak, greedy, and ambitious – to literally sacrifice their fellow brothers and sisters for their own advancement.

How is it that these people have come to this place? How is it that so many will simply turn a blind eye? How is it that so many purported servants of the public play a role in this whole game?

The conclusion I’ve come to is that they lack a moral compass because they don’t believe in God or a higher power. They have no faith in anything bigger than themselves which not only provides guide rails to living a good and moral life but also some meaning.

What we truly face is a battle between nihilism and spirituality. These people are focused on the material world and believe that that is all there is and if that is all there is then who gives a damn how they behave?

Some folks are blessed with an internal compass without a belief in God but in my experience, they are the exception. Though I believe in God, I also just believe in being good.

For most of us, faith in something bigger than ourselves with the accompanying appreciation for right and wrong, inspires us to be good, honest, decent, and principled human beings.

Although I have not always had faith in God, I do now and it gives me meaning, hope, and joy even if I don’t fully understand this experience we call life - and even if I don’t understand why it is so painful or why it has to be the way it is with so many horrible humans sacrificing their own brothers and sisters in service to their agendas.

I choose to believe it’s because there is some kind of a grand plan, that we are here in a sort of school for the soul to learn how not to live - and to learn how much it fills our hearts to be good, and kind, and honest, and decent.

Perhaps part of the origin of true happiness flows from the immense sense of wellbeing that comes from knowing one at least tries to be a beacon of light in a world of dark.

I have a son and I would do anything for him and he is in fact part of the reason I do the work I do but it’s also because I want to be a good, thoughtful, and conscious person.

I want to learn and grow as a human being. I want to be a better person. I want to be a benefit to humanity and my community - even if that means standing up and saying things and doing things that others don’t understand or even despise or condemn (like suing our school board and a local town over their mask mandates).

I just try to do good each and every day and to make a difference in my little piece of life. That gives me meaning and also reassures me in my own mind and heart that I am on the right path. No matter how painful life may be, at least I know that I am trying to be a work and force for the better.

Thankfully there are many other warriors for good and they inspire me as well. I honestly don’t know what I would do without them encouraging me and inspiring me to reach higher, dig deeper when I’m down, and continue on a path for good.