Alan Rubin is author of "Diabetes for Dummies," the very first book I ever read on the topic. That kind of makes him my hero and mentor, at least in my mind. He's not only well-informed; he also sports a healthy dose of cynicism, just like me ;)
In early June 2008 I stood in this vast hall at Moscone Convention Center in San Francisco, California at the 68th Scientific Sessions of the American Diabetes Association. I marveled at the huge exhibits that surrounded me, each representing one
or another of the enormous companies that produce products for the person with diabetes. Some of the largest were companies that make pills or injections that can make the difference between control of the blood glucose and a future of complications such as eye disease, kidney disease, nerve disease and heart disease. I can't show you a picture of these exhibits because no photography is allowed. I couldn't help but wonder, what are they trying to hide?
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The last 20 years have produced a litany of revelations about how the drug companies convince you and me of the value of a drug and the need for us to have it, regardless of its true value or even its potential to do harm. Some of the books and articles that have convinced me of this include the following:
"Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines and Hooked the Nation on Prescription Drugs" by Melody Petersen. Farrar, Straus and Giroux, March 18, 2008.
"The Truth About the Drug Companies: How They Deceive Us and What to Do About It" by Marcia Angell, Random House, August 9, 2005.
"On the Take: How Medicine's Complicity With Big Business Can Endanger Your Health" by Jerome Kassirer, Oxford University Press, October 20, 2005.
"Dangerous Deception—Hiding the Evidence of Adverse Drug Effects" by Jerry Avorn, M. D. , New England Journal of Medicine, November 23, 2006, page 2169.
"Investigators Find Repeated Deception in Ads for Drugs" by Robert Pear, New York Times, December 4, 2002.
"Revealed: How Drug Firms 'Hoodwink' Medical Journals" by Antony Barnett, The Observer, December 7, 2003.
For an avid reader of the New York Times, it seems like there are daily revelations about the obfuscation, lying, cheating, bribing, and stealing by the health industry. And it's not just on the side of the companies. Unfortunately, they could not succeed without the complicity of the doctors.
Some of the allegations include the following:
• Renowned medical researchers have hidden the payment of large sums of money by drug companies whose drugs they have highly recommended.
• Drug companies have failed to publish studies that don't support use of their drugs, while publishing only those that do.
• Drug companies have paid "ghostwriters" to write articles that are then signed by researchers who have had nothing to do with the research.
• Celebrities who are interviewed give glowing reports of how a certain medication helped them, without mentioning they are on the payroll of the maker of the drug.
• Drug companies pay travel agents to warn of disease that their drug treats.
• Drug companies promote their drugs to children by having video games and books written without mentioning they are the sponsors.
• Drug companies that make antidepressants sponsor "depression screenings" at colleges without noting they are the sponsor.
• Drug companies sponsor all kinds of sporting events.
• Drug companies pay for continuing education for doctors, where the drugs they make are recommended.
• Drug companies pay "thought leader" physicians to give presentations to doctors.
• Almost every physician who presents a discussion of a drug or device at a medical meeting is on the payroll of a drug company in one way or another, as a speaker, as a consultant, on a medical board, as a researcher or adviser. This includes not just private physicians but government researchers as well.
Does this suggest some conflict of interest? You bet it does. Even the best of the medical journals like the New England Journal of Medicine, the Journal of the American Medical Association, the Lancet and many others have found themselves the victims of these practices.
One thing you can depend on. You will never find a product recommended in any of my five books because I have been paid by the maker. I do recommend some products, but only because they are the best available, not because the manufacturer has paid me.
Stay tuned: In a subsequent article, I will tell you how to protect yourself from these dangers.
Dr. Rubin is author of Diabetes For Dummies, Diabetes Cookbook for Dummies, and Type 1 Diabetes for Dummies, among other titles. Visit him at www.drrubin.com.