Deadly pills
| Movie | |
|---|---|
| Original title | Deadly pills |
| Country of production | Germany |
| original language | German |
| Publishing year | 2004 |
| length | 43 minutes |
| Age rating | FSK 6 |
| Rod | |
| Director | Erich Schütz |
| script | Erich Schütz |
| production | SWR |
| camera | Detlev Koßmann |
| cut | Detlev Koßmann |
| occupation | |
| |
Deadly pills is a documentary from the year 2004 by Erich Schütz and Detlev Kossmann . The film is the first part of the 3-part series “Die Gesundheitsfalle” broadcast by SWR. On the occasion of new deaths resulting from interactions and side effects of commercially available drugs, the film uses the interviewed relatives and those affected - supplemented by interviews with prescribing and critical doctors, other critics and pharmaceutical representatives - to determine the background of a perfidious system. Subtle industrial influence and bribery, excessive demands and also cover-up on the part of the treating physicians result in exemplary documented cases of severe damage to health or death, which are not documented in any statistics .
Movie content
Numbers and experiences
Jürgen C. Frölich , at that time head of pharmacology at the MHH Hannover, reports of 58,000 deaths in Germany every year due to " undesirable drug effects" (ADR). However, this figure only refers to the " internal medicine departments " and is therefore "a small part of all hospital admissions that take place" and furthermore "a small part of all deaths that actually take place from drugs". In addition, it is so and depressed him that there is also "a great deal of damage from adverse drug reactions" which, under certain circumstances, would "seriously damage the patient for life, for life". Although Frölich's numbers would cause “malaise”, sometimes even an “annoying stomach grudge,” among his colleagues, Frölich stuck to his numbers. He knows the statistics of the hospitals from various studies. According to Frölich, “ten percent of hospital stays are due to adverse drug effects”, hospital admissions are also five percent, and in the departments with older patients even “fifteen percent of hospital admissions are due to adverse drug effects.” Therefore, this is “the most common disease there are". Frölich made these whole numbers "based on the deaths" and was able to "show numerous deaths from adverse drug reactions" and "name individual patients" - as the authors then also report.
Exemplary cases
One such case that Frölich mentions is that of Hilde Schellhorn , whose widower Siegmar Schellhorn from Hennef turned to him in his distress, reports the film team. You travel to Siegmar Schellhorn and interview him. Mr Schellhorn reports - supplemented by the reported information from Frölich - that his deceased wife received high-dose methotrexate as a chemotherapeutic agent in order to destroy an alleged tumor in the brain. With this administration, however, not only were the methotrexate administered far too high for her age, but also the antidote leukovorin, which is absolutely necessary (due to the high toxicity and bone marrow- destroying effect of the drug), was not administered sufficiently early and not long enough (“Leukovorin Rescue "=" Leukovorin rescue "). For now, further details about the diagnosed “tumor disease” of Ms. Schellhorn remain open. Especially at the age of 65 and over, the detoxification function is greatly reduced, the liver and kidneys work less, so it is not uncommon for older people to overdose - as was the case in this case. Kidney function , for example, has to be carefully determined, reports Frölich. Such drug-damaged patients would die “anonymously” from interactions and side effects - and are not counted in any statistics.
An interview is being conducted with the doctor Dirk Stichtenoth (MHH) on the basis of an acute case of poisoning at the Hannover Medical School. There, a patient interviewed in the film had been given Captohexal and Kalinor tablets together. His pulse dropped to 27, he became an emergency and, as a result, will probably require dialysis for the rest of his life . The dialysis catheter had already been placed.
Further case studies and initial backgrounds
This is not an isolated case: “Medicines botch is covered up every day”, as Frölich has shown on the basis of an exemplary study at the University Clinic in Magdeburg (emergency room). According to Frölich's investigation, "6 of 44 patients had to undergo dialysis for life because of incorrect prescriptions, 2 of whom died". The film team tries to get an interview with the Magdeburg clinic in this regard, but a spokesman fears lawsuits and rejects them. The Magdeburg public prosecutor's office explains to the film team that they would “not investigate without a specific case”.
The background to the interview with Dirk Stichtenoth is reported: The “Red List” drug directory alone contains “more than 10,000 preparations from 500 pharmaceutical companies in 13,000 dosage forms and 35 prices”. The clinical pharmacology but whether as a department in the medical school "incidental". “For all the drugs” one sees “no more medication” - which Stichtenoth affirms as the background to the problem. In contrast to surgery , drug therapy is greatly underestimated. The danger there is "just as great".
The background - participation of the pharmaceutical companies
The involvement of the pharmaceutical industry in the high number of deaths mentioned is critically questioned in the film. On the one hand, the above mentioned Overloading of the market with drugs that would overwhelm the doctor - especially young, inexperienced doctors. In addition to “60,000 drugs”, 60 new drugs are added every year, at most 6 of them are actually new - this is one of the reasons why “the pharmaceutical market has doubled in the past 10 years”. On the other hand, however, it is exactly the other way round - in areas with little profitability: the pharmaceutical industry develops far too few drugs in areas where sales are too low (see also orphan drugs ). Even conventional preparations are not available in the dosage for children, reports the pediatric cardiologist Martin Hulpke-Wette . The doctor Vera Regitz-Zagrosek (German Heart Center Berlin) reports that the metabolism of drugs in women - hormonally and enzymatically and depending on the body fat percentage - is different. Therefore, women’s tolerance to alcohol is also reduced. The studies for z. B. Heart medication, however, is mainly administered to men, for example because the hormonal balance of women is comparatively "complicated". This already applies to basic research in animal experiments , which is why mostly “male data” is used. Overall, "old people and children (...) and women" are "left behind" in the pharmaceutical industry, according to the authors. Walter Köberle from Pfizer Germany argues that studies cannot be carried out with children and that this is also problematic in women - because of a possible undetected pregnancy. When asked by the authors whether it is not a contradiction in terms that people “act on the basis of profit”, the pharmacist Matthias Bohn (University of Göttingen) commented with a grin: “I won't say anything about that”.
Doctors in the sights of the pharmaceutical industry, inactive public prosecutors
The doctor Winfried Beck , who became aware of a letter to the editor in the Arzneitelegram , is also interviewed . He reports that there were “repeated attempts at bribery”, that happened 3 years ago, in 2001. At that time, he was offered “a thousand marks” for “treating five patients with a new drug”. This was "seriously packaged", as " application observation " and with "expense allowance" as wages. That was a “disproportionately high sum” for what he had to do. Accordingly, “what is expected” is also said. For example, pharmaceutical companies also pay for “travel including a wife” as well as “computer allowances” in the doctor's office. Then, in the result, “colleagues also ask specific questions”, “including consideration”. In addition, colleagues are used to address colleagues, "because that is of course a much more collegial level". These are medical colleagues. Beck reports further details in his book Not Corresponding to Class. Beck also turned to the public prosecutor's office, but they declined: “You cannot bribe physicians practicing freely,” was the answer. According to the authors, the doctor must “be convinced of one drug among thousands”, then prescribe it. This explains that, in view of the enormous number of pharmaceutical companies and consequently the above-mentioned Overloading the market with drugs is "in the sights of the pharmaceutical industry" and is "wooed with great effort" by the same.
Through the doctor Beck, the film team became aware of a "press communication service" operating for the Wyeth company , which Mr. Beck supposedly mistook for medical colleagues. You visit it, but you are turned away. The "service" promptly complains to WDR superiors about the unwelcome visit. The film team interviews their client, the Wyeth company. It is reported that in addition to the “reward for the observation of the application” there was also an invitation to a “posh hotel” (in the picture Intercontinental) with “classy food”. There is a report of a “common reception” between doctors and pharmaceutical representatives: The “medical profession invites”, the pharmaceutical industry pays the expenses. Gisela Dahl from the Stuttgart Medical Association and colleagues and Klaus-Peter Emig from Merck are interviewed there . The doctors can be heard that the pharmaceutical industry has “the longer lever” because they “agree”. Emig argues that the doctor "is after all an academic" and therefore "not incapacitated". This is just "a prejudice," said Emig. In fact, however, the doctors are sometimes "not so convinced themselves", according to the authors. Wolfgang Becker-Brüser considers “experts who function as opinion leaders” but “financed by companies” to be particularly problematic. The opinions of such "experts", who "as a professor so and so" would actually spread "marketing clink", would often "trust and believe" by resident doctors.
Finally to the 1st case study
Finally, the viewer learns more details about the death of Hilde Schellhorn. Her widower reports that there was an "autopsy" after death, where the "initial suspicion was corroborated": You could autopsy "only one hematoma " in the brain and found "no signs or indications of tumor cells". Instead, however, "no more usable bone marrow " could be found in her (destroyed by methotrexate). Apparently “a bruise was treated with a high dose of methotrexate”, commented the editors, and Mr. Schellhorn's lawsuit had now been “for five years”.
First broadcast and broadcast dates
Thursday, July 15, 2004 at 8:15 pm on Phoenix.
Interview partner
- Jürgen C. Frölich (Prof. Dr. med., At that time head of clinical pharmacology at the MHH )
- Wolfgang Becker-Brüser (Editor Arzneitelegramm )
- Siegmar Schellhorn (widower, Hennef )
- Dirk Stichtenoth (Dr. med., MHH, Hanover)
- Martin Hulpke-Wette (Dr. med., Pediatric cardiologist)
- Katharina Gruber (mother)
- Matthias Bohn (Dr., pharmacist, University of Göttingen)
- Gisela Dahl (Dr. med., Stuttgart Medical Association)
- Klaus-Peter Emig ( Merck KGaA )
- Werner Baumgärtner (Dr., MEDI group)
- Walter Köberle ( Pfizer Germany)
- Vera Regitz-Zagrosek (Prof. Dr. med., German Heart Center Berlin)
- Winfried Beck (Dr. med., Frankfurt / Main)
- Peter Andreas Löschmann ( Wyeth Pharma GmbH)
Quotes
“We assume that in the internal medicine departments alone, 58,000 patients per year die from adverse drug reactions. That is a small part of all hospital admissions that take place, and that is a small part of all deaths that actually occur due to drugs. (...) We have to consider that about ten percent of the hospital stay is caused by adverse drug reactions; that five percent of hospital admissions are caused by adverse drug reactions, and in the departments where older patients are - and this is the case in almost all of our internal medicine departments - fifteen percent of hospital admissions are caused by adverse drug reactions. You have to keep that in mind! It is the most common illness there is! (...) I attach these whole numbers to the deaths and I can show them numerous deaths from adverse drug reactions. I can name individual patients for you. (...) What also depresses me a lot is that there is a great deal of damage from adverse drug reactions, which under certain circumstances can seriously damage the patient for life. "
“A big problem are of course the experts who are financed by companies. Who act as opinion leaders. Who do not actually spread a scientifically founded opinion, but rather do marketing for a company as an expert, as a professor and so on. That is actually particularly nasty and particularly annoying, because resident doctors, who are alone in their practice, often trust and believe in such opinions - but in reality they only spread marketing clash. "
"You use colleagues (...) to address colleagues, because of course that is also a much more collegial level."
"It is a disproportionately high sum for what I would have to do, and whenever something like this is offered - disproportionately high - something is expected."
"Doctors who practice freely cannot be bribed."
"Sham innovations - highly praised by questionable independent experts - bring pharmaceutical companies the greatest economic success because they can be produced without expensive research."
“Since the budgeting, more and more doctors have been prescribing cheap generics such as those from Ratiopharm, ie counterfeit drugs. The pharmaceutical giants are flooding the hospitals with free originals, forcing doctors to continue prescribing their expensive products (...) The patient is loyal, the market is easy to assess. Whether Pfizer, Bayer or Merck; they all create brand awareness through their gifts. The patient does not ask his doctor or pharmacist about risks and side effects, but specifically about the supposedly high-quality product that was given to him in the hospital. "
epilogue
Five times as many deaths as previously assumed
According to Frölich, the new projections are based on a Norwegian study of almost 14,000 patients. 732 men and women died in the study period of two years, 133 of them due to an undesirable effect of drugs. So far, the Federal Institute for Drugs and Medical Devices assumed 8,000 to 16,000 deaths per year due to too high or too low a dosage or an incorrect combination of drugs. The basis of these numbers, however, are voluntary reports from doctors to the Federal Institute. "And of course it is always uncomfortable for a doctor to have to admit that his patient has died of the medication he has prescribed," said Frölich according to the Berliner Zeitung . "Nevertheless, in case of doubt, it is always the illness from which the patient dies."
For two years, the internist Just Ebbesen and his colleagues observed around 14,000 patients in the hospital's internal medicine ward in Akershus, Norway. The doctors examined the blood of the sick for active ingredients of drugs. 732 of the 14,000 patients died. The scientists again took blood from these deceased and also autopsied 571 of the 732 dead. An independent commission of clinical pharmacologists and internists found on the basis of the results of the investigation that 133 of the 732 deceased had been prescribed incorrectly dosed or mixed medication and died as a result of these medications. According to the experts, 66 of these cases could have been avoided. "133 deaths, that's just under one percent of the 14,000 patients - five times as many as previously assumed," said Frölich at the conference.
Frölich transfers the Norwegians' results one to one to German conditions. "In Norway, the same drugs are prescribed in the same doses for the same diseases," he said. Many Norwegian doctors were trained in Germany and the death rate on internal medicine wards is around 5 percent, as in Germany. "No doctor likes to admit that his patient died of the wrong medication," said Frölich according to the Berliner Zeitung at the conference.
Background of the calculations
- According to Frölich, around half of preventable deaths can be traced back to incorrectly prescribed medication.
- In 31 to 58 percent, dosage errors are responsible for the death of the patient. In some cases, doctors would not adjust the dosage for patients with weak kidneys or would not take sufficient account of the patient's weight.
- According to Frölich, miscalculations can also have fatal consequences. According to his information, 150 doctors were asked to calculate five different dosages in another study. Only 44 percent of the doctors did not make any mistakes.
- Finally, allergies that doctors ignore could also cause adverse drug effects.
In the Norwegian study, according to Frölich, only six percent of doctors suspected that drugs could have been the cause of patient deaths.
development
In the summer of 2003 the media reported nationwide for the first time on the published figures by Frölich, in 2004 Tödliche Pillen was broadcast. While doctors initially often thought they recognized “ nest contamination ” in Frölich's numbers , Frölich was now increasingly receiving a tailwind. So in 2010 by his colleague Bruno Müller-Oerlinghausen , also a member of the drug commission of the German medical profession , as reported by the Süddeutsche Zeitung . Daniel Grandt , chief physician at the Saarbrücken Clinic and co-organizer of the "Congress for Patient Safety in Drug Therapy", which was initiated in 2005, wants other possible causes to be taken into account at least for drug interactions : every fifth patient takes medication himself "in the hospital", of which the treating person Doctor don't know anything. "Doctors and patients should know that drug administration is a high-risk process," says Grandt, according to the Süddeutscher Zeitung .
- The "drug therapy information system" ARTIS has existed at the Hannover Medical School since 1994 , through which doctors can obtain information on individual dosages and interactions and side effects.
- In 2005 the 1st “ German Congress for Patient Safety in Drug Therapy ” took place. Since 2005, drug therapy safety (AMTS) has become a fixed reference value in the discussion about drug therapy. This was made more concrete through the “Action Plan to Improve Drug Therapy Safety in Germany” of the Federal Ministry of Health (BMG).
- In 2011 , a professorship for drug safety was established for the first time - unique in Germany - at the Hannover Medical School .
See also
- Pharmaceutical company: criticism
- List of high-profile incidents related to the development, marketing or use of pharmaceuticals
- Examples of market withdrawals due to adverse drug reactions
- side effect
Individual evidence
- ↑ Curriculum vitae on the IPO Network for Competence ( Memento of the original from March 4, 2016 in the Internet Archive ) Info: The archive link has been inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. , Internationale-praevention-organisation.org, accessed on February 24, 2015
- ↑ Dirk Stichtenoth on the MHH website , accessed on February 24, 2015
- ↑ Werner Baumgärtner on doctor wiki ( memento of the original from February 24, 2015 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. , accessed February 24, 2015
- ↑ JU Schnurrer, JC Frölich: On the frequency and avoidability of fatal adverse drug reactions . In: Der Internist , 2003, 44 (7), pp. 889-895, PMID 14631585 .
- ↑ internationale-praevention-organisation.org ( memento of the original from March 4, 2016 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Curriculum vitae on the IPO Network for Competence, internationale-praevention-organisation.org, accessed on February 24, 2015
- ↑ Dirk Stichtenoth on the MHH website , accessed on February 24, 2015
- ^ J. Ebbesen et al .: Drug-related deaths in a department of internal medicine . In: Arch Intern Med. , 2001 Oct 22, 161 (19), pp. 2317-223, PMID 11606147
- ↑ The illness is not always to blame . In: Berliner Zeitung , August 27, 2003.
- ↑ "Death in the hospital" ( memento of the original from February 25, 2015 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. , Article in Stern magazine August 15, 2003, accessed February 25, 2015.
- ↑ Werner Bartens: Death from the pill box . In: Süddeutsche Zeitung , May 17, 2010, accessed on May 25, 2015.
- ↑ Information about the "drug therapy information system" ARTIS . MHH, Hanover, accessed on February 24, 2015.
- ↑ 4th German Congress for Patient Safety in Drug Therapy . ebm-netzwerk.de, 2012, accessed on February 25, 2015.
- ↑ “Professorship for Drug Safety ” set up exclusively in Germany at the MHH for the first time . ( Memento of the original from December 22, 2015 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. MHH press release of May 4, 2011, accessed on February 25, 2015.
