The Going Rate on Shrinks: Big Pharma and the Buying of Psychiatry. (Gazette)

Article excerpt

IT WAS LAST SUMMER IN BERLIN when I first encountered pharmaceutical funhouses. I was one of 4,000 attendees at the 7th World Congress of Biological Psychiatry. Until about a decade ago, pharmaceutical companies passed out pens or notepads with their companies' logos at such events, and most speakers presented data and opinions based upon their true scientific beliefs.

That all changed when Big Pharma took over. At the congress, I counted 15 major displays on the way to the lunch area, including an artificial garden (Janssen-Cilag), a brook running over stones (Lundbeck), and a 40-foot rotating tower (Novartis). Almost all offered free food and drink, T-shirts, or other inducements designed to get psychiatrists to pause so that an army of smiling sales representatives could give their sales pitch.

Eli Lilly's display included two large, walk-through tunnels set up like fun-houses. One tunnel, labeled "Zyprexa," included a mirrored room with dozens of telephones dangling from the ceiling. Was Lilly trying to convince me that God was calling, telling me to prescribe Zyprexa? The sales representative said no, the phones were meant to illustrate the communication problems common in schizophrenia, which Lilly claims Zyprexa improves. The other funhouse, labeled "Prozac," featured a 10-foot mouselike creature sitting in front of a blank television screen. I asked whether Lilly was recommending Prozac for mice. The representatives said no, the creature was really a depressed man who needed Prozac.

My favorite display, by the Dutch firm Organon, advertised Remeron, an antidepressant. It featured a small, multihued tent with purple doors and the painted head of a genie. Inside, a red-robed young woman with sprinkles in her hair was taking Polaroid pictures, one by one, of psychiatrists who had waited patiently in line for 20 minutes or more. This was no ordinary picture but rather a snapshot of one's aura, taken, as the Organon brochure noted, "with advanced biofeedback equipment." The equipment consisted of two small machines, on which I placed my hands. The result was a picture of my head peering out of a red, orange, and yellow cloud.

According to the brochure, "the aura colors give you information about your appearance, character, talents, and future energy." After taking my picture, the redrobed young woman escorted me to a yellow-robed young woman with even more sprinkles in her hair. "Hi! My name is Amber," she said, and proceeded to interpret the picture of my aura as indicating intelligence and good judgment, although with some hints of skepticism.

I privately asked the Organon sales staff if they thought it wise to associate their product with auras, magic, New Age thinking, and anti-science. They said the decision had been made at "a higher level" but pointed out that the waiting line was an ideal place for engaging psychiatrists in brief, friendly chats about the virtues of Remeron.

THIS IS, AFTER ALL, BIG BUSINESS. Antidepressant and antipsychotic drugs are among America's topselling pharmaceuticals. Last year Prozac and Zyprexa accounted for almost half of Eli Lilly's total sales. Sales of antipsychotic medications have quadrupled in the past four years to more than $4 billion. These drugs are a major reason why the profitability of the 11 pharmaceutical companies in the Fortune 500 "was almost four times greater" than the median for all Fortune 500 companies during the 1990s, according to a report by the Public Citizen Health Research Group.

Not surprisingly, psychiatrists have become a prime target of pharmaceutical companies' marketing, because prescription drugs can't be sold directly to consumers. In the United States, pharmaceutical companies spend an estimated $8,000 to $13,000 per physician per year on marketing.

At professional gatherings, of course, one must offer the attending psychiatrist more than an opportunity to view one's aura. …