Big Pharma shows us the money

What do free trade and depressed pregnant women have in common?

Published July 13, 2006 7:45PM (EDT)

I always thought Caesar's second wife, Pompeia, got a raw deal. Even though Plutarch alleges that she had no "aversion" to the ardor of the licentious and profligate Clodius, there is no actual historical evidence that she conspired with him to commit adultery. But after Clodius, wearing a woman's dress, caused a national furor when discovered sneaking around in a female-only religious ceremony in Caesar's house, Caesar immediately divorced Pompeia. Never mind the lack of a smoking gun -- as the famous quote goes, "Caesar's wife must be above suspicion."

Plutarch says that Julius Caesar was simply engaging in a bit of classic realpolitik. Clodius was popular with the people, and Caesar, mindful of his political career, was looking for a way to concede the seriousness of Clodius' blasphemy without actually punishing him. So the woman took the fall.

Oddly, despite the unfair fate of Pompeia and the suspect political motives, the phrase "Caesar's wife must be above suspicion" nevertheless still carries with it a tinge of unimpeachable integrity that one wishes more people aspired to. This came to mind this morning after learning that the Journal of the American Medical Association has acknowledged that it was misled by researchers who had "failed to reveal financial ties to drug comapanies" in a study that claimed pregnant women who stopped taking antidepressants risked relapsing into depression. The lead author, Massachusetts General Hospital's Dr. Lee Cohen, just happened to be on the "speaker's bureau" for eight drug companies.

Where is Caesar when you need him? Eight! Mass. General must not be paying its doctors very well, if they have to hustle for honoraria from every horse in Big Pharma's stable. But Cohen is hardly unusual. The practice of doctors hitting the lecture circuit for drug companies is widespread. Yet somehow, the doctors feel there is no problem. As Dr. Adele Viguera, another of the authors of the JAMA study, who has a speaking relationship with GlaxoSmithKline, told the Wall Street Journal's David Armstrong, who broke the story, "I don't see how any kind of relationship we have with a pharmaceutical company plays a role in that ... I don't believe there is a conflict of interest."

Put that together with a tidbit posted to the Intellectual Property and Health mailing list maintained by the Consumer Project on Technology. According to poster HeeSeob Nam, negotiations of the pharmaceutical subcommittee involved with the free trade agreement currently being hammered out between South Korea and the United States were suspended on Tuesday afternoon, due to disagreements about the Korean government's plan to change its drug reimbursement pricing system. The government wants to move to a "positive list" system, in which it will pre-announce which drugs it will pay for. Big Pharma hates this, because they're afraid that it will mean that the most expensive, and profitable, drugs, will not make the list. The industry has already been successful in undermining similar provisions in Australia via a free trade agreement. According to Wendy Cutler, assistant U.S. trade representative and chief negotiator, "The proposed positive list system could end up discriminating against innovative drugs and thereby limiting the access of Korean patients and doctors to the most innovative drugs in the world."

As How the World Works has learned more about Big Pharma's influence on free-trade negotiations and the crafting of international intellectual property laws, this blog has taken a harder and harder stance on the position that the pharmaceutical industry's power in international affairs is Exhibit No. 1 of what is wrong with globalization as it is currently practiced. But occasionally, there are some twinges of doubt. Is it always fair for a generics maker to break a patent for a drug that cost hundreds of millions to develop? Maybe not, if the sole motivation of the generic company is to gather a tidy profit for itself by underselling the original creator.

But recall a study discussed here last week: Why Are the Critics So Convinced That Globalization Is Bad for the Poor?" One of the reasons proffered by author Emma Aisbett is that "globalization is believed to exacerbate the problem of excessive corporate political power." Free markets aren't truly free, and free trade isn't truly free, when corporations capture the political process and dictate the content of treaties, or the letter of the law.

Drs. Cohen and Viguera wonder how their financial ties could be perceived to affect their findings. Meanwhile, most people with a brain or a conscience wonder how it is remotely possible for the money showered on doctors by drug companies to not affect them. It may seem like a stretch to connect a study on pregnant women and depression with the free trade agreement under negotation between South Korea and the United States. But the two dots are on the same continuum. Corporate influence over the U.S. government determines foreign policy; corporate largesse handed to doctors affects what the public is told about drugs.

The fact that the doctors in the JAMA study did not even acknowledge their financial ties to drug companies is so far from the principle that one should be "above suspicion" that it hurts to even laugh at the absurdity. Even more ludicrous is the thought that they would ever divorce themselves from their compromised cash flows without being forced to, either by government, journal editors, or public pillorying.

By Andrew Leonard

Andrew Leonard is a staff writer at Salon. On Twitter, @koxinga21.

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