On his Pharma Marketing blog today, John Mack recaps the controversy over the patient who was paid hundreds of thousands of dollars by Bristol Myers Squibb to promote Abilify and then changed his tune. (Andy Behrman, aka “Electroboy,” began talking out about the serious effects he had suffered while taking the anti-psychotic). In his blog, Mack asks the question: “Is this done often by all pharmaceutical companies or is it just something unique to BMS?”

Why do I have the feeling that Mack already knows the answer? It’s not exactly a state secret that drug companies routinely pay doctors and patients, the higher the profile the better, big bucks to hawk their drugs. Look at Bob Dole and Viagra, heart doctor Robert Jarvik and Lipitor. The list goes on and on. The drug companies would, of course, prefer to pay key opinion leaders in medicine (KOLs as they are known) and celebrities to promote their wares, but they will pay anyone whom they think has a shred of credibility with the population they are trying to target. As I reveal in Side Effects and on my blog, a number of drug giants including Eli Lilly, GlaxoSmithKline and Pfizer paid Jim McNulty, past president of the National Alliance for the Mentally Ill (NAMI), thousands of dollars to promote their antidepressants. In his talks around the country, McNulty billed himself as a patient since he took the drugs to combat bipolar disorder. But he never disclosed to his audience or the members of NAMI that he was getting all this money on the side from Big Pharma.

So why does this matter? For an answer, one has only to read the heartrenching story in The Miami Herald today about yet another young boy in Florida who died after being given a cocktail of potent psychoactive drugs. According to a wrongful death lawsuit filed by his mother, Denis Maltez, 12, who was living a state-funded group home and had been diagnosed as autistic, was on Seroquel and Zyprexa (atypical anti-psychotics), as well as Depakote, an anti-seizure drug, and Clonazepam, a tranquilizer. Denis apparently died of serotonin syndrome, according to a 2007 autopsy by the Miami-Dade Medical Examiner’s office. As reported in The Herald, that condition occurs when a combination of drugs causes the brain to produce an excess of serotonin, a neurotransmitter in the brain.

Maltez’s mother says she sent her son to the group home after he tried to choke his younger sister. Her lawsuit comes in the midst of a high-profile investigation by Florida authorities into the death last month of a 7-year-old foster child who had also been taking a cocktail of psychoactive drugs.

Why, you might ask, do some psychiatrists prescribe these potentially lethal drugs to young children and then not monitor them for side effects? I can’t answer that question. What I do know is that many doctors and consumers think these drugs are safe and effective for such off-label uses in large part because drug companies have paid big bucks both to KOLs and “patients” like Andy Behrmann and Jim McNulty to shill for them. And that’s precisely why we need public disclosure laws like the one that the Vermont Legislature passed this week — see New York Times article here — so that everyone knows who the shills are and can take what they say with a hefty dose of skepticism. Here’s hoping Congress passes the Physician Payment Sunshine Act and makes this a national trend.

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