Blaming Big Pharma for society’s ills
GlaxoSmithKline may have deserved its $3 billion fine, but it doesn’t deserve the blame for therapy culture.
The US Department of Justice has given pharmaceutical companies – or Big Pharma, to use the critics’ pejorative of choice – quite the legal battering in recent years. In 2009, Pfizer paid $2.3 billion as part of a settlement for mis-promoting medicines and paying kickbacks to doctors; in May this year, Abbott Laboratories settled for $1.6 billion over its misleading marketing of an antipsychotic drug; and then, last week, GlaxoSmithKline found itself on the receiving end of the biggest fine of all: a cool $3 billion.
There is little doubt that Glaxo was guilty of some serious wrongdoing. From the late 1990s until around 2007, it was involved in various forms of mis-selling. This included the promotion of the antidepressant Paxil to patients under 18, despite there being evidence that it was ‘no more effective than placebo in treating depression in kids’. In relation to the same drug, Glaxo even hired a company to prepare a medical journal that downplayed any potential safety risks, including reports that it increased the likelihood of suicide. Another Glaxo drug, Wellbutrin, was similarly mis-sold, this time as a treatment for weight loss and sexual dysfunction. And Glaxo also failed to reveal safety data about its diabetes drug Avandia - including an increased risk of heart attack - to the US Food and Drug Administration, despite being required to do so by law.
So it does seem that in several cases, Glaxo elevated pursuing a profit far above what might be good for people’s health. Yet, for those readily suspicious of Big Pharma, Glaxo’s behaviour is not simply seen in its own terms, as the unscrupulous actions of a profit-making business. Far more is attributed to Glaxo than just commercial malpractice. Alongside its competitors in Big Pharma, Glaxo is being held responsible, at some level, for turning us into pill-guzzling dupes. It has helped to create a problem, a need, to which it can then pose as the solution. In the words of a Fox Business columnist: ‘America’s children were depressed. They needed antidepressants. It was GlaxoSmithKline to the rescue.’
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This approaches the nub of the critique of Big Pharma in general. Driven to research, manufacture and sell drugs that will make them money, pharmaceutical companies have an interest in medicalising our lives, of turning even our children’s minds and bodies into sites for pharmaceutical intervention. For every problem invented, there is a neatly packaged foil tablet posturing as the solution. In the words of one critic of Glaxo, ‘companies are chiefly motivated by profit and, when billions of dollars are at stake, there is a huge motivation to bend the rules. We take for granted that companies are going to distort information when marketing their products to the public.’ ‘You don’t have to be an anti-capitalist’, writes another, ‘to admit the inadequacies of relying solely on market forces for our drugs’. Elsewhere, author Lisa Appiganesi has been even more damning: ‘Big Pharma, feeding its appetite for profits and ours for drugs, has gained an ever-greater hold over our mental and emotional lives, medicalising normality.’
Too much is being dumped on pharmaceutical companies here; too much agency is being attributed to them; there is too much, well, displacement activity. The ever-expanding market for new drugs, especially antidepressants, has not been created by Big Pharma’s insatiable thirst for profit. In reality, pharmaceutical companies are exploiting an already existing social demand for medical intervention. Our everyday life is not deemed ripe for drug-bearing interventions because of the avaricious machinations of Big Pharma. Rather, it is deemed so because we really do appear as being a bit ill.
Over the past decade, concerns by officials about our physical and especially our mental wellbeing have become the news equivalent of white noise. It always seems to be there, buzzing away in the background. Think of the claims of the World Health Organisation, which has gleefully predicted that by 2020, ‘depression will be the second leading contributor to the burden of disease’. Think also of the cross-university research last year which revealed that 38 per cent of Europeans are suffering from a mental disorder – that’s about 165million people. Think of the headlines generated last month by New Labour’s former happiness guru, Lord Richard Layard, who complained - to widespread nodding - that despite the fact that 6.1million people in the UK are estimated to be suffering from anxiety and depression, only a fraction are currently getting treatment.
Big Pharma didn’t create this situation. It didn’t germinate sickness in our midst as part of some grand profiteering masterplan. Rather, society, due to profound social and political changes, has increasingly been looked at through a medical lens. Everyday behaviours, which once might have been understood informally, politically even, as understandable responses to particular situations, are now all-too-readily medicalised by the state and its ever-growing retinue of therapists and health experts. So whether it’s the reclassification of shyness as avoidant personality disorder, or the diagnosis of depression, not to mention incapacity, in cases of unemployment, the individual, now socially isolated, is deemed incapable of overcoming the problems he or she faces. It is assumed that we need outside, expert help. It is assumed that we need treatment. And it is in this moment that the pharmaceutical industry is able to seize its opportunity.
Tim Black is senior writer at spiked.