Marcia Angell, a Senior Lecturer in Social Medicine at Harvard Medical School writes a review of three books that supports that judgment link here. E.g., when a doctor (a professor at Harvard Med School) is also on the payroll of a drug company, diagnoses a two-year old as bipolar, and is instrumental in the drug's widespread use among the very young, a drug produced by that company, it is hard to conclude anything else.

Four quotes from the review: "Because these psychiatrists were singled out by Senator Grassley, they received a great deal of attention in the press, but similar conflicts of interest pervade medicine. (The senator is now turning his attention to cardiologists.) Indeed, most doctors take money or gifts from drug companies in one way or another. Many are paid consultants, speakers at company-sponsored meetings, ghost-authors of papers written by drug companies or their agents, and ostensible "researchers" whose contribution often consists merely of putting their patients on a drug and transmitting some token information to the company. Still more doctors are recipients of free meals and other out-and-out gifts. In addition, drug companies subsidize most meetings of professional organizations and most of the continuing medical education needed by doctors to maintain their state licenses."

"Many drugs that are assumed to be effective are probably little better than placebos, but there is no way to know because negative results are hidden. One clue was provided six years ago by four researchers who, using the Freedom of Information Act, obtained FDA reviews of every placebo-controlled clinical trial submitted for initial approval of the six most widely used antidepressant drugs approved between 1987 and 1999 Prozac, Paxil, Zoloft, Celexa, Serzone, and Effexor. They found that on average, placebos were 80 percent as effective as the drugs. The difference between drug and placebo was so small that it was unlikely to be of any clinical significance. The results were much the same for all six drugs: all were equally ineffective. But because favorable results were published and unfavorable results buried (in this case, within the FDA), the public and the medical profession believed these drugs were potent antidepressants."

"Conflicts of interest affect more than research. They also directly shape the way medicine is practiced, through their influence on practice guidelines issued by professional and governmental bodies, and through their effects on FDA decisions. A few examples: in a survey of two hundred expert panels that issued practice guidelines, one third of the panel members acknowledged that they had some financial interest in the drugs they considered."

"In recent years, drug companies have perfected a new and highly effective method to expand their markets. Instead of promoting drugs to treat diseases, they have begun to promote diseases to fit their drugs. The strategy is to convince as many people as possible (along with their doctors, of course) that they have medical conditions that require long-term drug treatment."

The enormous profits based on drug patents have now corrupted the doctors as well. A new system, anyone?

Is regulatory capture a problem in FDA regulation of the drug industry? This question came to mind when reading this blog post by William Buiter about the regulatory capture of the Fed by Wall Street.

I think we have three themes to why drug companies are "sick". Two of which were discussed in the post.

1. Conflict of Interest - as discussed in the post between the Doctor and Drug Company.

2. Promoting "new" diseases to fit a companies drug catalogue as mentioned in the post.

3. Generic - The major drug companies seem to want to market PATENTED drugs. Whether patented drugs offer any superior treatment option appears to be irrelevant. The psychology of the drug companies seems to be geared to finding blockbuster drugs. Once a drug goes off-patent they can still make money selling it as a generic product like coke. In fact, I would advocate that the drug companies start hiring management from Coke or Pepsi to learn how to market generic commodity products.

Selling generics may not be as flashy as selling a patented drug, but it can still make you money. Corporations need to comprehend that money can be earned without mega-products, without overly paid executives, and without "innovative" product manipulation.

Ever read Robin Cook's thriller Mindbend?