i just i need i say no i mean i think you get more. honest than. i did though. i think they must what we saw in japan was something that's called a mega marketing project and mega marketing is the attempt not to change individual's minds about a given product but to change the entire environment in which that product is to be placed it's kind of. like. you could the japanese psychiatric community had a view. that depression was a was

a rare. disorder in japan and they didn't diagnose it often and what pharma did was it lobbied the japanese government in moralizing rhetoric to say that they were mistreating japanese patients and then day sponsored anti stigma campaign to try and reduce the reduce the feelings of shame that a japanese person might have if they felt sad or they felt they felt depressed they felt something not right and they might otherwise stay home and not go to the doctor so the n.t. stigma campaign was there to help normal lawers mental illness and there were. there were interviews with with celebrities and t.v. personalities and there were articles sponsored and placed in the newspapers

to try and similarly arise people with the idea of depression even the very word depression in japan on studio was a word that stood for major depression and so they they built an ad campaign a slogan that would make it feel more comfortable for people because of people heard that word depression would soon be oh it meant and then something in a hospital something someone very sick and so they came up with a slogan. which means a cold of the heart or a cold of the soul that terminology meant several things first of all catching a cold is quite common you're not one of those crazies that has to be locked up it's a cold many people have it if so many people have it then it can't be all that bad

. secondly. the japanese are big consumers of ability and stuff and they meant to them cold that's treatable. can be treated with a product. and finally the soul. sort of very very pointed and. really resonated very well with the japanese. it connected with how they felt. and so that really changed significantly the perception and created this concept of ma with depression. that physicians know started treating that big government started acknowledging because the japanese government didn't want to know that japanese were depressed except for those very few japanese government realized that. there was something that was

an obstacle to the productivity of japanese workers and so that all of a sudden made sense now to treat depression when you could cut it out of that region so that he got a name he died. that didn't need it and. i don't know i knew we had to guess and i got to tell. you know it's a. story and i. presume that. almost one important aspect was when. when the court when the imperial court acknowledged that the. the princess actually was suffering from depression and was being treated for depression what better celebrity can you get other than the emperor himself. i mean this is fantastic and this is how it all

begins the drug industry here let me do that for you let me run this let me run this program for you let me do this and the stigma campaign for you let me lobby the japanese government for you let me run these clinical trials for you let me get the word out and the japanese psychiatry especially the ones who are then in the employ of the industry they believe that they're doing it they're doing the right thing only at a certain point their interests diverged because from a commercial standpoint and this is. this is natural to all businesses from a commercial standpoint they don't want to stop until every every person every last man woman and child is taking their drug is using their product whereas the psychiatrists obviously they want to get off the train before that but once the faucet is turned on it's extremely difficult to stop.

people you've got to realize at least marketing to doctors is intense newbie asia salesman call ten times a week spend precious time listening to the same argument assess and medical journals. are just a vehicle for the same message that came in shoes then a subpoena masters of medicine at the best universities in the comp go around giving lectures in medical schools and a positive. thing out of the tackler success of some treatment that you know i will mock up to detroit where you know you're a fee of course hard to resist this document if we look on it you can see that it has key players in the us

anti psychotic marketplace regulators payers social not a cool. dispensers providers manufacturers and all of these are surrounded so in patients you have friends coworkers religion advocacy groups and then regulators have legislators media and so on and every actor is to be studied how can they influence the forward motion of the dr and the key the main key is in the science how can they how can they produce the science that will convince all of these people along the way that this is the best treatment the only treatment in fact so with eighty five percent of our clinical trials commercially funded and now ninety seven percent of the most influential clinical trials commercially funded

what we find is that the odds are more than five times greater that commercially funded trials will conclude that the sponsors drug is the treatment of choice compared to non-commercially funded trials of exactly the same drugs. those are pretty good odds and you know we tend to think of scientific studies as being objective and not being subject to bias but what we find when we look at the. the way the system is structured the companies sponsored the trials to help to sell their drugs the companies own the data the same way that the coca-cola company owns the recipe for coke where it is you have been particularly successful it has been to get control of to co-opt doctors who have no that is to industry at all who have never been paid a cent by industry who think that they're quite hostile to industry

doctors who say well we go by the evidence we want to see the evidence and we will make up our minds based on what the evidence shows nothing because we've been paid by industry not because we've been brought to meetings we will make up our minds based on the evidence the key problem for all of us is increasingly compared with the nine hundred sixty s. industry now controls the evidence industry runs the clinical trials all of them when i was a fellow between one thousand nine hundred eighty two we would spend hours and hours dissecting clinical trials and looking for statistical problems and outcome measures that didn't measure that didn't reflect what the study had been designed to do and we saw plenty of problems but i can't remember

a single time that we saw a problem that we assumed had to do with a commercial bias and of course science is imperfect it's always imperfect but the we didn't see that and our professors had no relationship with the drug companies it was unheard of for a professor to have a relationship with the drug company it was just a nonsensical thought. now we see that. articles have problems all the time and if you could put on truth goggles and you watch the prestigious press professors coming down the hospital. corridor in their white coats they look like formula one drivers and instead of saying pennzoil and mobil gas it would say merck and pfizer and then german genzyme because they're getting sponsored by all the professors a financial relationship the journey was to feed them a little bit still. remember we'll put up. some of. those aren't

invited to do was on to go to destroy the peace that they'll respond enough to think it was aunt sally's all of admits. to see delimited is. what the internet does that is allows patients allows you know every day people to go to the web and to feel empowered by getting all the medical information they could possibly ever want right they can get access directly to medical journals if they want they can go to any number of websites where data is presented where information is presented about diseases they could consult with their friends they can consult online on bulletin boards of other people suffering from these diseases and get lots of information and there's the idea that not only is it does it feel empowering but it's actually a requirement for being a good patient right being a good patient requires that you know all of this information before you even go to the doctor and that you've done your own research and that you are you're approaching your approach in your doctor not from not to just listen to his authority but that you'll be in negotiation with him to create to come up with your

own treatment plan but there's of course a catch here is that the internet in particular is. it is able to hide where the information comes from. it was a. very hard to take. care of that yet. with that. perfect there is no place let's play. lists play lists play

play lists displaced slim. playing drums in the future one show we go on tour and sometimes stun where we meet some of his sons going innovators in the night see the celebs we find out how the big black queens for companies and craft players will float in a modern day funking put still money stakes some smocks of the album said monday cheer on r.g.p. please don't assume church.

live. live live. live . i have an example for you of you know i just saw my doctor and found out

also have. i have had three years. these any kind my back hurts every morning creaky that can put more years. takes me an hour to loosen up if that showering isn't enough. when i watch the world cup on t.v. you mean i saw a commercial with franklin we musician adam on me said i might have spondylitis he was old. and it can be treated i'll buy so when i'm home what do i do. while i look it up on the internet when i've done it if they don't because i went to the site they suggest it was miss rehab is considered because the name is easy to recall so it happened to me.

just. get to know. each other the less clear title to top when it's such an attack you can. chill. i keep watching the film human but if you know because he's talking about back. then he's describing all these symptoms so accurately doofus on places like being tired and sore at night we each need to get in the morning and you must create the deal we need to i'm creaky left i have the same symptoms something when you are first so i click there is a doctor to decide all of this so should it also. help but ok to think they do feel to our shelter if they don't want to walk well this is sure to sell them all to. us . six. you could.

just say so he sure sounds trustworthy. but i'm surprised to see this man a prominent medical professor. standing in front of the pfizer locos. logos or strategically located what. one of my friends is a marketing specialist. marketing mix bigots if they live he told me those are key places. around a talking head in the middle. so maybe it's no accident to see if you know the picture is composed that way. the dr tell me. to sum it up. one hundred fifty thousand people reported every year young people the signs are easy to ignore. the symptoms are so common. that this professor calls it young people's back. he may be scarce me he says this back ache may

disable me though it may become a serious disability up. scares me but he reassures me ok maybe it's not very common. it can be very painful but it can be treated and the treatment is fully covered by you just. you know stick to the regime. issue. or this. particular why should the us. unfortunately the drug has adverse side effects. its long term effects are still unknown. but there's good reason to think it affects the cardiovascular system. and may also be a factor in cancer forgot to. mention treatment cost one thousand eight hundred euros.

now. they have are almost capsis this watching the pharmaceutical industry how they lobby how de market medicine how do you try to influence the public the doctors the government the media etc. prince so we have more rational use medicine to get over it all straight out with fake disease to show how pharmaceutical companies said this season we're in this kind of paying to market their medicines we approached market research agency we said we are working for a pick pharmaceutical company was coming up with a new truck against flatulence and we want to do market research and see how big this problem is. a few canadian thus have

lost funding to the fact from days of mensa have to. look across to us and. the company of mr. fay to save the present have to face look across the aisle scam to. make a had session save the post and if not more it's better to have charts from a source something that i've had problems as i'm to help bilbo maybe same can but i can only know that i take the. blame. so we made this folder or the nice lady with balloons we thought it fits well with it because flatlines with the air and it looks nice. it's the same way pharmaceutical companies do it because they using happy patients because the problem is solved. we went to doctors

and asked if it puts this leaflet in the waiting rooms and they greed. they thought it was a great campaign and they didn't ask who was behind this campaign and all of it was from a pharmaceutical company or a patient's organization they didn't care or the they liked the flyers so we could just sprout the leaflet with poster in the waiting rooms. and also we had thirty zero zero or of people suffering from federal and for example we used my daughter as a fake patient who get called names by close mates and the teacher is telling her that no good to far is in the classroom and so on polite and well but now the doctor has gave. just

a simple pill and. it's over. and we approached some t.v. programs. a soap opera us but also informed of programs and we asked them if it's possible to have attention for flatulence yes it was. for her. one show oprah a very popular program in the netherlands good times bad times we had to pay fifty thousand euros and one of the. well maybe a person. in the soap discuss. with his wife that he has a really problem with flatlands. she would advise him to go to the doctor and in the waiting room well they would fill him in the liaison for the doctor and

there would be our post office of the flatulence campaign. the polypill was announced in a special issue of the british medical journal in two thousand and three. in the preface by the editor suggested that this was the single most important article the b.m.j. had ever and possibly would ever publish and this is impressive given at the poly people at that time was an entirely theoretical intervention and the authors of this article suggested that rather than systematically screening the population for blood pressure for cholesterol for diabetes and for a number of other preventive concerns that might require pharmaceutical

intervention why not simply give the entire population over a certain age a pill that contains interventions designed to treat all of these things at the same time and so the poly pill in its theoretical form contained a thighs i direct contained a beta blocker. it contained a. an ace inhibitor. and i think folic acid and aspirin and the idea was that one could model each of these interventions carried with it a possible risk of side effect each conferred a possible benefit of prevention and by modeling those risks against each other the the the authors suggested that one could achieve a reduction in cardiovascular mortality by about eighty eight percent. by it

simply administering these pills to the entire population over the age of i think fifty and for what seems like quite an orwellian intervention the poly pill generated immediate enthusiasm hundreds of people wrote in to the to the b.m.j. website suggesting that if a polypill existed they would take it immediately others suggested will why just one poly pill why not make a poly pill for men they contained a prostate medication a poly pill for women that contained to mock safin to reduce the risk of breast cancer don't love so you're on board for a lifetime of treatment. you know what it's wallowing it doesn't kills a day to prevent real diseases or illnesses. you have a one percent chance of getting. the q what's going on here i mean how much has that become you know they've just lost any

sense of what's a reasonable risk you know to take and what isn't. if you want to introduce the french element into all this is of course the famous quote from. now about the art of medicine. you know it's great to be able to give a drug to treat an illness but it's an even greater rock to know when not to treat and that's the doctor we've lost it's the art we've lost because the market doesn't understand that it's. enough seats on still and sometimes to. listen to lindsey.

it's going to problems that it seems to. me to confuse one system for. the feel better since. he has a feeling when i close my eyes i see people in masks. sometimes i think that your image in itself is a face covered by a must. both of the people in mosques on both sides of the barricades if you must. and you know sometimes just it feels as if all of ukraine is now almost.

six. salo so-called. rights. little. pain of the young girls. of the future hotter. between two and three hundred million guns the united states so you can act like they're not here and keep kids away from them. the causes that is they long for you know i mean this teaches them a lot of responsibility and simply come to pay through the eyes of children if we can't do it for our children for our future. is the country we'll save.

the g twenty for jean-paul muslims we alternate exhilarating winter sports on our team a team you still need and use and i make seven zero in the rest of our lives take news team for sochi twenty four take. all odds.

violence on the streets of ukraine's capital as a test this clash with police there are reports of injuries on both sides and on rest to reignite just a day after a government amnesty came into force. same sex limits the kansas house of representatives ways through legislation that would have in frind in law the right to discriminate against gays. also the u.s. agrees to provide medical treatment to russian pilots suffering severe chest pains and dry after strong demands from moscow's foreign ministry. i will survive it all with only my son came home.