Tom Nesi, a former insider in the world of big pharmaceuticals, has just written a new book entitled ¬Poison Pills: The Untold Story of the Vioxx Drug Scandal. Nesi hopes to expose what happens when consumers take newly approved, heavily marketed prescription medications.
Nesi, a former long-time director of public affairs at pharmaceutical giant Bristol-Myers Squibb, boasts over 30 years’ experience in medical communications and strategy. Today, Nesi is a writer and consultant, with his latest book discussing the Vioxx scandal. Vioxx is the prescription painkiller that was pulled from the market after doctors realized too late it caused sometimes-fatal heart, blood, and kidney problems. Nesi says his overarching goal is to better enable consumers to utilize good medicines and avoid the harm that others can cause.
For example, Nesi explains that free samples are often the most expensive, citing Merck’s distribution of 17 million samples to 25,000 physicians and 375,000 patients. “The problem is that if you’ve been doing fine on a 20-cent pill, you get the free sample for a month or two, then you have to go to the drugstore to fill the prescription and then it costs you $3 a pill,” says Nesi. Nesi also points out that, “as extensively as a drug is tested before it’s approved [by the Food and Drug Administration], it’s still tested on a very small population. It’s also tested on a very select population. Drug companies don’t go out to try to find the sickest patients to test their drugs on.” Nesi explains there is more usage data with older drugs. “I don’t think it hurts to wait a few years. I would say, if you’re satisfied with your current therapy, stay with it,” Nesi adds.
Nesi’s book is a response to his wife’s death six years ago from cancer. After looking at experimental drugs, Nesi felt that “it was bogus,” saying he reevaluated his life’s work. “We’re being duped,” he says, adding that he “didn’t want to get out there anymore and tell people such-and-such a drug was a miracle compound when I knew that, (a) it wasn’t, and (b) even if it was helping people, it was destroying their quality of life.” Today, Nesi urges consumers to “ask their doctors for proof that new drugs are superior to older ones before accepting a prescription for the newer medicine,” pointing out that “the larger the marketing campaign, the more you should use caution.” Due to concerns over reproductive health, Nesi cautions women, in particular.
Nesi notes switching—doctors recommending patients stop a successful prescription to begin a newer drug—happens “all the time,” citing “huge campaigns” and pointing to “Prilosec, for heartburn,” saying, “AstraZeneca, the company that had the patent, wanted to keep making money after Prilosec went off [patent], so they came up with a successor drug called Nexium, which is ‘the little purple pill.’ I remember working with a colleague … who was just astounded and said, ‘Nexium doesn’t work any better.’”
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