Monday, April 25, 2011

Placebo: How a sugar pill became a poison pill. Part 5 of a continuing saga...

Read Part 4.

“Looking back over the past century, it is clear that medical science has made breathtaking advances,” said Roche CEO Franz Humer after a few opening pleasantries. “This is shown, for instance, by the fact that life expectancy has risen enormously to around 80 years, compared with 55 in the late 19th/early 20th century when Roche was established.” He continued in that vein for a while, touting the links between Big Pharma and enhanced lifespan, underscoring his industry's instrumental role in the progress of Mankind, subtly highlighting the Roche brand throughout. “While it may be unwarranted at this point to expect the same historic increases in lon
gevity looking forward,” he conceded toward the end, “there is little doubt that whatever gains we realize will be directly related to what we in our industry do.”

To humanize his point, he shared a few choice stories of striking longevity from the corporate archives, culled from a Roche outreach to doctors prescribing the company's products. When audience members applauded, they were applauding themselves as well.

Today's medicine is full of Franz Humers: men and women who say all the right things because it's in their interest to do so. Nowhere is this ethic stronger or more visible than in the area of life extension. Enhanced longevity via cutting-edge medicine is how the healthcare monolith puts a statistical face on its promises (though on close inspection that face turns out to be more of a carnival mask). From their perspective—and the perspective of most consumers—longevity is the ultimate metric of medical worth. It is how the Franz Humers of the world tangibilize the value of what they do. Longevity is also the quintessential debate-stopper, the trump card that makes all other points sound trifling, all skepticism sound contrary and quarrelsome. If doctors can show (or appear to show) that they deliver added life, then the patient (a) is predisposed to use more medicine and pay more for it and (b) will spend less time questioning what he pays now. In the same way, outsiders will spend less time scrutinizing what the healthcare industry does. Both literally and figuratively, the industry's stock goes up.

When it comes to taking credit for the march toward immortality, the hubris of the medical establishment is boundless and nonsectarian. Some insiders unabashedly project forward, reasoning from the purported gains in longevity over the past quarter-century that humans in the next century can routinely expect to live well past 100. Dr. Donald B. Louria of the Healthful Life Project—subsidized by Roche—writes, “I believe the question increasingly is not whether life expectancy in the United States at birth will increase from the current 77 years to 100 or even 120 years, but when.” Such musings are a way of setting a tone, establishing a warm buying (and investing) climate, without the point-by-point specificity that could come back to haunt someone later if construed by the SEC as an improper type of forward-looking statement.

It's an artful balancing act, and one that industry insiders have honed and perfected, such that no matter who's speaking, there's a decided sound-bite sameness to the words. Another pharmaceutical titan, Merck & Co., manufacturers the anti-cholesterol compound, Zocor. Here's Merck CEO Richard Clark (total 2009 compensation: $19.9 million) expounding on anti-aging: “At the start of the previous century, humans barely made it into their 50s. Today they routinely survive well into their 80s or more. The average lifespan is close to 78. How much clearer could the benefits of medicine be?” Hmm. Now where have we heard that before? Pioneering Texas Heart Institute surgeon Dr. Denton Cooley, who in 1969 performed America's first heart transplant, sounded as if he and his colleagues deserved personal thanks for improving longevity when he told a 1991 interviewer, “It's simple math: A half-million times each year surgeons do the [coronary bypasses] that we perfected here at the Institute... Those are a half-million men and women each year who have lived on and helped create this century's 25-year improvement in lifespan.” And in a keynote speech to another major symposium, Australian Health 2000, Michael Wooldridge, the nation's former Minister for Health, had this to say of Australia's track record in the area of life extension: “There has been a 20-year gain in life expectancy, for men from 55 years in 1900 to 76 years today and for women from 59 years to 82 years. Millions owe their very lives to the pills they take each morning with their juice and toast.”

It's not surprising that Wooldridge would credit much of that progress to pharmaceuticals, since he came from that sector of healthcare, and hoped to return there after his stint in government. This revolving door between politics and industry is another factor that raises questions about the credibility of the “official” information the public gets on longevity. During his tenure as Health Minister, Wooldridge was accused of having too-cozy ties with Big Pharma; critics alleged a serious conflict of interest that compromised government oversight of the drug industry. Unfazed, Wooldridge promptly appointed to a major healthcare regulatory agency a former executive of GlaxoWellcome-Australia who had just retired as head of the Australian Pharmaceutical Manufacturers' Association. (GlaxoWellcome is now part of the $28 billion GlaxoSmithKline empire. CEO Andrew Witty's total 2009 compensation including bonuses: $12 million.) A few years after Wooldridge left government, the Pharmaceutical Manufacturers—perhaps grateful for his advocacy and friendship?—appointed him head of their association.

Although it is not known whether Michael Wooldridge's audience applauded at the end of his speech that day, many in attendance were the same types who gave such a warm reception to Humer: numbers types, bottom-line types. Albeit a particular kind of numbers and bottom lines: the kind that appear in prospectuses and annual reports to shareholders. For the folks in Healthcare Central, those numbers have been quite good for quite some time.

And because they want things to stay that way, they're coy about another set of numbers—the ones that would reveal the grievously disappointing truth about supposed advances in human longevity.

To be continued...


Dimension Skipper said...

I have but one question right now in response to this series...

What sort of healthcare packages do the multi-millionaire CEOs of pharmaceutical companies typically have?

I'm guessing it's 100% paid by insurance (probably without caps or restrictions), though I don't know and could be wrong.

Cosmic Connie said...

I didn't see a "to be continued..." at the end of this post, but I hope you're not stopping now, Steve. You're just getting started. Looking forward to the next installment.

Steve Salerno said...

CosCon: The oversight ("TBC...") has been corrected. We will most assuredly be moving forward.