[Current & Culture]People Who Sell Their Souls to Sell Drugs

If the Number of Doctors Increases, the Market Grows Too
Strengthening Systems to Prevent Pharmaceutical Cartels

In a capitalist society, every sales field is a battlefield. Pharmaceutical sales, in particular, are known to be an extremely fierce battleground. Having several family members working in the medical field, I have heard many episodes that made me wonder if it really has to be this intense. In movies and dramas, the American pharmaceutical industry seems even harsher than in Korea. Today, I introduce a hot new film released less than a month ago, Pain Hustler.

Actress Emily Blunt not only stars in the film but also participated in its production. Chris Evans, known for Captain America, also appears. The plot is not very original, and the tone shifts abruptly to a didactic approach after the midpoint, which is disappointing. My rating is 2.5 out of 5 stars. Despite this evaluation, the reason I chose this film as today’s topic is because it is a timely project addressing the peak of the opioid crisis. There have been several similar works like Pain Killer and Dope Sick, but those were series requiring at least five or six episodes to watch. Pain Hustler packs the entire story into a single film. The pharmaceutical cartel depicted in this movie operates like this.

A new addictive opioid painkiller is released. The pharmaceutical company sends sales representatives to hospitals to get their new drug prescribed. They even offer huge bonuses worth tens of millions of won for securing the initial prescriptions. Sales reps compete with those from rival companies using flashy talk, bribes, parties, sexual favors, and various other weapons to win doctors’ prescriptions. Some doctors enjoy various perks and increase their prescriptions. As the rewards grow, some doctors recklessly write prescriptions. When market share increases this way, the pharmaceutical company’s profits grow and its stock price rises, making it a win-win situation. The painkiller market is worth a staggering 100 trillion won. To maintain this greedy cartel, enormous sacrifices are required, and someone is paying a tremendous price.

The sacrifices fall on the citizens who pay health insurance and the patients who take the painkillers. It is already unfair to lose money, but addiction to the drugs threatens their health as well. In the United States, fentanyl is the leading cause of death among adults. Not the total of opioids, but fentanyl alone kills more people than cancer or traffic accidents. Originally, opioid painkillers like fentanyl were developed for patients suffering from extreme pain, such as those with terminal cancer, but now they kill more people than cancer itself. At this point, they are no longer pain killers but just killers. Moreover, as regulations to prevent abuse have tightened, even patients who genuinely need these drugs have found it harder to get prescriptions, creating unintended side effects.

This is not just an American issue. Fentanyl is not the only problem. In Korea, the number of doctors is expected to increase significantly, which means a growing market and more lobbying targets for pharmaceutical companies?a golden opportunity. Systems to prevent over-treatment and over-prescription must be strengthened in advance. Efforts to eradicate inappropriate practices in the medical field are also necessary. While most doctors will resist temptation and care for patients conscientiously, when the total number of members in any group increases, the number of unqualified individuals inevitably rises as well.

If you enjoyed Pain Hustler, I recommend Dope Sick. As an eight-episode series with ample length, it offers richer characters and stories and is much more compelling. My rating for it is 4 out of 5 stars. If the former is like Tylenol, the latter is fentanyl.

Lee Jae-ik, Novelist