A drug salesman’s tragic death casts light on the profit motives that can fuel screening.

According to the New York Times the 27 year old salesman worked for Abbott Laboratories based in India.   He was a top performer but he faced a consistent “inhuman and unnatural” pressure to sell drug products for the company.   As a result of the excessive pressure the salesman rode his motorbike to a remote stretch of railroad track and threw himself in front of an oncoming train.

A note was found in his pocket that read “I’m going to commit suicide because I can’t meet my company’s sales targets and my company is pressuring me.”

The salesman’s suicide highlights inhumane aspects of drug company sales, but it also casts light on the dark side of screening.  Sales representatives in India are encouraged to organize “health camps” to promote screening for various diseases.  The camps are often held at doctors’ offices in an effort to increase business and drug sales.  Patients are screened by the drug reps, and those testing positive will be prescribed the represented company’s drugs by the doctor.  Following a round of screening patients, the drug company and the doctor both gain in increased profits.

The New York Times reveals that “some experts say these practices raise the prospect that people may be inappropriately diagnosed and could receive unnecessary treatment”.  This issue also occurs outside of India – the problem is global.

Research is uncovering the lack of benefits to screening.  A recent article published in the British Medical Journal titled “Why cancer screening has never been shown to ‘save lives’-and what we can do about it” highlights the lack of scientific evidence to support cancer screening.  The authors state that even when cancer screening identifies site specific cancers early, such as breast or prostate cancer, it has not been shown to benefit overall survival.

Basically, cancer screening has not been shown to reduce a person’s risk of dying. The motivation for undergoing cancer screening is to catch cancer early on, while there is still hope of treatment success.  However, research is finding this is not the case.  People are not living longer, even when cancer is caught early.  In fact,  even while there may be some gains in avoiding deaths from site specific cancers (e.g. breast or colon cancer), these gains may be offset by slight increases in treatment related deaths.

The authors highlight the importance of focusing on the harms of screening.  The harms of cancer screening include over-diagnosis and unnecessary follow up interventions such as biopsy, radiation, and chemotherapy. These harms have been largely ignored and undocumented.  In some cases, cancer screening may increase a person’s risk of dying.

The salesman’s death has helped uncover how the same profit motive that applies to drug sales can apply to screening and other types of  measures. The evidence is becoming clearer that cancer screening, and other types of screening, is not actually helping people live longer – and may be harming them.

Link to New York Times article: https://www.nytimes.com/2016/08/11/business/international/abbott-india-suicide-inhuman-drug-sales-tactics.html