big pharma i'm joined by david healy in bangor he is a professor of psychiatry at cardiff university and author of the book farmageddon we also have martha rosenberg in chicago she's an investigative health reporter in all three of warren with the junk food deficiency and in new york we cross to josh bloom he's director of chemical and pharmaceutical sciences at the american council on science and health all right crosstalk rules in effect that means you can jump in anytime you want david if i go to you first is the western world over pharmac aided if i can use that term. yes it is we use more and more drugs for conditions that we don't need to read treatments for what we need are our drugs to work well for conditions we do need treatment for and the pharmaceutical industry is less and less able to produce the kind of treatments that we need at the moment but in the country though if you and if you hoed shares in any of the public to companies you are doing quite well because they've been making massive profits out

of selling treatments that aren't particularly needed to us recently josh how do you respond to that it sounds like it's for the pharmaceutical industry and not for health. mostly disagree. but is some of both but keep in mind that i don't represent the pharmaceutical company in fact and i was laid off by the farmers out of coal i think it is tree i have no i have no dog in this fight i'm just speaking from my experiences as a researcher and my impressions following the the history of the last two decades or so and the major accomplishments that we've seen ok but you know our major ok but josh is it really a profit driven business i guess it isn't focused on health care everything it's a profit driven business and it is also focused on health care the two are not mutually exclusive the profit is necessary to do research for the next series of drugs and. there's no way around it no one else will pay to do it and no

one else is capable of doing it ok marty do you want to weigh in on that. let's go to mark the first well thank you peter yeah i certainly agree with dr healy and i think that what we're seeing in the united states is a lot of selling of diseases that didn't used to exist that now are selling pills through the t.v. ads and the direct to consumer advertising in the last fifteen years have really increased hypochondria and people who say well i can't sleep i'm depressed i have five gastro reflux disease and all these things that we never thought before and the t.v. ads selling the diseases to sell the pill ok you know david when i was growing up no but nobody took these pills you know my generation made it more or less ok but so many children are medicated right now this i find that perfectly extraordinary. yes i agree and part of the issue here is that i think about the wrong to blame the

for. their own in that they're just doing what we would hope they would do which is to make profits what we've got is a system put in place which means that making profits out of the wrong things but not producing pills for the things we need to become largely marketing companies rather than pharmaceutical companies part of the marketing is to get children on pills in a way that they haven't been on pills before and in particular it extends through to the elderly the elderly or told at the risk factors for heart problems and stroke and diabetes and this something the other with the result that many people over the age of fifty five or six or more pills and treatment didn't choose death has become illicit in its own right it's one of the leading causes of death and this wasn't the case fifty years ago john should be and that's a very interesting point to learn react to that i mean it's leading to. death

itself. that's nonsense. there are so. quick list of some of the breakthrough products the last ten or twenty years and these are real therapies that are really necessary and a preventive lots of death and in no particular order certainly the aids cocktails come to the top of the list it's changed the entire world and the same thing is happening now with hepatitis c. where cures are starting to come out the two of which have two hundred fifty million people infected worldwide so don't be telling me that there isn't a medical need for that or that this is a some kind of profit making comics i should also just mention some of the my personal favorite breakthroughs in the last ten or twenty years advair has put as much under control whereas it wasn't before. there's a drug called sophron which controls the therapy induced nausea and vomiting which

is revolutionized chemotherapy entirely. there are drugs for migraine headaches. osteo perreault says and heart disease including a little paler and i think we should get hurt we just we shouldn't forget by agra as well martha do you want to weigh in there because i mean people are taking more and more pills so ok and opiates well i would like to weigh in peter on what josh just said because first of all advair it's a very controversial ad that sound physicians have asked to have that withdrawn because of very negative side effects that are not necessarily well publicized and if it's boston it's a bone drug and can are likely to be withdrawn because of the host of side effects that emerged after it was approved and after. a lot of money was made on it i think

it's really sleazy just refer to the vaccines which big pharma has produced and ignore all that poor and risky drugs that it's made billions and billions on by convincing people they're at risk of us your pro says or convincing people who are already taking two asthma drugs to take the third one. ok that's it just you want to reply to that before i go to day i'd like you to suggest an alternative for advair for it's withdrawn i happen to have asthma and when i started on advair twenty years ago i threw my inhaler away and i haven't carried it sense david are people taking too many drugs let me let me go to david now. we need all the stuff for this peter no no we don't and just about this to three points about the list josh gave you one is that the aids drugs for instance didn't come out of the problems who accompany you the breakthrough drugs we've come and come from university are and i funded research they have not come from sort of companies if

we take the drugs that the companies are making money out of the antidepressants the stuff the mood stabilisers drugs like this there's an excess of deaths on these drugs in the clinical trials of just these drugs on their own compared to placebo and not true for very also can be helpful for people it leads to more deaths than you would otherwise expect the treatment of as a part of the problem here is that industry are terribly good at producing drugs and other drugs might be useful for people who are severely ill and infrastructure to just people who are severely oh that wouldn't be a big problem but in the marketing of these drugs to make money they extend the use of these drugs to people who have got very mild conditions where the chances that the person is going to benefit from the drug is almost zero and the chances that they're going to be home by the drug is fairly substantial josh if you want to react to that i get it but it's excessive get used to. first of all i'm in

agreement with with pretty much everyone about the direct to consumer advertising i think it's awful. i think it shows the worst side of the drug industry rather than the best and maybe they're making some money out of it but it's a pyrrhic victory and i think many of my. former researchers agree with this. with regard to your statement david statement about the where the drugs originate that is technically true but it's completely misleading because academia and government are good at developing screens and underlying biology that can be then used to screen for drugs into then spur the drug discovery process that is about one percent of the process. that's when things get difficult anybody can run

a screen anybody can under under cover an underlying mechanism and no one can do anything with it because that's when the drug companies know what they're doing and they can take a screen or a compound that was found by a screen which is completely useless and turn it into a drug over a process of fifteen years ten thousand compounds and hundreds of chemist people have no idea how difficult this is not my life in the middle of it and it's almost impossible david. yeah you know i'd like to come back on two or three points here first of all i think josh is skirting the issues which is in the one nine hundred sixty s. when industry would actually developing drugs in a completely different way we had much better life saving drugs than we have now and i thought put into the united states had the best health care in the world in

terms of life expectancy and now the united states is full of the way down the list it's beneath cuba in terms of life expectancy on the other hand what's happening is the major companies now are running clinical trials in countries like russia and it's not clear about the ethics of the trials that they run the recruiting patients russians. sions to western trials where the patients don't always exist it seems where the rest of us kind of get access to the data from these clinical trials to find out what has actually happened and it's because of this because companies can write goes right up to goes about trials where they hide the data and then market these drugs extremely happily that the rest of us are being put on drugs we don't need and ending up dead that's a result all right i'm going to jump in here folks we're going to go to a short break and after that short break we'll continue our discussion on big pharma stay with our team.

at least.

you know sometimes you see a story and it seems so for lengthly you think you understand it and then you glimpse something else and you hear or see some other part of it and realize everything you thought you knew you don't know i'm tom harman welcome to the big picture.

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a new most sophisticated robot which all unfortunately doesn't give a darn about anything tim's mission to teach music creation why it should care about humans and world events this is why you should care only on the. welcome to cross talk we're all things are considered i'm peter lavelle to remind you we're discussing big fun. david who runs the medical establishment in the west as a doctor's physicians professors pharmaceuticals a driver. i think back in the nineteenth sixty's medicine had control

over from a secluded industry in a way that it doesn't have back then the folks who come to a relatively small since then they've become global multinational corporations the most profitable corporations are nerds and medicine has shrunk the capacity of doctors to control the pharmaceutical industry he's not what it once was so industry these days because actually one of the curious things here is that drugs are available on prescription only and this means that unlike what most people think when they take a pill that they're the consumers of the pill they aren't your doctor is the consumer of the pill and industry in essence target marketing on a very small number of people and they they they deploy at least twenty to thirty thousand dollars per doctor per year understanding doctors better than they understand themselves sixteen or support leads doctors security people who are so

liberal at handing out pills compared with the situation during the nine hundred sixty s. he's if they only talk if they only treated teachers that way josh how do you react to that. i have a lot. troubled hearing could just first address david's previous argument which is a fallacy and it's also a disingenuous argument and that's about life span in the united states. it's an easy argument to make and you can use it is an indictment of our health care system and the pharmaceutical industry but in fact multiple papers that if you factor in violence automobile accidents suicides and you normalize it across the industrialized company countries the united states has the highest life expectancy it is not seventy that's number well josh what is the correlation between taking

antidepressants and suicide for example in murder antidepressants definitely have their place in medicine they're not perfect there are far from perfect i think on the whole they've probably helped more people by far than they've hurt and they've probably hurt some people also but. you know that that is medicine and those are drugs there are various and there are benefits and there are not always clear answers for which is which ok we're talking about lives martha would you like to jump in well i would like to jump on me and i'm depressed and the world leader on the negative parts of and i depressant is probably dr healy but what i would like to add because my background is advertising and marketing and i'm a reporter and i'm i'm thinking over the last decade or more that. and i depressants are given for things that used to be true to transplant only in other

words they used to say well you have anxiety take this when you go to the dentist you get on the plane and now it's like you have major anxiety disorder you need to be on this drug all the time because if it doubles and triples their profits and the overall business model. mentioned is it's. the kids the wife lifetime drugs is where the profits come in so this is why in the united states we have no we have a real lack of operative antibiotic because people will take them for ten days so there's no profit for big pharma to create life saving antibiotics where it's helped push things i needed to out. people who don't need them ok let's go to david first of all go to josh but i use depressants and i use most of the pills that we have my concern as a doctor is that the quality of the pills i is improving it is not improving compared with the pills available to me to the nine hundred fifty s.

we have weaker and less effective pills now but specifically on the antidepressants it's just six to eight trials it's an excess deaths depressants and there are in the placebo arm of these trials so josh simply hasn't the evidence to say that these pills have helped more people than not the evidence points the other way around josh would you like to react to that if you could find it to a six to if you can find it to a six to eight week trial that may or may not be true but it's largely irrelevant. these things don't work for six to eight weeks so. i think you need to take a look at five years out and and see they're i don't know the answer i suspect you'd get a slightly different result josh josh we've had a look at this issue as five years out if you look at patients who have got sick it's a free and you're taking anti-psychotic drugs five years out most of the patients

who got schizophrenia these days who are on the drugs go on to commit suicide i mean the most of the loss of life comes from people committing suicide one hundred years ago patients who had schizophrenia did not commit suicide but we've got five years that is. hundreds didn't create the risk of death from suicide that's linked to the anti psychotics these patients are on that we didn't talk before. josh would you like to reply to that david i can't you're the expert on this i can't argue with you i don't know the data ok mark i do agree with those of you. that are in your face every night. really you know they're very poor taste and i wish they would just go away but i certainly agree with both of you on that one thing you want to jump in and go ahead. yes i would like to jump in now you know dr king was talking about the suicidal side effects of the and i depressive. are

exhibit a in the united states are afghanistan and iraq. troops the suicide rate in the military is often actually one person a day and a large percentage of the suicides did not see combat and some did not even deploy the variable the only difference between this population and others of that age is that these are very doped up psychiatric cocktails and anchored by the s.s.r.i. antidepressants which are suicide going to especially for that age group and to me it's astounding that the government allows big pharma to make it a cash cow and so many of the soldiers are on drug cocktails with four and five and six drugs and so many of killing themselves and that's why and i think that the data shows as well as you would watch you know david i want to go back to something

you said earlier because you made it so my doctors are pill dispensers now that's about it. i think yes i think peter part of the problem here is that doctors have agreed allies who are prescription only arrangements for drug. do it means that compared to a pilot for instance if you take a flight from moscow to new york the pilot has a real incentive to make sure that you get there alive because if you don't get there alive she will get there alive doctors on the other hand when they put you on pills we both think we all think that doctors are just as much in the business of keeping us safe as pilots but in fact when a doctor puts you on a pill if you don't get to where she wants you to go she does get there and she can put the fact that you didn't get there down to the fact that you had an illness to no cost to the doctor here and partly because of the pills have become an answer to

the stress that you're turning up the doctor poses the doctor if she gives you a pill it means you go away and it's meant that doctors have transformed from people who are cautious about using pills people who regarded pills as poisons which could do good if used with judgment into people who regard pills as fertilizers to be sprinkled as widely as possible see how would you like to respond to that. because when you go to a doctor you actually go into environments to to find it interesting go ahead. i find it interesting that everyone is focusing on pharmaceuticals and a.d.h. d. drugs for instance i mean that's an easy area to criticize because it's murky. and. you know it is what it is and i cannot address the marketing of pharmaceuticals. you know as an expert because i was in discovery

research but let me just turn it around a little bit and get away from this one area where there is seems to be such an emotional component and i want to talk about the probably the two great. contributions of the drug industry. in the last fifty years and that would be aids and hepatitis c. someone said before that hiv therapies started with the government that's partly true because a.z.t. which was the first aids drug and didn't work wise and i h screening library it was there because it was put in by glass by burroughs wellcome which is now part of glaxo. nothing worked on aids until one thousand nine hundred four when roche after many many years of incredibly sophisticated drug design

put injuries on the market and that became the basis of. the cocktails and you saw the death where the death rates drop. in oregon which i would want to finish with david how would you like to see this scenario change with the pharmaceutical sorry you got thirty seconds ok i think what we've got to do is that we have to change the system another involves changing the patent status of drugs we may need to look at whether drugs should be available on prescription only but we certainly should insist that the pharmaceutical companies kind of do clinical trials and hide the data from those trials for the rest of us these data need to be to be openly accessible to experts who can scrutinize the claims that are being made about whether these pills are helpful are not many thanks my guest say this is a fascinating discussion and many thanks to my guest today in bangor chicago and in new york and thanks to our viewers for watching us here are see you next time remember.

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