"I was up to 3." "6 a day." "7 or 8 per day." "I wanted to die." "Around 8 a day, nothing strong." "10 a day." "I take 10 different ones." "Zyprexa could knock out a horse." "I take about 10 meds a day." "15 a day." "Lots." "Tons." "Easily 15 to 20 a day." "So many - 24." "I've seen 25, 26, 27 pills a day." "Easy." "I could use even more." "QUEBEC UNDER THE influence" "Emma-Rose is sleeping." "She is resting." "She's lucky- she doesn't need sleeping pills." "Yet." "That day will come:" "Quebec is the leading consumer of sleeping pills." "But she does get cranky and a tad aggressive." "is this normal, or the first sign of a more serious problem?" "Researchers claim one-third of 3-year-olds are irritable and show signs of hyperactivity." "One-third of Quebec children should be treated without delay." "Emma-Rose can rest easy." "If she's racked with depression at 4, anxiety at 5, or angst at 8, doctors are just waiting for medical research to provide the cure for what ails her." "Say a product is proven effective for anxiety and depression..." "Psychiatrist ... observed in 7-to-9-year-olds." "If studies show a product to be effective, I'll prescribe it." "And why not 4- or 5-year-olds, if research bears it out?" "In the UK, antidepressants are prescribed to 8-year-olds." "In Quebec, the age of eligibility is 12 - for now." "We shall later see how research is conducted." "But what is clear, is that children are taking pills at an increasingly younger age." "Overprescription to infants..." "international Pediatrics Society ... is a glaring example ofjust how we care for, and cater to, our children." "We hate to see our children suffer." "psychologist" "So we give them something." "Take Ritalin, in recent years." "Quebec once had the lowest prescription rate in the country." "Today, it has one of the highest." "Psychiatry Department Head lf we don't treat these children, they risk long-term consequences." "True, some children need it." "But thousands of children are needlessly prescribed medication." "Why?" "Because school principals decide to play doctor." "President I've seen it." ""Put your child on Ritalin... or he can't come to class."" "Parents want calm, docile, high-achieving children." "Parents themselves sometimes request medication, because they look for quick and easy answers, to avoid having to question how they might otherwise answer their child's needs." "Some children are simply sad, unhappy;" "orphaned, undisciplined." "Parents don't know their kids." "They have no authority, because they neglected their children as babies." "They are too passive." "Total chaos ensues." "And who, then, is prescribed pills to alleviate these social ills?" "Laurie-Anne and Jean-Simon are part of the Ritalin generation." "It helped, at first." "The dosage was low." "Cool!" "Only one pill to be normal." "I'm not restless anymore, or constantly twitching." "In Quebec, Ritalin is being prescribed more than ever." "Should we not weigh the effects of this medicine, dubbed "kiddie cocaine"?" "Does administering a product to 8-year-olds..." "Psychiatrist make them vulnerable to addiction?" "Quite the contrary." "A number of our clients did, in fact..." "Director, Portage take Ritalin as children." "It's much easier to swallow a pill than to inhale powder," "Substance specialist ... or dissolve it in order to inject it." "It's much less pleasant." "Conversely, taking a pill is acceptable to a child." "He then prescribed Seroquel and Epival, claiming I was bipolar." "But I was actually playing him." "Then Concerta, Remeron... I've taken Ritalin, Rivotril," "Celexa and Seroquel." "These are ADD medication, sedatives, antidepressants and antipsychotics." "I manipulated my doctor to get more meds." "Basically, you just fake paranoid delusions to manipulate him." "He'll check his big book, diagnose anxiety problems, scribble something and send you off to the pharmacist." ""Next!"" "You just wanted to get high?" "To seek oblivion?" "To be feel nothing at all." "Why?" "It didn't feel right." "I'd been numb since childhood due to Ritalin." "Kids on medication don't enjoy better quality of life." "psychologist" "But it's reassuring." "To parents, doctors and therapists." "At 7, Elisabeth is starting to have problems at school:" "poor concentration, stress, low self-esteem." "Her parents sought medical advice and followed guidelines developed by specialists." "But Elisabeth's problems have persisted." "The doctor then suggested she take medication." "To reassure me, the doctor said, "Not Ritalin, but Strattera."" "When I got home, I looked it up on the Internet." "That's when I saw the warnings." "Simply typing in the name brought up warnings in the U.S., Europe..." "Less so in Canada." "Some children taking Strattera had attempted suicide." "Some had even succeeded." "My daughter won't be committing suicide because we opted for anti-stress medication." "We will practise relaxation and meditation." "Our children are thus stressed, anxious, hyperactive and suffer from ADD." "Bipolar at 12, depressed at 8 - children are developing illnesses once limited to adults." "We can't even begin to imagine the burden placed on a young child - going through the Oedipus complex, seeking security at home - whose parents are separating, at the age of 2, 3 or 4." "It's an enormous psychological strain." "Some adults panic at the mere idea of moving." "Can you imagine?" "We simply can't conceive what it's like for a toddler to go through his or her parents' breakup." "We don't seek to discover our children's real problems, but, rather, the right pill to administer." "Being over 65 is the golden age." "But the golden years are a goldmine for the industry." "Heart, lungs, kidneys, chronic illnesses, cancer..." "Pharmacists have hit pay dirt." "They fight amongst themselves over exclusivity rights to sell pills in retirement homes." "A recent study shows they are offering gifts and discounts to the owners of such facilities." "Do seniors need so much medication?" "Former Health Minister Lucienne Robillard said, in the '90s," "philosophy professor that 10 to 15% of hospitalizations among seniors were due to medication." "Furthermore, a '90s study by Dr. Tandland of McGill University indicated that 45% of pharmaceutical prescriptions issued to seniors... were inadequate, if not dangerous." "Overmedication does occur." "hospital pharmacist I once attended a course given by a geriatrician." "He said that geriatric patients - that is, 80-year-olds dealing with the vagaries of old age - who encounter problems are promptly taken off their meds." "Medication prescribed at age 40 may no longer be suitable at 80." "Benzodiazepines are alcohol in pill form." "Psychiatrist" "Antidepressants are a different story." "That's why the College of Physicians issued a warning not to prescribe Rivotril or Ativan to patients over 60." "They become totally confused!" "These medications have many adverse effects." "It surprised me." "I'm used to it now, having been here 3 years." "But at first I thought..." "Why does everyone walk out of a GP's office with antipsychotics or antidepressants?" "Claudia Fentanes practiced medicine in Argentina." "Now living in Quebec, she doles out pills at a senior-citizens home." "It's a vicious circle:" "to counter the side effects of one drug, they give us another." "To avoid complications so we may live comfortably." "I think people here do take a lot of medication." "3:45." "Time for a pill?" "No, 6 o'clock. I took one at 2:00." "So I'm fine till 6:00." "Two hours to go!" "Room number." "Morning, noon, dinner and bedtime." "Unbelievable." "I'm on a tighter schedule than you working people." "Those pillboxes downstairs?" "Nope." "No, thanks." "I don't know, I don't like that." "It implies you can't manage." "I still can." "I'm lucid enough to know my own mind." "It's very important to make sure the person swallows their meds." "Some don't?" "They hide them, throw them away." "Why?" "Because some seniors don't want to take medication." "I can't believe my life revolves around pills and drops and whatnot." "It's frustrating." "I can still take the bus and go dancing." "So I can take pills." "I'll take my medications earlier, say 9 o'clock." "So when it kicks in, I can keep up on the dance floor." "Medication is of course useful and can save lives." "Yet we need to know what we're taking, why, and the side effects." "Although blood sugar and cholesterol can be accurately measured, the same cannot be said of depression." "The temptation to administer medication upon diagnosis is great." "Psychiatry Deparment Head" "We forget that the symptoms we're dealing with - whether anxiety, depression, agitation or lack of concentration - are not necessarily pathological symptoms of a disease." "Sadness and heartbreak" "philosophy professor are now basically classified as depression." "Winter blues, for example, can't really be classified as depression." "Yet treating it with antidepressants is recommended." "Psychiatrist ln Quebec, we gobble up antidepressants and anxiolytics, the famous benzodiazepine, like there were no tomorrow!" "It's appalling!" "It's like candy!" "The boss is really stressing me out." "How so?" "He's insufferable." "Come on, he's a sweetheart." "I have to watch my weight." "Really!" "My cholesterol, too." "It's hard to eat healthy." "Now this is for heart palpitations." "Did you know it was a sign of pre-menopause?" "I'm not there yet." "You have a boyfriend?" "Yeah." "He drives me nuts." "Thank goodness for these." "That ought to wipe him from my mind." "This here counters the side effects of my antidepressant." " Are you depressed?" " Not really." "This is for later." "Helps me sleep." "Apple?" "I've got all the vitamins I need right here." " What's wrong?" " My back is killing me." "Wait, is that your lunch?" "Course not!" "This is." "Want one?" "It'll do you good." "This is a private medicine cabinet." "It contains basic products and many bottles of pills." "Normal, there are 400 millions of prescriptions in Canada for 32 millions of citizens." "Now let's look inside Quebec's medicine cabinet." "It contains $4- to $5-billion in medication." "The biggest sellers are those for cardiovascular problems, mental health and depression." "In 10 years, the cost of healthcare in Quebec has risen from $1.3- to $3.1-billion." "The number of prescriptions is 107 millions for 3 millions of subscribers." "The average Quebecer consumes 750 pills a year." "Quebecers were told, "You're not unhappy, you're not fucked up, you're depressed!" "And we have just the miracle drug:" "antidepressants."" "Yeah, that worked!" "I'll go ahead and say it:" "pharmaceutical companies are pushers and dealers, too." "Raymond is 54." "He's bipolar." "He needs 10 different medication a day to function." "Here's the list of all my meds." "Every week... I get a Dosett." "I've got my morning meds, evening meds, dinnertime and bedtime meds." "I also take two more kinds of medication for anxiety and nervousness." "And this is for osteoarthritis." "It's like Tylenol - but 625 mg." "Prescription only." "Huguay is a factory worker." "He works days or evenings, sometimes night shifts." "He has trouble sleeping." "When I work the night shift, I take Seroquel, 100 mg." "It... completely... lt relaxes me." "It completely knocks me out." "He's been fighting depression for years." "I had trouble sleeping for 15 years." "It was chronic and going from bad to worse." "My depression was triggered by anxiety." "It wasn't generated by anything in particular." "But I've got this lump of anxiety." "It keeps me awake." "Living with anxiety and not knowing why is no picnic." "Jason is 21." "He has used every drug imaginable." "He has traded pot, hash, speed, cocaine and crack for antidepressants prescribed by his doctor." "I became aggressive, with my mother, my family." "My mother gave me an ultimatum." "She threw me out a couple times." "I was angry at first." "Now I'm thankful." "'Cause I stopped using." "My life makes more sense." "You take Rivotril?" "Yes." "To sleep?" "I don't even know why I take Rivotril anymore." "Wait." "You don't know...?" "I can't remember why it was prescribed." "Rivotril: antianxiety drug Possible side effects:" "dizziness, unsteady gait, drowsiness, speech impairment, change in libido, constipation, diarrhoea, nausea, tremors, etc., etc." "I was given Rivotril one day." "I've been taking it ever since." "I take a lot of medication without knowing why." "What about Zyprexa?" "It's an antidepressant and a mood stabilizer." "Zyprexa: antipsychotic agent Possible side effects..." "Last year, Lilly agreed to pay over $1 billion to Zyprexa patients who developed diabetes." "The Bromazepam is new?" "I take Bromazepam as needed." "It's for anxiety and nervousness." "As soon as I started on Serzone, I went straight downhill." "Serzone: antidepressant" "Serzone was taken off the market in 2003." "It caused severe side effects, including liver failure." "In some cases, a transplant was required." "Bristol-Myers Squibb paid $10 million in damages." "In addition to Serzone, I was prescribed sleeping pills:" "lmovan." "Serzone scared me." "He then switched me to... not Rivotril, Paxil." "Paxil: antidepressant, panic, anxiety" "Possible side effects:" "anxiety, backpain, constipation, etc." "The famous, highly marketed Paxil." "Works forjust about everyone but me." "I take one Paxil." "Paxil increases the risk of suicidal behaviour in teenagers during the first two weeks of use." "Plus two Wellbutrin." "Wellbutrin: antidepressant" "Possible side effects:" "dizziness, perspiration, insomnia, etc." "Desyrel too, but only when I have trouble sleeping." "Desyrel: antidepressant" "Possible side effects:" "dizziness, drowsiness, headache, etc." "So they put me on Desyrel, Paxil..." "Plus Rivotril." "That didn't work, either." "They gummed me up but good." "Then they added Zyprexa." "Then Epival." "A mood stabilizer used to treat epileptics." "My life is tedious." "It's monotonous." "Always having to remember to take my pills." "I often forget." "That's a problem." "Without community services..." "President ... we only step in once patients flip out." "Then the SWAT team has to drag them out." "We are responding to a 91 1 call." "A man with a history of psychiatric problems has barricaded himself in his home." "Damn - all those cars!" "The first paramedics at the scene tried talking to him, to establish communication." "He then cut off contact." "So the police had to storm their way in." "We tried talking to him again, but he had become extremely aggressive." "A recurring problem is that medication is unmonitored." "Patients generally get discharged fairly quickly." "They can't stay indefinitely." "Some people are taken to the hospital daily." "ambulance worker" "Some rack up 300 to 350 trips a year as a result." "When the decision was made to deinstitutionalize patients, the money was supposed to be redirected to them." "The Auditor General clearly demonstrated that wasn't the case." "They were discharged and left on their own." "Sometimes I feel completely indifferent." "I'll witness an accident - nothing." "A stabbing - nothing." "I'm totally indifferent." "I had an overriding obsession:" "to kill my father." "Went to the kitchen, grabbed the first knife in sight." "I hadn't planned on stabbing him, but I reached for the knife." "Unfortunately, he was lying in bed, and I stabbed him." "I did that." "My mother then called the police." "She saw what was going on and called 911." "I didn't stop until the cops showed up." "I was told to drop the knife, then handcuffed." "The judge believed I had committed this act while mentally impaired." "I was found not guilty by reason of insanity." "He recognized the signs of schizophrenia, paranoia." "Religious mania and so on." "René Bilodeau spent 18 months at the Pinel Institute, then stayed at a halfway house before reclaiming his freedom." "Fifteen years after his father's murder," "René Bilodeau must take medication to silence the voices that pushed him to kill." "Two antipsychotics:" "Astelazine..." "Five milligrams." "It's not very potent." "It's not very potent." "Then there's Nozinan, another antipsychotic." "This one's even weaker, but helps me sleep." "Keeps me happy!" "Say René stops taking his pills." "I'd have trouble sleeping without the yellow one." "I'd suffer from the same symptoms as an insomniac." "The blue one?" "Considering my previous offence, it might spare someone's life." "Medication allows Huguay," "Raymond, Jason and René to function." "To stay alive." "To have a life - or some semblance thereof." "This because of the numerous side effects and an addiction to pills they cannot do without." "The meds turn me into a zombie." "I'm oblivious to everything around me." "Before Effexor came into my life, I was a zombie." "I wake up a zombie." "It takes me 3-4 hours to become fully alert." "Life isn't worth living otherwise." "It's too scary." "I'm less confused." "Lost my train of thought." "We really are guinea pigs." "What choice do we have?" "A lot of pills are alike." "It's basically an addiction." "I'm not addicted, but I need my meds." "It's hard to explain." "I don't want to be addicted." "But, psychologically, I need them." "Pharmaceutical companies are dying to sell us meds." "And we're willing to oblige." "I take pills to sleep and for my nerves." "A great big one that would do it all!" "That'd be great!" "Quebec Under the influence, sponsored by Painacyl" "Any pain?" "Muscular pain?" "Mostly my shoulder." "My fingers, back..." "No side effects." "Unless you're lactose intolerant." "My neck, all over." "There you go." "I'll let you rest." "See you in 10." "The pain in my fingers is gone." "I feel better." "It's unbelievable." " That good?" " Absolutely." "Ten minutes ago, I was in agony." "It's much better." "I'm impressed." "I've tried pill after pill..." "Nothing works." "It's a miracle." " My God..." " This way." " Thanks so much." " Bye now." "Yikes." "Painacyl, the fast-acting placebo" "Companies invest huge sums everywhere." "An AFEAS convention here, medical symposiums there, and patient association websites." "Why AFEAS?" "Because it is women who influence families health decisions." "For 3 years now, many pharmaceutical and other companies have been working in partnership with AFEAS." "We discuss AFEAS's needs and assess health problems." "Rheumatoid Arthritis:" "What's New?" "We raise awareness about illnesses:" "diabetes, cancer." "Today it's about rheumatoid arthritis." "Why rheumatoid arthritis?" "We work in the field of arthritis." "Hmm, might Bristol-Myers Squibb possibly be in the midst of developing a new arthritis medication?" "These are biological - not chemical - drugs." "They are composed of protein extracts." "We're a stakeholder." "It's the first drug being developed worldwide by Bristol-Myers Squibb." "Mr. Barakat was simultaneously registered in the Lobbyists Registry, pushing to include this new product, Orencia, on the list of government-refunded drugs." "Let us now turn to Diabetes Québec's website." "Click on "Useful Links,"" "then "Pharmaceutical Companies."" "And here we are." "Yet another way to influence patients." "They even go so far as to use patients to push the government into adding products to the list of state-refunded drugs." "Especially when approval is delayed." "Some patient associations are subsidized by Big Pharma." "President lt's an open secret, though not officially recognized." "Say the industry is lobbying for a given drug that affects an association of patients." "Some associations spring up overnight." "The patient association will be used as a conduit to convey its dissatisfaction with the Council." "Displeasure over a Council ruling, or government ruling." "The Department of Health." "The industry consequently keeps its hands clean." "It's never officially involved in such cases." "But its message is clearly conveyed through patients or their families, and therefore more credible to the public." "It's a common tactic." "Ultimately, the blame for unavailable products..." "Quebec health Minister ... will obviously fall squarely on the government." "Some patients need pills, and some pills need patients." "Healthy or ill, you're entitled to a pill." "It's your right!" "Emergency specialist" ""My friend finished third in last week's race;" "I want what he's having."" "That attitude is also common in everyday life." "A man will share his pills with his wife, believing they will do her good." "People self-medicate somewhat." "Their neighbours laud the benefits of their pills and, like sheep, they follow suit, even though it might not be suitable." "People love putting things in their bodies." "People look for quick solutions." "Much like in other aspects of society." "To my mind, this is not a happy solution, nor a deeply rewarding one." ""lt hurts here; gimme a pill."" ""Got a sore throat;" "gimme something."" "The public needs to be educated about this." "People are very demanding." "They want miracle cures." "Pain is unacceptable and must be nipped in the bud." "Patients want pills?" "Happy to oblige." "pills FOR SALE" "Big Pharma deploys its troops." "Thousands of sales reps sent on a mission to win over doctors." "Call him Frank." "One of Big Pharma's foot soldiers, he is a pharmaceutical sales rep." "His voice has been altered and his identity concealed so that he may freely spill trade secrets." "Pharmaceutical companies examine doctors' psychological profiles." "We take weeks-long courses on how to interpret scientific studies." "We learn to match the data to our company's medication." "The main goal is to encourage doctors to write more prescriptions." "Chummy relationship between pharmaceutical companies and doctors has clearly resulted in an increase in prescriptions." "hospital pharmacist" "A doctor claims to remain uninfluenced by sales reps?" "Ha!" "Sales representatives are trained to influence people." "If a doctor is more responsive to women, we confer and send in the pretty one." "Nathalie Lemoine, Gomed Laboratories." "It won't be long." "Of course they always hope the saleswoman will fall for them." "Which never happens." "But prescriptions do go up." " A real pleasure, Dr. Hébert." " Thank you." "Till Monday, then." "In Washington, football cheerleaders do double-duty as pharmaceutical sales reps." "A sales rep's invaluable tool:" "the Quebec doctors'list." "A complete list in the hands of all companies, complete with names, phone numbers, and prescription profiles." "Sales reps thus know precisely what each doctor prescribes." "I'd like your opinion on documents we've obtained." "I don't generally review documents." "They're not documents, but lists." "You know what I'm talking about." "I won't review them." "I'll just answer your questions." "It's an exhaustive, specific list of doctors:" "name, clinic address, practice profile." "Whenever pharmacies purchase medication, they request reimbursement from the government." "That's how the government collects prescription data." " lt's the lMS system." " Exactly." "As you say, it's legal." "In 2001, legislation was passed authorizing companies to acquire this information." "lMS, a private corporation, draws up these lists and sells them to pharmaceutical companies." "Every quarter, sales reps thus know precisely how successfully they have influenced each doctor." "A Christmas gift presented in 2001." "This bill amends the "Act respecting the protection of personal information in the private sector"." "This authorizes the Commission on Access to information to disclose business-related information while respecting individuals' right to privacy." "After the introduction and first reading of the bill, and considering the key issues at stake, the National Assembly engaged in a heated debate." "Are we agreed to override section 237, providing for a week's delay between the introduction and the adoption in principle of the bill?" "All in favour?" "Any comments?" "is Bill 75 - amending the "Act respecting the protection of personal information in the private sector" - adopted?" "Adopted." "Admittedly, lMS had previously made a formal commitment before a parliamentary commission." "lMS will only release this information as consolidated data." "The prescription practices of any given doctor will thus remain confidential." "Concerning the same bill, Mr. Speaker, I request consent to override sections 22 and 230 and move on to the adoption stage." "MPs can thus rest easy:" "no need for debate - time is of the essence, what with Christmas coming." "All in favour of overriding section 230?" "is there also consent to override section 22, as the Bill was introduced after November 15?" "All in favour?" "Any comments concerning Bill 75 amending the "Act respecting the protection of personal information in the private sector"?" "is Bill 75 - "Act amending the Act respecting the protection of personal information in the private sector" - adopted?" "Adopted." "This is a profile obtained by Glaxo and Bristol reps." "It outlines Dr. Beaudoin's prescription rate." "He is a client worth pursuing." "This means every doctor in Quebec - short of opting out of the list, which only 10% do - is put on file." "lMS will only release this information as consolidated data." "The prescription practices of any given doctor will thus remain confidential." "Yves Lamontagne of the College of Physicians said lMS knows more about doctors than the Ministry of Health." "I'm not talking about an overall regional profile, nor a specific treatment." "They know what each doctor prescribes monthly, how much, and whether they're good targets." "They're categorized from D1 to D10." "D1 designates high-prescribing physicians," "D10 designates low-prescribing physicians." "When we meet with doctors, we can then know whether they prescribe our drug or our competitors'." "I've worked all over Quebec." ""This rep's in town."" "Obviously, prescriptions had changed." "It may be possible to reidentify individuals through postal codes." "I have here doctors' names, addresses, clinics..." " Listed by physician." " l can only assume they consented." "It seems fairly easy to get on the list." "If I had hair, it would be standing on end." "That's news to me." "And absolutely appalling." "NephroIogist I withdrew from the list." "NephroIogist" "Being profiled as such was reason enough to dissuade me from participating." "Would you accept being profiled?" "My profile may have been filed without my knowledge." "I don't know." "You have to opt out." "But I never gave consent." "I wouldn't be surprised if many others were unaware of it." "Personally, as a health professional, I'd be reluctant." "We're being exploited." "They're using us for marketing purposes." "What's in it for us?" "We don't get a red cent." "Yet 90% of doctors are on file." "They thus receive Big Pharma's invitations." "Gone are the glory days of all-expenses-paid cruises and trips down south - as per the new code of ethics." "But there are still oh-so-many ways in which doctors can be indulged." "Most of my colleagues prefer attending dinners financed by the pharmaceutical industry than dining out with friends." "When we pick up the tab at a restaurant, we budget for $100 a head." "If the tab doubles, we add names of people who weren't present." "I know reps who play golf with doctors on weekends." "We pay doctors' registration fees for international conferences." "In Greece, Rome..." "Companies will cover travel, accommodations, registration fees." "cardiologist" "RxD modifications are no longer under pressure by Big Pharma." "The latest trend:" "specialists offering colleagues training sessions - usually in Quebec's finest restaurants." "They want everything nice and perfect, and completely commerce-free." "But the companies failed miserably." "The company sends specialist reps who deal exclusively with specialists and speakers." "They direct the best speakers to push their meds." "The most productive speakers can make $50,000 to $100,000 a year." "We thus influence the influencer." "Credibility rests on objectivity and independence from pharmaceutical companies." "Surprisingly, we're allowed to remain impartial." "Otherwise, I'd refuse." "Overly impartial speakers are kicked to the curb." "lmpartial ones who ultimately position the product fare better." "Continuing medical education is important." "I work hard." "Remaining current is important, but so is family time." "It's perfectly feasible." "I don't need a third party." "Nor Big Pharma." "I can manage fine on my own." "While companies who create new drugs spend a fortune on influencing doctors, generic-drug companies target pharmacists." "It's open bar for pharmacists!" "85% of pharmacist-owners..." "Quebec Order of Pharmacists Trustee ... between 2000 and 2003 allegedly received kickbacks." "From pillboxes to swimming pools, ask and ye shall receive." "I've seen generic-drug companies give pharmacists home entertainment systems, snowblowers, if they reached their quotas." "They'd meet them down south, in December, and say:" ""Substitute X brand-name drugs for generics, and you'll receive X amount."" "I'm constantly offered gifts." "I steadfastly refuse all offers." "Employees of generic-drug companies would scour shopping centres for gift certificates." "I've known pharmacists to receive up to $100,000 in certificates." "Medicare documents mention gift-certificates from state-run liquor stores." "My guess is, it's to buy wine." "I wouldn't know about that." "Quebec pharmacist-owners association Executive vice president I've heard things, too." "Rumours of pharmacists receiving gifts." "I don't know of any." " l've read about it." " Meaning?" "Canadian Generic pharmaceutical Assoc." "Quebec executive director I can't discuss ongoing cases." " The Supreme Court ruled- - l'm aware of the ruling." "Unfortunately, I've forgotten the details." "Let's refresh Mr. Dupré's memory, the Supreme Court of Canada ordered generic-drug companies to produce the list of all pharmacists and the benefits they received." "We're well aware." "But they're not priority cases." "We wouldn't have taken it to the Supreme Court otherwise." "Quebec Order of Pharmacists General Director" "Do you have any idea what that costs?" "Fighting companies that can buy and sell us 100 times over!" "Given the expense, there were grounds for investigation." "It's simple enough:" "pharmacists are offered discounts by various companies that produce the same drug." "They accept the best offer and shill for the winning company." "It's win-win." "A money saver for patients, a cash cow for pharmacists." "Some pharmacists wrote letters to the editor stating they'd received kickbacks." "Their words, not ours." "If they say so, then it must be true." "Up to 40% , depending on the product and the maker." "There are many variables." "Volume, for instance." "Say you walk into a pharmacy with a prescription in hand." "Quebec Order of Pharmacists Trustee" "The pharmacist offers you the generic version." "You'll obviously be delighted to save a few bucks." "But knowing your pharmacist may have snagged a swimming pool in exchange might dampen your enthusiasm." "The government authorized this formerly illegal practice, but instituted measures and a 20% ceiling." "But will the syndic really prosecute over 85% of Quebec pharmacists?" "Doctors are literally bombarded with often-irrelevant information." "It's the marketing game." "Sales reps swear up and down, citing countless studies, that this new product is vastly superior to its rival." "A so-called noninferiority study is conducted on new medication." "But such studies do not prove its superiority." "I've been an academic for over 20 years." "I've attended seminars..." "montreal Institute of cardiology Emergency specialist ... on how to decipher medical reports." "Yet I still have trouble judging whether test results are legitimate." "I've left many a conference thinking:" "Interesting." "I would then show the data to experts in the field, who promptly demolished the study." ""This is worthless."" "Some doctors are undoubtedly bamboozled by sales reps." "Most of the studies in favour of our meds are financed by our industry, our research centres." "We study pharmacology during our training, but we must..." "NephroIogist ... read up on all the new drugs." "We leave university somewhat ill-equipped in that regard." "Some studies thus promote meds." "But what happens when studies do not produce the desired results?" "I once conducted a study on anxiety treatment, wherein I combined an anxiolytic and a relaxation technique." "I determined that combining the two was more effective than one alone." "However, six months post-treatment, patients who had mastered the relaxation technique could be taken off the anxiolytic." "I wrote my article." "The company funding the study was none too pleased." "I was pressured to alter my results." "I flatly refused." "The study was published." "Needless to say, the company never funded me again." "CHUM Research Centre Director" "Week-long debates over one sentence!" "We met a guinea pig participating in generic-drug trials." "The next one is Losec, a heartburn medication." " You suffer from heartburn?" " Nope." "They'll measure my level of stomach acid." "If I qualify, they'll use me." "Everyone has stomach acid." "The study simply requires a certain level." "The danger is very real." "Take any medication on the market." "Companies conduct studies to find other applications." "To determine if it's suitable for children or other ailments." "If it works for schizophrenia, they'll try it on Alzheimer's." "Negative results go unpublished." "Negative results are buried and that's that." "Worried?" "You should be." "You tell yourself Canada protects its citizens from companies whose research is suspect." "Health Canada conducts no independent or clinical studies." "Drugs and health Products health Canada" "We rely on drug-makers' data." "You heard right:" "Health Canada does not conduct independent research." "Health Canada relies on the companies' own studies." "A famous example:" "Vioxx." "An anti-inflammatory manufactured by Merck Frosst." "Three years ago," "Merck Frosst pulled the drug off the market." "Studies showed that longtime Vioxx users developed serious heart problems, some of which proved fatal." "Question:" "when did Merck Frost learn there was a problem, and when were the authorities notify?" "U.S. researchers claim to have alerted the company long before." "A court battle ensued." "Drugs such as Zyprexa and Seroquel suffered the same fate." "The major issue:" "do companies disclose everything, and if so, in a timely fashion?" "In some cases, information is released postmarketing and the system is unable to respond adequately." "This is but a polite way of saying that once a pill is on the market and purchased by consumers, there is no law or regulation requiring doctors and manufacturers to report all side effects." "What really struck us is how easy it is to get meds." "I know you don't like surprises, but just look at what we scored." " This here was ordered" " Online?" "Yes." "From India." "It was delivered no problem, without a prescription." "This, too." "Also from India." "This here's from Pakistan." "We have to realize that when you order medication from abroad, you have no control over its composition." "In British Colombia, a 57-year-old woman died after ingesting meds purchased online." "A coroner's investigation determined the pills contained arsenic, uranium, copper and nickel." "Astonishingly enough, we were also able to get medication" "from a hospital." " There are samples" " Sample cabinets." "Unlocked, uninventoried..." "No safeguards whatsoever." "If you'll follow me to the sample cabinet." "NephroIogist" "Sales reps come through here?" "Right through." "The waiting room's back there." "Through the waiting room and down the hall to the examination rooms." "Sales reps wait here, then greet the doctor between patients:" ""May I have a minute?"" "Let's see." "Here's the sample cabinet." "It's self-serve." "Doctors use it, but anyone can grab whatever sample." "What kind of samples?" "New meds, patented meds." "For chronic illnesses." "So long-term meds." "It's unmonitored, open to anyone?" "Anyone at all." "A nurse, for example." "Or a corrupt journalist." "Anyone can help themselves." " Me too?" " Go right ahead!" " What's Celebrex?" " A pain reliever." "Always good for sports-related muscle pain." "Add to shopping cart..." " Dioval?" " High blood pressure." " Nitrodur?" " Angina." "That too, then." "Micardis?" "High blood pressure." " All set for blood pressure!" " Nice haul." "Doctors have repeatedly explained they want access to these samples." ""Here are two samples and a prescription." "Try it out." "If you experience no side effects, have the prescription filled."" "The sample / prescription combo allows doctors to prescribe new meds without delay." "Some doctors repeatedly request samples, but write few prescriptions." "Their offices are located above pharmacies." "They trade meds for toilet paper, Kleenex, etc." "That's just shameful." "We make enough money - we don't need to resort to reselling pills." "Pathetic." "They've even been sold in hospitals." "We visited a few doctors' offices." "Within minutes, a "patient" feigning depression was prescribed antidepressants, including heavy-duty ones like Effexor." "Honestly, only one doctor refused to prescribe meds." "Anne visited several doctors, falsely claiming to be depressed." "Four out of five doctors gave her meds." "In and out with a prescription in hand." "What should I do about my problem?" "I suggest... you see a psychologist." "Doctors need to explain to patients that medication isn't always the solution." "I don't feel right." "How do you mean?" "Meaning what exactly?" "I've lost the will to live." "Since when?" "You're depressed." "Why?" "Had a fight with your boyfriend?" "How can I help you?" "I just want to be alone." "You're depressed, my dear." "We see it every day." "This is very effective." "Few side effects." "Won't turn you into a zombie." "At bedtime, especially initially." "It'll help you sleep, but won't make you a zombie." "Take this to the pharmacy downstairs." "Don't hesitate to call me." "OK?" "Cipralex, 10 mg, one tablet." "Effexor is a powerful antidepressant." "After just a few minutes, this doctor gave Anne 6 weeks' worth of Effexor." "Just enough to get her hooked, then wean her from her addiction with another drug." "Start with... lt can take 3 days." "This is 37.5." "Then, 75." "What you do is take one Desyrel at bedtime, 50 mg." "This is a sample?" "Yes." "We usually prescribe a week's worth." "You should take it for a month." "Fairly cheap." "When you run out, take this prescription to the pharmacy." "Patients who leave a doctor's office without a prescription shouldn't think the consultation was a bust." "Quite the opposite." "We bought tons of stuff on the street." "Even morphine!" " Twenty bucks." " Twenty?" "That should do it." " Don't follow me, now." " l won't." "I'll go get it." "Then I'll show it on camera." "Be right back." "It's all in here." "Seriously, check it out." "This is it." "All ready to shoot up." "How do I know it's real?" "What do you think?" "It's morphine." "Ex-drugstore employee" "Should the syringe be clear?" "Don't confuse them." "Cocaine is yellow." "This is white: a liquefied pill." "I know." "With purified water." " Taste it, you'll know." " No way." "I had it analyzed." "It was morphine." "Obviously, this is reprehensible." "Expired medication should be returned to the pharmacy for safe, proper disposal." "That's not what happened here." "No society is perfect." "We make the exchange." "Let's have a look." "We had all these street drugs analyzed." "Conclusion: half the pills were fake." "They were billed as antidepressants, antipsychotics, and powerful painkillers." "What we were actually sold were pills for diabetes and acid reflux." "Anti-depressant" "This could be Amitriptyline." "But 5-mg pills aren't available on the market." "Available doses are 10, 25, 50 and 75 mg." "Pharmacist lt's clearly a fake." "This one looks like 25 mg, except - it's hard to see on camera - there are different colours from different lots." "is it a very good copy, or the real McCoy?" "Hard to say." "But judging by the different shapes and colours, I'd say it's a fake - though a very good one." "In Canada, pill presses are freely sold." "We could buy one today, no questions asked." "In the States and abroad," "Substance specialist ... press sales are monitored." "Here are a few over-the-counter drugs." "No prescription required." "Over the counter and sold like candy." "You can buy up to four boxes, no questions asked." "And more still- up to 6, 8, 10 boxes at a time." "We sent 2 teens to 3 pharmacies to buy over-the-counter meds." "Within 1 5 minutes, they had purchased 30 boxes." "They paid with $50 bills." "No problem." "Going on vacation?" "Air Miles card?" "These meds contain pseudoephedrine, used in the making of other drugs." "Pseudoephedrine extracted from these meds is used to make methamphetamine, Ecstasy, and other synthetic drugs." "Crystal meth, too, yeah." "Crystal meth is a hard drug that is both cheap and highly addictive." "It is stronger than cocaine and longer-lasting." "Just take one ingredient found in these products and mix with ammonia, solvents, lithium from batteries, brake fluid, Drano and iodine." "A recipe concocted by so-called "cooks."" "There's a saying:" "Once a cook, always a cook."" "It's very lucrative." "Once you've successfully cooked up a batch, you can do it again and again." "Meds bought on the black market or online are extremely dangerous." "Nevertheless, patients must remain vigilant- with doctors, pharmacists, and in hospitals alike." "Pharmacist" "Prescription errors are all too common." "Doctors must be contacted about all these meds here." "This is for today alone." "Doctors write illegible prescriptions." "If pharmacists don't double-check, and dispense the wrong drug, who's held accountable?" "Pharmacists." "We held a weekly contest, published in a medical journal." "Participants had to decipher a physician-issued prescription." "Nobody ever won." "Some nights, 1 of 3 prescriptions has a problem." "Pharmacist" "The dose may have been increased without advising the patient." "It raises a red flag;" "we must then contact the prescribing physician." "It may be the wrong dose for the child's weight or whatnot." "At 9 months, Chloe underwent surgery." "Everything went well, but her level of potassium, an essential micronutrient, was too low." "The treating physician gave her an injection." "The dosage error had devastating consequences." "Chloe turned white as a sheet and her head fell back." "Then she stopped breathing." "She had gone into cardiopulmonary arrest." "Probably due to the potassium overdose." "The mistake was made by the resident endocrinologist." "The prescribed dosage was increased 10-fold, from 4 to 40 mg!" "They rolled Chloe by me." "Her eyes were open." "She was on a respirator." "She clearly had trouble breathing, but her eyes were open." "She was taken to intensive Care." "I was told I could see her once she was settled in." "Once there, she fell into a coma." "Georgette Patenaude suffered from Myasthenia Gravis, a condition characterized by accelerated weakness and fatigue of the voluntary muscles." "She was at the hospital for routine treatment." "On his way to pick her up, her husband received a call." "They told me to come asap;" "she was unconscious." "I rushed over." "They wouldn't let me see her." "A doctor came and took me aside." "He explained there'd been an accident..." "A medication error." "I was told there'd been a mix-up." "The details... were unclear." "After some digging, I finally found out what she'd been given." "KCl." "Instead of NaCL, or saline." "I later found out that KCl is what U.S. death-row inmates are given." "Instead of being gassed, they're given this lethal injection." "It stops the heart cold." "But they're not revived." "That's what they gave her." "Accidentally." "Unconscious, hooked up to machines." "She was unresponsive." "It was her attending nurse." "She took the vial off the shelf." "But the wrong one." "It was similar to another vial, with a similar label." "They revived her." "There was no apparent brain damage." "Everything seemed fine." "They'd "unplug" her tomorrow if she could breathe on her own." "She was out of danger." "She was - but not for long." "A couple weeks." "One Friday, I was notified she wouldn't make it overnight." "The family gathered - children and grandchildren." "They all came." "She died that night." "A routine treatment, and they killed her." "Simple as that." "Maurice Laturaze was hospitalized for pulmonary problems, and contracted C. difficile." "He was treated and about to be released." "I was told that around 7 a.m., the nurse made her morning rounds." "She gave my father the wrong iv bag." "He went into cardiac arrest." "I was in shock." "Definitely." "I entered the room and there he was." "They'd already cleaned up the room, removed all the equipment." "He was ready to receive the family." "I was told I should call the whole family together, because the nurse had given him the wrong serum." "They didn't acknowledge it was a medical error." "They said, "The nurse inadvertently gave him the wrong medication."" "He died within 6 minutes." "It took the nurse 10 minutes to realize her mistake." "I even asked the head nurse," ""My father's medication went to another patient;" "was that patient the victim of medical error as well?"" "She never responded." "He was prescribed Flagyl, 500 mg, but was given Dilaudid, along with Versed." "That drug cocktail sent him into cardiopulmonary arrest." "It was totally contraindicated for someone with his condition." "When Chloe was in a coma, I told her," ""Listen, Chloe, it's all up to you now." "But if you choose to fight for your life, don't put me through hell." "If you want to let go, you have my blessing." "It's okay, I'll understand." "I won't hold it against you."" "The day she opened her eyes, I realized she was a fighter." "My partner and I looked at each other and vowed to do everything in our power to make her life comfortable, that we'd always be there for her." "The one thing he couldn't check - because with an iv bag, you never know." "Why worry?" "They come, stick the tube in..." "But that's what killed him." "Her sense of balance is very shaky." "She also has double hemiparesis." "Her upper limbs are most affected, especially the right side." "She also has trouble rotating her wrists." "Her hands are like this." "She also has a learning disability." "Delayed language development, too." "We've always put the medical profession on a pedestal." "Second only to God, we blindly put our trust in doctors, because our health is at stake." "We shouldn't hesitate to ask questions." "When you're handed a cupful of pills, make sure you know exactly what you're taking." "Julie Groulx knows of what she speaks." "She's a nurse." "Honestly, I have made drug-administration errors." "Lawyer" "The number-one medical error." "The person administering medication must abide by the "5 rights" rule:" "1." "Right Patient." "They never checked my husband's name." "What's the point of a hospital bracelet if they never look at it?" "2." "Right drug." "She took the wrong one of two similar vials." "3." "Right dose." "lncreased 10-fold, from 4 to 40 mg!" "4." "Right route." "5." "Right time." "They made errors." "Like often forgetting his meds." "That these things still happen in 2007 is beyond comprehension." "But that's why they're called errors." "A tiny pill has enormous power." "Quitting is easier said than done." "Mireille was diagnosed with affective schizophrenia." "She is trying to give up her meds." "They're pill pushers." "They're convinced it's a physical and chemical disorder that can only be treated with medication." "Find the right dose and stick with it for life." "I believe it's partly psychological." "Emotional trauma can be upsetting, but not necessarily permanent." "Diane has been taking medication since suffering a back injury." "My family, husband, friends often remarked  that I was a walking pharmacy." "I've been on Effexor for 5 years." "It's time to stop." "I tried quitting Demerol." "Demerol: narcotic analgesic" "Possible side effects:" "addiction, dizziness, vertigo, etc." "A few times." "But after a couple days, you get cravings." "They're calling your name." "I didn't last 3 weeks." "I can't imagine life without meds." "I could use even more." "I saw my life in shades of grey." "I went back on Effexor." "After two days, I was myself again." "I was off medication for years, after taking high doses day after day." "I gave it up, and stayed drug-free for a long time, no problem." "I got scared, once again." "So now I'm sticking with it." "I'd like to take something to help me sleep better." "Like Seroquel." "Seroquel: antipsychotic" "Possible side effects:" "constipation, dizzyness, drowsiness, etc." "To relax me." "When did you take your last Rivotril?" "Just now." "Nelson walks slowly." "He has the shakes." "The result of high doses of medication." "Nelson is psychotic." "These meds are temporary." "I can't take them year-round;" "they're too strong." "It's very potent stuff." "I'll explain." "This is lithium." "For manic-depression and depressive tendencies." "This is for my prostate." "I was bound to have prostate problems, what with all the meds I take." "This is Zyprexa - 20 mg." "These are for my cholesterol." "More lithium at bedtime." "And one Rivotril - 1 mg." "Zyprexa could knock out a horse." "I was on low dose for 12 years without a problem." "No psychotic breaks." "I took one Zyprexa - 5 mg at bedtime." "Just one pill a day and I was perfectly functional." "The high-dose meds give me the shakes." " You weren't employed?" " Oh, no." "I don't know if I should I mention... sex." "Sexually, you're screwed." "Your pecker's dead as a doornail." "Cases like mine are common in Quebec, but swept under the carpet." "You can encounter someone on the street and never know they shared my illness." "Early colonists didn't have these problems." "There was less depression - l'm quite sure of that." "They bedded down at sundown, rose at sunrise." "Didn't watch TVtill midnight on the pretence of relaxing, living life to the fullest." "Modern life requires us... to be productive 24/7." "No human respect." "We followed Raymond to his doctor's office to see whether it was possible to lower his medication." "How often do you see Raymond?" "Every 3 months or so." "How much time do you spend with him?" "Not much." "Say 5 to 15 minutes." "More like 5." "Our role is to provide general supervision." "He looks at my prescription sheet, compares it to my medical file." "He scribbles endlessly, then asks how I'm doing." "It provides an overview." "It's not a 90-minute psych evaluation." "He asks a few questions, but 5 minutes is hardly enough time for discussion." "Writing the prescriptions takes up all our time." "Does your psychiatrist review your medication?" "I'm not seeing a psychiatrist." "Haven't seen one in 2 years." "Raymond spends less than an hour a year with his doctor, most of which is spent renewing his prescriptions." "His doctor didn't know he wasn't seeing a psychiatrist." "Raymond is hostage to his illness and his medication." "The current state of availability of care and of specialists is such that he may have to make do with that." "I think I need a shrink." "They're hard to find." "THE POWER OF THE pill" "Pharmaceutical companies set up shop in Quebec due to government-mandated monetary incentives, ranging from tax breaks to extended patent protection." "And these companies know precisely how to get their message across." "Otherwise, there'd be less RD and industrial relocation to Quebec." "Quebec Minister of Economic development" "And certainly not 18,000 jobs." " Do companies tell you so?" " Explicitly." "How so?" " The chosen locations" " How?" "They don't quite use blackmail, but use the power of persuasion." "Negotiations are contingent" "Do they use blackmail?" "Lobbying?" "If you understand the other party's decision-making process, it can help tip things in your favour rather than, say, Shanghai." "There are more than jobs at stake, too." "Had Quebec's drug-pricing policy not changed, access to essential drugs would have been jeopardized." "Another example:" "Americans buy their meds from Canada because they're cheaper here." "And lo and behold, we've experienced a shortage of certain drugs." "This cross-border trade peaked some 5 years ago." "Quebec Order of Pharmacists general Director" "The number of drugs shipped south of the border was then in the $1-billion range." "This sometimes led to shortages." "Of course, this wasn't the official reason." "But, ultimately, it was." "Canada's own supply was thus reduced." "In short, when Big Pharma feels thwarted, the government had better listen up." "Sometimes it's subtle..." "We rely on governments..." "Communications and public Affairs Vice president, RXD ... to assist us in supplying drugs to those who need them, when they need them." "Sometimes less so." "Don't expect Texas to extend us an offer," "Director, Government relations as they did with Bombardier, to relocate our businesses." "Could our drug supply be better controlled?" "We are hopeful that governments will realize... that there's a potential threat and take the appropriate measures to ensure that we can continue to supply drugs to patients who need them." "So it's not completely out of the question?" "We're optimistic governments will take the initiative to ensure that we can continue supplying drugs to patients who need them." "So supply control isn't completely out of the question, then?" "Once again, we are very optimistic and believe governments... will rise to the challenge and act proactively." "It's also interesting to see how the government and the industry work hand in glove." "Russell Williams heads the biggest pharmaceutical lobby." "Why are we being videotaped?" "It's somewhat unusual." "We've always filmed our interviews." "President, RXD" "For archiving purposes." "It's standard practice." "It's unusual..." "Mr. Williams wanted to detail his lobbying actions with the government." "There was no danger of misquoting Mr. Williams." "Of course, we must ensure drugs are available to patients." "It's in everyone's best interest to see that patients have access to the right drugs in a timely fashion." "Once again, when a drug is proven effective... it should logically be made available to patients." "We want to ensure that physicians prescribe the right drugs at the right time to the right patients, if I may put it that way." "Mr. Williams became president of RxD 3 weeks after leaving his post as Parliamentary Assistant to the Health Minister." "A man who shows great single-mindedness." "To ensure the availability of high-quality drugs..." "The population must have access to them in a timely fashion." "I know Mr. Williams to be an honest, ethical man." "Yet another coincidence:" "Special Advisor to the Quebec Health Minister Marie Gagnon resigned a few months later, right before the drug policy was tabled, to join Mr. Williams's team." "The intention was fairly obvious:" "to recruit the minister's assistant and senior advisor." "It's the result that matters." "I let no one influence me." "Quite the opposite." " Really?" " Yes." "Had a former employee behaved inappropriately - using his or her new position to pressure me - l'd have put an immediately end to it." "Why hire Ms. Gagnon?" "I consider her very competent in our line of work." "How so?" "Because she served as a drug-policy advisor?" "She is very competent." "She's not the only one." "Opposition-party assistants have also joined the ranks of the pharmaceutical industry, which recruits a great many professionals." "I'm joined by one of my political advisors," "Mr. Maxime Barakat." "Mr. Barakat, you may recall, works for Bristol-Myers Squibb - as a lobbyist to the government." "I worked on the Quebec prescription-drug-insurance plan alongside Pauline Marois." "And I want to keep working in a field where l can be of more use than as a cabdriver." "Caroline Barber assisted Louise Harel during the drug-policy parliamentary commission." "Ms. Barber now works for a pharmaceutical company, Schering." "At the parliamentary commission, Marie Gagnon sat by the minister, and Caroline Barber by Louise Harel." "The two political rivals now work for the same industry." "Convincing patients there is a pill for whatever ails them;" "that they are ill, but can be treated." "lnfluencing doctors' choices by convincing them they are independent." "lnfluencing pharmacists in what they buy." "lnfluencing government policies." "Quite the lobby-fest!" "It's just the beginning." "And it works." "Companies don't spend billions in marketing dollars for nothing." "They calculate the return on every dollar spent." "For you see, only 3 to 4 new drugs are actually launched every year." "Max." "Hardly enough to maintain sales and profits." "Companies thus have a strategy." "They constantly broaden the market for particular drugs." ""Niche" is a marketing term describing this practice." "Ex-pharmaceuticaI industry executive" "They take extreme cases - say, severe hyperactivity or extremely serious bipolar disorder." ""Don't you want to treat these people?" "It's appalling!" "Look at them!" "They need medication to alleviate their terrible suffering."" "Of course, everyone agrees, these people need help." "Then, building on this niche, the market is broadened to include less-severe cases." "A good example is cholesterol." "When I first sat on the Drug Council," "Quebec was spending $2.5 million on treating cholesterol." "Standards have changed over time;" "CHUM Research Centre Director ... they're forever dropping." "Lowering the threshold is akin to creating a new disorder." "The same pill is used to treat a variety of diseases." "Companies emulate their competitors, or slightly modify the pill to prolong its commercial life." "They must always appear to be offering a new drug, presumably better and, above all, more expensive, with an extraordinary profit margin." "Know how much Coca-Cola makes on a bottle of Coke?" "It's a particular industry, as it markets a particular product." "You can't compare medication - which sustains lives and health - to convenience goods." "Canadian Generic Pharma." "Assoc." "Quebec executive director" "A $1.25 Coke bottle is worth about 10 cents." "I take $12,000 worth of medication a year." "The little blue pill is worth $14." "That's a lot of money." "That means the government spends $12,000 a year on your medication alone." "I'm not interested in Coca-Cola, but in an industry that manufactures drugs." "These are not consumer products." "Let's get something straight." "A trademark- or generic-drug company is not a charity." "Right?" "Its goal isn't to provide the public with all the drugs they want at ridiculous prices." "Mr. Dupré is right." "Big Pharma is not in the business of charity." "Pfizer recorded $19 billion in profits on sales of $48 billion." "Oil giant Exxon had to sell 7 times that amount to make as much profit." "Big Pharma's profits: $78 billion." "Quebec's budget: $61 billion." "In pharmaceutical reps'right hand:" "lMS's list revealing physicians'prescription habits and the extent to which they may be influenced." "In their left hand, countless samples to push sales." "In their briefcase, studies and research papers - every sentence negotiated in the companies'best interests;" "otherwise, the study ends up in the trash." "Doctors who lack the time or training to decipher the avalanche of scientific data." "Pharmacists who sell teens box after box of Sudafed or Claritin without asking a single question." "Experts directly paid by Big Pharma." "Companies pressuring governments through economic threats." "Governments that undertake no independent studies." "Pills that hit the market in a fanfare of publicity, and others taken off the market due to overly severe side effects." "New diseases are created, or the number of patients suffering from existing ones increased." "Billions are spent on publicity and marketing to convince you there's a pill for your every ill." "It's a world of contacts, networking, pressure tactics, kickbacks, and money." "Lots of it." "Pills and yet more pills, both legal and illegal, useful and useless, essential and harmful, with few or many side effects." "Pills that undermine patients, because the healthcare system is unable to care for them." "Then, there's you, the demanding patient- self-diagnosed, influenced by advertising or your brother-in-law." "A docile patient who rarely asks questions." "A pill can just as easily save your life as sign it away." "Emma-Rose can rest easy." "For the time being, all she needs is love and protection." "That doesn't come in a pill." "Translation and Subtitles:" "D. Gauthier, F. Nobert, CNST, Montreal" "Subtitling made possible with the contribution of Telefilm Canada"