We hate Big Pharma--but we sure love drugs
By Geoffrey Colvin

(FORTUNE Magazine) – WE ARE MEDICATION NATION. WE ♥ DRUGS. WE'RE THE land of the free--but please, not chemical-free.

It's fashionable just now to beat up on Big Pharma, which is understandable in light of the Vioxx business, the flu vaccine mess, and the link between antidepressants and teen suicide. But America's anger at the pharmaceutical industry isn't nearly as pure as most of us want to admit. Yes, we can get legitimately steamed at big drugmakers for squelching valid research that undermines their claims or for extending patent protection by tinkering with molecules in ways that don't change a drug's performance. Tempering that anger, most obviously, are the life-enhancing miracles the companies have performed. But in truth, we have a far more profound problem with hating Big Pharma. More than any other nation, and more than ever before, we have become a country that simply adores drugs and the very idea of drugs. When we rage at Big Pharma, we're not just angry at the industry's failings, we're also pleading to be saved from ourselves.

Consider what these snapshots of the culture, all recently in the headlines, reveal about us and our relationship to the pharmaceutical industry.

• We're using way more prescription drugs than ever before. About 40% of Americans use at least one prescription medication, and 17% use three or more, says a new report from the Centers for Disease Control and Prevention; both figures are big increases. It's tempting to think that trend just reflects the aging of America, but it doesn't. The figures are age-adjusted. In every age group, people are taking a lot more drugs.

Keep that in mind next time you read that drug costs are the fastest-growing component of health-care costs. Many people conclude that drugmakers are still getting fat and happy, jacking up prices at will. In reality those days are over. In 2002, the most recent year for which we have data, drug expenditures rose 15%--but drug prices rose only 5%. The reason we're spending more is that we're taking more. For example, the number of Americans taking antidepressants now far exceeds the best estimates of the number of Americans with depression. We really like those pills.

• The drug culture in sports came further into the open as Jason Giambi of the Yankees admitted taking steroids, as steroid supplier Victor Conte called Major League Baseball's drug-testing program a "joke," and as San Francisco Giant Barry Bonds's denials became harder to believe. There's no disputing that we Americans seem perfectly okay with sports being rife with drugs at every level of competition. After all, the evidence is in plain sight. When a player gains 50 pounds of muscle in the off-season or suddenly becomes significantly, inexplicably better, do we have any doubt what happened? When we find, without looking very hard, that college and even high school athletes are using performance-enhancing drugs, why don't we crack down? Baseball may finally get serious about drugs, but for fans to profess shock at the revelations is just hypocritical.

• Procter & Gamble sought (and didn't get) an advisory panel recommendation for Intrinsa, a new drug to increase the sex drive of women. Tests showed it increased the number of "satisfying sexual experiences" per month by only one more than a placebo. Panel members worried that the drug's long-term effects were unknown, but they believed millions of women would take it if approved, despite its extremely modest effectiveness.

• Bayer and GlaxoSmithKline hired a new ad agency for Levitra; Pfizer made a similar move with Viagra in June. If anyone had told you ten years ago that one day soon we'd happily watch prime-time TV commercials for these drugs ("Grandma, what's erectile dysfunction?"), would you have believed him? More important, Viagra, Levitra, and Cialis have created a new class of prescription party medications, a factor in the growth of this $2-billion-a-year market.

To be clear: Prescription medications deliver incalculable benefits. They're good. What may not be so good is our new, warmer relationship with them. Not so long ago, ordinary Americans didn't use the term "meds," let alone "selective seratonin reuptake inhibitors." Now we do. We all talk about meds with a familiarity never before heard. They are no longer the doctor's province but are mainstream consumer products, pushed by another recent phenomenon, $3 billion a year of direct-to-consumer advertising.

So go ahead and rail against Big Pharma if you like--you have reason to--but realize your attitude is, to use an overpopularized medical term, schizophrenic. We may hate the drugmakers, but we don't hate their products. We aren't even neutral about them. More than ever, we love them. ■