“Dose of Reality” Breaking Down the Big Pharma Dollar

This post was originally published on CSRXP.org here.

The average American spends $1,200 per year out-of-pocket on prescription drugs. Altogether, the 10 largest U.S.-based Big Pharma drug manufacturers pulled in a colossal $245 billion in revenue in just one year.

As prescription drug prices continue to climb, causing one in four Americans to not be able to afford their medications, do you ever wonder how Big Pharma spends all those dollars? We set out to get you the answer.

CSRxP, in partnership with GlobalData, conducted a study to determine how Big Pharma allocates revenue across six categories and broke it down to the dollar:

So far, we’ve poked holes in Big Pharma’s faulty defense that they have to raise drug prices because they need the money for research and development (R&D). Yesterday, we looked at Big Pharma’s soaring profits. Today, we’re looking at one of Big Pharma’s fastest growing spending priorities: marketing and advertising.

It’s almost impossible to turn on your television without seeing a commercial for a brand name prescription drug. Ads for blockbuster medications like Humira, Lyrica and Chantix are everywhere – and it’s no wonder considering how much money Big Pharma is pouring into marketing.

Spending Big and Still Climbing

The CSRxP and GlobalData study found more than 19 cents of every Big Pharma dollar goes to marketing and advertising — a whopping $47 billion when looking at just the top 10 U.S.-based drug makers.

And that number appears to be on the rise.

A report from Kantar Media released last month found that while Big Pharma continues to hike prices of life-saving medication, the industry’s spending on advertising is growing. In 2018, spending on advertising for just the top five selling brand name prescription drugs climbed five percent over the previous year.

Top Ad Spenders = Top Price-Gougers

The Big Pharma giants who are spending big on advertising are also among those who are the most aggressively raising prices on their top-selling drugs.

Take AbbVie and its top-selling drug Humira, for example:

AbbVie doubled the list priceof Humira from 2012 to 2018 from $19,000 to a whopping $38,000. Sales of Humira reached a record breaking $20 billion in 2018.

The Kantar Media report found that AbbVie increased advertising spending on Humira by 13 percent last year – bringing total ad spending on the drug to a staggering $487 million.
Pfizer was no different:

Since 2012, Pfizer has increasedthe price of its pain management drug Lyrica by 163 percent. In January, Pfizer increased the list prices of Xeljanz and Chantix by 9.4 and five percent, respectively.

Kantar Media found that Pfizer’s top advertising spending for those three drugs reached nearly $750 million dollars.
These Big Pharma giants who are investing boldly in advertising received a dose of badly needed medicine last week.

The U.S. Department of Health and Human Services (HHS) announced that starting in June, drug makers would be required to disclose list prices in their ads. A move to bring much-needed transparency to the marketplace.

Big Pharma’s trade association complained after the announcement and were met with a swift response:

“If you are ashamed of your drug prices, change your drug prices, it’s that simple.” – U.S. Secretary of the Department of Health and Human Services Alex Azar, POLITICO, 5/8/19

Welcome to the HealthCare Freedom Alliance

Mainstream and social media companies MUST #stophealthcarecensorship.

Scientists, researchers, doctors, patients, and parents of victims MUST be able to exercise their freedom of speech by questioning and debating the positions held by government health care agencies that have clear, proven financial conflicts of interest.

Healthcare policy decision-makers MUST NOT personally profit from their decisions to promote or denounce any specific Pharma sponsored therapeutic or vaccine.

Decision-makers MUST be independent to follow the data, research, and science that supports policies in the public’s best interest versus being censored if their conclusions don’t align with Pharma’s highest profits.  

Mandatory policies, whether for masks, lock-downs, and shots, MUST have sound, valid, accurate, health research and data as their basis, not political affiliation, intimidation or censorship.  

Media MUST stop instilling irrational fear in society day after day after day. Fear is the virus that justifies the evaporation of our personal civil liberties and freedoms. 

We MUST exercise our common sense and remember that Pharma is the same industry led by convicted criminal corporations that created the Opioid Crisis and have been found guilty of fraud, bribery and illegally selling products known to cause death and community devastation. 

We MUST acknowledge that Pharma has a long history of being guilty of making “False Claims” and consistent practice of “Off-label promotion” to sell more product without scientific basis along with “kick-backs” aka illegal bribery and intentionally creating Phalse Hope and Phear as scare tactics to create unnecessary demand for their products. 

Be open to exploring, innovating, and promoting solutions not exclusively controlled and sold by Pharma.


Build awareness of the corruption and financial conflicts of interest in politics, practice, and the media that have influenced what we all believe about health and healthcare. 


Prevent mandates for anything that does not hold up to the highest level of safety and efficacy standards over time, considered within the larger societal context of cost versus benefit.






CHD Holds Press Conference with Legal Team and Plaintiff in Lawsuit Against Facebook, Mark Zuckerberg, and Three of Facebook’s So-Called “Fact-Checkers”

This is post was originally published on ChildrensHealthDefense.org here by Robert F. Kennedy, Jr.

Watch the Press Conference with the attorneys and a pediatrician directly affected by Facebook’s censorship by clicking here.

Children’s Health Defense (CHD) filed a lawsuit on Monday, August 17, 2020 in San Francisco Federal Court charging Facebook, Mark Zuckerberg, and three fact-checking outfits with censoring truthful public health posts and for fraudulently misrepresenting and defaming CHD. CHD is a non-profit watchdog group that roots out corruption in federal agencies, including Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), and the Federal Communications Commission (FCC), and exposes wrongdoings in the Pharmaceutical and Telecom industries. CHD has been a frequent critic of WiFi and 5G Network safety and of certain vaccine policies that CHD claims put Big Pharma profits ahead of public health. CHD has fiercely criticized agency corruption at WHO, CDC and FCC.

According to CHD’s Complaint, Facebook has insidious conflicts with the Pharmaceutical industry and its captive health agencies and has economic stakes in telecom and 5G. Facebook currently censors CHD’s page, targeting its purge against factual information about vaccines, 5G and public health agencies.

Facebook acknowledges that it coordinates its censorship campaign with the WHO and the CDC. While earlier court decisions have upheld Facebook’s right to censor its pages, CHD argues that Facebook’s pervasive government collaborations make its censorship of CHD a First Amendment violation. The government’s role in Facebook’s censorship goes deeper than its close coordination with CDC and WHO. The Facebook censorship began at the suggestion of powerful Democratic Congressman and Intelligence Committee Chairman Representative Adam Schiff, who in March 2019 asked Facebook to suppress and purge internet content critical of government vaccine policies. Facebook and Schiff use the term “misinformation” as a euphemism for any statement, whether truthful or not, that contradicts official government pronouncements. The WHO issued a press release commending Facebook for coordinating its ongoing censorship campaign with public health officials. That same day, Facebook published a “warning label” on CHD’s page, which implies that CHD’s content is inaccurate, and directs CHD followers to turn to the CDC for “reliable, up to date information.” This is an important First Amendment case that tests the boundaries of government authority to openly censor unwanted critique of government.

Attorneys Robert F. Kennedy, Jr., Roger Teich, and Mary Holland represent Children’s Health Defense in the litigation.

The lawsuit also challenges Facebook’s use of so-called “independent fact-checkers” – which, in truth, are neither independent nor fact-based – to create oppositional content on CHD’s page, literally superimposed over CHD’s original content, about open matters of scientific controversy. To further silence CHD’s dissent against important government policies and its critique of Pharmaceutical products, Facebook deactivated CHD’s donate button, and uses a variety of deceptive technology (i.e. shadow banning) to minimize the reach and visibility of CHD’s content.  In short, Facebook and the government colluded to silence CHD and its followers. Such tactics are fundamentally at odds with the First Amendment, which guarantees the American public the benefits to democracy from free flow of information in the marketplace of ideas. It forbids the government from censoring private speech—particularly speech that criticizes government policies or officials. As Justice Holmes famously said, “the best test of truth is the power of the thought to get itself accepted in the competition of the market.” The current COVID pandemic makes the need for open and fierce public debate on health issues more critical than ever.

Mark Zuckerberg publicly claims that social media platforms shouldn’t be “the arbiters of truth.” This case exposes Zuckerberg for working with the government to suppress and purge unwanted critiques of government officials and policies.

The court will decide whether Facebook’s new government-directed business model of false and misleading “warning labels,” deceptive “fact-checks,” and disabling a non-profit’s donate button, passes muster under the First and Fifth Amendments, the Lanham Act, and RICO. Those statutes protect CHD against online wire-fraud, false disparagement, and knowingly false statements.

CHD asks the Court to declare Facebook’s actions unconstitutional and fraudulent, and award injunctive relief and damages.

Hospitals Must Let Doctors and Nurses Speak Out

This post was originally published on TheAtlantic.com here by staff writer Conor Friedersdorf.

Nicholas Christakis says that “clamping down on people who are speaking is a kind of idiocy of the highest order.”

Throughout the United States, doctors and nurses at the forefront of the fight against the coronavirus want to share what they are seeing and hearing with the public. But some fear that doing so could get them punished or fired by hospital administrators or medical-staffing agencies. Recent press reports document that many institutions have formally warned employees against speaking out, while some have already terminated various medical professionals.

NYU’s Langone Medical Center is among the institutions that sent a written warning to its health-care workers. It later asserted in a public statement that limiting the speech of its doctors and nurses is a long-standing policy intended to protect patient and staff confidentiality. “Because information related to coronavirus is constantly evolving, it is in the best interest of our staff and the institution that only those with the most updated information are permitted to address these issues with the media,” the statement said. “We have a responsibility to the public at large to ensure that the information they receive from our institution is accurate.”

Does that rationale stand up to scrutiny? To think that through, I called Nicholas Christakis, a physician and professor who directs the Human Nature Lab at Yale. For 15 years, he has studied different contagions, including the H1NI flu. One study probed what happens when a biological contagion such as H1N1 unfolds alongside a behavioral shift, or a so-called social contagion, such as wearing masks. How quickly must a social contagion spread through human networks to arrest a biological contagion?

“When the pandemic began, I never imagined that two topics I have an intellectual or philosophical interest in—processes of contagion and issues of free expression—would overlap in the United States,” he told me. “I realize there’s a world of a difference between speech suppression by the Chinese Communist Party or a government entity. But it’s just not a good look for hospitals—and especially for academic medical centers, for which many of the doctors and nurses are on the faculty, and which have a commitment to free expression—to be disciplining their doctors and nurses in the middle of a pandemic.”

What follows is a condensed and edited version of our conversation.

Conor Friedersdorf: What specifically is wrong about policing the speech of doctors and nurses?

Nicholas Christakis: It is bad for morale. It is inefficient in the sense that we’re taking health-care workers out of commission at the time we need them the most. It is absurd that administrators are spending time surveilling the social-media posts of their personnel rather than trying to actually fix the problem by addressing inefficiencies in their hospital or sourcing [personal protective equipment]. And finally, we are not going to kill this germ with censorship! The idea that we can hide from inconvenient truths or close our eyes and pretend that the situation is not the way it is by clamping down on people who are speaking is a kind of idiocy of the highest order. I find the whole thing absurd. The sharing of information is extremely useful and important to optimize efficiency. And don’t these administrators have anything better to do? Hospitals are scrambling. Why try to run around and shut up your staff when you could be fixing supply chains or sourcing ovens to heat PPE or preparing to divide wards to separate the sick from the not so sick? There are so many urgent things to do right now.

Friedersdorf: You’ve studied a lot of pandemics and epidemics. Is there any compelling public-health reason for restricting information flows?

Christakis: I cannot see any legitimate reason for such practices. I can imagine that people will say they’re trying to tamp down on panic or to provide a consistent message to a confused public. But if anything, in my view, the ham-fisted way this is being done is going to contribute to public disbelief in experts.

Friedersdorf: One can imagine an irresponsible doctor or nurse somewhere who says something that’s false or needlessly inflammatory.

Christakis: The way we gain credibility and show our expertise is by forthrightly addressing false information or taking ownership when uncomfortable true information is released. I get the idea that there could be rumors, there could be false information, there could be inconsistent information. In fact, our own government has been inconsistent in a number of its recommendations.

Now imagine for the sake of argument that back in February, when the government was reassuring everyone that everything was okay, if people like me and other epidemiologists trying to sound the alarm had been muzzled, or told that we were giving inconsistent information when we were telling the truth. I don’t accept that we are better off silencing people saying things that we don’t agree with. I totally, fundamentally reject that, not just from a principle of free expression, but also wanting to optimally meet grave challenges. So let me tell you what I would put in its place.

If a hospital is concerned that wrong information is spreading, the way to gain credibility is to stand up in a meeting or release a public statement once a day saying, “We have heard the following things: Our nurses are reporting a shortage of PPE in our hospital. This is true! And here is the challenge we’re facing as a nation. This is what we’re trying to do about it. Or, “This is false, and here’s why we reject it. Here is the evidentiary basis.” This increases credibility when we need it. It provides the public with confidence that the people leading them or who are responsible for their lives are telling the truth. Whereas if you try to suppress it, I’m thinking, What else is the hospital hiding that they don’t want me to know? Why should I trust anything they say?

Friedersdorf: What useful things might we learn if doctors and nurses are able to speak freely?

Christakis: We might learn, for instance, that doctors and nurses need housing because they don’t want to go home to their loved ones, that they’re willing to work but would welcome it if a local hotel owner gave them a place to stay. We might learn that they need child care, and be motivated to figure out how to provide it. We might learn that they need meals or want food delivered so that they can be more efficient at work and work harder. We all know now about the shortage of PPE. The more we hear about it, or the more anecdotes or stories that people in different communities get, the more people might be motivated to share the PPE that they’ve previously been hoarding.

We might learn about hot spots that we didn’t know about, or that even though the governor of state X says nothing is wrong, actually workers in a hospital there say we have an outbreak. There are so many ways in which the frank exchange of information and the forthright confrontation of falsehoods that may circulate, perhaps as rumors, enhance our ability to fight this epidemic. A hospital that corrects a false rumor has an opportunity to enhance their credibility.

Friedersdorf: But surely some false rumors do harm.

Christakis: We have all these hucksters in our nation—including some TV celebrities, some religious figures—who are circulating falsehoods about the efficacy of certain treatments. And they’re just making a buck. These people should be despised. They are in the worst tradition of snake-oil salesmen. So much so that they were caricatured in the movie Contagion by the man who was selling forsythia.

These people are awful. They have no basis for their claims. They are lying. And they are exploiting the fear of the public. But I would not stop them from saying these awful and wrong things. Instead, I would get up and say that they are lying, as I am to you now, and why they are lying, that there is no evidentiary basis for their claims.

So what I am saying is that I am not familiar with a case where the flow of information has been shut down in ways that have been beneficial even when we are sorely tempted to shut some people up.

Friedersdorf: Because the free flow of information also bolsters public trust in experts who deserve to be heeded?

Christakis: Yes. Look what’s happening in China right now. The populace doesn’t know what to believe. There are all these indicators and rumors that deaths in Wuhan were four times as large as official figures, judging by the number of funerary urns being delivered. And when officials say yes or no, nobody believes them, because they don’t have any credibility. It is so important to not be seen as squashing the flow of information and to acknowledge your mistakes so that when you get up and say something, people believe you. That kind of credibility is incredibly important when you’re trying to organize large groups of people. Look at the send-off Captain [Brett] Crozier just got when he disembarked from the Theodore Roosevelt. His sailors knew what was going on. His credibility was enormous.

Friedersdorf: Institutions often censor their employees reflexively. Still, I’m a bit confused about the institutional incentives that are causing hospitals to crack down on employee speech, even in this anomalous emergency. If a nurse at a hospital were to tell a local newspaper, “I’m not getting the protective equipment that I need,” or to post on Facebook, “God, we’re overwhelmed. This is really tough,” that doesn’t seem like it would hurt the hospital’s consumer brand in the long run or affect who goes there two years from now for a knee surgery. Would I have found this same approach from hospitals before this pandemic?

Christakis: Yes, this managerial posture is long-standing––this effort to clamp down on information. So I don’t think it’s a new thing. I think the coronavirus heightened it. I also think it reflects a shift in the last 20 or 30 years from doctors being perceived as professionals to doctors being treated as corporate employees. The idea that some administrator is authorized to tell doctors what they can and cannot say and do comes from a shift in vision of the function of doctors in our society. Nurses too. Instead of being treated as independent professionals who swore a Hippocratic oath and are carrying out a moral calling—I mean, these health-care workers are literally risking their lives. It’s hard to imagine a more important calling than one that requires this of you. And they’re doing it for us. The idea that they can simultaneously be shut up is just offensive to me.