In The Good Place, the former pharmaceutical drug pusher Eleanor probably doesn’t deserve the saintly eternity she’s been dealt. Is it a coincidence that she, a former salesperson for a shady drug company, was killed by a hit from a pharmaceutical delivery truck? Recent research into the world’s Martin Shkrelis would argue the answer is no.
Sure, #NotAllPharmaceuticalDrugSalespeople, but a recent review of “unnecessary, misleading, and conflicted systematic reviews and meta-analyses” in the Milbank Quarterly by John Ioannidis of Stanford University shows evidence that many drug prescription decisions are built off of shady science. And it appears that all too many pharmaceutical companies turn a willing blind eye to it.
“We have a massive factory of industry-supported reviews that paint a picture of antidepressants being wonderful and easy-to-talk,” Ioannidis told Quartz. “These systematic reviews have become a marketing tool.”
This is how it works: The way drugs are developed, sold, and prescribed is based on systematic reviews of evidence that the medicine works without harm. These reviews, Ioannidis argues, aren’t trustworthy. Many of them, produced in recent years at a startling pace, ultimately draw incorrect conclusions because the data they begin with is wrong. In some instances, that data comes from studies that are later proven to be faulty. Sometimes it’s caused by human error, induced by the pressure to produce data at an unprecedented speed. And in many other cases, it’s the result of author bias — researchers employed at the pharmaceutical company that commissioned the study.
Ioannidis argues that one of the reasons that this influx of redundant, inaccurate meta-analyses persists is because they work to the advantage of pharmaceutical companies. As the Quartz analysis explained: “[When] an industry author contributed to a systematic review, the review is 22 times less likely to make a negative statement.” Many of the analyses are produced by contractors hired by pharmaceutical companies who, in part, request the reviews as a “means to obtain extra insights about the relative merits of their products and of those manufactured by competitors.” In other words: Meta-analyses make your product look legit, even if the analyses themselves are not.
There’s a growing movement to hold Big Pharma accountable for exploitation. Just this Wednesday, the executives of Mylan Pharmacueticals were brought to a congressional hearing to explain the 500% increase price gouging of their EpiPen. We’ll have to keep watching to see if Eleanor of The Good Place was bad enough to pull shit like that.