Pharmaceutical companies come away winners
WASHINGTON — Military doctors are prescribing more meds to soldiers to treat depression and anxiety, yet there is an increasing rate of suicides among active duty soldiers and veterans. This includes recent veterans from the Iraq and Afghanistan wars. Meanwhile pharmaceutical companies – the Big Pharma crowd and an increasing showing from low-cost generic brands – are benefitting from the uptick in business without clear disclosure of just how much each is receiving.
The Military Times and affiliated Army Times Group publications have been doing a series of reports pointing out the liberal distribution of prescription medicine to those in the military and a potential connection to the mental instability that leads to suicide. Although a combination of therapy and medication has proven to be of significant help in treating depression, anxiety and trauma, it may be the case that active troops have access to a dangerous variety of drugs without much concurrent therapy. The Times based its report on the government data obtained via Freedom of Information Act requests. Use of antidepressants in the general population itself has exploded, yet it has not come with such a spike in suicide and possibly includes more clinical care.
While the Afghanistan/Pakistan and post-Saddam Iraq battles drag on interminably, the continued presence of terrorism, either independent or organized, assures the continuation of ubiquitous U.S. armed forces and support personnel. Troops are subjected to myriad traumas and stress, only to come back stateside with Post Traumatic Stress Disorder (PTSD) in many cases and then even the most iconic among them have struggled in attempts to receive care. This may compound the problems created by the loose dealing of prescription drugs to active soldiers, experts say.
The number of annual suicides per 100,000 troops serving has risen from 8 in 2001 to 14 in 2009, according to the Times analysis of Defense Logistics Agency data. What’s more, citing information from the Veterans Affairs Department, The Army Times reported last week that as many as 18 veterans are committing suicide each day.
Bart Billings, a doctor and retired colonel, recently testified before the House Committee on Veterans’ Affairs that soldiers should not be taking antidepressants at all, let alone at the alarming rate and in such varied combination. “Drug cocktails,” however, have become common in the armed forces despite there being little research to support many of the combinations, according to Billings.
I caught Billings on the phone this weekend while he was at the Annual Combat Stress Conference, which he founded 18 years ago.
Billings is an outspoken critic of the lax oversight of what appears to be a huge proliferation of drugs in the field that is not being reported. He said that it’s hard to quantify how much of these kinds of medication are being used in the field , but that there are documented cases of sudden death as a result of so-called medication cocktails.
“It’s easier to figure out how many drugs are coming from Colombia to the U.S. than trying to figure out the number of drugs going to the field,” Billings said, in a reference to cocaine cartels.
Peter Breggin, Ph. D., presented an article to appear soon in a scientific journal in which he draws the clear connection between the use of antidepressants by soldiers put in stressful situations who are taught to use violence and increased incidence of suicide or even homicide.
Following the money
The Pentagon has more than a $6 billion annual budget for prescription drugs. I tried to find out if there is information available about just how much taxpayer money is going to which drug manufacturers, but ran into some road blocks.
The DLA, a part of the DoD, is the place that orders the drugs eventually used by all U.S. armed forces. That agency spent at least $1.1 billion on psychiatric and pain medication between 2001 and 2009, according to the Military Times report. Yet the DLA doesn’t purchase anything directly from the manufacturers such as Ely Lilly, Wyeth, Pfizer and GlaxosmithKline.
Instead, the DLA uses a network of pharmaceutical “prime vendors,” according to DLA spokeswoman Diana Stewart. So they contract with distributors in the pharmaceutical industry to purchase and deliver pharmaceuticals in different geographical regions while the prime vendors purchase direct from the manufacturers.
It’s not yet clear whether those in the DoD have a say in which manufacturers are used or if it would matter whether they are courted by pharmaceutical companies. Yet it is certain that the pharmaceutical industry shells out money for at least the travel of DoD doctors and other medical professionals.
The Center for Public Integrity had previously collaborated with Medill to report on the amount of money drug companies spend on travel for the Defense Department officials. The 2009 report showed that from 1998 to 2007, the medical industry paid more than $10 million for 8,700 trips, or about 40 percent of all outside sponsored travel.
Health care bill sunlight
The momentous Obama administration health care bill recently passed by Congress might actually illuminate how much the Department of Defense pays to each manufacturer, as a sunshine act actually will track the relationship between Big Pharma and physicians to see whether there’s any undue influence in who uses which drugs.
Until then, the DLA is working on gathering the information on its prime vendors, and the Army Times publications are working on another reporting package on the subject.
