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How can pharma turn its ship around?

Updated: Jul 17, 2020

Today I read an article about how Novartis paid about $700 million to settle a lawsuit accusing them of illegally paying physicians to put patients on Novartis' drugs. Vas Narasimhan, a physician and the CEO of Novartis, said the company would "resolve and learn from legacy compliance matters. We are a different company today..."

When I see such articles and statements, I'm painfully reminded of Marcia Angell's words over a decade ago.

...similar conflicts of interest and biases exist in virtually every field of medicine, particularly those that rely heavily on drugs or devices. It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine. -Marcia Angell, Senior Lecturer, Harvard Medical School

In my first book, Michelangelo's Medicine, I wrote that I don't see the transformation of medicine as an us vs. them matter in the sense of public vs. pharma or public vs. health insurance companies. I see that as self-defeating. There are "good" people working in pharma and other industries who want to do the right thing. But when we have been trained to maximize profit and prestige in the eyes of a few at the expense of many, doing the right thing is hard.

I remember a moment in my residency training when I was taking care of a teenager with a bullet wound. Fortunately it wasn't a fatal wound and he was hemodynamically stable. While talking to him and attending to the wound, I realized that he and I were quite alike. What was different was the situation he was born into and the environment in which he was raised. If we had switched roles at birth, he may have been the one attending to my wound.

The same is happening in pharma and similar industries. There are people that want to do the right thing - that, for example, want to tell the public that many chronic diseases can be reversed - cured - without drugs. And not only tell the public that, but implement a massive, ongoing education campaign across all media channels with a primary goal of reversing disease without drugs when possible. These people do exist, but they're incognito because they're incentivized against acting on such natural urges. They'll lose pay. They'll be ridiculed as soft.

I'll take it one step further. It's not even that there are some "good" people and some "bad" people. No. This interplay of doing-the-right-thing vs. going-with-the-current exists within each of us. It exists within the CEO of Novartis just as it exists within me.

This led me to send the following tweet to Vas Narasimhan.

A massive, omni-channel, ongoing public education campaign on how to reverse disease without drugs may not be something Vas and Novartis are ready to commit to, but it's worth putting out there. I wouldn't be surprised if some small-scale version of this exists already. The goal here is not to put pharma out of business, but to allow it to serve its proper role as a bridge between the disease state and healing state, as and when needed. Moving into this kind of role will take serious introspection on the part of pharma's leaders. They are capable of it, and, in many cases, want to do it, if only they can access and reconcile their deepest fears and insecurities with their notions of success, leadership, and responsibility.

I put myself in the same boat. I am a physician in a healthcare system that navigates by the guiding star of profit. Much of my own livelihood has come from this very system. Speaking up and trying to change the system are imperative.

Some may ask what all this has to do with what I usually communicate about, which is the relationship between consciousness and everything else. My view is that consciousness is not predominantly spiritual or philosophical, though we can choose those lenses if we wish. Rather, it's supremely practical precisely because it influences everything we do, all the time.

Today, for the topic at hand, we don't have to dive into the depths of consciousness. We don't need to the examine the metaphysics of consciousness appearing as a body. We can approach it at the practical level: Reconciling our innermost insecurities with our actions is an essential step on the path of growing up. That may happen early in life, late it life, or not at all in this lifetime. Sooner or later, however, it happens.

Let's choose sooner.

P.S. - Vas, I hope to hear from you.

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