I had the pleasure of speaking to a large group of senior citizens yesterday at a Jewish community center in the Boston area. I had been invited there to talk about Side Effects, and while the focus of my talk (like my book) was how drug companies deceived the American public about the safety and effectiveness of SSRI antidepressants in treating children, the seniors very quickly made the leap to how this issue affects them. During the Q&A, a number of them spoke up about the difficulties they’d had in getting a straight answer out of their doctors about potential side effects. They talked candidly of their confusion in not knowing whom to trust and where to get accurate, objective information about the drugs they were being prescribed.
This was a savvy, educated bunch of people, mostly in their 70s and 80s, and it was clear they took the business of their health seriously. A number of those in attendance said they didn’t always accept their doctor’s word that a particular drug was safe, and they seemed to have no problem understanding how pharm-bred gifts, free meals, junkets, not to mention lucrative consulting and speaking fees, could compromise the most devoted doctor's judgment.
One woman, for example, told me that two different doctors in recent months had prescribed neurontin, a drug approved for epileptic seizures, to ease her chronic pain, even though there is little scientific evidence it works as a painkiller. Indeed, four years ago, Pfizer paid a whopping $430 million fine for illegally marketing neurontin for off-label uses such as pain and anxiety. (The drug company essentially paid academics to put their names on research papers prepared by the company to promote these uses – shades of the Vioxx court saga currently shadowing Merck). Fortunately, the woman at the JCC had taken the time to ask around about neurontin and a family member who is in the health care field discouraged her from taking the drug. So she didn’t. She found a safer and more effective alternative.
In fact, I was surprised at the level of skepticism these seniors seemed to share about their doctors and the medical establishment as a whole. And it made me think: If this age group, which has witnessed some true miracles in medicine over their life span, is so cynical about the current state of health care, perhaps the time really is ripe for reform, and I’m not just talking about reform in the way medical care is paid for and delivered, but also in how new drugs and medical devices are tested and brought to market.
Indeed, it appears as if the senior set has already taken matters into their own hands. According to Medco’s annual report on drug spending, released yesterday, spending on drugs actually fell among people age 65 and older. Medco attributed the drop in spending among this age group to its increased use of generic drugs. Now maybe this has something to do with the economic climate, but it could also be attributed to the fact that senior citizens, along with other consumers, are wising up to the misleading blandishments of the pharmaceutical industry. And at the risk of generalizing from the comments and questions I heard yesterday, it appears as if they want their doctors to wise up too.