Dr. Kaveh Hoda
Appearances
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.