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Dr. John Virapen


Confessions of a pharma-insider,


The truth,
The whole truth
And nothing but the truth,
So help me God.

Night after night shadowy figures gather at my bedside. They usually appear during the early hours of the morning. They bang their head against the walls and cut their arms and throats with razor blades. I wake up drenched in sweat. I indirectly contributed to the death of the people, whose shadows now haunt me.

I didn’t personally kill anyone, but I feel indirectly responsible for their deaths. No, I was a willing tool of the pharmaceutical industry.

“Really?” you might ask. “Well, yes, I was a tool; a mere tool like a hammer is to a carpenter.” And you might sneer. You are right. I was more than that. Unlike the hammer I have my own will. But honestly, how freely does one make their own decisions? Manipulation of will in the pharmaceutical industry plays an important role in my story. And, is there a more dangerous tool than a person whose will has been manipulated? It’s like selling your soul to the devil.

Today I no longer play this game. As an individual, I wasn’t that important, I was only a pawn in the game. It was important that I functioned to their satisfaction. And the game continues. Others function as I did and do what I did.

As a patient, you are always a pawn in the game. You are the most important pawn. The game is tailormade for you and for your children.

Now, you will surely say, that the pharmaceutical industry does good for mankind for example; they do research to develop new drugs to help people. That’s what they loudly proclaim. They produce pictures of children laughing and old people dancing on a beautiful sunny day, and yet the picture isn’t correct. Unfortunately, it is stained, and that is putting it mildly.

  • Did you know that large pharmaceutical corporations spend about $35,000–$40,000 per year and per practicing doctor to persuade them to prescribe their products?
  • Did you know that so-called opinion maker/leaders – that is to say recognized scientists and doctors – are specifically bribed with expensive trips, presents and quite simply with money to report positively about medicines, when their serious and even fatal side effects have become public, in order to banish the valid concerns of doctors and patients?
  • Did you know that there are only short-term clinical trials for many newly approved drugs and nobody knows the effects on patients who take them for long periods or even for the rest of their lives?
  • Did you know that the research reports and statistics, which are necessary for the approval of drugs by the regulatory authorities, are constantly being edited, so that deaths caused by the side effects of the drug can no longer be found in them?
  • Did you know that more than 75 percent of the leading scientists in medicine are paid by the pharmaceutical industry?
  • Did you know that there are drugs on the market where bribery played a role in the approval process?
  • Did you know that the pharmaceutical industry invents illnesses and promotes them with targeted marketing campaigns to increase the market for their products?
  • Did you know that the pharmaceutical industry increasingly has its sights on children?

No. Much of that you couldn’t know, because the pharmaceutical industry has a large interest in keeping it secret. If some of it is made public, then only if it is unavoidable – as was the case with the German pharmaceutical manufacturer TeGenero. This was in London in 2006. Do you remember? “Drug trial creates ‘Elephant Man’” was the headline on CNN News.2 The head of one of the human guinea pigs swelled within two hours of taking the new wonder pill to three times its size and resembled the “Elephant Man”. Something went wrong at TeGenero. Not the head swelling. That doesn’t worry the pharmaceutical industry. The fact that it became public, which is the real problem. “Amateurs,” is what I would have said back then, when I was active. TeGenero had no choice. They disappeared and filed for insolvency. That doesn’t happen to a global player.

Such cases, however, are always exceptions. Often it is maintained that the test subjects were critically ill, anyway. They are given the blame for their own kidney failure or their own death. It is constantly stressed how useful drugs are for many other people. My book reveals how wrong both of these self-serving declarations are.

I Was a Global Player

I’m not talking as an outsider and not as an investigative journalist. I am not pointing with a morally clean, sterile finger at the evil people up there. I know what I am talking about because I was actively involved. I was one of them.

I worked for the pharmaceutical industry, beginning in 1968. I started out as a salesman, who knocks on doctors’ doors. I worked my way up. Each step of the career ladder is shaped by the ignorance the respective bosses allow their employees to remain in. Since I carried on climbing, I found out more and more. And I became an offender myself. I worked for various companies. I left one company and went to the next in a higher position, allowing me to climb steeply upwards. I got to know some multinational companies from the inside. I became the General Manager of Eli Lilly & Company in Sweden and later worked for global players such as Novo Nordisk and Lundbeck from Denmark.

As far as the product range goes: sometimes, it was wonder pills against arthritis, or the human insulin scandal, or rejuvenating cures (growth hormones), and finally the new psychotropic family of selective serotonin reuptake inhibitors (SSRIs), which are wrongfully called mood lifters. These drugs are anything but that. They drive people to suicide or to kill others. These dangerous substances are not drugs that only treat rare diseases. On the contrary, just one single drug from this family generates billions of dollars in turnover. Per year. Every year.

Marketing and Bribery

I developed and implemented marketing campaigns for these dangerous and widely-used products. Marketing comprised the whole range, starting with expensive presents for doctors, trips for opinion maker/leaders, money for paid articles in scientific journals, the preparation and realization of scientific conferences, right up to brothel visits for particularly high-maintenance managers.

And finally, bribing authorities became a part of my sad repertoire. One of these cases is, in particular, the flagship of my career and generated specific consequences. It was the bribing of an independent expert, employed by the regulatory authorities of a country, to attain approval of a drug.

The fact that I willingly took part in it is what torments me the most. Pajamas drenched with sweat – that is the motor for self-awareness. I had performed a criminal act. I was forced to use bribery to influence drug approval, even though I knew the drug would harm people.

I am 64 years of age now, and I live in the south of Germany. I am married and have a young son (3 years old), who is the most important thing in the world to me. The pharmaceutical industry is constantly searching for new lucrative markets – today, it is children. And I am scared.

I am not afraid of my former bosses, even though I know that others, who revealed wrongdoings, have all gambled with their lives to do so. The pharmaceutical industry’s lobby is extremely powerful. It constantly lobbies politicians and the judiciary and even blackmails governments by threatening to withdraw investments or to close down sites, thus, creating unemployment in a country. Before you know it, the government backs down and plays the game, just as the industry stipulates. The influence of the pharmaceutical industry is often invisible.

A year ago, I had a telephone conversation with the editor of a famous German scientific publisher. This editor was very interested in my story, thus, interested in this book. “The lid must be lifted”; he said fervently, “the public must finally be informed about what is going on.” He was all for it.

I said, “Good, then publish the book.”

He laughed heartily and said that it was impossible for them because publishers usually thrive from the ads of the pharmaceutical industry. This publisher publishes standard medical reference works. However, he urgently requested a copy of this book to be sent to his private address, should it ever be published. He didn’t want to miss the satisfaction of being among the first to read it.

A man, Alfredo Pequito, was attacked with a knife for revealing inconvenient truths about the pharmaceutical industry. He had to have 70 stitches. And that didn’t happen in a third-world country or in Los Angeles and not in the second to last century in the Wild West. No, it happened amongst us, in the middle of civilization. This happened despite enormous personal protection. The man had worked in Portugal as a representative for the German pharmaceutical company BAYER, so he was on the career step that I had started on, some thirty years ago. He was one of those guys who always appear at the doctors with free samples, candy, and perhaps a bit more.

My Past and the Future of My Son

Such cases don’t frighten me. No, I’m scared that my son will also be turned into the type of person that the pharmaceutical industry loves the most – a willing pill-popper, who takes medicines for made-up illnesses and those you are talked into having, with deadly side effects included in the price. The pharmaceutical industry is changing the reasoning of the coming generation.

As a matter of fact, it has already begun. Have you heard of ADHD? No? It is popularly known as Fidgety Philip or hyperactivity in children. Children, who can’t sit still, who interrupt when others are talking, who disturb lessons – children who behave like plain, unadjusted children. According to the pharmaceutical industry, these children are suffering from a disease called, ADHD (Attention Deficit Hyperactivity Disorder). Of course, there are medicines for this. Otherwise, there wouldn’t be so much enormous and aggressive advertising for these products. Ritalin® is one of the most well-known products. Strattera®, a newer one, originates from the company, for which I worked, for many years, Eli Lilly & Company. So far, no one knows about the developmental disorders and long-term damage Strattera® causes. Nevertheless, it is prescribed thousands of times every day to allegedly hyperactive children.

The pharmaceutical industry takes care of that. I was involved – not with Strattera®, but with Prozac® (Fluoxetine), a predecessor of Strattera®. As of this year, Prozac® can also be prescribed for children in Germany, where I live (the trade name for Prozac® in Germany is Fluctin®). It’s what is called a lineextension in marketing jargon: If a market segment has reached its upper limit, you start looking for a new market segment. Children are a new market segment. Now, it’s their turn to swallow Prozac® – a medicine that can make you aggressive and even tired of living. Approval should not be given to such crap. But, unfortunately, it is. And I know how to arrange this.

Don’t get me wrong: There’s nothing wrong with maximization of turnover, and I would be the last who would make capitalism alone responsible for the sordid deals with health I describe in this book. Be profitoriented, if you sell cars or screws or burgers, for all I care, but here we are dealing with the physical and mental well-being of people, whose destruction is deliberately accepted by the pharmaceutical industry, in order to make money and even more money. Hidden and unnoticed death.

If a car’s brakes don’t work every time, if its windshield falls out, when it is driven at over 40 mph, or if its exhaust fumes are channeled into the inside of the car – it wouldn’t make it onto the market. Medicines with equally dangerous side effects do. How is that possible? Why are consumers better protected against defective cars than against what happens to their bodies, to their health, to their lives?

Of course, not the entire pharmaceutical industry is bad. I can’t judge them all since I don’t know all of the companies. But the search for an ethically pure company can be equated with searching for a needle in a haystack. Pharmacists started out differently. They were suppliers of medicine. The search to cure diseases was the motive behind their research. Today the driving force is turnover.

Which active pharmaceutical ingredient brings the most money? This is the question. Particularly since supposedly new active pharmaceutical ingredients are allowed to be sold at higher prices. Whether these medicines are effective or their damage greater than their benefit – who cares?

It’s All Just a Question of Money

It’s all just a question of money – which is the most important message of my book. You achieve what you want, you break your back and avoid every legal boundary, if you just know the correct price – and are prepared to pay. It doesn’t even have to be an astronomical sum, as my example with Prozac® will show, and, even in other cases, the sums were indeed high or rather the goods were valuable – but not exorbitant. For bribery, you need a lot of instinctive feeling. It can’t be too heavy-handed. First-rate small talk is just as important as the price itself.

State authorities will not be able to save you or my little son from the criminal structures within the pharmaceutical industry. Authorities are bribable, experts are bribable and the doctors are, too. Everyone is corruptible in a sense. Every father, every mother knows that. Mothers and fathers manipulate their children by promising to let them stay up later to watch TV – if they will just finish the food on their plate. Conversely, a child will stop its whining, as soon as it gets what it wants. That’s all just part of normal, daily life. The activities I refer to are strategically planned and part of the official procedure, just as they are part of a pharmaceutical company’s business plan. It is not coincidence. And today, it is progressing further than ever. Particularly with psychotropic pills. Many new products have developed since I was involved in the approval of the first ever blockbuster.

On February 7, 2004, a nineteen year old student hanged herself with a scarf in the laboratory of the pharmaceutical company, Eli Lilly, during a clinical study. Suicide under clinical conditions. This is insane. This was only one of a whole series of suicides, and one of the few which the public found out about. The young woman was completely healthy at the beginning of the trial. The money she was to receive for participating in the trial was to help finance her studies. To be on the safe side, people with any signs of

depression were excluded from the trials. Although the drug to be tested was supposed to be approved for people with depression.

As always, the suicides were kept secret for as long as possible. If a religious sect were to drive young, healthy people psychologically crazy by means of chemical and/or other methods of brainwashing to the extent to which suicide seemed to be the only logical solution; these sects would be banned immediately, with good reason. But the research laboratories of the pharmaceutical industry are not banned, nor are the even bigger laboratories, with millions of patients, who are unknowingly given such badly tested and life-threatening drugs with fancy and expensive names. You are part of this laboratory. And you pay for it, sometimes with your life. Did anyone inform you about this?

Productive Concern

There is every reason for concern. Don’t let this concern remain an unspecific feeling inside you, let it become active. That is my wish. Everyone in the pharmaceutical industry can play their part, as well. People like me, who have had enough of their bosses’ and their own lies, whose conscience is stricken.

After reading this book, you probably won’t like me very much. Condemn and damn me. You cannot be harsher on me than I am on myself. But you will start to be more aware, when you visit your doctor and see how they prescribe medicines; you’ll be aware of the latest scientific news, research reports and scientific symposia, medical journals, government recommendations, as well as being able to see the safety of drug approval procedures in a completely different light.

The Set-up of this Book

The first part of this book is about the upward climb of a child from a corner of the Third World to the global stage of the pharmaceutical industry.

The second part deals with the transformation of the pharmaceutical industry to a corrupt dream factory in the early 1980s – and about my involvement in that. Furthermore, I will describe the further development of the pharmaceutical industry’s unethical sales strategies, up to the present day.

In the third part, you will find my suggestions for the improvement of patient protection, a glossary of the most important terms, as well as addresses for further information.

There is nothing worse than the pharmaceutical industry’s being exposed to public attention because negative publicity, such as patients who slash themselves open in clinical trials, test subjects whose heads swell to the size of balloons, all have effects on the sanctum of the pharmaceutical industry, namely their turnover. The public, YOU, have the power to change things. Help stop this madness. You have the power to do it.

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