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Did Johnson & Johnson put profit over safety?
Did Johnson & Johnson put profit over safety?

USA Today

time22-05-2025

  • Business
  • USA Today

Did Johnson & Johnson put profit over safety?

Did Johnson & Johnson put profit over safety? | The Excerpt On a special episode (first released on May 21, 2025) of The Excerpt podcast: For generations of Americans, the Johnson & Johnson brand has been a beloved one, as quintessentially American as baseball and apple pie. Its baby shampoo 'no more tears' has been a fixture in bathrooms for decades, as has its iconic band aids and talcum power. But it's this last item, the talcum powder, that may prove to be a tipping point in destroying its hard-won 139-year-old reputation with consumers. Author and freelance investigative journalist Gardiner Harris joins us on The Excerpt to discuss his new book 'no more tears: The Dark Secrets of Johnson & Johnson,' which is on bookshelves now. Hit play on the player below to hear the podcast and follow along with the transcript beneath it. This transcript was automatically generated, and then edited for clarity in its current form. There may be some differences between the audio and the text. Podcasts: True crime, in-depth interviews and more USA TODAY podcasts right here Dana Taylor: Hello and welcome to The Excerpt. I'm Dana Taylor. Today is Wednesday, May 21st, 2025, and this is a special episode of The Excerpt. For generations of Americans the Johnson & Johnson brand has been a beloved one, as quintessentially American as baseball and apple pie. Its baby shampoo No More Tears has been a fixture in bathrooms, as has its iconic Band-Aids and talcum powder. But it's that last item, the talcum powder that may prove to be a tipping point in destroying its hard-won 139 year-old reputation with consumers. To find out why, we're now joined by author and freelance investigative journalist, Gardiner Harris, his new book, No More Tears: The Dark Secrets of Johnson & Johnson is on bookshelves now. Gardiner, thanks for joining me. Gardiner Harris: Thanks for having me, Dana. Dana Taylor: There are two products that immediately come to mind when I think of Johnson & Johnson. One inspired the title of your book, Johnson & Johnson's baby shampoo, No More Tears. The other, the topic of your investigation, is J&J's Baby Powder. What are the risks associated with talcum powder, and can you share some of the evidence you uncovered that the company knew about those risks? Gardiner Harris: About talcum powder, the risks are clearly about its chronic contamination with asbestos. But I also want to make clear, Dana, that my book is not just about baby powder. It is about nine separate products. The products that I go through include Tylenol, that is the most widely used drug on the planet, and is far more dangerous than most people know. I also talk about Epo or Procrit, that most people know because Lance Armstrong used it to win seven tours to France, but actually ended up killing more than 500,000 Americans in the worst cancer drug disaster in American history. Also, Risperdal, an antipsychotic that is part of a disaster that's killed more than a million Americans. So through these various products, I point out that Johnson & Johnson has been responsible for contributing or causing more than 2 million American deaths over the last 50 odd years, and that's more deaths than have died in all of America's wars combined. It's an extraordinary toll from what has long been one of the most admired corporations in the world. And it is that contrast between what we think of Johnson & Johnson and how Johnson & Johnson has actually behaved. That is the focus of my book. And that I hope people can come away and find ways to protect themselves, not only against Johnson & Johnson, but against corruption writ large in American healthcare. Dana Taylor: So can you give us some of the evidence that you uncovered specifically as relates to baby powder? Gardiner Harris: Sure. So talc and asbestos are chemically identical. They have the same exact constituencies. And the only difference between the two, is a little bit of pressure and time as to whether those chemicals form into talc deposits or they form in asbestos deposits. And basically, what geologists will tell you is that you cannot have a talc deposit without a little bit of asbestos ribboned in the middle of it, and you can't have an asbestos deposit without some talc ribboned in there. And basically, Johnson & Johnson began to understand this problem in the 1950s and the 1960s. Now, in the fifties and sixties, these small contaminations, and these tests showed that up to three to 5% of baby powder was asbestos in the early years, but there was asbestos everywhere in American society during those years. There wasn't a boat, plane, house, car that didn't have asbestos in it and often pure asbestos. So it didn't seem like a big deal. But science began to discover in the 1960s and the 1970s that even microscopic quantities of asbestos could cause cancer, particularly a cancer of the lining of the lung, which is known as mesothelioma. The industry then rallied, came up with an asbestos testing standard that it sold to the FDA as safe. In fact, this testing standard would bless talcum powders as being asbestos free, even when they had up to 3% asbestos. And then FDA basically washed its hands of the issue. It didn't have the money to police cosmetics at the time or even now, and it didn't. And so Johnson & Johnson then tested its own products for decades repeatedly finding asbestos in Johnson's Baby Powder, but not telling anyone. And this started to get very, very dark, Dana, beginning in the 1980s as researchers around the world, the first one at Harvard, began doing epidemiological studies comparing the cancer rates of women who used talcum-based powders like Johnson's Baby Powder with women who didn't. And those studies began to show that women who used talcum-based baby powders suffered somewhere around 80% more cancers, usually ovarian cancer, than women who didn't. And Johnson & Johnson saw this research. Nearly all other companies that were using talcum powders got away from talcum powders and substituted in cornstarch. Johnson & Johnson stubbornly clung to this iconic product, and it is now paying the price. It has been sued over the last several years by 93,000 people, mostly women suffering ovarian cancer, who are blaming their illnesses, and in some cases the death of their loved ones, on their use of Johnson's Baby Powder. Dana Taylor: As you say, there are literally tens of thousands OF pending lawsuits against J&J. and while this J&J subsidiary is still in bankruptcy because of all the lawsuits, the company's been unable to reach a settlement that's acceptable to the courts. What's the big sticking point here? Gardiner Harris: So Johnson & Johnson wants to use the bankruptcy system to solve all of its baby powder liability, not only now, but ever in the future. The problem with ovarian cancer and asbestos is that it can take 30 years for asbestos to cause the changes that lead to cancer. So it's possible that Johnson & Johnson will be sued by tens of thousands of women annually every year for 30 years. And it's that that Johnson & Johnson wants to get out from under, and so try to use the bankruptcy system to do that. Three judges have now thrown out all three of Johnson & Johnson's bankruptcy claims. And so Johnson & Johnson is now being forced to fight each one of these claims individually in the usual court system. Dana Taylor: Gardiner, did you find that the people you approached for your book, doctors, former employees, were willing to speak to you on the record? What kind of risks did they face in coming forward? Gardiner Harris: Johnson & Johnson is the most litigious company arguably in American history. It has spent more than $35 billion on lawyers and litigation since 2011. It sues anyone at the drop of a hat. And so it also has this huge cavalcade of consultants in just about every major American medical center in the country. So it first tries to sweet talk you, and then if you are not amenable, it often sues. So the people I talked to universally were really afraid. I ended up getting grand jury records, which as you may know, Dana, are the last truly secret institutions in American society. So in those documents, I got access to hundreds and hundreds of Johnson & Johnson employees cell numbers. I called hundreds of them. I got many of them to talk to me, but only because I promised them again and again that I would keep their name secret. Dana Taylor: Tylenol, another Johnson & Johnson product became a target of product tampering in the 1980s. People died when someone successfully slipped cyanide into Tylenol bottles. The tampering crisis led to their creation of tamper-proof bottles still in use today. They're an important part of the Johnson & Johnson legacy. But your book takes aim at their response. Why? Gardiner Harris: There is a lot of evidence that Johnson & Johnson knew that the poisoning probably happened somewhere in their own distribution system, and that they kept that knowledge from not only the public, but investigators themselves. To this day, Dana, the Johnson & Johnson response in 1982 is considered the gold standard of corporate response to crises. And it's taught as among the first things that students at the Harvard Business School, Wharton School, all of them, learn. And the lessons that are taught to these students is if you're open, if you're honest, if you do the right thing, the public will reward you and you will be profitable. Those lessons are all wrong. It's fairly clear that Johnson & Johnson kept a lot of what it knew from the public and from investigators. So the real lessons that students at HBS, at Harvard and Wharton should be taught, is if you lie to the public, you might really get away with this, which is what Johnson & Johnson did, and what it has been doing for decades. Dana Taylor: Yours is a story about a beloved American brand. At its core, it's a story about the people behind the brand and the people affected by the brand. What compelled you to tell this story? Gardiner Harris: Dana, you and I are both reporters. I was a reporter at the highest levels of media, becoming a White House correspondent for the New York Times, but we fail the American public all too often. And I think the story of Johnson & Johnson is one of our greatest failures. It is essentially, a killer in our midst that we fail to warn the public about. Now, I tried a couple of times, but this is a very difficult story to tell. It's a complicated story. It needed a book to show its sweep. And I felt like it was partly my responsibility that this company had been allowed to behave so badly for so long without anyone knowing about it. Because I was one of the top drug reporters in the country, and so I left daily journalism to write this book, and it took me basically six years to get it done. Dana Taylor: And finally, your book was released last month. How has J&J responded? Gardiner Harris: So far, crickets. Haven't heard from them, which is not at all unusual. I covered the company at the Wall Street Journal, at the New York Times. For tough stories, Johnson & Johnson has historically refused to participate in any of these stories. And I actually tell story after story in the book about Johnson & Johnson managing to kill some very critical stories over the course of its history, by calling up headquarters of these big media conglomerates. And because Johnson & Johnson was one of the largest advertisers in the world, was able to threaten these organizations, "If you run this piece, we will pull all of our ads." And again and again, that succeeded in having critical stories about the company killed. So the company has been very successful by these backdoor mechanisms of keeping its brand pristine. That has not happened in this case. They have not responded, and I don't really expect them ever to. Dana Taylor: We reached out to Johnson & Johnson for comment on Harris's investigation, and they issued a statement saying, "We stand by the safety of our products and are focused on what we do best, delivering medical innovation for patients around the world." Investigative journalist, Gardiner Harris's new book is called No More Tears: The Dark Secrets of Johnson & Johnson, and it's on bookshelves now. Gardiner, thanks for being on The Excerpt. Gardiner Harris: I'm thrilled to be here, and thanks for inviting me. Dana Taylor: Thanks to our Senior Producers, Shannon Rae Green and Kaely Monahan for their production assistance. Our Executive Producer is Laura Beatty. Let us know what you think of this episode by sending a note to podcast@ Thanks for listening. I'm Dana Taylor. Taylor Wilson will be back tomorrow morning with another episode of The Excerpt.

A Devastating New Exposé of Johnson & Johnson Indicts an Entire System
A Devastating New Exposé of Johnson & Johnson Indicts an Entire System

Yahoo

time12-05-2025

  • Health
  • Yahoo

A Devastating New Exposé of Johnson & Johnson Indicts an Entire System

If health care industry corruption and criminality were a city skyline, it would be booming, with tower cranes and half-built skyscrapers in every direction. Among the downtown giants at the center would stand Johnson & Johnson, an iconic U.S. company whose villainy receives a just and overdue accounting in Gardiner Harris's No More Tears: The Dark Secrets of Johnson & Johnson. The book is an investigative demolition job in the best tradition of muckraking exposés and should find a sizable and receptive audience at a moment when public sentiment toward our corporate health care system ranges between Ralph Nader and Luigi Mangione. Harris, a former reporter for The New York Times, spent years digging into the company's past and conducted hundreds of interviews, but the most damning evidence in the book comes from internal documents that have surfaced during decades of lawsuits against the company's long record of public endangerment. This story begins with the firm's flagship product and defining scandal. Introduced in 1894, Baby Powder marked Johnson & Johnson's wildly successful venture beyond its origins as a maker of sterile cotton and gauze. For years, it had included tins of powdered talc in its bandage shipments to hospitals, but the company we know today resulted from the idea of selling them individually to consumers as a treatment for diaper rash. Long associated with war and surgery, Johnson & Johnson began calling itself 'the baby company' and never looked back. For more than a century, Baby Powder was the American infant's first exposure to the insidiousness of modern marketing. Its singular scent was neither natural nor accidental but born of a laboratory effort combining more than 200 ingredients to produce 'a sweet, vanilla-like base' with 'overtones of jasmine, lilac, rose, musk, and citrus.' The company sold images of innocence to mothers while nurturing its next generation of customers in the crib. 'Smells feed directly into the brain's limbic system, the ancient seat of human emotion,' writes Harris. This insight formed the basis of a priceless association with birth and motherhood, and provided a durable 'protective halo' even as the company's innocence was revealed to be as fraudulent as its famous first studies flagging possible dangers in the pediatric use of talcum powder, focusing on asphyxiation threats, appeared in 1922. They were followed by studies decades later noting high rates of talcosis, a fatal lung disease, among talc miners. Research then expanded to include asbestos, a fibrous mineral and common talc contaminant so loaded with potent microscopic crystalline needles that inhaling trace amounts damages lung tissue DNA and can cause cancer. By the early 1960s, researchers had linked asbestos exposure to rising rates of mesothelioma, an aggressive lung and abdominal cancer. This research gained a public profile only in 1968, when The New Yorker published an investigation containing data that suggested half of New Yorkers had asbestos in their lungs. One of the researchers profiled, Mount Sinai's Dr. Irving J. Selikoff, was alarmed by higher rates of contamination among housewives. When he ran baby powders under an electron microscope, all contained asbestos. The bad press shocked Johnson & Johnson, but the science did not. The bad press shocked Johnson & Johnson, but the science did not. The company had known since 1958 that its bestselling product contained up to 3 percent asbestos. Six years later, it purchased a talc mine in Vermont, located three miles from the country's biggest asbestos mine. 'That colocation was no accident,' writes Harris. 'Talc and asbestos are so chemically, geologically, and structurally similar that veins of one are often sandwiched between or ribboned with the other.' Just one year before the New Yorker story, the company had tested talc from the new mine and found two types of asbestos. Instead of warning the public and switching from talc to cornstarch, the company declared what Harris calls a 'scorched-earth public relations campaign' on troublesome science. It leaned on Mount Sinai's board to discredit its own research; devised a novel method for measuring contamination that was designed to fail; and turned to a Mengelean in-house researcher named Dr. Albert M. Kligman to conduct disturbing experiments that involved injecting talc and asbestos into the flesh of Black prisoners. Kligman's reports to corporate confirmed the minerals caused extreme irritation when injected, but said nothing about cancer, because it was not a subject of study. For another three-plus decades after the experiments, Johnson & Johnson successfully pressed the same strategy, with reputation unscathed, sales robust, and public trust intact. 'We attribute this growing opinion,' read a self-satisfied internal company memo, to 'favorable data from the various J&J sponsored studies that have been disseminated effectively to the scientific and medical communities in the U.K. and the U.S.' This was only possible, Harris notes, due to its parallel success 'muddying the record on asbestos … and persuading [inconvenient researchers] to get out of the talc testing business altogether.' Johnson & Johnson continued its disinformation campaign as further dangers came to light. In 1982, the journal Cancer published data showing that regular use of talcum powder on female genitals nearly doubled the risk of ovarian cancer. Even as nine subsequent studies confirmed the link—with most reporting higher risk—the company stuck to its playbook. For Johnson & Johnson, switching to cornstarch would amount to admitting error and risk cracking the cornerstone of its corporate mythology. A slide from an internal presentation describes the company's claims on 'both the mother-infant bond and mother's touch' as the company's 'Golden Egg.' Another depicts a piggy bank receiving coins next to the words 'mother-baby bond.' As the first lawsuits loomed in the late 1990s, Johnson & Johnson attempted to shift its Baby Powder liabilities onto a shell company with limited funds. Only when a judge blocked this Hail Mary did the full story emerge. Between 2010 and 2021, the company spent $25 billion fighting lawsuits representing hundreds of thousands of people, the largest of which produced bounties in incriminating evidence in discovery. Among the worst defeats was a 2018 suit in which a jury awarded 22 women with ovarian cancer $25 million each and ordered the company to pay $4.14 billion in punitive damages. In 2020, a bruised Johnson & Johnson finally discontinued domestic sales of the talc-based powder that Roberta Ness, former president of the American Epidemiological Society, estimates is a factor in 2,500 cancer diagnoses and 1,500 cancer deaths every year. The company continued selling the product abroad until 2023. Harris could have written an entire book about the story of Baby Powder, and No More Tears would still warrant an honorable mention among notable recent narrative investigations at the intersection of corporate perfidy and public health, such as Bartow J. Elmore's 2021 history of Monsanto, Seed Money. Alas, Johnson & Johnson's original sin was nowhere near its is Johnson & Johnson's second-most iconic product. And like Baby Powder, its ubiquity obscures decades of deceitful and ultimately deadly marketing. When Johnson & Johnson purchased McNeil Laboratories in 1959, it acquired the firm's new acetaminophen-based painkiller called Tylenol. Years after the blockbuster's over-the-counter release, research revealed the drug's toxic effects on the liver. When the company applied for an 'Extra Strength' version in 1975—upping the recommended dose by about a third, to 500 milligrams—The Lancet declared acetaminophen 'one of the commonest causes' of liver failure in Britain, and editorialized that if it 'were discovered today it would not be approved.' With Extra Strength's approval by the Food and Drug Administration in 1976, the drug's slim margin of error between recommended and dangerous doses all but disappeared. Documents show that Johnson & Johnson was aware of this, and knew that adding even small amounts to recommended doses on top of moderate drinking could cause 'catastrophic liver damage.' Once again, it fought tooth and nail to protect the illusion of Tylenol's safety, resisting even updated warning labels until 1994. Harris writes that this was especially baleful for pediatric versions of the product, including an infant formula. Between 2000 and 2009, the FDA estimates that at least 20 children died from overdoses. As with Baby Powder, this legacy persists in the (at least) 150 Americans who die and the 30,000 hospitalized every year from overdosing on acetaminophen. For many years, the company maintained that all acetaminophen-related adult deaths were intentional suicides. Harris ably covers the famous tampering scandal of 1982, in which several people in Illinois died after consuming Tylenol deliberately contaminated with cyanide. While the company's response is still taught in business schools as a textbook case of responsible corporate crisis management—in which the company leveled with the public and helped initiate the age of tamper-proof packaging—the real story is predictably sordid. Far from serving as a model of accountability, the company covered up extensive evidence that the poisonings resulted from soft spots in its distribution system, and not from a 'madman in retail,' as the public was led to believe. A company whistleblower later told investigators that the company knew the killer worked for its contractor, but 'kept that knowledge not only from the public but from investigators.' From the perspective of Johnson & Johnson's executives and investors, the cyanide scare was dwarfed by another crisis: generic competition. The Hatch-Waxman Act of 1984—which lowered barriers for smaller drug companies to introduce nonbrand versions of drugs whose patents had expired—was negotiated just as bigs like Johnson & Johnson were facing a generational 'patent cliff.' The perfect storm required they get creative if they were to preserve their extraordinary margins and profits. Like their peers, Johnson & Johnson responded, not by investing more into R&D, but by raising prices and expanding markets by inventing and pushing new use cases for patented drugs. To accomplish this, the company hired a national sales force—D1 cheerleaders and West Point grads were favored—and spent enormous sums systemically bribing the nation's doctors and medical thought leaders. Like previous gambits, it was a spectacular success. 'Every dollar given to doctors led to between $3.50 and $5 in additional drug sales,' writes Harris. One of the post-Hatch-Waxman 'blockbusters' to result from this strategy was a protein called Erythropoietin that increased red blood cell counts. It was initially developed to help dialysis patients avoid transfusions, but in the run-up to its 1989 debut under the trade name Procrit, the company decided that market was too limited. Instead, Johnson & Johnson targeted the much larger (and untested) cancer market by selling Procrit as a treatment for anemic chemotherapy patients. Wall Street thought the strategy inspired; Fortune named Procrit 1989's 'Product of the Year.' There was just one problem. Independent researchers quickly discovered that the drug not only posed heart-attack risks, but also supercharged the growth of tumors. Some tumors, it turned out, even had Erythropoietin receptors. As the evidence solidified, the chief medical officer of the American Cancer Society dubbed the product 'Miracle-Gro for tumors.' But rather than pull Procrit from the cancer market, the company dusted off its Baby Powder script and sought to bury and discredit the science linking Procrit to tumor growth. A company researcher later testified to overhearing one Johnson & Johnson employee tell another, 'We have to kill this work.' That they did. Johnson & Johnson hired doctors, writes Harris, to undertake scientifically dubious clinical trials, contracted with ghostwriting firms to write up the results in deceptive ways, and then paid the purported authors to exaggerate or lie about the trials at medical conferences in lectures many doctors were required to attend. A few years after launch, Procrit had made the company more money than any other drug in its history, accounting for 10 percent of its drug sales and its fattest margins. The company charged $1,000 per dose—of which oncologists pocketed nearly one-third. Harris estimates that oncologists participating in Johnson's deadly fraud doubled their salaries, on average, from $300,000 to $600,000. The company could not claim ignorance. It was later revealed that Johnson & Johnson shut down several in-house studies to test hemoglobin levels because cancer patients who got the drug showed accelerated tumor growth and died at much higher rates than the placebo group. Harris mentions one epidemiologist who estimates Procrit's death toll in the hundreds of thousands and counting. In 2016, more than a decade after an investigation by The New York Times broke the scandal, Johnson & Johnson finally released internal data from one study showing that women with breast cancer who took Procrit were twice as likely to suffer stroke or pulmonary embolism and were at a higher risk of dying. Also in 2016, Johnson & Johnson sold $1 billion worth of Procrit on the cancer market, mostly to provincial doctors who likely did not have subscriptions to the Times or leading medical journals. It may seem impossible that Procrit could have a rival for Johnson & Johnson's most depraved scandal of the '90s. But Harris presents a candidate. Risperdal was an antipsychotic hatched in the laboratories of Johnson & Johnson's biggest drug subsidiary, Janssen Pharmaceuticals. It was released in 1993 to replace Haldol, a similar drug sold by Johnson & Johnson whose patent had just expired. It was always going to be a tricky transition. Not only were 'chemical straitjackets' passing out of style, there was evidence that the pricey new drug was no more effective, and more dangerous, than Haldol, now available as a cheap generic. Of course, the company was never interested in proving Risperdal's therapeutic advantage. Since the FDA did not require comparison trials, none were conducted. As with Procrit, the company focused on persuading doctors to prescribe the heavy tranquilizer to as many people, and for as many conditions, as possible. Harris quotes a sales plan draft from early in the process in which one executive observes, since the schizophrenic market is limited, 'Aggressive expansion of Risperdal use in other indications is therefore necessary.' Here we are properly introduced to one of the book's recurring villains, Alex Gorsky, the sales rep turned division chief tasked with creating markets for Risperdal. The strategy he devised, at once immoral and illegal, centered on telling psychiatrists that, because the drug was approved for schizophrenics, it could be prescribed for any and all conditions associated with schizophrenia. Gorsky focused on two demographic extremes. He established an 'ElderCare' sales force to hype the drug's benefits for 'aggressive' dementia patients—despite the company's own trials showing the drug caused high blood pressure, strokes, and higher rates of death among elderly patients—and another focused on pediatric psychiatrists, who were given samples and pamphlets that touted Risperdal as a broad-spectrum treatment for bipolar disorder and any 'aggressive behaviors that annoy others.' Aside from the obvious harm caused by putting hyperactive children on heavy tranquilizers, Johnson & Johnson concealed the extent to which Risperdal impacted the endocrine system by raising prolactin levels in hormone-secreting glands. In other words, the drug caused young males to gain weight, grow breasts, and lactate. Before Johnson & Johnson's marketing campaign, pediatric bipolar diagnoses were extremely rare; the disorder's very existence was a subject of debate. But that was before one-third of the nation's psychiatrists started working as part-time sales reps for drug companies. After the rollout of Risper­dal, diagnoses surged, growing fortyfold between 1994 and 2003. The key figure in what Harris calls the company's 'sophisticated disinformation scheme' was Harvard University's Joseph Biederman, who received millions to legitimize the notion that very young children could be diagnosed as bipolar and prescribed ­antipsychotics. He was worth every penny the company paid him. In 1997, Risperdal sales reached $600 million. In 2000, an independent study showed 13 percent of children on the drug had grown permanent breasts, more than a hundred times the rate on the warning label. Harris estimates, conservatively, that 'twelve thousand boys were disfigured in that year alone.' Three years later, Johnson & Johnson rolled out a 'back to school' campaign around a new dissolving tab form of Risperdal, replete with sales reps throwing 'ice cream and popcorn parties' at child psychiatry offices across the country. As part of the campaign, the company distributed a branded chart, called 'DART: Depression, Agitation, and Racing Thoughts,' to lower the prescription threshold to include more moderate behavioral issues. This chart may remind you of the infamous frowny-face Wong-Baker FACES Pain Rating Scale that Purdue Pharma promoted during the same period. It should. Among No More Tears' contributions is filling in the role Johnson & Johnson played in prepping and exploiting America's opioid 1990, six years before Purdue's OxyContin hit the market, the FDA's painkiller chief Curtis Wright approved a 'timed release' 72-hour fentanyl patch produced by Johnson & Johnson, called Duragesic. The patch had the same conceptual design flaw as Purdue's more famous pill: Where Oxies could be crushed to immediately access the full dose, Duragesic could be chewed. Even when it was used as directed, patients received, on average, 150 percent of target dose in the first day. After 52 people died in their sleep hours after putting the patch on their bodies, the FDA ordered Johnson & Johnson to add a black box label. But the company refused to give up on the patch or the related project of normalizing opioids for common pain. Leading the charge once again was Gorsky, who activated the American Pain Society—founded with a grant from Johnson & Johnson in 1977—and compiled maps with the locations the country's most 'pain-sensitive' doctors, i.e., pill mills. These efforts expanded apace with OxyContin's massive success into the late '90s, as openly envious Johnson & Johnson executives explored a partnership with Purdue to co-promote their opioids as treatments for moderate pain. To help them catch up with Purdue, Johnson & Johnson executives in 2002 hired a group of McKinsey consultants who encouraged the company to market Duragesic for chronic back pain and 'target high abuse-risk patients (e.g., males under 40)' for extended treatment periods. 'Both strategies ensured soaring addiction and death rates,' writes Harris, who dryly observes that Gorsky would later be named Humanitarian of the Year by the Community Anti-Drug Coalitions of America. Space does not allow for a full summary of the systemic criminality recounted in No More Tears, the first draft of which, Harris notes, was twice as long. Other outrageous examples he documents include a metal hip replacement with a high fail rate in trials that the company tried to fix by making last-minute design changes not included in its FDA application; a vaginal mesh that the company continued selling even after it painfully ruined the sex lives of tens of thousands of women; and the Ortho Evra birth control patch, which delivered spikes of estrogen that caused unwanted pregnancy, stroke, and death. The story of Propulsid, meanwhile, is practically a footnote. The drug was known to cause arrhythmias and pose a high risk for infants. Johnson & Johnson 'quietly underwrote a marketing campaign that succeeded in getting one in five premature infants in the country to be given this dangerous and useless medicine,' writes Harris. The company pulled the product in 2000, once again only as the first lawsuits came into view. Harris ends with the company's scandal-plagued single-shot Covid-19 vaccine, for which the FDA revoked authorization in 2023 after investigating a rare and severe type of cerebral blood clotting and more than 100 suspected cases of Guillain-Barré syndrome among those who had received the this history, the question presents itself: Where the hell was the FDA? Throughout this history, the question presents itself: Where the hell was the FDA? Harris, to his great credit, never lets this question out of sight. His story only makes sense if braided into the concurrent corruption and capture of the only agency standing between the public and the Alex Gorskys of the world. This is not the lesser aspect of the story, but is arguably the more enraging. We know corporations are sociopathic institutions; the government exists to protect us from their sociopathy. And as Harris puts it, 'No major government agency has failed as fully, frequently, or consistently as the FDA.' The result is a health care system 'riddled with criminality' and responsible for deaths 'in the millions—more than the combined American toll from every war since the birth of the United States.' The period covered by No More Tears spans the FDA's infancy, perceived golden age, and neoliberal gutting, charting its devolution into the corrupted husk of an agency we know today—one that is dependent on industry funding and staffed by a combination of demoralized idealists waiting to transfer out, and salivating industry lackeys waiting to enter the gilded revolving door. A key event in Harris's narrative of decline is the appointment of Arthur Hayes Jr. as FDA chief in 1981, recommended by Donald Rumsfeld to ensure a green light for aspartame, the possibly carcinogenic sweetener developed by his employer, the drug company G.D. Searle. A decade of enervating funding cuts followed, leaving the agency ripe for a full neoliberal makeover under Bill Clinton, who oversaw the transition to a new regime of five-year deals through which industry provides much of the agency's budget. The 1997 legislation was the knockout blow: It green-lit direct marketing of prescription drugs, reduced the number of clinical trials from two to one, and authorized drug companies to give doctors reprints of 'studies' urging unapproved off-label uses. Soon after, regional offices lost the authority to launch criminal investigations, giving the power to a headquarters overseen by cautious aspiring drug company consultants and future white-shoe corporate lawyers. Thereafter, writes Harris, Approvals [of investigations] became almost impossible to get…. Financially dependent on the drug industry after 1992, the FDA would never again ... visit the homes of top Big Pharma executives unannounced, and never again delay the approval of a new drug while an investigation continued…. Getting tough on drugmakers is simply not part of the agency's mandate anymore. It isn't just the FDA that's been captured. The Johnson & Johnson story is one of broad and deep elite corruption. 'Again and again and again, Johnson & Johnson sold dangerous products and hid the risks from patients and regulators, all while being widely praised for a high standard of ethics,' writes Harris. 'That praise most often emanated from a professional class—doctors, lawyers, and academics—that J&J sponsored with huge payments.' Despite occasionally playing a heroic role, the fourth estate does not escape censure. Harris opens the book with an embarrassing mea culpa about his own erstwhile naïveté. It was only in 2004, after five years covering Johnson & Johnson and the drug industry for The New York Times and The Wall Street Journal, that he 'began to suspect that the company's culture and its apple-pie image might be entirely at odds.' Left unstated is the possibility that Harris's protracted innocence helped produce that image. (Here, he is not alone in the halls of elite journalism: Just as Johnson & Johnson prefers West Point grads who follow orders, business editors like reporters who believe in capitalist fairy tales.) Given the depths of his disillusionment, Harris ends on a confused note that suggests his education remains incomplete. To explain Johnson & Johnson's 'ruthless, sociopathic indifference,' he resorts to the 'corporate deviance' model of organizational theory—a sociologist's explanation for why good people and good companies do bad things. But this cannot explain the endemic criminality across a health care sector that accounts for nearly one-fifth of the U.S. economy. Johnson & Johnson is paradigmatic of a more fundamental corruption. But rather than extend the implications of his reporting to a system critique, Harris closes with a bizarre attempt at evenhandedness that lauds Johnson & Johnson for developing Bedaquiline, a tuberculosis drug. As Harris should know, Bedaquiline, like nearly every other drug in the modern pharmacopeia, was developed largely in publicly funded labs, with the government heavily underwriting every step of the process, beginning with basic research. Johnson & Johnson's main achievement was to claim the patents and proceed to charge scandalous sums. Far from an argument in favor of Johnson & Johnson's existence, Bedaquiline is a testament to the need for a fully public bench-to-bedside drug pipeline. If the government conducted trials of the drugs it spends hundreds of billions of dollars developing, and maintained an active, if not dominant, role through to distribution, many of the episodes recounted so powerfully in No More Tears could have been avoided. Harris not only shrinks from this conclusion, but includes in his list of Johnson & Johnson's accomplishments the fact that its 'financial success has made hundreds of thousands of shareholders and employees richer and happier.' No More Tears illustrates why these profits do not belong in a win column. Indeed, they are the very root of the problem.

Stinging accusations
Stinging accusations

Winnipeg Free Press

time26-04-2025

  • Health
  • Winnipeg Free Press

Stinging accusations

This mighty company that keeps us in stitches is no laughing matter. Johnson & Johnson is a powerful American conglomerate that, among other things, supplies the world with surgical sutures and drugs that ease suffering and save lives. But journalist Gardiner Harris, in an astonishingly penetrating and meritorious five-year investigation, concludes in No More Tears that behind an envied reputation, this company was a corporate pariah — a business that served itself first, ignored or scared away government oversight, hid the truth, muzzled media by threatening their jobs or financial ruin and promoted dangerous drugs and devices by unethical marketing and copious public denial. Jessica Hill / Associated Press files In this March 2021 photo, a pharmacist draws a syringe of Johnson & Johnson COVID-19 vaccine at Hartford Hospital in Hartford, Conn. According to Harris, Johnson & Johnson's 'decades-long transformation from ethical to evil mirrors the slow-motion metamorphosis of American healthcare from best to worst, protected by smokescreens of disinformation and mythologizing.' Says Harris: 'J & J has knowingly contributed to the deaths and grievous injuries of millions. And for much of the early twenty-first century, almost every one of J & J's top selling drugs benefited from criminal marketing schemes. Many of its devices gained wide acceptance because of bribery.' Johnson & Johnson was founded as a mom-and-pop venture in the 18th century. It is now the largest pharmaceutical enterprise in the world. In the public eye, Johnson & Johnson's reputation became priceless when it began marketing baby products that didn't irritate infant eyes. The catch line 'No More Tears' brilliantly promoted this cleansing benefit with a smiling baby and a contented mom. Reassurance from Johnson & Johnson meant everything to mothers and was to them a sign of proper parenting. There was the same acceptance of the company's other products. Harris unmistakably exposes Johnson & Johnson as a longtime corporate scoundrel, as harmful to public welfare as was its fellow drug peddlers, the notorious and disgraced Sackler family's Purdue Pharma, marketer of the addictive painkiller OxyContin. Harris says a former Johnson & Johnson executive told him: 'The Sacklers are pikers compared to Johnson and Johnson.' Harris is a former award-winning investigative journalist with the New York Times. He lives in San Diego. His research is mind-boggling; he gathered tens of thousands of documents, read hundreds of thousands of pages of trial transcripts and contacted hundreds of executives and employees. Among the history chronicled by Harris: a scheme in which Johnson & Johnson, in effect, paid doctors to prescribe the company's drugs; the failure of Johnson & Johnson's COVID vaccine, banned in 2024 for causing fatal blood clots; the company threatening to bankrupt media outlets that ached to tell the truth about its famous baby talcum powder (that it contained asbestos and increased the risk of ovarian cancer among users); promoting its blood thickener, knowing it encouraged tumor growth; concealing that its metal hip implants had much higher failure rates than competing plastic, and also poisoned patients with metal ions; and deceptive marketing that accelerated opioid addictions, promoting antipsychotics that cost lives. 'For all intents and purposes Johnson and Johnson was a criminal enterprise,' writes Harris. 'Indeed, mafia families get a large share of their income from strictly legal activities. But no mafia outfit ever consistently targeted the kind of vulnerable people that J & J exploited. And if one of the most admired corporations in the world is in reality a criminal enterprise and a killing machine, what else are we missing? How many other killers are out there?' Harris proposes changes, and in the book explains them in detail. 'In this reporter's opinion, first, doctors should be barred from taking money or gifts from drug or device companies while simultaneously treating patients.' No More Tears Secondly, says Harris, 'states should stop certifying continuing medical education courses that are funded by drug and device companies.' Third, the Federal Drug Administration (FDA) should be funded by taxpayers, not industry. During Elections Get campaign news, insight, analysis and commentary delivered to your inbox during Canada's 2025 election. Fourthly, 'companies and their executives must be punished for lying under oath for lying to the FDA and federal courts.' Fifth, 'states should repeal laws that forbid personal injury suits or punitive damages against makers of FDA approved products.' Harris passes judgment on his country's health care system: 'No other health care system is as expensive or inefficient.' A Trojan horse of guile rather than a smiling baby in the bath would have better represented the Johnson & Johnson Harris has uncovered. Barry Craig is a retired journalist.

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