Murderous Fraud

As we Americans haplessly continue to search for a way to bring human decency — a.k.a. public non-profit “single-payer” universal coverage, a.k.a. actual insurance — to health insurance, we remain miles from raising the next obvious topic: the extreme underlying conflict between money-making and medical practice.

The latest evidence of this un-discussed elephant-in-the-room lies in today’s New York Times, and involves our old friend, Vytorin:

When the Food and Drug Administration approved a new type of cholesterol-lowering medicine in 2002, it did so on the basis of a handful of clinical trials covering a total of 3,900 patients. None of the patients took the medicine for more than 12 weeks, and the trials offered no evidence that it had reduced heart attacks or cardiovascular disease, the goal of any cholesterol drug.

The lack of evidence has not stopped doctors from heavily prescribing that drug, whether in a stand-alone form sold as Zetia or as a combination medicine called Vytorin. Aided by extensive consumer advertising, sales of the medicines reached $5.2 billion last year, making them among the best-selling drugs in the world. More than three million people worldwide take either drug every day.

But there is still no proof that the drugs help patients live longer or avoid heart attacks. This year Vytorin has failed two clinical trials meant to show its benefits. Worse, scientists are debating whether there is a link between the drugs and cancer.

Researchers reported last month that patients in three clinical trials had a 40 percent higher chance of dying from cancer if they took Vytorin instead of a sugar pill or another medicine, although the leader of that study says the finding might be due to chance.

Now some prominent cardiologists say that the evidence has swung so decisively against the drugs that they should not be sold. “The only place people should be taking it is in a clinical trial,” Dr. Allen J. Taylor of the Walter Reed Army Medical Center said of Zetia. (Vytorin is a single pill that combines Zetia with a statin, an older form of cholesterol-lowering medicine whose effectiveness and safety are not in question.)

Merck and Schering-Plough, which jointly make Vytorin and Zetia, strongly defend their medicines. The companies say that ezetimibe, the generic name for Zetia, showed no cancer risk in animal trials and argue that the cancer finding is probably a result of chance.

Just a few issues there, no?

The response? None. The market simply cannot be interfered with. The people need their only-possibly cancer-causing worse-than-placebos. Clearly, public enterprise could never achieve such superb results!

Justice? It’s Vytorin.

kinuko y. craft painting

That Justice is a blind goddess
Is a thing to which we black are wise:
Her bandage hides two festering sores
That once perhaps were eyes.
- Langston Hughes

The 01/21/08 issue of Advertising Age reports:

“Merck & Co. and Schering-Plough Corp. [the makers of Vytorin] kept under wraps for more than a year findings that Vytorin does not deliver results.”

All the while, Merck and SPC continued their $100+ million television and print ad campaign claiming the precise opposite.

Now, overall, the official, court-certified FTC definition of what constitutes fraud in advertising is laughably lax, if you understand how the marketing process works and how utterly central planned deception is within it.

But this particular case easily and obviously crosses even the ridiculously loose, faux-naive fraud standards that are alleged to be in place. The planners of this affair belong in prison, and the corporations involved ought to be severely penalized, if not simply nationalized and restructured to make them what they allege themselves to be — namely, inventors and manufacturers of genuine modern medicines.

None of this will happen, of course. At most, the “Democratic Party” wing of the reigning two-party Business Biumvirate (the Democrats, of course, being the “party” that killed the Independent Counsel Statutes after their great triangulating hero, Killiam Klinton, perjured himself) will stage a show “hearing” in Congress, where they may possibly extract some “sincere” verbal regrets about managerial “mistakes.”

After all, who were Merck and Schering-Plough executives to say that the evidence of Vytorin’s ineffectiveness might not someday be reversed by further studies? You know — kind of like who were the Democrats to say that illegally invading Iraq on blatantly false and irrelevant pretexts was anything to actually vote against? Nod, nod, wink, wink, “regret,” “regret”…

Actual law enforcement, meanwhile, is now strictly for the little people in this country. Let them eat Value Meals and Vytorins, in jail, if need be.

High-Tech Snake Oil?

If you pay attention to the news, you’ll have noticed the breaking scandal over anti-cholesterol medicines. One, Vytorin, turns out to be at least half fake. The other, Lipitor, has VERY deceptively employed “Dr.” Robert Jarvik, the Harvard Med School student who never completed his training, and is not a physician and cannot prescribe medicines, but invented the artificial heart.

Turns out “Dr.” Jarvik — who looks every inch like a marathon-running vegan — probably didn’t start taking the Lipitor he says in his ads that he’s been personally using thankfully “as a doctor, and a dad” until after he started shilling for the Pfizer corporation, Lipitor’s peddler.

This, of course, raises the obvious follow-up question about whether Jarvik has actually ingested the pills or merely flushed them down his heated, gold-plated crapper.

But whatever the details of these two huge, well-researched medi-frauds may prove be, the most important points are certain to go unmentioned. Among these are:

1) The human meaning of the fact that there was $4.8 billion spent on U.S. drug advertising last year. That sum is greater than the GDPs of each of the Earth’s 45 poorest countries. And $4.8 billion is only the ADVERTISING number, meaning it’s only the tip of the iceberg. As is known by those who take the trouble to comprehend what corporate marketing is and how it works, advertising is merely the endpoint of the marketing process. Before it comes targeting, marketing research, and “product management.” Those processes are much more expensive than even advertising, which, per minute, is by far the most lavishly-funded form of video and pictorial drama, Hollywood blockbusters included.

2) The amount of fraud and waste in the capitalist medical-industrial complex. This cholesterol fracas suggests the share of naked snake-oiling going on is far bigger than even most single-payer advocates have suggested. How affordable could we make single-payer if we also ended these criminal schemes?

3) The profound irrationality of the corporate capitalist health destruction/care process. The amounts big business investors spend on drug marketing are beyond dwarfed by the megabucks they allocate to selling fast food, junk food, television-watching, and automobile-owning/driving. It’s the perfect racket: With one hand, you create the epidemic dangers; with the other, you profitably throw (often fake) pills at the symptoms. It is what Joseph Schumpeter famously called “creative destruction” — but the entity involved in the process is none other than the supposedly (and actually) sacred human life/body. Can you say “blasphemy”?