When I was a reporter for a local newspaper in Northern Virginia, I was of course on the mailing list for all of the police press releases. Pharmacy robberies were among the most common crimes committed in the area. I remember one thief even dressed up as Spiderman to steal Oxycontin from a CVS. In fact, if one does a Google search of “oxycontin robberies,” over 100,000 results pop up.

In any event, “Drugstore Cowboy” did an excellent job of portraying the subculture of prescription drug addicts, and it’s interesting to see that not much has changed since 1989.

Dr. Phil Astin, 52, is facing a total of 175 charges linked to the distribution of prescription drugs to more than 17 patients. Astin was doctor to pro wrestler Chris Benoit. Last year, Benoit killed his wife and child and then took his own life – a tragedy that shocked those who knew the wrestler.

Although no one really knows what caused Benoit to kill his family and commit suicide, there are those who theorize that his brain was addled by the bevy of prescription drugs he was taking. Astin has been accused of prescribing anabolic steroids to the wrestler.

Prior to these most recent charges, Astin had already been indicted a year ago on seven counts of over-prescribing to two different people.

Clearly, there is no shortage of doctors who are willing to bend the law and prescribe drugs to patients who want them. My guess is that for many doctors, it simply boils down to finances – if you’ve got the cash to pay, then the medicine cabinet is at your disposal. And of course, that is why celebrities have easy access to prescription meds. But I always wonder, how does one go about asking their doctor for these drugs? Do you just waltz in on the first appointment and say, “Hey doc, I’m dying for some Vicodin, can you hook me up?” And what is the motivation for doctors that aren’t getting paid to write prescriptions? Do they just want to shut patients up, take their consultation appointment fee, and get them out of their office?

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INTERVIEW TRANSCRIPT

Michael Santoro, co-author of “Ethics and the Pharmaceutical Industry,” is an Associate Professor in the Business Environment Department at the Rutgers Business School in New Jersey, and a faculty member of the Rutgers Center for Global Change and Governance. He holds a Ph.D. in Public Policy from Harvard University, and teaches MBA courses on the Social and Ethical Responsibilities of Global Business, the Ethical and Legal Aspects of the Pharmaceutical Industry, Business Ethics and Business Law. “Ethics and the Pharmaceutical Industry,” which Mr. Santoro co-authored with Thomas Gorrie in 2005, examines the tense relationship between society and the pharmaceutical industry through the eyes of leading industry figures. The book discusses the role of intellectual property rights and patent protection, the moral and economic requisites of research and clinical trials, drug pricing, and marketing and advertising. In a phone interview on May 12, Mr. Santoro discussed his book and some of the current issues surrounding the pharmaceutical industry today.

I was interested in what inspired you to co-author this book in the first place? “Seven or eight years ago, my dean asked me to put together a course on ethics and the pharmaceutical industry for an MBA program that was specifically geared towards students that wanted to work in the pharmaceutical industry, and the more we worked on these issues, the more I realized that there was not out in the public domain a comprehensive and balanced discussion of the many, many ethical issues that face the pharmaceutical industry.”

Did you find that doctors felt torn ethically between the industry and their patients when you were interviewing them? “Yes, there was a really poignant essay by Dr. Chuck Bardes who is the Dean of Admissions at Cornell Medical School and who also has his own practice in internal medicine, and he in very frank terms, described what it was like to be a physician in the middle as it were, from having patients come in who these days are extremely well-informed, both because of direct consumer marketing and because of all the information that’s available on the web, and having those patients come in and request or demand certain kinds of drugs, and also having to face on the other side of the equation, the constant scrutiny of insurance companies that are watching what you’re doing and watching the drugs that you’re prescribing, and the physician is really caught in the middle of all this, trying to do what’s best for the patient, but also being bombarded by information and requests from various parts of the health care system.”

I know that one of your goals in producing this work was to examine the complicated relationship between society and the for-profit pharmaceutical drug industry, while also shedding some light on possible ways to better align the interests of the two — do you think it is in fact possible to strike that balance, and can you give an example or two of how you think that might be achieved? “I think the big news that really has finally passed over us is that the era of blockbuster drugs and direct consumer marketing is over. I mean that’s been really the dominant pharmaceutical market for the past 10 years or so – so I think in the future what needs to happen is the pharmaceutical industry needs to be much more attuned to medical needs and the companies that are nimble and efficient in finding straight pockets of medical need and serving it are going to be the profitable ones. The companies that are kind of sitting around and waiting, or trying to create blockbuster drugs, are going to be mostly disappointed.”

What do you think it will take to improve the public’s perception of the pharmaceutical industry and where do you think that attitude is currently? “Well, I think that attitude has now been permanently set in stone for quite a long time. I think there has been a sustained period where the public has been unhappy with the behavior of the pharmaceutical industry. I think the pharmaceutical industry responded unsuccessfully to those perceptions. I think a lot of things contributed to the unsuccessful response, but the bottom line was that the industry as a whole really never properly engaged the public about their concerns, and as a result I think that we’re going to have a kind of semi-permanent sense among consumers that the pharmaceutical industry is not one that they respect.”

Chris Rock hits it right on the nail.