Wednesday, May 20, 2009

Denis Maltez is the reason we need to know who is shilling for Big Pharma

On his Pharma Marketing blog today, John Mack recaps the controversy over the patient who was paid hundreds of thousands of dollars by Bristol Myers Squibb to promote Abilify and then changed his tune. (Andy Behrman, aka "Electroboy," began talking out about the serious effects he had suffered while taking the anti-psychotic). In his blog, Mack asks the question: “Is this done often by all pharmaceutical companies or is it just something unique to BMS?”

Why do I have the feeling that Mack already knows the answer? It's not exactly a state secret that drug companies routinely pay doctors and patients, the higher the profile the better, big bucks to hawk their drugs. Look at Bob Dole and Viagra, heart doctor Robert Jarvik and Lipitor. The list goes on and on. The drug companies would, of course, prefer to pay key opinion leaders in medicine (KOLs as they are known) and celebrities to promote their wares, but they will pay anyone whom they think has a shred of credibility with the population they are trying to target. As I reveal in Side Effects and on my blog, a number of drug giants including Eli Lilly, GlaxoSmithKline and Pfizer paid Jim McNulty, past president of the National Alliance for the Mentally Ill (NAMI), thousands of dollars to promote their antidepressants. In his talks around the country, McNulty billed himself as a patient since he took the drugs to combat bipolar disorder. But he never disclosed to his audience or the members of NAMI that he was getting all this money on the side from Big Pharma.

So why does this matter? For an answer, one has only to read the heartrenching story in The Miami Herald today about yet another young boy in Florida who died after being given a cocktail of potent psychoactive drugs. According to a wrongful death lawsuit filed by his mother, Denis Maltez, 12, who was living a state-funded group home and had been diagnosed as autistic, was on Seroquel and Zyprexa (atypical anti-psychotics), as well as Depakote, an anti-seizure drug, and Clonazepam, a tranquilizer. Denis apparently died of serotonin syndrome, according to a 2007 autopsy by the Miami-Dade Medical Examiner’s office. As reported in The Herald, that condition occurs when a combination of drugs causes the brain to produce an excess of serotonin, a neurotransmitter in the brain.

Maltez’s mother says she sent her son to the group home after he tried to choke his younger sister. Her lawsuit comes in the midst of a high-profile investigation by Florida authorities into the death last month of a 7-year-old foster child who had also been taking a cocktail of psychoactive drugs.

Why, you might ask, do some psychiatrists prescribe these potentially lethal drugs to young children and then not monitor them for side effects? I can't answer that question. What I do know is that many doctors and consumers think these drugs are safe and effective for such off-label uses in large part because drug companies have paid big bucks both to KOLs and "patients" like Andy Behrmann and Jim McNulty to shill for them. And that's precisely why we need public disclosure laws like the one that the Vermont Legislature passed this week -- see New York Times article here -- so that everyone knows who the shills are and can take what they say with a hefty dose of skepticism. Here's hoping Congress passes the Physician Payment Sunshine Act and makes this a national trend.

1 comment:

Dan said...

Great post, Alison.

First, as a former sales rep with three of the largest drug companies in the world, BMS not included, patients as spokespeople has occured with all of them often.

In addition, at similiar conventions Andy was paid about 10 grand to speak at with each event, big pharma hires hundreds of doctors to attend such meetings to listen to sales rep pitch their products.

Then, the doctors grade the reps. It was an insult to my intelligence every time this occured. We as reps drank copious amounts of adult beverages at such meetings for reasons such as this.

Secondly, while Abilfly is a toxic drug, and what Andy said happened to him I have no doubt, Andy lacked character and integrity in his timing to share with the public what he is now.

BMS declined to offer Andy a contract for continued services in an amout exceeding 7 million dollars.

It was only at that time Andy decided to share what he is now.

If he was a bit more authentic, Andy should have done this disclosure upon his own volition, and not as revenge against BMS. We would have liked to know, and he would have truly had the intention to help others, perhaps.