Twelve years ago my voice joined the chorus of whiners griping about the evil ways of Big Pharma. I agreed with those accusing pharmaceutical companies of profiting from the weak and taking advantage of the sick. I uttered an Amen when reading angry editorials lambasting pharma reps for pushing drugs on vulnerable peeps to meet their bottom lines, asserting that these companies don’t give a damn about the devastating side effects of their products.
Pharma King and Medication X
My opinion was largely shaped by my experience with a psychiatrist whom I dubbed “Pharma King,” a physician highly recommended by my primary care physician and an outpatient psychiatric program I participated in. Although some professionals claimed he was the best psychiatrist in Annapolis, something seemed off from the very first visit. For starters, every time I sat in his waiting room, there were two pharmaceutical reps in line to see him. These attractive twenty-somethings were on a first-name basis with the receptionist. The familiarity of their casual conversations made me uncomfortable.
Pharma King sent every patient home with the same prescription – at least, every patient I saw leaving his office. It didn’t matter what your diagnosis was. The routine was the same. You described your symptoms, you visited his closet of pharma samples, and you left with a small bottle of Medication X and its accompanying brochure, six pages of side effects printed in a five-point font, listing everything from “ballooning like Violet in Charlie and the Chocolate Factory” to “a running stream of diarrhea.”
Unfortunately, Medication X only worsened my symptoms, not to mention the 25 pounds it added to my hips. When I told him that I did not like the drug — not at all — he urged me to give it some time. His solution was to augment Medication X with other drugs. Lots of drugs. At one point, I was swallowing 16 pills a day. At least eight kinds of medication were coursing through my bloodstream.
A year after I left him, I discovered that Pharma King was making nice coin from Company X that manufactured Medication X. He was a regular presenter at pharmaceutical conferences, boasting about how well his patients were responding to the drug. I felt cheated and betrayed. I was beyond furious.
A more nuanced perspective
For at least a decade, I unfairly associated the entire pharmaceutical industry with the sins of Pharma King. It was akin to tossing out the entire Catholic faith based on the allegations of one bishop. Even as I relied on certain medications to treat my depression, I still drew devil horns on their brochures and rolled my eyes at their simplistic ads. I sought a doctor with no ties to the drug industry.
However, by participating in several advisory boards, I’ve been privy to the many objectives and missions of pharmaceutical companies to reduce suffering, to their agendas to help disseminate pertinent information. I see the genuine care and consideration on behalf of the community-engagement committees to help persons live fuller lives, the investment of various groups to design solutions for living with chronic conditions. I am impressed by their efforts to reduce stigma and beef up support for persons with mood disorders and with their many creative programs to educate persons about different paths to wellness.
Having tried to go without medication and living through the devastating results, I appreciate the life-saving force of pharmaceuticals in my life. A gluten-free diet, meditation, and yoga were simply not enough to manage my symptoms. Drugs are a critical piece of the treatment regimen for countless people, myself included. The research and innovations on behalf of pharma companies have afforded me a better life, and I am appreciative of their ongoing efforts for better treatments.
Protecting my authenticity
Having said that, though, collaborating with pharma companies remains a delicate issue for me. Pharma King’s revenues and the knot in my stomach I felt when I saw his numbers are foremost in my thoughts whenever I receive an invitation to collaborate on a project. I would never want my readers to put me in that category: a woman who sold out to make a few bucks. I’ve worked hard to earn a reputation as an unbiased, authentic voice.
I have considered not accepting any money from pharma companies – anywhere or anytime. However, such a policy would prevent me from contributing important feedback to their initiatives, from offering constructive insights about the realities of living with depression, from helping them design support programs that benefit many people. I have decided, instead, to weigh each opportunity carefully and ask myself these questions: Does this contribute to the common good? Can I stay objective and unbiased? Would getting paid for the project jeopardize my readers’ trust? On some occasions, I have declined payment–not because I felt pressured to say or do anything by the company, but because getting paid didn’t feel right. At other times a nominal stipend made it possible for me to collaborate.
With power comes responsibility
I no longer believe that pharmaceutical companies are inherently evil. In fact, I think they do a lot of good. In addition to their life-saving medications and innovations for effective treatment, they aim to educate patients and their loved ones, promote hope for persons with chronic conditions, and provide support for those who need it. However, pharmaceuticals must be dispensed and used responsibly. Put into the hands of the wrong people, they have the potential to do great harm. Like any powerful resource, they must be handled with prudence and sensitivity. Proper treatment must always take precedent over profit.
My mission is to be a trusted voice for those suffering from depression and my allegiance is to my readers. I proceed cautiously with anything that has the potential to distract me from that mission or diminish trust. That means declining pay at times, carefully evaluating opportunities, and abiding by integrity in everything I say and do. You can trust that I am no Pharma King.