An Insider Tells All

Tom Nesi used to be the director of public affairs at Bristol-Myers Squibb. He quit, and now he is a whistle-blower. Welcome aboard, Tom!

Last week's issue of U.S. News and World Report carried this interview with Nesi about his new book, Poison Pills: The Untold Story of the Vioxx Drug Scandal.

Here is an excerpt from the interview:

You argue that in the context of pharmaceuticals, new is not always better. Why?

It's extremely important that people understand 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.
[With older drugs], not only is there more data but more usage experience. Doctors know how to use it—they become familiar with it. An example in the pain market: When some of these non-steroidal anti-inflammatories were released, like Motrin and Aleve, they were actually given at doses that were too high. As the years go by, [drugs] can actually become safer.

As a veteran drug marketer, you warn consumers to beware huge marketing campaigns for new drugs. In fact, you urge people to ask their doctors for proof that new drugs are superior to older ones before accepting a prescription for the newer medicine.

I would say the larger the marketing campaign, the more you should use caution. I would also say if there are good drugs in a category—in a type of illness that you suffer from—that have been out there for a while, there's no reason not to use those first.

If you are interested in a more in depth discussion of Vioxx in particular, read this interview with Ed Silverman at Pharmalot.