Last Week Tonight With John Oliver (2014) s02e01 Episode Script

Marketing to Doctors

1 Last Week Tonight with John Oliver S02E01 Marketing to Doctors welcome, welcome to "Last Week Tonight" I'm John Oliver.
It's so great so great to be back with you.
Clearly clearly, clearly we have been gone for the last three months.
And you're probably thinking I was on vacation.
That was not, in fact, the case.
Much like Brian Williams, I voluntarily took myself off the air, after the merge, I presented false information to you last year.
Roll the clip.
My theory always was that Hemingway was hung like a hamster, not that there's anything wrong with that.
Oh oh, you're right.
There's absolutely nothing wrong with that.
We googled "hamster penis", and this is what you find.
That's adorable.
I'm embarrassed to say that it turns out that is not, in fact, a hamster penis.
It is a hamster tail.
I would like to truly apologize to you the viewers, to the editorial staff here, and most of all to that hamster.
You deserved better, Niblet.
You deserved much better.
So with that out of the way, we trust, we build.
But let's move on to a quick recap of the week.
It began with a glorious looming scandal in the U.
Illinois congressman Aaron Schock is being asked a lot of questions right now after redecorating his capitol hill office suite style of the PBS TV series "Downton Abbey.
" Oh, "Downton Abbey".
" That is perfect.
What better way to show you're in touch with your constituents than decorating your office in the manner of a 1920's British aristocrat.
But, le-let's I'm intrigued how "Downton Abbey" -ish is his office? This is Schock's office, bright red, a gleaming chandelier, just like on television, and a vase of pheasant feathers.
Pheasant feathers! Somewhere in Illinois, there's a pheasant freezing his ass off and going, what, you couldn't just pick something up at West Elm? Have you ever heard, have you ever heard of a eucalyptus bundle? Unbelievable! The congressman had some explaining to do.
And explain he did.
A couple of things there.
You are definitely an old, crusty white guy if you think Taylor Swift was the first person to say haters gonna hate.
But to be fair to him, quoting "Shake It Off" is probably as close as a congressman can come to saying "hey, go fuck yourself, my office is magnificent!" Haters gonna hate.
Shake it off.
Shake it off, shake it off.
Moving on.
Moving on to what may have been the most spectacularly ill-advised moment in diplomacy this week.
Argentina's embattled president Christina Fernandez is under fire for a tweet during a state visit to China after meeting with the Chinese president.
And if you're thinking, how bad could a tweet from a world leader be? Well, this bad.
Fernandez tried to mimic a Chinese accent by switching r's" with what appeared to be maybe I's in a tweet that translates as "did they only come from lice and petroleum.
Instead of rice and petroleum.
Holy shit.
Lice and petloleum.
That is a level of clueless racism on the Internet you'd expect from a Dartmouth sorority pledge.
And perhaps, you're the worst.
You're the worst.
And perhaps the most amazing thing is that she tweeted this during a vitally important four-day state visit.
They're negotiating 15 major agreements, which include two huge hydroelectric dams in Patagonia, investment in ports through which Argentina exports thousands of ton of soy to China and military hardware.
I have to say it's actually pretty bick of China to just go ahead with their negotiations like nothing had happened.
Because if I were them, at the very least, I would've served president Kirchner a bowl of lice saying "here's your food, it's you know Your funny jokes, that funny joke you said.
Why don't you eat your funny joke? You still owe us billions of dollars, by the way" And finally, finally this week, there was sad news for a true American icon.
RadioShack, the 94-year-old consumer electronics chain, has filed for bankruptcy protection.
Half of its 4,000 stores will be turned into sprint locations.
The others will be shutdown.
You know, it's a rough day when 2,000 new sprint locations is the happy part of the sentence.
Sure, sure, Radioshack has not been in great shape in recent years.
It's easy to forget it once ran ads like this.
So much more than just a store.
The best in America, RadioShack nobody compares to RadioShack.
That is a catchy song, my friend.
If they'd left that on the air, they'd be the most powerful company on earth today.
The death of Radioshack in itself is not surprising.
What is surprising is the glib, jokey tone with which its demise has been discussed over the past year.
If you have the name radio in your corporate name, that's probably not a good sign in 2014.
Is Radioshack doomed to remain a punchline? I actually like Radioshack.
I go there a few times a year.
And I kinda like it, I guess I'm old school.
You must have a very full junk drawer.
It's all I can say.
This is a dying 94-year-old business! At this point, it's like you're sitting across from your grandfather at Thanksgiving dinner and saying: "You know, I don't really see the point of grandpa Fred in 2015.
" Frankly, I'm sort of surprised he still exists.
RadioShack would be well within its rights to be a little hurt at this level of disrespect, which is why we've prepared a farewell message for them, that they should feel free to use.
For nearly a century we at RadioShack had proudly served America, providing you with the highest quality home electronics at the best prices and now sadly it's time for us to say goodbye.
And so we would like to offer this special farewell message to America.
Go fuck yourselves! That's right.
Take a dirty pack of batteries and shove them directly up your ass.
Who sold your parents that remote control car you got for Christmas in 1993 that you love so damn much? RadioShack, motherfuckers, that's who! And remember in 1989, when you needed a cable to plug your Nintendo to the TV, who was there for you? That's right, Radioshack again, assholes.
And now look at you, laughing at our slow painful death.
Well, laugh while you still can, shit heads because one day you too will be obsolete.
One day you too will be left behind in the wake of time ceaseless onslaught.
And when that day comes know that we'll be standing on your god damn grave laughing our asses off.
So America, from all of us here in RadioShack, goodbye and go to hell you filthy animals.
Moving on, moving on.
Our main story tonight: Prescription drugs.
The only ovals that can bring people in the Seattle area joy anymore.
To put it mildly to put it mildly, America takes a lot of these things.
70% of Americans take at least one prescription drug.
More than half of us take two.
Researchers say a record 4 billion prescriptions were written in 2011.
Total drug spending jumped last year by 3% to nearly $330 billion with a "b.
" Wow.
That works out to $1,000 per person on prescription drugs.
Kind of makes you feel like Walter white could've made more money cooking up rheumatoid arthritis medication.
But should this really be that surprising? Cause it's impossible to escape pharmaceutical ads.
You can't turn on the TV without being subjected to an endless stream of sleep-inducing moths, old men getting bonners while varnishing chairs or this.
If your bladder is calling the shots, you may have a medical condition called overactive bladder or o.
Again? But we just went.
Okay, okay.
Listen what that woman really needs is a pill to stop her hallucinating anthropomorphic bladders.
You're locked inside a prison of your own mind, Susan! Be gone demon bladder! Be gone! But that's only one small part of pharmaceutical marketing.
You see, drugs aren't like most other products, because you need someone's permission to buy them.
Which is why all drug ads end with the same catchy phrase, ask your doctor if Lunesta is right for you.
Ask your doctor about Myrbetriq.
- Ask your doctor - Ask your doctor ask your doctor "Ask your doctor.
" Three words you're either hearing in a commercial or saying to your coworker when he asks you if the mole on his back look cancerous I don't know, gene! Ask your doctor! All I said was "how was your weekend?" It's probably fine.
Drug companies know, the doctors hold all the real power in the prescription drug business which is why, while they spend nearly $4 billion a year marketing directly to us they spend an estimated $24 billion a year marketing directly to doctors.
In fact, one analysis claimed that, in 2013 nine out of the top 10 drug makers spent more on marketing than they did on research.
Drug companies are a bit like high school boyfriends they're much more concerned with getting inside you than being effective once they're in there.
So we thought we thought Don't think about that too much.
We thought We thought we'd take a look.
We thought we'd take a look at how all that marketing money gets spent which turns out to be surprisingly difficult.
It's a pretty secretive world.
You usually only get tantalizing glimpses into during lawsuits, years after the fact.
For instance, in 2012, the government settled a case with the makers of asthma medication Advair over-allegedly irresponsible marketing practices.
Which meant, for the first time, we were able to see this video of a 2001 Advair sales meeting.
Ladies and gentlemen, please welcome Darryl Baker, Simon Joades, Ralph Yaats and Ken Saima.
Y'all ready for this.
What the fuck? That was for an asthma medication! And they were treating it like an NBA pregame show! Please welcome he's 59, white, he likes turkey sandwiches and his wife's name is Karen.
Ladies and gentlemen say hello to Daryl "boom-boom" Baker! The audience in that room were pharmaceutical reps, the foot soldiers in every company's drug-marketing efforts.
Now, drug companies will tell you reps are there to educate doctors.
But behind closed doors, the message can be a little different.
There are people in this room who are going to make an ungodly sum of money selling Advair.
And you know who you are! Ungodly.
That would barely be an appropriate tone if they were trying to get cereal into people's bodies, let alone drugs.
Now, you don't need to see the people whooping in that room to know what they look like because pharmaceutical sales reps are famously young, attractive people.
This is so widely known, it's been a sitcom punchline for years.
Today's the day that pharmaceutical reps show up to peddle new drugs.
And at sacred heart, that means one thing: Julie's here.
If something's a joke on "Scrubs" you know it's common knowledge.
That show didn't do a lot of arcane.
Hey, what is it with phlebotomists and French cuisine, am I right? You are right, Turk.
We're great friends.
The problem comes, the problem comes if those reps don't understand the effects of the drugs they're pushing.
Listen to one former rep describe his first training session.
I was in a room with 21 classmates and two trainers, and I was the only one with a science background.
In fact, on the first day of training I taught my class and my instructors, the very basic process by which two braincells communicate.
So essentially, pharma reps are like the cast of "Grey's Anatomy.
" They're young, they're hot and they have virtually no medical training whatsoever.
To be fair, most doctors will probably take that into consideration the problem comes when some don't.
I even had one physician who would often bring out a patient chart if she was having a difficult patient or whatever the case is and she'd bring out a patient chart and be like, ok, Kathleen, I've tried this.
I've tried this.
What do you recommend here in terms of tweaking"? And I'm sitting here thinking I'm a political science major and you're asking me "you know what to prescribe for this patient?" Yeah, exactly.
Because the only question a poli sci major is really qualified to answer is was it weird having to move back in with your parents after college? Now if you're thinking If you're thinking if you're thinking at these points if you're thinking why do doctors let drug reps into their offices at all? Well, they don't come empty handed.
They'll often show up with free samples.
And, even better, free chicken parm.
Whoever said there is no such thing as a free lunch, hasn't worked in a doctor's office.
There are some offices that advertise in the front desk job description, free lunch everyday, not because the doctors are paying for it but because the drug reps are bringing it in everyday.
Free lunch every day! That might not seem like a big deal, but think about it.
Lunch is awesome.
If Charlie Manson brought me a free lunch every day, I'd at least listen to his sales pitch on forehead swastikas.
I don't think it's for me, Charlie.
But keep talking.
It's delicious.
And drug companies don't do this to be friendly.
They do it because they know it works.
In fact, they know a terrifying amount about nearly every prescription coming out of a doctor's office.
Every time a patient goes into a pharmacy to get a prescription filled.
The information is sold to drug companies who send it to laptops out in the field.
So we see everything that the doctor does.
How many prescriptions he prescribes of our medication and the competitor's medication.
If the computer shows a doctor's not prescribing as promised all's you have to do is say hey, you're banging out a lot of prescriptions for the competitor's drug and not mine.
What's going on? Yeah, what's going on, Carl? You seem to be making medical decisions based on your best judgment.
I brought you a meatball sub with chips, Carl! Don't fuck me on this! Don't fuck me, Carl! With this level of pressure, unsurprisingly, drug companies have, in the past, crossed the line, pushing doctors to prescribe pills for non-FDA approved uses.
That's called "going off label".
And here's a horrifying example involving Astrazeneca, who the government charged with going off-label with Seroquel, an anti-psychotic with dangerous side effects.
The allegations, which were very troubling, were that they were taking a drug that was really approved for fairly narrow uses, bipolar disorders and schizophrenia, and marketing it for everything from sleeplessness to depression and dementia.
Here's the thing you can't just give people potentially dangerous drugs and see what happens.
You're a fortune 500 company, not a white guy with dreadlocks at burning man.
Astrazeneca denied any wrong doing, but it paid half a billion dollars to settle the lawsuit.
And if you're thinking, well, that's just one company with one drug, you should know that just about every major drug company has paid money to settle similar charges.
Johnson & Johnson paid $2.
Eli Lilly paid $1.
4 billion.
Pfizer and its subsidiary paid $2.
3 billion.
And Glaxo Smithkline paid out a record $3 billion to settle accusations that it had, among other things, pushed Wellbutrin, an antidepressant, as a cure for weight gain and sexual dysfunction or, as one former drug rep describes the pitch it was a quick zinger for your doc, to tell your doc, hey doc, remember Wellbutrin is the happy, horny, skinny drug? Ok.
That's not just irresponsible, that's copyright infringement because there is only one happy, horny, skinny drug, and that is crystal meth and that's a fact.
That's a fact right there.
And for that increasing number of doctors who will refuse to even see drug reps, the companies have one other trick up their sleeve simply paying doctors to talk to other doctors about their products over dinner.
And that sounds ridiculous, but not as ridiculous as the special ego-boosting title they use.
I essentially say to a doctor, hey, our company has identified you to be a thought leader.
Would you like to be a thought leader for our company? The doctor will normally almost every time say yes.
Of course they say yes! That's an appealing phrase.
And doctors like to be called thought leaders in the same way Brendan Fraser likes being called two-time academy award winner Brendan Fraser.
It's clearly not true, but it's got a lovely ring to it.
Look how happy it makes him! Give the guy a gold, look how happy he is! In fact, the problem is for a position described as thought leader not a lot of thought goes into the job.
In many cases, the slides and the content and script are actually prepared by the drug company.
Its not always clear to the audience that this is material that was really scripted completely by the drug company that was paying the doctor to give the talk.
So if you're a doctor just regurgitating a script, you're not really a "thought leader" so much as you are a "thought sayer".
Abraham Lincoln was a thought leader.
You're more like the animatronic Lincoln at Disneyland.
Now, to be fair, Glaxosmithkline will no longer pay for "thought leaders".
And the industry in general claims that they reforming.
In fact, a spokeswoman for pharma, the drug industry's trade group, has even bragged about the tough new restrictions they put in place.
In our pharma code, we say that pharmaceutical representatives can bring an occasional meal, a modest meal.
Turkey sandwiches, pizza.
I don't want to just focus on turkey.
Maybe we could have ham sandwiches.
But modest meals, not steak in a restaurant.
Oh, no, no, no.
Not in a restaurant.
Although we'd probably allow a steak at an outback steakhouse.
Because, come on, that's not a great steak.
It's basically a chunk of horse meat with grill marks drawn on it with a sharpie.
No doctor's getting ethically compromised by that.
That's what we saying.
This voluntary pharma code is I guess a step in the right direction.
Let's see how one of their members has been abiding by it.
The justice department filed a civil fraud lawsuit against the Swiss drug maker Novartis, accusing it of paying kickbacks and lavishly spending on doctors, including taking some out to Hooters in exchange for prescribing its drugs.
Don't worry, research has shown the best medical decisions are always made with an Arizona state college football game blasting in the background.
But at least Hooters qualifies as a modest meal.
They allegedly also paid doctors to speak at places like l2o in Chicago a restaurant whose Zagat review read and I quote: "Tabs may bring tears to your eyes, so many say it's for special occasions only unless, of course, you go on someone else's dime.
" I'm guessing at the end of the meal, the waiter came over and asked: "Separate checks, or is one person buying your influence?" "Just one is it? Oh, that's very nice of him.
There you go.
" And at least they were there for that one.
The suit says many doctors took payments for speeches they never even gave.
All of which Novartis has denied, saying that everything they did had a legitimate business purpose, and besides, speaker programs like theirs are an accepted and customary practice in the industry, which is kind of the whole point: Even in its best form, hiring doctors as paid spokesmen seems like a conflict of interest.
And multiple reports have found that many drugs top prescribers are also often getting money from that drug's company, which is worrying because we trust doctors.
When you see Rihanna trying to get you to drink coconut water, you know she's getting money to do that, and you take that into account, and you think to yourself "I'm glad you're getting paid, ri-ri.
But I'm actually not going to drink that" because you and I both know that coconut water tastes like cereal milk mixed with bull semen.
So we both know that.
So I'm going to take that into account when I make this decision for myself.
I know this has all been disheartening, but luckily, there is actually some good news here.
A new clause in the affordable care act will for the first time ever, allow average citizens to search a federal website to see all of the perks given to physicians by pharmaceutical companies.
Now, I know what you're thinking.
A federal website? Made up of a list of doctors? Let me command-t up a new tab right now! But this website is actually kind of fascinating.
The first batch of numbers are now online, covering the last five months of 2013.
And you can, and absolutely should, go online and look-up your doctor at this address.
And see what you find.
Maybe you'll find your doctor did a little research for a drug company, which is probably fine.
Or maybe, as Propublica did when they looked at pharma payments, you'll find a doctor who's earned more than $1 million delivers promotional talks and consulting or maybe, like we did, you'll find a doctor who got food and beverages one day worth four cents.
Four cents! I have to know what that meal was! Because the only way a four-cent meal makes sense is if that doctor is a mouse! The only way it makes sense! Whip the cheese on your whiskers before you prescribe me anything! The point is, there is information on this database you should know.
And this should really be just the beginning.
If drug companies really want to regain our trust, maybe they should let us know the effect their money has on doctors in the only way they know how.
Have you noticed anything strange about your doctor? Does he seem happier than usual these days? Is he quick to prescribe drugs you think you might not need? You know what? One more actually.
Does the waiting room feed your surprisingly attractive not-sick-looking people? Well, that might be because your doctor has been taking pharmaceutical money.
Pharmaceutical money takes many forms from free lunches to speaking fees.
Here's how it works.
Money combines with the cash receptors in your doctor's wallet to create fast-acting financial relief.
So your doctor can rest easy and enjoy life.
Common side effects of doctors taking money may include: Chronic over-prescription, unusually heavy cash flow, dependency of free samples, inflammation of confidence affluenza, and an increase tendency to suggest off-label prescriptions which intern can cause hearth attack, stroke, depression, lost in feeling in arms and legs seizures, blurred visions, grinding of the teeth, temporary deafness total blindness, numbness, sudden bursts of rage, reduction of trust angry erections lasting over 17 hours, and death.
Ask your doctors today if he's taking pharmaceutical company money.
Then ask the doctor what the money is for.
Ask your doctor if he's taking any money from the company who makes the drugs he just prescribes for you and then ask yourself if you're satisfied with that answer.
Pharmaceutical money ask your doctor if his taking it is right for you.
Finally finally tonight, a quick word about Ecuador.
Ecuador's president is Rafael Correa, a charismatic leader who once a week does an address to the nation he calls "citizen link" where, as you'll see, some amazing things can happen.
That is how a president should address a nation in fact, every presidential speech should now on have somewhere within it, in brackets, clown enters.
So these addresses can clearly be pretty fun.
Unfortunately, they can also take a darker turn, yes, darker even than a clown because Correa frequently uses them as a platform to attack people he feels insulted by.
On more than one occasion, he's ripped up newspapers that have criticized him.
Because, I guess, he doesn't realize that newspapers tend to print more than one copy.
And last week, it got even worse, when for some reason, he decided to start calling out individuals, by name, who'd been abusing him on Twitter.
Another little angel.
He is @tuiterovendido.
His real name is Johan Arturo Aicedo Rovira.
So young, what a shame.
He's 18 years old, very young.
Oh, 18.
So young, so immature unlike me the 51-year-old head of state who is currently attacking him on public.
Now, to be fair to him, that 18 year old had expressed a hope that Correa would die.
But Correa should have people who take care of that sort of thing for him.
Rather than spending, like he did, nearly 15 minutes calling out online trolls, even attacking one individual's Facebook page.
The little angel, and I didn't even know his name.
He was just Crudo Ecuador.
He's got a whole bunch of trash on his page.
Yes, of course, he has.
That's what Facebook is, it's pages full of trash.
Stop Googling yourself.
You're president of Ecuador! He even explicitly encouraged his supporters to tweet back at his attackers.
We are more.
Many more.
We will respond in the exact same way, my friends.
If they send one tweet, we'll send 10,000, because we are 10,000 to one.
How are you now getting involved in a Twitter war? You do know no one has ever won one of those,right? It's impossible.
Look, look president Correa, if you're this sensitive, then Twitter and Facebook might not be for you.
And to be honest, being a world leader might not be for you, unless you can build up your tolerance for personal abuse.
Trust me, I've been through it.
I used to be very sensitive, and then I became a comedian, and got insulted so much I can't feel anything anymore.
It's made me stronger as a person.
Emptier and stronger.
So you don't need less abuse.
You need more.
You need more abuse to tip you over the edge.
So allow me to help you right now.
Hey president Correa, nice smug smile you've got.
You look like a used Jeremy Piven salesman.
You look like every real housewife's third husband.
In fact, you're the only president for whom this might be the single most dignified moment of your presidency.
Oh, and by the way, what the hell is happening here? That's a necklace made out of penises.
That's not even a joke! That's dick-lace around your neck.
And don't get offended by this, president Correa.
Because if your skin was any thinner, you'd be a taint.
So don't get offended.
Oh oh! Uh-oh, uh-oh.
I think we all know what that music means.
A psychotic clown is about to tell me my time is up.
But I would encourage you to tweet insults directly to president Correa's @mashirafael Twitter handle all week to help him get over his oversensitivity.
That's our show! Thank you so much for watching good night! Yes! Ok.
All right.
So you don't feel good.
That's what I'm getting.
There we go.
How strong are your teeth? So when I had my color scheme done, I found out I'm actual an autumn and not a winter.
So that's why I changed my whole wardrobe to answer your question.

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