Saturday, March 6, 2010

Capitalist health care at its best

Is WebMD Pushing Eli Lilly’s Agenda?

It is not too hard to find evidence of links between WebMD and drug giant Eli Lilly.

A 2002 article on the gigantic medical site about pain and depression says “Lilly is a WebMD Partner,” and an advertising award in 2004 went to the FCB “client” Eli Lilly & Co./WebMD–not clients.

Banner and skyscraper ads for Lilly’s blockbuster antidepressant Cymbalta on WebMD’s home page never seemed to yield to other advertisers in 2009–and the Washington Post reported Lilly and WebMD to be partners in 2000.

Now Sen. Charles Grassley (R-Iowa), ranking Republican on the Senate Finance Committee, is investigating financial ties between Lilly and WebMD Health Corp because of a WebMD TV ad exhorting people to undergo a Lilly depression screening.

You can joke about the need to tell people they are depressed–do people need to be told they have a headache?–but pharma’s screening ruse to recruit new patient pools for the volatile drugs among teens, adolescents and new mothers is not funny.

3,500 news articles about antidepressant linked violence appear on the web site, SSRIstories.com, including 700 murders, 200 murder-suicides, 51 school shooting incidents and 54 postpartum depression cases since 1989.

In addition to WebMD, WebMD Health Corp. includes the web sites Medscape, MedicineNet, eMedicine, eMedicine Health, RxList, theHeart.org, and drugs.com. Original partners and investors says the Washington Post included “Microsoft, DuPont, Rupert Murdoch’s News Corp. (and his Fox TV networks), Silicon Graphics and Netscape founder Jim Clark, drug maker Eli Lilly, and EDS, the computer services company founded by H. Ross Perot.”

Lilly is not the only pharma company receiving unmarked product placement on WebMD.

Last summer, a video featured a woman patient confessing she was fearful of life while a voice over said she needed treatment for “general anxiety disorder” and the camera showed bottles of Forest Pharmaceuticals’ antidepressant Lexapro moving down the manufacturer’s assembly line. Get it? No disclaimer on the video or “sponsored content” appeared.

Another unsponsored WebMD video last summer urged people on antidepressants to remain on their therapy “despite side effects” and a third suggested women concerned about cancer, heart attack and stroke risks of postmenopausal hormone therapy should continue their treatment at lowered doses. Hang in there, valued customers.

A search for Wyeth (now Pfizer) antidepressant Effexor a few months ago on WebMD elicited a JAMA study finding Effexor superior to other antidepressants by a Wyeth funded second author, Graham Emslie, MD. Effexor was the drug Andrea Yates took when she drowned her five children in 2001, a case found on SSRIstories.

Questions about conflict of interest have surfaced at WebMD’s Medscape too which administers many of the lucrative drug company sponsored continuing medical education [CME] courses in the US which doctors must complete to keep their state licenses.

Last year psychiatrist Daniel Carlat, MD–who recounts his adventures as a Wyeth paid Effexor promoter in the New York Times magazine–writes that he received, as a member of Medscape, an envelope with “a brochure from Forest Laboratories advertising Lexapro, and nothing else. It was creepy, like Invasion of the Body Snatchers.”

While Lilly is known for launching the SSRI antidepressant revolution with Prozac, Cymbalta does much of the heavy lifting now with worldwide sales of $3.075 billion in 2009.

Many remember Cymbalta as the drug 19-year-old healthy clinical volunteer Traci Johnson killed herself on, during trials on the Lilly campus in 2004–soon after FDA investigations into suicide/antidepressant links.

Traci had no depression history said Rev. Joel Barnaby, a spokesman for the Johnson family, who called Lilly’s decision to proceed with Cymbalta’s launch as scheduled “offensive” posturing.

Five others suicides occurred during Cymbalta clinical trials, said the FDA and twice the rate of suicide attempts were seen in women prescribed the drug for stress urinary incontinence–also patients with no depression to blame.

Others remember Cymbalta as the drug Carol Anne Gotbaum, daughter-in-law of New York City Public Advocate Betsy Gotbaum, was taking during her macabre death in police custody at the Phoenix’s Sky Harbor airport in 2007.

But now Lilly and WebMD are pushing Cymbalta for pain since it was approved for fibromyalgia in 2008. “Across cultures, patients who complain of pain tend to be depressed,” says the 2002 article which calls WebMD and Lilly partners, a finding from a “huge international study by Prozac manufacturer Eli Lilly and Company.”

“Could your muscle aches be related to depression?” hawks WebMD text under the heading, “Recognizing the Symptoms of Depression.” Next to it is a picture of a depressed women with arrows pointing to the pain in her head and neck, chest and stomach, arms and hands, legs and feet and of course back.

“Print out this symptom diary, and fill it out. Then take it to your doctor to discuss what may be causing your symptoms.”

This content, we’re told, is “selected and controlled by WebMD’s editorial staff” but “funded by Lilly USA.”

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