Zyprexa, Act III - In which Big Pharma assaults the foundation stones

Now comes more news -- unflattering to the company -- about Eli Lilly's, um, selective release of data about its antipsychotic drug Zyprexa. Lilly is trying to squash the full release (aka "leak" or "unauthorized publication") of internal company documents that allegedly reveal its attempt to cover up Zyprexa's dangerous side effects. But as Jake at Pure Pedantry outlines and the New York Times details, the attempt -- which itself hardly looks good -- will likely fail, partly because many of of the documents have already been posted on web servers outside the U.S. ,and thus out of reach of U.S. courts.

This latest in a string of horrifically damning drug-industry scandals is quite a beaut. It seems to embody and dramatize the full package of flaw, foible, folly, and fuck-up that is costing the drug industry its credibility and some patients their lives.

Now comes more news -- unflattering to the company -- about Eli Lilly's, um, selective release of data about its antipsychotic drug Zyprexa. Lilly is trying to squash the full release (aka "leak" or "unauthorized publication") of internal company documents that allegedly reveal its attempt to cover up Zyprexa's dangerous side effects. But as Jake at Pure Pedantry outlines and the New York Times details, the attempt -- which itself hardly looks good -- will likely fail, partly because many of of the documents have already been posted on web servers outside the U.S. ,and thus out of reach of U.S. courts.

This latest in a string of horrifically damning drug-industry scandals is quite a beaut. It seems to embody and dramatize the full package of flaw, foible, folly, and fuck-up that is costing the drug industry its credibility and some patients their lives. Don't get me wrong: I value immensely the many useful drugs the drug companies have produced over the years. I'd be dead without them, and so would about half of you. Medicines have played and still do play a crucial role in the far greater health and lifespan we enjoy.

Which is precisely why it's so dismaying to see these scandals and the machinations they reveal. The covers are pulled off, and we see a stunningly broad, ferociously determined attempt to downplay dangers, overplay effectiveness, bamboozle overwhelmed doctors, sell sell sell those drugs like candy, and co-opt every part of the medical system in service of these goals. These shenanigans not only give opportunism (as Gore Vidal once said of Tom Hayden) a bad name; they also demoralize the many nobly motivated people in drug development. And they stain, in a way that will be hard to wash out, the very idea that drug treatment is an empirically based means of improving health. Medicine is supposed to be evidence-based. But the drug companies seem determined to make doctors practice medicine based on selective evidence. This won't work. Let this thing run long enough, and many people will view all of medicine as a farce. At that point we'll have lost -- we're losing now -- one of the most valuable things science has ever produced. This follly doesn't just tromp on patients' rights and lives, though that's plenty reason enough to damn it. It erodes the faith in empiricism that underlies all of science.

Let me repeat: There are many good, smart, and nobly motivated people in the drug industry. Unfortunately, they don't seem to be in the driver's seat. Those that are -- well, I don't know what they're taking. But it's bad medicine.

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