Arthur Hailey - Strong Medicine

Celia continued to sense that the antagonism generated at their first meeting a year and a half earlier would remain a permanent part of their relationship. But despite it, and with Celia's persistence, the contribution of the Research Department to sales training proved substantial. Not that the plan to raise the standard of detailing was entirely successful or wholly accepted. It wasn't. Celia had wanted to set up a report system, with spot checks of detail men's performance obtained through confidential questionnaires. The questionnaires would be mailed to doctors on whom the detail men called. The suggestion went to the highest level and was vetoed. Then Celia asked that letters of complaint about detail men sent in by doctors be routed to Sales Training and a record kept. She knew from her own contacts that such letters were mailed in, but no one in the company ever admitted seeing them, and presumably they were buried in some archive, with corrective action, if any, remaining secret. This request, too, was refused. As Teddy Upshaw patiently explained, "There's certain things the powers-that-be don't want to know. You changed that some because when you stood up at our sales bash and spelled things out, and then Sam fescued you, they just weren't hidden anymore, and the brass had to make the best of what was on their plate. But don't push 'ern too far too fast.”

It sounded uncannily like the advice Sam Hawthorne had given before her Waldorf speech and Celia retorted, "Someday the government is going to step in and tell us what to do.”

"You've said that before," Upshaw acknowledged, "and maybe you're right. Also, maybe it's the only way.”

They had left it there.

The subject of drugs and the pharmaceutical industry was on other minds elsewhere. Through much of 1960 the drug business was in the news almost daily-mostly unfavorably. The continuing U.S. Senate hearings, chaired by Senator Kefauver, were proving a gold mine for reporters and unexpected agony for companies like Felding-Roth. Both outcomes were due, in part, to skillful staging by the senator and his staff. Like all such congressional hearings, much of the emphasis was on politics, with a bias decided in advance. As a Washington reporter, Douglass Cater, wrote, "They... move from a preconceived idea to a predetermined conclusion.”

There was also, on the part of Estes Ktfauver and his aides, a constant quest for headlines; thus their presentations were one-sided. The senator proved a maestro at disclosing sensational charges just before reporters had to leave the hearing room to file their stories-11:30 A.M. for afternoon papers, 4:30 P.m. for morning editions. As a result, rebuttals occurred with reporters absent. Despite the unfairness, certain ugly truths emerged. They revealed excessive pricing of drugs; unlawful collusive price-fixing; illegally rigged bids for government contracts for supplying drugs; misleading advertising to physicians, including minimizing or even ignoring dangerous side effects; infiltration of the Food and Drug Administration by pharmaceutical companies and acceptance by one high-ranking FDA official of "honorariums" totaling $287,000 from a drug firm source. Newspaper headlines, though sometimes one-sided, zeroed in on some abuses.

SENATORS FIND 1,118% DRUG MARKUP

-Washington Evening Star

SENATE PANEL CITES MARKUP ON DRUGS Ranging to 7,079%

-New York Times

DRUG PERIL CLAIMED

-Miami Herald

BIG PROFIT FOUND IN TRANQUILIZERS Chlorpromazine 6 Times Costlier in U.S. than in Paris -New York Times

Testimony revealed that drugs which had been discovered and developed in foreign countries were far cheaper in those countries than in the United States. This was absurd, it was pointed out, since the American companies marketing the drugs had incurred no development costs. In French drugstores, for example, fifty tablets of chlorpromazine cost fifty-one cents compared with three dollars and three cents in the United States. Similarly, the U.S. price of reserpine was three times greater than in Europe where the drug was developed. Another strange contrast was that American-made penicillin was selling in Mexico for two thirds of its retail price at home. These and other American prices, it was suggested, were high because of unlawful collusion between manufacturers.

PET FOOD SAID BETTER INSPECTED THAN DRUGS

-Los Angeles Times

FDA AIDE'S TALK EDITED BY AD MAN Drag Firm Slogan Written Into Speech -New York Times

Testimony disclosed that a speech delivered by an FDA division head at an International Antibiotics Symposium had been sent to a drug company, Pfizer, for prior approval. An advertising copywriter changed the text to include, by inference, a plug for a Pfizer product, Sigmamycin. Later the drug company bought 260,000 reprints of the speech, treating it as an FDA endorsement. The disagreeable newspaper headlines continued, sometimes on successive days, in big and small cities coast to coast, with TV and radio adding their reports. All in all, as Celia expressed it to Andrew in December, "It hasn't been a year for boasting about where I work.”

At the time, Celia was on leave of absence because their second child had been born in late October, again in accord with Celia's schedule. As Andrew had been confident, it was a boy. They named him Bruce. Both their lives had been made easier several months before by the advent of a young Englishwoman, Winnie August, who now lived in and took care of the children during their parents' absence. Andrew had found her through an agency that advertised in medical journals. She was nineteen, had previously worked as a shop assistant in London and, as Winnie herself put it, she "wanted to lave a workin' 'oliday findin' out what you Yanks are like, then maybe spend a couple o' years down under with the Aussies.”

She was cheerful, quick and, to Andrew's great joy, whipped up breakfast each morning with lightning speed.”Comes o' practice. Did it for me mum at 'ome," she told him when he complimented her. Winnie also liked children and Lisa adored her. Andrew and Celia hoped that Winnie's departure for Australia would be long delayed. One other event that came to Celia's attention happened near the end of 1960. The German drug Thalidomide-to be known in the U.S. and Canada as Kevadon-was submitted to the FDA for marketing approval. According to drug industry trade magazines, the Merrell Company, which now had North American rights, had large-scale plans for Thalidomide-Kevadon, believing the drug would be a huge seller, as it was continuing to be in Europe. The company was pressing FDA for swift approval. Meanwhile samples of the drug--officially for "investigative use," though in fact, without restriction -were being distributed to over a thousand physicians by enthusiastic Merrell detail men. The news reminded Celia of her conversation with Sam Hawthorne eight months earlier when he had reported resentment within Felding-Roth because, at Celia's suggestion, Thalidomide had been tested only on old people, then rejected. She wondered briefly if the resentment still remained, then dismissed the subject as unimportant. She had other business concerns. Following Bruce's birth Celia returned to work more quickly than she had after Lisa was born and was back at Felding-Roth by mid-December. One reason: it was a busy time in Sales Training. The company was expanding and a hundred more detail men were being taken on-plus, at Celia's urging, some detail women, though only a half dozen. Also contributing to her decision was an infectious sense of national excitement. In November John F. Kennedy had been elected president and it seemed-from the graceful rhetoric at least-as if a new era, stimulating and creative, had begun. "I want to be part of it all," Celia confided to Andrew.”People are talking about 'a new beginning' and 'history in the making' and saying it's a time to be young and in charge of something. Going back to work means being involved.”