Authors: John R. Maxim
The third thing that happened on that Thursday morning
was that an agitated Arnie Aaronson appeared unan
nounced in Doyle's office. He was dressed in jeans, loaf
ers, and a white golf jacket. Arnie had not worn a suit since Wall Street. This was less a question of lifestyle
than the consequence of having gained fifty pounds.
“Sit, Arnie. Want coffee?”
The bigger man sat but ignored the offer. He set a
briefcase across his lap, toyed briefly with the latch, but
did not open it. Instead, he reached into the pocket of his shirt and drew out a slip of lined paper, small and folded,
that looked as if it had been torn from a notebook. He
stared at it for a long moment. He spoke without look
ing up.
“Brendan . . . you want to tell me what's going on?”
First Fat Julie, now Arnie. “Why do you ask?”
”
Why?’' He waved the slip of paper.
“
Because every
one I spoke to said those same four words. ‘Why do you
ask, Arnie?' Brendan? Why did I ask?”
“I'll tell you when I'm sure. They wouldn't discuss it?”
“What, that half of all drugs are counterfeit? Sure they
would. They said it's impossible.”
“Tell me why.”
Doyle listened as Arnie Aaronson took him through a
litany of industry practices and safeguards, FDA spot
checks, even appeals to common sense.
“The question you have to ask yourself,” he said, “is
who would knowingly buy this stuff? A drug chain
wouldn't. A hospital of any size wouldn't. Even if they
were tempted by the prospect of windfall profits it
wouldn't begin to be worth the risk. They get caught,
they'd get sued up the ass. A doctor wouldn't because,
unlike in Japan, for example, doctors don't get a cut on
the prescriptions they write.”
“You said
knowingly.
What if the hospital doesn't know
it's counterfeit?”
“Theoretically, that's possible. Hospitals buy from dis
tributors or from pooled buying groups. The distributors,
and now the HMOs, buy direct from the manufacturers.
In the case of counterfeits, however, the distributor would
have to buy from some third party. To do that, he would
have to be getting a very good price. But the second he
sees that price—well below what it's been costing him
to buy direct—he would know right away that this stuff is bogus.”
“So? He's greedy. He buys it anyway.”
“But again, if he gets caught, he's out of business and
there's a chance he'll go to jail. And he could very well
get caught because, aside from the FDA doing spot checks, the major manufacturers have
thousands
of salespeople out
there keeping tabs on how their products are selling. If a distributor, say, has more of a given product than that
salesperson's computer says they ever bought, the red flag
goes up like a rocket.”
Doyle had to look away. The image of those salespeo
ple, some of them, trading samples for nose candy left
him less than convinced of their proprietary zeal.
“U
m
. . . back up a second.”
The subject of drug dealing reminded him of something
that Johnny G. had started to say. That there's very little
risk in this. And his uncompleted “even if you get
caught . . .” He asked Aaronson about that.
“Compared to what? Pushing hard drugs?”
“For instance. Yes.”
“Well . . .” Arnie began counting on his fingers. “You
don't have three thousand DEA agents kicking doors in
all over the world. Add two thousand FBI agents who
work full time on illegal drugs. You don't have the coast
guard stopping boats at sea or the air force tracking planes.
You don't have dogs sniffing luggage at airports. You
don't have all those local narcs that you see on ‘Cops' . . .
the ones who bring film crews on busts . . . and you don't
have undercover cops either. You don't even have the
regular local cops because this is strictly the FDA's juris
diction. The FDA can call in the FBI but unless it's high-
profile, the FBI won't get excited.”
“What
do
you have?”
“In the F
D
A? Maybe thirty-five full-time, unarmed
criminal investigators.”
“For the whole country?”
“For the world.”
Aaronson continued counting.
“Unlike with hard drugs there are no mandatory mini
mum jail sentences. There are probably no sentencing
guidelines either. That means it's easy to work out a fine
and maybe do some community service. The fines, by
the way, run about five hundred bucks for a first offense.
Informers get half of any fines levied but at those prices
there's not much incentive for whistle-blowers either. The
laws are soft because it's not a sexy subject. It doesn't
get headlines. You don't see outraged politicians doing
talk shows on it and rushing to put their names on
legislation.”
He paused for a breath.
“Brendan?”
Doyle nodded.
“These people I talked to . . .” The slip of paper again.
”I called seven. Out of the seven, five called me back a
second time to give me even more reasons why it can't
happen. How's that for cooperation?”
Doyle's eyes narrowed.
“And also to ask me again. Why am I so interested?”
The lawyer's antennae started to rise. “Arnie
...
do
you believe them or don't you?”
“No.”
“Because the question shook them up?”
“Because three of them tried to buy me.”
Aaronson, having said that, instantly wished he hadn't.
“Come on, Arnie. Talk to me.”
“Forget it.”
“Arnie
...
if three multinational drug companies want
to shut you up with money, doesn't that tell you . . .”
“Brendan
...
it doesn't tell me shit. Forget it.”
Doyle let it drop, if only to keep Aaronson from leaving.
He spent the next ten minutes settling him down. Arnie,
like Michael, had a lot of respect for the industry. Maybe
not so much for the marketing people but certainly for the
technical side. They're the people who'll cure cancer one day. And AIDS and MS and cystic fibrosis. It's personal
with them, he said.
Aaronson, in their earlier conversation by phone, had mentioned some counterfeit birth control pills
f
rom Searle.
He had since refreshed his memory. He didn't mind talk
ing about that because it was fairly common knowledge
and because it served to support his point that these com
panies are very responsible.
The product was Ovulen-21. When it was discovered,
the company acted instantly to recall two entire lots at a
cost of over a million dollars. What was scary, said Aaron
son, was that normally a counterfeit product is chemically
identical to the original. That's simply good business. A
chemically identical counterfeit is that much harder to de
tect. Further, because counterfeiters don't pay R&D or
taxes, the cost of making a good copy is relatively small
versus what the real thing would cost.
In fact, the differ
ence
can run as high as two
thousand
percent.
But if the counterfeiter should run short of an essential
chemical, or, say, he doesn't want to leave a chemical trail
by buying each of the correct ingredients in bulk, he might
decide to use a substitute. In the case of the counterfeit
Ovulen,
the Guatemalan lab that made it substituted a pro
gesterone hormone for one of the real active ingredients—enthynodiol diactate. They also reduced the estrogen com
ponent by half.
“So the pills didn't work.”
'‘Oh, they might have. It's not like they used oatmeal.
Other oral contraceptives use progestins. They just
wouldn't have worked as well.”
“How were they distributed? Did Searle know?”
”I didn't get this from them. In fact, none of the majors
would talk except to tell me how things like this can't
happen.”
“Then what's your source? Newspaper accounts?”
“This stuff never makes the papers. For obvious rea
sons, the big drug companies like to keep it quiet.”
”I can imagine.”
“Brendan . . .” Aaronson's voice was pained. “Don't
look for cover-ups here. These people try very hard to nail
counterfeiters. When they do nail them, their attitude is,
what the public doesn't know won't hurt them as long as
we stay
on top of this. By and large, I think that's fair.
Why should they let a good and useful product go under,
its reputation destroyed, just because some Guatemalan
sleazeball tried to make a buck off it?”
Doyle could appreciate that, he supposed. It certainly
explained their sensitivity to Arnie's even asking about it.