Thread by @doctorow

For years, the pharma giant Novartis ran a "speaker program" that laundered vast payments to doctors - speaking fees, trips, top-shelf booze, strip club nights and fancy meals - in exchange for overprescription of its products.

corporatecrimereporter.com/news/200/james…

1/

This was common knowledge, but it wasn't until the Novartis sales rep Oswald Bilotta blew the whistle in 2009 that the company faced legal jeopardy. Now the company has settled with the SDNY for $678m (Bilotta could get as much as $75m of that).

2/

Novartis's bribery was unbelievably blatant and tawdry: picking up the catering bill for a doc's son's Bar Mitzvah? Really? You're not even pretending it's anything but a bribe at that point.

nbcnews.com/business/econo…

3/

The fine is satisfying, but honestly, the company should be shut down and its operations nationalized, and the doctors involved should be - at the minimum - barred from prescribing without oversight from another doc (most of them should be struck off altogether).

4/

This kind of corruption is why we have anti-vax, mask denial, and other forms of epistemological crisis. Very few of us are qualified to review the evidence in pharma research, so when our doc prescribes to us, we are trusting the process as much as the doc.

5/

Anti-vaxers and mask-deniers' claim goes like this: pharma, big health, and docs only care about money. The regulators are either wilfully ignorant or actively complicit. They would all conspire to get you to take unnecessary or even dangerous steps if it enriched them.

6/

THEREFORE, you should not vaccinate your kid, disbelieve the science on covid, etc etc.

The first part isn't wrong. From the Sacklers' corruption and profiteering on opioids to Novartis's decades of bribery, the evidence is undeniable.

7/

Which leaves us in an epistemological void. Either you go and master cell biology, epidemiology, AND statistics, or you just have to make up your own mind about which parts of the medical consensus are genuine and which parts are corrupt.

8/

You're just throwing darts at that point. The fact that Novartis is still in business, that its execs are not facing criminal sanctions, that the docs it bribed are still writing scrips - all of that tells you that the system is not reliable.

9/

In the face of an unreliable system, all you've got is your gut. That is unsustainable. At BEST, it kicks off measles epidemics in Southern California. At worst, it makes it impossible to address the covid pandemic.

10/

The people involved in this scandal committed literal crimes against humanity. They should not be allowed to keep a single penny of their wealth, and should not be allowed to make a single decision that affects the public, ever again.

eof/