Airs Tuesday, November 13, 8pm EST on CBC The Nature of Things
http://www.nfb.ca/drugdeals/

FILM REVIEW

Drug Deals –The Brave New World of Prescription Drugs

A co-production between the National Film Board of Canada and Merit Motion Pictures in association with CBC The Nature of Things.
Airs Tuesday, November 13, 8pm EST on CBC The Nature of Things
http://www.nfb.ca/drugdeals/

On March 19, 2000, 15-year-old Vanessa Young collapsed from a fatal cardiac arrest in her father Terence’s study. The death was attributed to an uncommon reaction to Cisapride, a heartburn medication manufactured by Janssen Pharma, a subsidiary of Johnson & Johnson. The following week the FDA withdrew Cisapride from American pharmacies. It is one of seven major medications to have been withdrawn from shelves since the early nineties when drug approval processes were abbreviated by over 75%.

Drug Deals follows the stories of individual families, centering on Terence and Vanessa Young, who have found themselves to be among the acceptable losses of a health system, and pharmaceutical industry, which allow financial interests to take precedence over public safety.

During Vanessa’s inquest, we witness a representative of Janssen Pharma turn her back and walk away from reporters who are raising questions of the company’s responsibility and accountability to those who suffer adverse reactions to its products. We are shown Johnson & Johnson’s corporate "Credo" in action and are made painfully aware of the wide disparity between their marketing and policy.

Johnson & Johnson makes a great show of its "Credo" on their website: It is boldly featured on the home page, a search for the word "Credo" generates almost 400 results and the text is made available in translation for readers from over 60 nations. Written by founder General Robert Wood Johnson in 1943, it commits to the following hierarchy of corporate responsibilities:

-First Responsibility Is to Those Who Use Johnson & Johnson Products
-Next Come Its Employees
-Next, the Communities in Which the Employees Live and Work
-Its Final Responsibility Is to Its Stockholders

As of 1999 annual figures, J&J was spending over 4 times the amount on marketing and administration as on research and development. Almost 2 million dollars were invested in Washington, exerting influence on legislation by retaining lobbying firms and with direct contributions to federal candidates.

Attempting to make sense of the seeming impotence of regulatory and health protection agencies (like the FDA and Health Canada) –as well as hospitals, universities, doctors and pharmacists– when fulfilling their directive of institutional and public education and safety on health matters, Drug Deals cuts deeply into the belly of the pharmaceutical juggernaut.

It suggests a perspective shift –with the introduction of user fees– that gave corporations the appearance of clientele, in the eyes of Health Canada, compromising the agency’s independence by making it beholden to the industry it was mandated to regulate. This is demonstrated to have coupled with a pervasive climate of top-down illegitimacy, having the effect of undermining workers’ day to day acts of conscience and resulting in employees whispering interviews over the phone to avoid the repercussions of going against the dominant paradigm of industry interests.

On the topic of manufacturers going to extreme ends to conceal their products’ risks, Drug Deals examines the industry’s method of reporting any possible negative effects of medications in so-called "Dear Doctor" memos, –written by company "linguistics officers"– who strategically place actual information at least 200 lines in, bogged down by as much confusion-inducing jargon and as many superfluous irrelevancies as can be included. An additional study cites potential violations of FDA advertising regulations in 92% of pharmaceutical ads. As Terence Young puts it, "Vanessa’s death was not only preventable, it was predictable."

The film examines manifold methods of manipulating doctors. Beyond the ‘Dear Doctor" notes, specialized market research firms target individual physicians according to the quantity of prescriptions they write, and pharmaceutical reps, working with these details and on commission, treat doctors to elaborate dinners, retreats and other sales events with a mandate to suggest extensive off-label prescription possibilities. A survey concludes that 75% of physicians admit to garnering the body of their drug knowledge from industry reps and publications. Additionally, in a further 75% of instances, doctors are shown to prescribe on demand any broadly advertised medication a patient may request. The all-important line between education and promotion has been blurred out of existence.

Several individuals propose a solution being the creation of an arms length body, with real influence and 100% operational transparency, empowered to preside over the approval of medications. This would be paired with legislation requiring a full removal of private interest funding from bodies with regulatory duties.

During the post-screening panel discussion, an audience member made the claim "Walkerton is Canada and Canada is Walkerton". This perspective was reiterated by David Suzuki –in his capacity as panel moderator– to contextualize the film’s content. He discussed issues within the health system as being symptomatic of deeply flawed national and international neo-liberal trends of privatizing the public domain and faith in the superiority of a society built on the back of a market economy. The effects of these changes to public broadcasting and to the Nature of Things were touched upon with criticism of the vested financial interest, corporate editorializing that is born of breaking up each episode with 16 minutes of commercials. It’s true that it would be hard to imagine a broadcaster airing a pharmaceutical ad during Drug Deals. This is the trade-off made for allowing it to speak with a valuable critical voice, and part of what makes it rare, worthy and essential, politicized filmmaking.

Sources:
Public Citizen, www.citizen.org
The National Film Board, www.nfb.ca
Johnson & Johnson, www.johnsonandjohnson.com
Open Secrets, www.opensecrets.org
Transnationale, www.transnationale.org