YouSaid · the spoken record

John Abramson

lines on the record: 108
first: 2022-02-11
most recent: 2022-02-11
sittings or episodes: 1
sources: podcast

Every line below is reproduced as it was said and linked to the record it came from. Nothing here is summarised or generated. Directory · Search · Corrections

“I agree with that. I'm not advocating for any kind of censorship. But Marshall McLuhan was very influential when I was in college. And that meme, the medium is the message. Little bit hard to understand when you're comparing radio to TV and saying radio's hotter or TV's hotter or something. But we now have the medium as the message in a way that we've never seen, we've never imagined before, where rage and anger and polarization are what drives the traffic on the internet.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“I don't think it should be fully open. I don't think people who are committed to an anti-vaccine position and will tailor their interpretation of complex scientific data to support their opinion. I think that can be harmful. Constraining their speech can be harmful as well. So I don't have an answer here.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“And particularly in the era of COVID, where there are large public health ramifications to this public discourse, the ante is way up. So I don't have a simple answer to that. I think everyone's allowed their own opinion. I don't think everyone's allowed their own scientific facts. And how we develop a mechanism. That's other than an open internet where whoever is shouting the loudest gets the most clicks and rage creates value on the Internet. I think that's not a good mechanism for working this out. And I don't think we have one. I don't have a solution to this. I mean, ideally, if we had a philosopher king, we could have a panel of people who were not conflicted by rigid opinions. Decide on what the boundaries of public discourse might be.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Right. And if we had a true democracy and everybody had one vote Everybody got decent information and had one vote. Ann Rand's position would get some votes, but not many. And it would be way outvoted by the common people.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, that's an orthodoxy of several decades ago, and I don't think people can really say that in good faith. When you're talking about vaccinating the third world so we don't get hurt, it's a little bit hard to make the argument that the world's a better place because the profits of the investors went up.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Think it's the issue we were talking about earlier on where they're in a different culture and their culture is that their moral obligation, as Milton Friedman would say, is to maximize the profits that they return to shareholders”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Ordinary selfish people like most of us are, and you're worried about the health of Americans, you would ensure global vaccine distribution. Let me just make one more point, that $50 billion that was requested by the four organizations back in May of 2021, $32 billion made $50 billion from the vaccines at that point, took it into their private wealth. So what had been taken, there's enormous amounts of money that had been taken into private wealth was enough to do what those organizations said needed to be done to prevent the subvariants from coming back and doing what they're doing.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“And it was unrequited. Nobody answered. And now Africa has about 8.9% vaccination rate. India is coming up, but it's been very low. The problem with all this is I believe those mRNA vaccines are excellent vaccines. But if we leave the third world unvaccinated, we're going to have a constant supply of variants of COVID that are going to come back into the United States and harm Americans exactly like Delta and Omicron have. So we've made a great drug. It reduces the risk of mortality in Americans who get it by a lot. But we're not doing what we need to do to protect Americans from Omicron. You don't have to be an idealist and worry about global vaccine equity if you just”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“We paid a lot of money. The one mistake that I think the federal government made was they were paying these guaranteed fortunes and they didn't require that the companies participate in a program to do global vaccinations. So the companies doing their business model distributed the vaccines where they would make the most money. And obviously they would make the most money in the first world. And almost, I think, 85% of the vaccines early on went to the first world and very, very few vaccinations went to the third world. What happened is there was such a low vaccination rate in May of 2021. There was an all-hands on deck cry for help from the World Trade Organization, the World Health Organization, the IMF, and the World Bank made a plea for $50 billion so that we could get to 40% vaccination rate in the third world by the end of 2021.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“voluntarily to the NIH. I don't know how much it was. I don't think it was a whole lot of money. But I think they wanted to avoid the litigation that Moderna got itself into by just taking that 2016 knowledge and having that be the foundation of their product. So Pfizer took that and they did their R&D. They paid for their R&D having received that technology. And when they got the genetic code from China about the virus, they very quickly made a vaccine and the vaccine works. And President Trump, to his credit, launched Operation Warp Speed and just threw money at the problem. They just said we spent five times more per person than the EU early on. Just pay them whatever they want. Let's just get this going. We were vaccinated more quickly.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“We're going to get to what I think is one of the key problems with the pharmaceutical industry model in the United States about being profit driven So in 2016, the NIH did the key infrastructure work to make mRNA vaccines. That gets left out of the discussion a lot. And Pfizer BioNTech actually paid royalties.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“And let's just put this in perspective for folks. The best-selling drug in the world has been humira for a number of years. It's approved for the treatment of rheumatoid arthritis and eight other indications. And it sold about $20 billion globally over the past few years. It leveled out, it peaked at that level. Pfizer expects to sell $65 billion of vaccine in the first two years of the pandemic. So this is by far the biggest selling and most profitable drug that's ever come along.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Having not been able to see the data that the FDA and Pfizer seem to be willing not just to put effort into preventing the release of, but seem to have quite a bit of energy into preventing not releasing that data. The reason why that doesn't tip me over into the anti-vaxxer side is because that's clinical trial data, early clinical trial. We now have millions of data points from people who have had the vaccine. This is real world data showing the efficacy of the vaccines. And so far, knock on wood, there aren't side effects that overcome the benefits of vaccine.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Camp I think that's all possible. Nonetheless, the data are about the original clinical trial. And the emergency youth's authorization was based on the first few months of the data from that trial. And it was a two-year trial. The rest of that data has not been opened up, and there was not an advisory committee meeting to look at that data when the FDA granted full authorization. Again, I am pro-vaccine. I am not making an antivax argument here. I suspect that there's something pretty serious in that data. And the reason why I'm not an anti-vaxxer”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“There's only one explanation that I can think of. Which is that the FDA and Pfizer don't want to release the data. They don't want to release the $300 or $500,000 of documents. And I don't know what's in there. I want to say one thing very clearly. I am not an anti-faxer. I believe the vaccines work. I believe everybody should get vaccinated. The evidence is clear that if you're vaccinated, you reduce your risk of dying of COVID by 20-fold. And we've got new subvariants coming along. And I just want to be very clear about this. That said, there's something I would You 10 to 1 odds on a bet that there's something in that data that is going to be embarrassing to either FDA or Pfizer or both.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“And they can't come up with the money. And now Pfizer has joined the suit to help the FDA fight off this judge, this mean judge, who thinks they ought to release the data. But evidently Pfizer isn't offering to come up with the $3 million either. So, but for $3 million, I mean, maybe the FDA should do a GoFundMe.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“This is really troublesome. And just to put it in just plain English terms. Pfizer's making the case that it can't The FDA and Pfizer together are making the case that they can't go through the documents that's going to take them some number of hundreds of folds more time to go through the documents than the FDA required to go through the documents to approve the vaccines, to give the vaccines full FDA approval. And the FDA's argument, talk about Kafkaesque, is that to do it more rapidly would cost them $3 million $3 million equals one hour of vaccine sales over two years. One hour of sales.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Months ago. So that was just recently it's come out just in the past week. It's come out that Pfizer isn't battling the FDA. Pfizer has joined the FDA in the opposition to the request to release these documents in the same amount of time that the FDA took to evaluate them. So, Pfizer Offering to help the FDA Petition the judge. To not enforce the timeline that he seems to be moving towards.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Yes, and I'm going to read between the lines and Albert Borla certainly didn't ask me to speak for him. But I think when did you speak to him? How long”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Do you know that since you spoke to him, Pfizer has petitioned the judge to join the suit on behalf of the FDA's request to release that data over 55 or 75 years? Pfizer's fully aware of what's going on.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, it's hard to put that toothpaste back in the tube. That's pre-publication transparency, which is essential. And you could have whoever saw that data pre-publication could sign confidentiality agreements so that the drug companies couldn't argue that we're just opening the spigots of our data and people can copy it and all the excuses they make. You could argue that you didn't have to, but let's just let them do it. Let the peer reviewers sign confidentiality agreements, and they won't leak the data. But then you have to go to post-publication transparency, which is what you were just getting at, to let the data free and let citizens and citizen scientists and other doctors who are interested have at it kind of like wiki. Wikipedia have at it and let it out and let people criticize each other.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“I agree 100%. So let's turn the microscope. Let's get a little bit more granular on the peer review issue. We're talking about pre-publication transparency. And that is critically important. Once a paper is published, the horses are out of the barn and docs are going to read it, take it as evidence-based medicine. The economists call what then happens as stickiness, that the docs hold on to their beliefs. And my own voice inside says once doctors start doing things to their patients' bodies, they're really not too enthusiastic about hearing it was wrong.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“But it would be easy to have full-time statisticians. Hired by the journals or shared by the journals who were independent of any other financial incentive to go over these kind of methodological issues and take responsibility for the For certifying the analyses that are done and then pass it on to the volunteer peer reviewers.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“The motivation is to keep To be a good citizen in the medical community, and to be unfriendly terms with the journals so that if you want to get published, there's sort of an unspoken Incentive.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“And see if the companies, if the way the company has analyzed the data is consistent with their statistical analysis plan and their pre-specified outcome measures, it's not hard. And I think you're right. Peer reviewers, I don't peer review clinical trials, but I peer review other kinds of articles. I have to do one on the airplane on the way home. And it's hard. I mean, we're just ordinary mortal people. volunteering to unpaid.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Yes, this is not a hard problem to solve. When a study is completed, a clinical study report is made. And it's usually several thousand pages. And what it does is it takes the raw patient data and it tabulates it in the ways it's supposedly, and usually, in the ways that the company has pre-specified so that you then end up with a searchable, let's say 3,000-page document. As I became more experienced as an expert in litigation, I could go through those documents pretty quickly, quickly may mean 20 hours or 40 hours, but it doesn't mean three months of my work.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“You have to be the judge of that, but the person who was in charge of the data safety monitoring board Issued a letter that said they'll stop counting cardiovascular events a month before the trial is over, and they'll continue counting GI events. And that person got a contract to consult with Merck for $5,000 a day, I think for 12 days a year for one or two years, that was signed, that contract was signed within two weeks of the decision to stop counting heart attacks.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Because this is crossing. No, let me interrupt. No, that's not true. The study was completed. The blind was broken, meaning they looked at the data. In March of 2000, the article was published in the New England Journal in November of 2000. In March of 2000, there was an email by the head scientist that was published in the Wall Street Journal. That said the day that the data were on blinded, that it's a shame that the cardiovascular events are there The drug will do well and we will do well.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“They had an excuse. It's complicated, and the FDA didn't accept it, so there's no reason to go into it. But Merck just left out the three heart attacks. And the three heart attacks, it may seem three heart attacks and a 10,000-person study may seem like nothing, except they completely changed the statistics so that had the three heart attacks been included, the only conclusion that Merck could have made was that Vox significantly increased the risk of heart attack. And they abbreviated their endpoint from heart attack, strokes, and blood clots to just heart attacks.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Likely to cause serious GI complications, bleeds and perforations in the gut. Now, in that study that was published in the New England Journal that was never corrected, it was a little bit modified 15 months after the drug was taken off the market, but never corrected. Merck left out three heart attacks. And the FDA knew that Merck left out three heart attacks. And the FDA's analysis of the data from that study said that they weren't going to, the FDA wasn't going to do the analysis without the three heart attacks in it. And the important part of this story is that there were 12 authors listed on that study in the New England Journal. Two were Merck employees. They knew about the three heart attacks that had been omitted. The other 10 authors, the academic authors, didn't know about it. They hadn't seen that data. So Merck just.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“It happened. All three happened. I don't know what the denominator is. But I spent about 10 years in litigation and, for example, in Viox, which was withdrawn from the market in 2004 in the biggest drug recall in American history. The problem was that it got recalled when a study that Merck sponsored showed that VIACs doubled the risk, more than doubled the risk of heart attacks, strokes, and blood clots, serious blood clots. It got pulled then. But there was a study that a bigger study that had been published in 2000 in the New England Journal of Medicine that showed that Viox was a better drug for arthritis and pain, not because it was more effective. It's no more effective than a leave or advil, but because it was less”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“And then we have the clinical practice guidelines, which are increasingly more important as the information, the flow of information keeps getting brisker and brisker, and docs need to get to the bottom line quickly. Clinical practice guidelines become much more important. And we assume that the authors of those clinical practice guidelines have independently analyzed the data from the clinical trials and make their recommendations that set the standards of care based on their analysis. That's not what happens. The experts who write the clinical trials rely almost entirely on the publications presenting the results of the clinical trials, which are peer-reviewed, but the peer reviewers haven't had access to the data. So we've got a system of the highest level of evidence that doctors have been trained.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“The peer reviewers have had access to the data and they've independently analyzed the data and they corroborate the findings in the manuscript that was submitted or they give feedback to the authors and say we disagree with you on this point and would you please check our analysis and if you agree with us that's what they assume the peer review process is but it's not the peer reviewers don't have the data The peer reviewers have the manuscript that's been submitted by the usually in conjunction with or by the drug company that manufactures the drug so peer reviewers are unable to perform the job that doctors think they're performing to vet the data to assure that it's accurate and reasonably complete they can't do it”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Yet, number one, the information that comes through legitimate sources that doctors have been taught to rely on, evidence-based medicine, the articles in peer-reviewed journals, the guidelines that are issued. Now, those are problematic because When an article is peer-reviewed and published in a respected journal, People and doctors obviously assume that”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Don't care, their insurance is going to cover it, and it's a $25 copay. But we could figure out how to deal with that. The main point is that if we assume that advertisements are going to keep going, and they are, we could Require that there be outside evaluation of the message that reasonable, unbiased viewers take away from the ads and the ads would have to tell the truth about the dru”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“How much it costs. Now, that can go either way because if you say humirica $72,000 and it's no more effective as a first line drug than methotrexate, which costs $480, people might say I want the expensive drug because I can get it for a $25 copay. You'd have to temper that a little bit.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Have independent analysis of the message that the viewers are left with about the drug so that it's realistic. What's the chance the drug will help them? Well, in trulicity, it's one out of 323. 322 people aren't going to benefit from the cardiovascular reduction risk reduction. What's the true cost? When drugs advertise that you may be able to get this for a $25 copay or something, tens of thousands of dollars a year drug for a $25 copay, what an enormous disservice that is to misrepresent the costs to society. That should not be allowed. So you should have to make it clear to the viewers how many people are going to benefit, what's your chance of benefiting, how does it compare to lifestyle changes, or less expensive therapies, what do you give up if you use a less expensive therapy or gain perhaps?”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“I believe I've been told by lawyers who I trust that the freedom of speech in the US Constitution is such that you can't ban them, that you could ban cigarettes and alcohol which have no therapeutic use, but drugs have a therapeutic use. And advertisements about them can't be banned. Let's assume that they can't be because we know they won't be anyway. But let's assume they can't be. And especially our Supreme Court now would be unlikely to take that seriously. But that's not the issue. The issue is that if drugs companies want to spend their money advertising, they should have to”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Present it to physicians, it would be stamped in big red letters. This study did not compare trulicity to lifestyle changes. They need to know that. And the docs are kind of trained. These blinders get put on, and they're trained to kind of forget that that's not there.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Reductionist model. And that's another issue is that we kind of, nobody says to doctors in training, only listen to reductionist studies and conclusions and methods of promoting health. Nobody says that explicitly. But the respectable science has to do with controlling the factors. And I mean, it just doesn't make sense to me. I'm going to pick on trulicity because it's such an obvious example, but it's not more egregious than many others. It doesn't make sense to me to allow a drug to be advertised as preventing cardiovascular disease when you haven't included lifestyle changes as an arm in the study. It's just so crystal clear that the purpose of that study is to sell trulicity. It's not to prevent cardiovascular disease. If we were in charge, I would try to convince you that anywhere that study, the results of that study were”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, I think you got to tip your hat to Joe for getting that message out. And he clearly believes it and does his best. But it's not coming out in the legitimate avenues, in the legitimate channels that are evidence-based medicine from the sources that the docs are trained to listen to and modify their patient care on. Now, it's not a hundred percent. I mean, there are articles in the big journals about the benefits of lifestyle, but they don't carry the same gravitas as the randomized controlled trials that test this drug against placebo or this drug against another drug. So the Joe Rogans of the world keep going. You know, I tip my hat. But it's not going to carry the day for most of the people until it has the legitimacy of the medical establishment.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Right, that's exactly right. And the answer is that We assume that the market has to solve all of these problems. And the market can't solve all of these problems. There needs to be some way of protecting the public interest for things that aren't financially driven so that the overriding question has to be how best to improve Americans' health, not Companies funding studies to try and prove that they're new and expensive drug is better and should be used.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“So this study really tested whether you can get people in a randomized controlled trial assigned to intensive lifestyle changes, whether that works. Now, the common wisdom amongst physicians, and I think in general, is that you can't get people to change. You can do whatever you want. You can stand on your head. You can beg and plead. People won't change. So give it up, and let's just move on with the drugs and not waste any time. Except this study that was published in the New England Journal, I think, in 2002 shows that's wrong, that the people who were in the intensive lifestyle group ended up losing 10 pounds, exercising five times a week, maintaining it, and reduced their risk of getting diabetes by 58% compared to the Metformin group, which reduced its risk of getting diabetes by 31%. So that exact...”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Right. And that study was done actually in the 90s. It's called the Diabetes Prevention Program. It was federally funded by the NIH so that there wasn't this drug company imperative to just try to prove your drug was better than nothing. And it was a very well-designed study randomized controlled trial in people who were at high risk of diabetes, so-called pre-diabetics, and they were randomized to three different groups, a placebo group, a group that got treated with metformin, and a group that got treated with intensive lifestyle counseling.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“that allows direct to consumer advertising that part of allowing direct to consumer advertising would be to mandate that the companies establish whether their drug is better than say healthy lifestyle adoption to prevent the problems that they claim to be preventing but we don't require that so the companies can afford to do very large studies so that very small differences become statistically significant and their studies are asking the question how can we sell more drug they're not asking the question how can we prevent cardiovascular disease in people with type 2 diabetes and that's how we get off in this we're now on the in the extreme arm of this distortion of our medical knowledge of studying how to sell more drugs than how to make people more healthy”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Stroke, and that's one of the major morbidities, risks of type 2 diabetes. What the ad doesn't say is that you have to treat 323 people to prevent one non-fatal event at a cost of $2.7 million. And even more importantly than that, what the ad doesn't say is that the evidence shows that engaging in an active, healthy lifestyle program reduces the risk of heart disease and strokes far more than trulicity does. Now, to be fair to the company, the sponsor, there's never been a study that compared trulicity to lifestyle changes. But that's part of the problem of our advertising. You would think in a rational society that was way out on a limb as a lone country besides New Zealand.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Well, it's the whole nexus of influence. There's not one thing and they don't invest all their, they don't put all their eggs in one basket. It's a whole surround sound program here. But in terms of advertisements, let's take the advertisement. Trulicity is a diabetes drug, a tub for type 2 diabetes, an injectable drug. And it lowers blood sugar just about as well as metformin does. Metformin costs about $4 a month. Trulicity costs, I think, $6,200 a year, so $48 a year versus $6,200. Trulicity has distinguished itself because it did, the manufacturer did a study that showed that it significantly reduces the risk of cardiovascular disease in diabetics. And they got approval on the basis of that study, that very large study being statistically significant. So the ads obviously extoll the virtues of true listening.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“From a common sense person's point of view, a drug company paying highly skilled media folks to take the information about the drug and create the illusion, the emotional impact, and the takeaway message for viewers of advertisements that grossly exaggerate the benefit of the drug and minimize the harms, its sociopathic behavior to have viewers of ads leave the ad with an unrealistic impression of the benefits and harms of the drug. And yet he's playing by the rules, he's doing his job as CEO to maximize the effect of his advertising. And if he doesn't do it, this is a key point. If he doesn't do it, he'll get fired and the next guy will.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“Yes, yes. I hope we can quickly get back to whether or not they're playing by the rules, but in general. But let's just look at the question of advertising specifically. I think that's a good example of what it looks like from within that culture and from outside that culture. He's saying that we follow the law on our advertising. We state the side effects and we state the FDA-approved indications. And we do what the law says we have to do for advertising. And I have not been an expert in litigation for a few years and I don't know what's going on currently, but let's take him at his word. It could be true. It might not be, but it could be. But if that's true, in his world, in his culture, that's ethical business behavior.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source
“I think you're both right. I think that the, I agree with you that the aggressive advertising campaigns do not add value to society. And I agree with him that they're, for the most part, legal, and it's the way the game is played.”
2022-02-11 · Lex Fridman Podcast · #263 – John Abramson: Big Pharma · IDENTIFIED FROM THE TRANSCRIPT · source