Dr. Kaveh Hoda
Appearances
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
You're doing a really good. You can call it Cox, by the way.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Yeah. Yeah. In his honor. But this is interesting. I didn't expect I was going to be getting this like trip down medical school like memory lane. This is fantastic. You're doing great.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Yeah, ginger is my magic thing. My little magic creation in my mind that works more than it really does.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Yeah, it's one of the most commonly used medications in the world.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
This is such a recurring theme with pharmaceutical companies. I just did an episode about a medication called Zygris. which was, wow, it sounds like the Tigris. It sounds awesome. It sounds awesome. It's this medication that was touted as like this new breakthrough therapy for sepsis. And it was super exciting.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
It ended up falling apart for a lot of different reasons and being withdrawn and then being a big marketing scandal, in my opinion. But at the end of the day, it all started because they were losing their patent on their big like sellings and medications. Like the one, the things that were making them tons of money were about to run out and they needed a new like cash stream as quick as possible.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
So things started happening probably faster than they should have.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Right. And when the money starts to shift from research and development in these companies to marketing, which it does more and more.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Yeah, I'm assuming that's the problem here.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Oh, I'm the people who deserve to.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
I mean, that is that is that's the kind of thing I hear a lot about, like every medication. You name it out there. Someone has had someone blames that medication for their life being in shambles.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Yeah, the Vagelos Award is like this award that's still given out to people who are doing humanitarian work in the pharmaceutical world. So this is a major shift, a major shift away from somebody who was, I think, ostensibly a very good person from all accounts, a very good person, a good researcher, to something very different. Yeah.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
And, you know, it's medication. We're talking about today. Lots of risks. It's true. They all they all do some more than others. I think we're probably going to discuss here. But yeah, I don't know if lines mean which I'm not familiar with, really.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Yeah, it's the same family.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
And it does have that comes with a warning on it. That's more striking than most other NSAIDs. Yes. I don't know. Actually, it's a good question. I don't know how often it's used these days. I assume it's pretty, pretty rare or not as often as it was for sure.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
I don't have a lot more to add to it either, but it feels like there's other NSAIDs out there that we use a little more frequently and seem a little safer.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Yeah, you're... You're almost officially a doctor because that is correct. That is the appropriate diagnosis is that it's not good.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
This is like almost... You don't even have to take it more than is recommended to run into problems because sometimes people only take a little and they run into problems in the GI system, for example, or other issues like kidneys that can be affected or the heart. But it is a sole underlying known fact that...
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
That's... It is. It's a bit tricky how they're doing it, too, because, you know, so far, a lot of what they have done sounds very I mean, sounds sound from a distance.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
You know, the whole idea of like looking at Cox two inhibitors, like looking at medication specifically for this and comparing it, you know, say, hey, look, at least we're better than the other medications to some degree from a high from when you're way back. vantage point, it all makes sense.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
It's when you start to look a little bit more closely that it's questionable, especially given that they seem to know early on that there was high risk of these cardiovascular injuries and that the whole narrative is being shifted to try and take focus away from that. This is why it's a difference between marketing and between scientists running the program.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Yeah.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
I mean, I don't know what numbers were in that paper, but removing three can make a huge difference.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
You're never going to hear me say cigarettes are OK. They know what they've done.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
And I'm wondering if in these studies they were talking about the rates of peptic ulcer bleeding, gastric bleeding as well, because I mean, that's.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
These are all being published in decent journals. I'm sure that just people want to be in good journals. They want to have another publication in, you know, New England Journal of Medicine or The Lancet or whatever.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
I mean, I remember at the time it was huge. It was I'd never seen a campaign like it. I remember I think it was one of the first times I remember really having like being conscious of like how much of medicine was being marketed. Yeah. You know, and, you know, I think it's one of these medicines where it's like.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
you know maybe five to ten percent of the people who are using it maybe had some benefit real benefit where they maybe it did help them from a a gastric ulcer perspective maybe they didn't have the option of taking another medicine but for the other 90 of people that were taking it uh it wasn't necessary for them it wasn't something that they needed and it was just increasing their risk of of heart attack or stroke and and i think that this is i bet you i mean you probably know this but i bet
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
up to this point this was the most that ever been spent on direct marketing
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Oh, for sure. For sure. I'm not I'm a huge fan of vaping either. There is harm reduction. There's a good argument about that. But I'm not you're not going to see me promote vaping either.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
I love your quaint country colloquialisms. It's great.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
My first girlfriend, the first girl that really smashed my heart into like a billion pieces, scattered them across the globe. Was Dorothy Hamill? She's really taken some strays in this episode. She had Dorothy Hamill's haircut. Oh, okay. which I don't know why at the time didn't bother me. But so now when I see that haircut, I'm like, oh, yeah, that reminds me of that. That lost love.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Yeah. Painful, painful.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Was this when Larry King still had some credibility?
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
You know, I was too young to really be... I wasn't really practicing medicine when it happened. But I did know about it, and I've heard some about it since then. I'm really very fascinated by the story, and I'm really looking forward to getting into it today. So I'm excited about that. I will say, I think it was...
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Thank God for yellow jackets. I sometimes don't know if you're kidding. And I just hope in my heart that you are. And I'm just going to pretend that this is all part of a bit.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
That's good for your heart.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
And what little oversight there is is going to be gone.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
It's all one big organized end of humanity cash grab. The next couple years, any drug you want to get through is gonna get through.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
That's fair. But it's not going to be even heroin. It's going to be like, you know, blood pressure pills that the company just gets through. And then it makes people's hearts explode. And then the company will just say, hey, we're bankrupt. And then they're fine. And then they just move on with their lives. And then people are going to be left in the wake.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
it feels like a turning point in regards to how people looked at pharmaceutical companies. I think it was really like a sentinel event in that. Like, I think doctors were always skeptical of pharmaceutical companies. We still are. But I think that was when people started to become cynical. That change started.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
He was always doing research that RFK.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
You almost slipped into your 50s radio announcer voice. You kind of shifted to the 90s. I saw what you did there.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Right.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
First of all, I take back what I said about her hair. I think it actually looked really good there. I don't know. Maybe it's like time and the cycle change and fashion. I don't know.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
It's a brilliant strategy. Like the people who grew up watching her and knew who she was and admired her are that age where they were having lots of osteoarthritis and joint pains looking for medication. It's a she's the perfect spokesperson. Yeah. And she and she has that innocence that you believe, you know.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
I do. Plug is my show. That is the plug that I want to plug is my show. I'm plugging it now. It's called The House of Pod. It is a humor adjacent medical podcast. If you like the subjects like today's subject, you'll like our show. In fact, one of our most recent episodes is about sort of similar, a little bit less egregious, but similar pharmaceutical shenanigans
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
I don't know if that's a word about the medication Zygris. And there's all kinds of fun guests like Robert and Prop and all the people you know and love here, Margaret. So check out my show, The House of Pod. And if you want, you can follow me at Blue Sky, which I'm giving a shot now. Seems a little bit less fascist.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Exactly.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
In fact, just for thinking about stopping, you should listen to extra podcasts today.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Podcast your way through it.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
That's right.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
No, it's just so ridiculous. I mean, all of those shows. Scrubs is the only one that's watchable for me.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
That's good. As a doctor, I feel like I should. I will talk to you at great length about how supplements are a fantastic waste of time. And I will tell you in detail, and I have on many episodes, why they're more dangerous generally than they are good. And you should only use them with strict instructions from your physician. But that being said...
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Kids have always loved fire trucks.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
They love Tylenol.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
And that's dispenser, right?
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
And livers. I mean, acetaminophen, that's worldwide one of the biggest causes of liver failure from people taking too much acetaminophen. And then, yeah, these other non-steroidal anti-inflammatory drugs, they're the kind of thing that make me, a gastroenterologist, have to go in the middle of the night to go put a scope into someone's stomach because they're bleeding a ton.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
in the setting of somebody who's swallowed too much Advil or something like Aleve or something.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
I feel like ginger really helps me in like a power up way that it doesn't. I know it doesn't, but I love it. And the placebo effect is so strong for me that, you know.
Behind the Bastards
Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
More than you want to know. Yeah. A lot of things we do in medicine that we, we just, they seem to work. It does it. It definitely helps.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Wow, I'm just impressed that the orthopedic surgeons were reading anything. Hey-o! Sorry. Sorry, that's my little dig at the orthopedic surgeons.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Did he say that himself? He called his own studies meticulous? No, no.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
You know, it's like the it's what's interesting to me is looking at these things is what could the FDA have done better in some of these circumstances? It's hard because some of the information just not being given to them in what seems like a very fraudulent manner. But they need to have the power to do certain things.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
When a drug is first approved, there's still a lot of unanswered early safety questions. Because for most of the studies that are getting them approved... There's like maybe 2,000 to 4,000 at most patients in a study. Oftentimes, that's not enough to see the safety evidence and what risks are associated with it.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
So the FDA has to be there pushing to see more data, making sure that it stays safe once those numbers come out. They need to be there to do the post-marketing studies. It's interesting to me to see, it's terrifying to me to see, going back to what's coming in the future, what's going to happen to our FDA. Oh, God.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
and how deregulated it's going to become and to see what they're going to be able to accomplish. It's going to be, I mean, I hate to say it, but I think we're going to see more drug-induced injuries than ever before because more medicines are going to be coming out and fewer of them are going to have the post-marketing studies to prove it.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
I'm like, you know, I get a lot of shit online for being like a pharma shill. Yeah. Because like, you know, I promote vaccines like because they work and they're great. And, you know, I can go into that in great detail if you like. But like the...
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
The funny thing is the people, those people who are so against drug companies, so few of them are against drug companies for the right reason, for reasons like this. You know, when there's a real reason to be mad about pharmaceutical companies, more people are upset about drugs.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Like the vaccines have come out with good data behind them and with good studies in the limited amount of time that they're able to do. You know, it is it is hard. It's hard for me to wrap my brain around that. How I have to be the one defending the pharmaceutical companies. And I'm as skeptical of them as anybody. Yeah. Because of shit like this and stuff we've seen like this.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Yeah.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
No girls allowed.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
wow dodgeball they're literally playing dodgeball with their death medicine you know questions about their death medicine it is death medicine it is interesting like they they the way they train their reps like they train them to deal with different types of doctors they're very smart they recognize that there's like four or five different types of doctors and they range from like
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
The owl, which is like the name they'd give one when they're training sessions, which is the guy you want to avoid, the person you want to avoid because they're going to ask the more detailed questions. They're going to keep drilling to get the answers. And then the one they love are the ones they call the peacocks.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
which you just have to kind of stroke their feathers, tell them they're pretty and smart. And those are the ones that are going to sell your medication. I mean, they know the psychology of doctors very well, probably better than doctors do. So it is, there's the farm reps. It's changed maybe a little bit, but this was like the most evil time of the farm reps.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
They had the most power and doctors were the least prepared to deal with it.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
We're trying to be better.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Back when Alex Berenson used to write useful things.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Yeah. It is funny. I didn't realize until this how slow moving a car wreck this was. Yes. This is a whole thing that's been happening for a while. I didn't realize that. It's more nefarious than I expected.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
I wonder how they justified it to themselves if they did. Money, money, money! I know, I know. And your listeners are like, what the fuck is wrong with this guy? What kind of... Does he not listen to the show? Does he not understand? But I mean, like, I feel like everybody thinks... Box sheesh, baby. But like... The people, the head of this farm company, they're doing this now.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Are they lying to themselves in some way? And what lie is that, that they're telling themselves? That's the part I don't understand.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
There's just like in every episode I do, there's like this one moment where I turn to you and I'm just like, Robert, why do bad people do bad things? I just don't understand it. I'm so dumb in that way.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Don't do that, people.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
No part of her training of her many hours prepared her to look critically at the data. Yeah. That was available to her. What was available to her?
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
I want to go check it out now. I mean, I live in San Francisco, so we don't have like, you know, 40 minutes outside of town is like another town. So I got to like go pretty far.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Yeah.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Can we live stream that? I think that would be a good thing.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
It's so fucked up. You're totally right. It was like this era where it was like people like, there has to be personal accountability for this. Like they should have known that there was a small risk with medications. And they, I mean, they're missing the point, which was that the risk of, was obfuscated in the beginning.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
I have never seen you figure skate.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
I think, I mean, it sounds like, to be honest with you, it's still, at some point, they look back at these medications and they said, you know what, there might be a role for them. And they're actually, you know, very well could be a good use for some of these meds.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
I mean, even Vioxx could have had specific uses for very well-chosen patients. Yeah. And they'll never get to that. Those patients will never get to that.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
They'll never get to have that benefit of a medicine that could actually work because, again, instead of all the money going into research development, figuring out exactly who benefits and who gets harmed from it and who should have it and who shouldn't, they spent all their money and energy in finding ways to sell it and for as long as possible.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
And they painted themselves into a corner at the end, and they couldn't at that point then say, okay, well, actually, Only these small subset of people should use the medication because the risk is then worth it in the small subset. But they couldn't do it. They had to withdraw completely. So it's just so stupid on so many levels. It's such a waste of time.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
And it's a waste of all the time and effort that went into making the medication again, too. Because again, the concept behind the medication, looking at COX-2 inhibitors, looking at ways to selectively attack the pain pathways, shut down the pain pathways before they cascade into inflammation and pain, it's all smart. It's good.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
And now, to my knowledge, I don't know if people are even thinking about this anymore. And, like, we still have problems with NSAIDs. NSAIDs still cause problems. Lots of health problems still come from them. Advil, Aleve, Ibuprofen, they still cause me headaches because I have to go and take care of people bleeding because of them. They cause heart issues, kidney problems, liver problems.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Like, people should be—we should be researching new pain medications and— worrying about how to do that right, as opposed to how to make as much money off of it as possible. But that's not where we are. It's not who we are. So I don't know why I'm saying this.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
How much do we know?
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Yeah. Okay.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Striking imagery.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
We'll fight every one!
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Skating free.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Man, you know, it's giving anesthesiologists a bad name. It is. It is. And these are guys who deal with a lot of fentanyl. Yeah. That is wild. That is, well, I am actually, I would love to read his articles that are totally fabricated.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Holy shit. Actually, I mean, he did some time. That's something. I mean, I do know doctors that have gone to actual prison for, like, Medicare fraud and that sort of thing, like, done actual time. It's not common, but...
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
you know it can certainly happen i mean the the things i'm seeing are are there it's always fraud related you know yeah and actually six months isn't as long as i've seen other people go for what i kind of consider to be lesser crimes but yeah they weren't crimes committed directly against the american government and medicare fraud so that's probably why he only got six months yep
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
I mean, you know, again, it comes down to, like, I'm always a little torn when I do episodes or talk about how terrible pharmaceutical companies are because they are terrible, and I have so many problems with them. But there's always a part of me that's like,
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
They are super important at the same time, and we do need them more than ever to be really focused on important world health issues and infectious diseases. And the problem is... The things I really care about, the things I think are really important are not necessarily things that they are going to make money off of and they just don't really care. So I'm very torn.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
I have a lot of mixed emotions about pharmaceutical companies in general. And it bothers me when people assume that I am like pro-pharmaceutical company because I hate them more than anybody, really. I mean, I really do. But at the same time,
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
we do need their help unless we get more scientists like Dr. Peter Hotez, who's, you know, a friend of the show has come on who has made his own pharmacy or like vaccines, um, at cost, these great like vaccines and people still accuse him of being a pharma show, even though he works completely outside of the pharma world. So I, I'm very torn about pharmaceutical companies in general.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
And I think it is very, very, very important, um, that we continue to pick at them, analyze them, be super critical of them, but also be fair about what they can do, what they should do, and what we should expect from them. I think we have to be able to look at them critically and look at them in a sort of
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
We have to look at them critically, but we also have to be able to be fair and reasonable about what we expect from a massive corporation.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
These are examples, like this case here, of things that should never have been allowed to have happened and are going to continue to happen because we aren't going to have the oversight of these companies, and it's going to become easier and easier for things like this to happen, which is my fear.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
unless doctors and scientists around the world have the time and energy to really pick apart at every detail and every study that comes from them. But I think even academic medicine is going to be under the gun in the coming years, too. I don't feel great for my friends who have, like, who have academic jobs in medicine, I think they're all going to be at risk. Who's going to get paid?
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Who's going to be able to get to stay? Who's going to be able to get their research done? It's all going to be at the whim of people who know very little about science and care very little about science. So very depressed is the answer to your question.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Yeah, that's exactly right. That's exactly right. So, yeah, it's going to be a wild four years. There's going to be so much diarrhea.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
So many, so many foodborne illnesses. So much. It's going to be the golden age of diarrhea.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Perfect.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Thanks for having me. It was a blast. Yeah. It's always good. It's nice seeing you. Nice seeing your face. For your listeners who may have an interest in learning more about medical topics. You can listen to my podcast, the house of pod, anywhere you get your podcast and, uh, follow me at blue sky at Kaveh MD. And, uh, thank you.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Brew two shots of espresso.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
That's real bad. I mean, because... I mean, I know it's not a medical journal that he's writing in, but that is like the New Yorker, though. Like, I mean, yeah, you would think he would he would know he should know better. Like that is like if you write anything. I wrote a piece in the BMJ recently and I had to disclose everything, including who I was voting for. Yeah. You know, in the election.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
So it's like in who I donated money to in the election. So that's pretty shocking to me that like they did not require that.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Right. I mean, by a Harvard doctor. I mean, if COVID has done nothing else, it has also raised some doubts about, you know, the. reputation of places here in the Bay Area, like UCSF and Stanford, where a lot of anti-vaccine cranks seem to be coming out of.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
So it's not totally shocking to me that it's Harvard, but I could absolutely see the danger in someone with a name that big, the H-bomb you're dropping there, leading people to believe this. And New Yorkers, the intellectual elites, leading them all to believe the safety of it.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
If I am doing the safest procedure in the world, I am never, ever going to say this is no risk because that's like jinxing it. Why would you do that? You never do that. It's just stupid. It's untrue. That is zero shocking. I mean, this is maybe that's a big old red flag.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
Absolutely. Yeah.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
And it's read by people understandably who are going to then relate it to somebody else as this is what it does. This is like we think it does this. And like there's so many steps. There's so many steps. There's years of steps between point A and point B in that.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
accusing dr grootman of doing anything criminal uh the same cannot but it's a slippery slope it is i mean it is you can see why it leads to people doing it you know and i've said this to you before too it's like i think in the past you know when i was earlier in my medical training in my career i didn't care that much about things like that i would probably read it and be like what is he saying what does he mean ah forget it and let it go not worry about that much
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
But this is how it starts. This is how it starts. It raises enough doubt. It raises enough like it makes it vague enough and makes it cloudy enough that it's hard for people to know what is real and what isn't real. And this is where medical information like the roots of it begin. It begins in good places sometimes like a Harvard doctor.
Behind the Bastards
Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam
I'm here for the treatment of people. And there's going to be people who are going to be upset if Celebrex goes away or if these medications go away because there are people out there who are like, this is the one that works for me. Yeah.
Behind the Bastards
It Could Happen Here Weekly 172
Hi, I'm Kristen Davis, host of the podcast, Are You a Charlotte? Sarah Jessica Parker is here, and she is sharing stories from the very beginning, like the time she forgot we filmed the pilot episode.
Behind the Bastards
It Could Happen Here Weekly 172
Yes, but then you forgot about it in the very long time they took to pick us up. I completely forgot about it. Listen to Are You a Charlotte? on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.
Behind the Bastards
It Could Happen Here Weekly 172
Hi, I'm Kristen Davis, host of the podcast, Are You a Charlotte? What we have all been waiting for. Sarah Jessica Parker is here and she is sharing stories from the very beginning, like the time she forgot we filmed the pilot episode.
Behind the Bastards
It Could Happen Here Weekly 172
But then you forgot about it in the very long time they took to pick us up.
Behind the Bastards
It Could Happen Here Weekly 172
And she reveals what she thought when she read the script for Sex and the City the very first time.
Behind the Bastards
It Could Happen Here Weekly 172
And does she think Carrie is too good for Mr. Big?
Behind the Bastards
It Could Happen Here Weekly 172
You can't miss this. Listen to Are You a Charlotte? on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.
Behind the Bastards
It Could Happen Here Weekly 172
Hi, I'm Kristen Davis, host of the podcast, Are You a Charlotte? Sarah Jessica Parker is here, and she is sharing stories from the very beginning, like the time she forgot we filmed the pilot episode.
Behind the Bastards
It Could Happen Here Weekly 172
Hi, I'm Kristen Davis, host of the podcast, Are You a Charlotte? What we have all been waiting for. Sarah Jessica Parker is here and she is sharing stories from the very beginning, like the time she forgot we filmed the pilot episode.
Behind the Bastards
It Could Happen Here Weekly 172
But then you forgot about it in the very long time they took to pick us up.
Behind the Bastards
It Could Happen Here Weekly 172
And she reveals what she thought when she read the script for Sex and the City the very first time.
Behind the Bastards
It Could Happen Here Weekly 172
And does she think Carrie is too good for Mr. Big?
Behind the Bastards
It Could Happen Here Weekly 172
You can't miss this. Listen to Are You a Charlotte? on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.
Behind the Bastards
It Could Happen Here Weekly 172
Yep. I'll add to that, they set the lead of importance here too, because if we're talking about telemedicine, telehealth, how important that is to Medicare patients, to everyone in the country at this point, then if they are to cut it, if that happens, as I think we're probably going to discuss, if that goes away, then the other private insurance companies are going to follow. That's right.
Behind the Bastards
It Could Happen Here Weekly 172
It could be across the board changes led by these changes in Medicare.
Behind the Bastards
It Could Happen Here Weekly 172
I'll start this one, but Venkatesh, definitely want you to weigh in on it as well. Just to give a little background, over the past five years, it's grown quite a bit. And it's gone from being kind of this emergency stopgap to a real cornerstone of what we consider modern healthcare. And now it's exceedingly common, like over 75% of hospitals in the U.S. connect at a distance.
Behind the Bastards
It Could Happen Here Weekly 172
via video conference or some technology to patients. And it's been popular on both sides. It's been popular on both sides of the aisle. When it first was done, as you mentioned, during COVID, when they said, okay, we're going to peel back some of the restrictions on Medicare coverage for these telehealth things.
Behind the Bastards
It Could Happen Here Weekly 172
It was considered like a victory, like one of the few good things to come out of COVID. Both sides liked it. It was popular amongst patients. It was popular amongst medical providers.
Behind the Bastards
It Could Happen Here Weekly 172
it was good for republicans and democrats alike and as you mentioned it's been kept going through being put in some bill or another since it was initially put in in i think as they called in 2020 and it's been put in one bill or another to go with the funding but then came this last december when congress was going through their spending it was only given this three-month reprieve which is going to be up as you mentioned at the end of this month
Behind the Bastards
It Could Happen Here Weekly 172
And if it goes away, there's a lot of factors, we'll go into a lot of them, but there's a lot of people, older patients, immunocompromised patients who don't want to come into office, people with disabilities, people who can't get around that well, people in rural areas, which is, you know, really how it started. People who are going to be hurt all across this country.
Behind the Bastards
It Could Happen Here Weekly 172
And at this point, the majority of people have had at least one experience or more in a year with telemedicine. It's become a part of a lot of people's lives. And if it goes away, you know, there's still going to be health care as it is. I mean, it doesn't mean health care is going away, but it is going to put a tremendous burden on patients and hospitals, for that matter, across the country.
Behind the Bastards
It Could Happen Here Weekly 172
Yeah. You know, I might just add to that, that aside from all the things we mentioned about it, how, you know, it helps people in rural areas, people with difficulty getting places or just really busy schedules. It also, you know, helps free up hospital beds. It helps prevent emergency rooms from being overwhelmed. It leads to faster testing. It leads to a higher number of people that we can see.
Behind the Bastards
It Could Happen Here Weekly 172
And in terms of its quality, we know it works well, but, And about 90% of cases of telemedicine, they get the same outcomes if the patient was there in clinic. And that 10%, that's not, it's not clear that they're getting inferior care in most of those cases. So it's an effective treatment. And you could make an argument that it is cost effective in some ways too.
Behind the Bastards
It Could Happen Here Weekly 172
It's particularly clearly for like things like dermatology, pediatrics. These are things where it's clearly cost effective to have it. But even beyond that, it's not even necessarily, I think a strong argument that we'll be losing money from it and that cutting it would help us in the long run. I feel like we're being smart about how to manage American healthcare system and how to keep it afloat.
Behind the Bastards
It Could Happen Here Weekly 172
Telemedicine is going to be an important part of that going forward.
Behind the Bastards
It Could Happen Here Weekly 172
I would add also, you know, we're seeing this active dismantling of the U.S. healthcare infrastructure. And our friends in the academic world in particular, it's a very stressful time for them. Who knows if their studies are going to go through? Who knows if they're going to get their funding? Who knows what's going to stay, what's going to go in the next couple of years.
Behind the Bastards
It Could Happen Here Weekly 172
There's a lot of concern over that, obviously. But even in the medical world outside of the academic centers, I know a lot of doctors right now are concerned. And they're concerned about what's going to happen to the state of our scientific community that helps us with new advancements in medical technology in the coming years. And it seems like, as Venkatesh was alluding to,
Behind the Bastards
It Could Happen Here Weekly 172
We're dismantling all our ability to follow, to study, to really closely track infectious disease in a time that is exceedingly dangerous across the world with rising disease, tuberculosis in this country, measles in this country. In Uganda, there's Ebola again. There's threats all over the world, and this is one of the worst times I could think of to be in this moment of austerity.
Behind the Bastards
It Could Happen Here Weekly 172
And particularly because so much of it seems unclear to us why. Why these things are being done. Is it all because of this ridiculous gender ideology? Do they actually think they're saving money with some of these things? It's a very unclear time. And of course, there are a lot of
Behind the Bastards
It Could Happen Here Weekly 172
People in the medical world, doctors included, that are conservative or Republican voters, getting into conversations with them about this is sort of a tough thing to do. Because, like Venkatesh mentioned, they, like a lot of us, want to make sure we're doing this in a cost-effective manner.
Behind the Bastards
It Could Happen Here Weekly 172
Something we talk about and we have been talking about in medicine for a long time, particularly academic medicine, interestingly enough. which is really on the cutting board. It's academic medicine that usually talks about, you know, trying to be cost-effective. What tests are we going to order? What labs do we need to get? How are we doing this in the most cost-effective way?
Behind the Bastards
It Could Happen Here Weekly 172
Yes, but then you forgot about it in the very long time they took to pick us up.
Behind the Bastards
It Could Happen Here Weekly 172
These are important things that are discussed. And across the political spectrum in medicine, I think there is some concern, even amongst some of the more right-leaning doctors. But again, it's hard because they've gone this far down the road. It's hard to know, you know, when they're going to pull back. What's the line in the sand for them about what is maybe too far for this administration?
Behind the Bastards
It Could Happen Here Weekly 172
Yeah, that's right. I mean, even here in the San Francisco Bay Area, you know, I've seen more vaccine hesitation than I remember ever seeing before in the past.
Behind the Bastards
It Could Happen Here Weekly 172
I would add, though, I agree with you on pretty much all of that. I agree that we need to have those conversations, even if they're difficult. We need to be able to look back objectively about things that worked and didn't work. But a lot of these sort of mea culpa's that have come out about like, you know, this is what we went wrong and why we lost trust.
Behind the Bastards
It Could Happen Here Weekly 172
If I'm being honest, including that one from Ashish Jha, it has a lot of, in my opinion, pick me energy, right? A lot of people who are trying to appeal to the incoming administration and be like, hey, look, I'm cool, too. I'm not always about vaccines. And to me, that's just as bad, too. And I do think we need to have an honest conversation.
Behind the Bastards
It Could Happen Here Weekly 172
And I do think we need to be clear about how we do science, something we need to be able to explain. And you're absolutely right, which we didn't do very well. is, look, we are working with information we have at hand. We're doing everything we can. This information may change. When it changes, our recommendations are going to change too. And that is tough.
Behind the Bastards
It Could Happen Here Weekly 172
That is a tough message to get across because people don't like nuance like that. People don't like the uncertainty of that. People want to know yes or no, absolutely. And sometimes it's hard. It's hard to find good communicators in science to do that. But you're exactly right. It is incumbent upon us
Behind the Bastards
It Could Happen Here Weekly 172
as doctors who have a substack like yours, have a podcast like mine, who are academics, who have a reach to students and beyond to communicate these things. And even though it would be awesome If for the next four years, my podcast was just about farts and poop, I know I have to do a lot of this stuff because I know how important this is now more than ever. So I totally agree.
Behind the Bastards
It Could Happen Here Weekly 172
Listen to Are You a Charlotte? on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.
Behind the Bastards
It Could Happen Here Weekly 172
You know, and to answer your question from my perspective is a challenge because I think people should be concerned. In fact, I just did a two-parter with one of the world's best virologists talking about the, you know, possible bird flu pandemic that could arise and all the threats that are out there. And so I do think there are some really significant, serious risks to be worried about.
Behind the Bastards
It Could Happen Here Weekly 172
However, I'm never going to say there's nothing that can be done about it. There's plenty that can still be done about it. I still maintain hope in the medical community for what we're able to do and what we're able to accomplish.
Behind the Bastards
It Could Happen Here Weekly 172
And to echo what I think both of you guys have said or would at least agree with, there's a lot of changes that we can make locally amongst our small sphere of influence and then growing out from there in terms of getting vaccinated, in terms of wearing masks when needed, or at least looking at the data with an open mind and sharing good resources.
Behind the Bastards
It Could Happen Here Weekly 172
Because one thing that the younger population is good about and what some of these people you're mentioning, James, is they're good at detecting bullshit online. And that's a skill that needs to be honed for medical literacy as well. And I'm hopeful that that's going to continue to improve.
Behind the Bastards
It Could Happen Here Weekly 172
maybe stupid optimism, but I do believe the younger generation is going to continue to be better at that than the older generation. And I think that will help battle a lot of the misinformation that's out there, but there are things that they can do. In fact, for getting back to the telehealth thing, for example, talking about telemedicine slash telehealth, as Venkatesh sort of broke down.
Behind the Bastards
It Could Happen Here Weekly 172
In terms of it being cut at the end of the month, there are people that are really pushing against that, including Ro Khanna, who's a legislator here in California, who's proposed a new bill. I haven't been able to see any of the details of it, but there are a lot, including Amazon, by the way. Amazon is one of like 350 companies
Behind the Bastards
It Could Happen Here Weekly 172
that have written a letter to Congress to help push for this funding. So if you can call a Congress person, if you can do that, if you can keep bothering them, telling them how important it is, I think those are things that can help. So I think that's a good place to start.
Behind the Bastards
It Could Happen Here Weekly 172
I don't disagree with that, but I also think you're giving... Doge more credit than I would, which is to say that they actually really, they really would focus or listen to.
Behind the Bastards
It Could Happen Here Weekly 172
I think what they've just done is literally, you know, take a chainsaw and cut away at major federal funding and then kind of seeing what was really bad about that and what wasn't and being like, oh, okay, maybe we do need people in charge of nuclear security. Oh, maybe this is popular. We'll put it back. You know, I kind of, I kind of think that they're not taking as much attention or care.
Behind the Bastards
It Could Happen Here Weekly 172
But I also do agree that the point is valid. I mean, sure, is there fraud in some telemedicine? Yeah, I'm sure. Probably small, very small percentage. But if we can specify its use, if we can be better about that, I agree, I'm all for it.
Behind the Bastards
It Could Happen Here Weekly 172
Yeah, I would also recommend Venkatesh's Substack if you're in the medical field in particular. I think you'll appreciate it. A focus on burnout is as important as it's ever been, if not much, much more. I mean, we were talking about burnout and moral injury in doctors before COVID, and now, you know, a couple years down the road, it's only worse.
Behind the Bastards
It Could Happen Here Weekly 172
So I think it's really important, and I do recommend it. Or you know, check out his latest article in the Los Angeles times, as you'd mentioned before, as for me, find me on blue sky at Kaveh MD, but more importantly, just listen to the podcast, the house of pod. If you are a fan of this show, I think you're going to like the house of pod.
Behind the Bastards
It Could Happen Here Weekly 172
If you haven't already given it a try, it's a lot of the same people. Yeah. that you hear on this show on the House of Pod, James included. He's going to be coming back to talk about the measles and with an author of a new book down there about the measles outbreak. And we take a look at grifters, medical grifters. We take a look at some people that would be considered medical contrarians.
Behind the Bastards
It Could Happen Here Weekly 172
We take a look at some of the quackery in medicine as well. So I think you'll appreciate this show. If you like the whole behind the bastards verse, I think you'll, you'll get into the house of pod too. So check us out, uh, wherever you get your podcasts.
Behind the Bastards
It Could Happen Here Weekly 172
Hi, I'm Kristen Davis, host of the podcast, Are You a Charlotte? What we have all been waiting for. Sarah Jessica Parker is here and she is sharing stories from the very beginning, like the time she forgot we filmed the pilot episode.
Behind the Bastards
It Could Happen Here Weekly 172
But then you forgot about it in the very long time they took to pick us up.
Behind the Bastards
It Could Happen Here Weekly 172
And she reveals what she thought when she read the script for Sex and the City the very first time.
Behind the Bastards
It Could Happen Here Weekly 172
And does she think Carrie is too good for Mr. Big?
Behind the Bastards
It Could Happen Here Weekly 172
You can't miss this. Listen to Are You a Charlotte? on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.
Behind the Bastards
It Could Happen Here Weekly 172
Hi, I'm Kristen Davis, host of the podcast, Are You a Charlotte? What we have all been waiting for. Sarah Jessica Parker is here, and she is sharing stories from the very beginning, like the time she forgot we filmed the pilot episode.
Behind the Bastards
It Could Happen Here Weekly 172
But then you forgot about it in the very long time they took to pick us up.
Behind the Bastards
It Could Happen Here Weekly 172
And she reveals what she thought when she read the script for Sex and the City the very first time.
Behind the Bastards
It Could Happen Here Weekly 172
And does she think Carrie is too good for Mr. Big?
Behind the Bastards
It Could Happen Here Weekly 172
You can't miss this. Listen to Are You a Charlotte? on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.