(theme music playing)
(cheering, applause)
Welcome, welcome, welcome...
to "Last Week Tonight."
I'm John Oliver.
It is so great-- so great to be back with you.
Clearly-- clearly-- clearly, we have been gone
for the last three months, and you're probably thinking
I was on vacation. That was not, in fact, the case.
Much like Brian Williams, I voluntarily took myself off the air...
after it emerged I presented false information
to you last year. Roll the clip.
My theory always was
that Hemingway was hung like a hamster.
Not that there's anything wrong with that.
Oh. Oh, you're right.
There's absolutely nothing wrong with that.
We Googled "hamster penis," and this is what you find.
That's adorable.
I'm-- I'm embarrassed to say
that it turns out that is not, in fact, a hamster penis.
It is a hamster tail.
I would like to truly apologize
to you, the viewers, to the editorial staff here,
and most of all, to that hamster,
because you deserved better, Niblets.
You deserved much better.
So with that out of the way, with trust rebuilt,
let's move on to a quick recap of the week.
It began with a glorious, looming scandal in the US Congress.
Reporter: Illinois Congressman Aaron Schock
being asked a lot of questions right now
after redecorating his Capitol Hill office suite
in the style of the PBS TV series
"Downton Abbey."
Ooh! "Downton Abbey."
That is perfect. What better way
to show you're in touch with your constituents,
than decorating your office
in the manner of a 1920s British aristocrat?
But let's-- I'm intrigued.
How "Downton Abbey"-ish is his office?
Reporter: This is Schock's office.
Bright red, a gleaming chandelier,
just like on television.
And a vase of pheasant feathers.
Pheasant feathers?
Somewhere in Illinois, there is a pheasant
freezing its ass off, going,
"You couldn't just pick up something at West Elm?
"Have you ever heard of a eucalyptus bundle?
"Unbelievable!"
The congressman had some explaining to do,
and explain he did.
Okay. Couple-- couple of things there.
You are definitely an old, crusty white guy
if you think Taylor Swift was the first person to say, "Haters gonna hate."
But-- but to be fair to him,
quoting "Shake It Off" is probably as close
as a congressman can come to saying,
"Hey, go fuck yourself! My office is magnificent.
"Haters gonna hate. Shake it off.
"Shake it off. Shake it off."
Moving on-- Moving on to what may have been
the most spectacularly ill-advised moment
in diplomacy this week.
Reporter: Argentina's embattled president, Cristina FernÃ¡ndez,
under fire for a tweet during a state visit to China
after meeting with the Chinese president.
And if you're thinking, "How bad could a tweet
"from a world leader be?" Well, this bad.
Reporter #2: FernÃ¡ndez tried to mimic a Chinese accent
by switching "R's" with what appear to be maybe "L's"
in a tweet that... translates as,
"Did they only come for 'lice'
"and 'petloleum'?"
instead of "rice" and "petroleum."
Holy shit!
"Lice" and "petloleum"?
That is a level of clueless racism on the Internet
you'd expect from a Dartmouth sorority pledge.
And-- And perhaps-- You're the worst. You're the worst.
And perhaps the most amazing thing
is that she tweeted this during a vitally-important four-day state visit.
Reporter #3: They're negotiating 15 major agreements,
which include two huge hydroelectric dams in Patagonia,
investments in ports through which Argentina exports
thousands of tons of soya to China, and military hardware.
I have to say, it's actually pretty big of China
to just go ahead with their negotiations like nothing had happened,
because if I were them, at the very least,
I would have served President Kirchner a bowl of lice,
saying, "Here's your food. Here's the food.
"You know, your funny joke. That funny joke you said.
"Why don't you eat your funny joke?
"You still owe us billions of dollars, by the way."
And finally-- finally, this week,
there was sad news for a true American icon.
RadioShack, the 94-year-old consumer electronics chain
has filed for bankruptcy protection.
Half of it's 4,000 stores
will be turned into Sprint locations.
The others will be shut down.
You know it's a rough day when "2,000 new Sprint locations"
is the happy part of a sentence.
And look-- Sure, sure,
RadioShack has not been in great shape in recent years,
but it's easy to forget it once ran ads like this.
* So much more than just a store *
* The best in America, RadioShack *
* Nobody compares to RadioShack *
That is a catchy song, my friends.
If they had left that on the air,
they'd be the most powerful company on Earth today.
Look, the death of RadioShack
in itself is not surprising.
What is surprising is the glib, jokey tone
with which its demise has been discussed over the past year.
If you have the name "Radio" in your corporate name,
that's probably not a good sign in 2014.
Is RadioShack doomed to remain a punch line?
Tyler Mathisen: I actually like RadioShack. I go there a few times a year,
and I kinda like it. I guess I'm an old-school guy.
Brian Sullivan: Tyler, you must have a very full junk drawer,
is all I can say. (Tyler laughs)
(mocking laugh) Hey, hey!
This is a dying 94-year-old business.
At this point, it's like you're sitting across from your grandfather
at Thanksgiving dinner saying, "You know, I don't really see the point
"of Grandpa Fred in 2015.
"Frankly, I'm sort of surprised he still exists."
RadioShack would be well within its rights
to be a little hurt at this level of disrespect,
which is why we've prepared a farewell message for them
that they should feel free to use.
Narrator: For nearly a century,
we at RadioShack have proudly served America...
RadioShack. ...providing you with the highest-quality
home electronics at the best prices.
And now, sadly, it's time for us to say goodbye.
And so we would like to offer this special farewell message
to America.
That's right. Take a 30-pack of batteries
and shove them directly up your ass.
Who sold your parents that remote controlled car
you got for Christmas in 1993 that you loved so damned much?
Cool! RadioShack, motherfuckers. That's who.
And remember in 1989 when you needed a cable
to plug your Nintendo into the TV?
Who was there for you?
That's right, RadioShack again, assholes.
And now look at you, laughing at our slow, painful death.
Well, laugh while you still can, shitheads,
because one day, you too will be obsolete.
One day you too will be left behind
in the wake of time's ceaseless onslaught.
And when that day comes, know that we'll be standing
over your goddamn grave, laughing our asses off!
So, America, from all of us here at RadioShack...
* RadioShack!
Moving on. Moving on.
Our main story tonight, prescription drugs--
the only ovals that can bring people
in the Seattle area joy anymore.
To put it mildly--
To put it mildly, America takes a lot of these things.
Reporter: 70% of Americans take
at least one prescription drug.
More than half of us take two.
Researchers say a record four billion prescriptions
were written in 2011.
Total drug spending jumped last year by 3%
to nearly $330 billion, with a "B."
Wow. That works out to $1,000 per person
on prescription drugs.
It kind of makes you feel like Walter White could've made more money
cooking up rheumatoid arthritis medication.
But should this really be that surprising?
'Cause it's impossible to escape pharmaceutical ads.
You can't turn on the TV
without being subjected to an endless stream
of sleep-inducing moths, old men getting boners
while varnishing chairs, or this...
Woman: If your bladder is calling the shots,
you may have a medical condition called overactive bladder
or OAB. Again?
But we just went.
Okay, okay, listen, what that woman really needs
is a pill to stop her hallucinating anthropomorphic bladders.
You're locked inside the prison of your own mind, Susan!
Begone, demon bladder! Begone!
But that's only one small part of pharmaceutical marketing.
You see, drugs aren't like most other products,
because you need someone's permission to buy them,
which is why all drug ads end with the same catchy phrase.
Announcer: Ask your doctor if Lunesta is right for you.
Announcer #2: Ask your doctor about Myrbetriq.
Ask your doctor.
"Ask your doctor."
Three words you're either hearing in a commercial
or saying to your coworker when he asks you
if the mole on his back looks cancerous.
"I don't know, Gene. Ask your doctor.
"All I said was, 'How was your weekend?'
"It's probably fine."
Drug companies know
that doctors hold all the real power
in the prescription drug business,
which is why, while they spend
nearly $4 billion a year marketing directly to us,
they spend an estimated $24 billion a year
marketing directly to doctors.
In fact, one analysis claimed that in 2013,
nine out of the top 10 drug makers
spent more on marketing than they did on research.
Drug companies are a bit like high school boyfriends.
They're much more concerned with getting inside you
than being effective once they're in there.
So we thought-- we thought--
Okay, don't think about that too much.
We thought-- Don't--
We thought-- We thought we would take a look--
We thought we'd take a look
at how all that marketing money gets spent,
which turns out to be surprisingly difficult.
It's a pretty secretive world
you usually only get tantalizing glimpses into
during lawsuits years after the fact.
For instance, in 2012, the government settled a case
with the makers of asthma medication Advair
over allegedly irresponsible marketing practices,
which meant, for the first time,
we were able to see this video
of a 2001 Advair sales meeting.
* Announcer: Ladies and gentlemen, please welcome
Darrell Baker,
Simon Jose,
Rob Yott,
and Ken Tyma.
* Y'all ready for this?
What the fuck?
That-- That was for an asthma medication,
and they were treating it like an NBA pregame show.
* Please welcome-- he's 59, white,
he likes turkey sandwiches, and his wife's name is Karen--
ladies and gentlemen, say hello to Darrell "Boom Boom" Baker!
The audience in that room
were pharmaceutical reps,
the foot soldiers in every company's drug-marketing efforts.
Now drug companies will tell you their reps are there
to educate doctors, but behind closed doors,
that message can be a little different.
There are people in this room
who are going to make an ungodly sum of money selling Advair.
(cheering) And you know who you are.
"Ungodly."
That would barely be an appropriate tone
if they were trying to get cereal into people's bodies,
let alone drugs. Now you don't--
you don't need to see the people whooping in that room
to know what they look like, because pharmaceutical sales reps
are famously young, attractive people.
In fact, this is so widely known,
it's become a sitcom punch line for years.
J.D.'s voice: Today's the day the pharmaceutical reps
show up to peddle their new drugs.
And at Sacred Heart, that means one thing:
Julie's here.
* Doctor, Doctor, gimme the news *
* I got a bad case of loving you *
If something is a joke on "Scrubs,"
you know it's common knowledge.
That show did not do a lot of arcane,
"Hey, what is it with phlebotomists
"and French cuisine? Am I right?"
"You are right, Turk." "We're great friends."
The problem comes-- the problem comes
if those reps don't understand the effects of the drugs they're pushing.
Listen to one former rep describe his first training session.
I was in a room with 21 classmates
and two trainers, and I was the only one
with a science background.
In fact, on the first day of training,
I taught my class and my instructors
the very basic process by which two brain cells communicate.
So, essentially,
pharma reps are like the cast of "Grey's Anatomy"--
they're young, they're hot,
and they have virtually no medical training whatsoever.
Now to be fair,
most doctors will probably take that into consideration.
The problem comes when some don't.
I even had one physician
who would often bring out a patient chart
if she was having a difficult patient,
or whatever the case is, she'd bring out a patient chart
and be like, "Okay, Kathleen,
"I've tried this, I've tried this.
"What do you recommend here in terms of tweaking?"
And I'm sitting here thinking, "I'm a political science major.
"You're asking me what to prescribe for this patient."
Yeah, exactly. Because the only question
a poli-sci major is really qualified to answer is,
"Was it weird having to move back in with your parents after college?"
Now if you're thinking--
If you're thinking-- If you're thinking at this point--
If you're thinking, "Why do doctors let drug reps
"into their offices at all?"
Well, they don't come empty-handed.
They'll often show up with free samples
and, even better, free chicken parm.
Reporter: Whoever said there's no such thing as a free lunch,
hasn't worked in a doctor's office.
There are some offices that advertise
in the front-desk job description,
"free lunch every day."
Not because the doctors are paying for it,
because the drug reps are bringing it in every day.
"Free lunch every day."
Now that may not seem like a big deal,
but think about it. Lunch is awesome.
If Charlie Manson brought me a free lunch every day,
I'd at least listen to his sales pitch
on forehead swastikas.
"I don't think it's for me, Charlie,
"but keep talking. That's delicious."
Drug companies don't do this to be friendly.
They do it because they know it works.
In fact, they know a terrifying amount
about nearly every prescription
coming out of a doctor's office.
Woman: Every time a patient goes into a pharmacy
to get a prescription filled...
Woman #2: The information is sold to drug companies
who send it to laptops out in the field.
So we see everything that the doctor does--
how many prescriptions he prescribes of our medication
and the competitor's medication.
Woman #2: If the computer shows
a doctor's not prescribing as promised...
All you have to do is say, "Hey, you're banging out
"a lot of prescriptions for the competitor's drug and not mine.
"What's going on?"
"Yeah, what's going on, Carl?
"You seem to be making medical decisions
"based on your best judgment.
"I brought you a meatball sub with chips, Carl.
"Don't fuck me on this!
"Don't fuck me, Carl!"
With this level of pressure,
unsurprisingly, drug companies have, in the past, crossed the line,
pushing doctors to prescribe pills for non-FDA-approved uses.
That's called "going off-label,"
and here is a horrifying example
involving AstraZeneca, who the government charged
with going off-label with Seroquel,
and antipsychotic with dangerous side effects.
Lew Morris: The allegations, which were very troubling,
were that they were taking a drug
that was really approved for fairly narrow uses--
bipolar disorders and schizophrenia--
and marketing it for everything
from sleeplessness to depression and dementia.
Here's the thing, you can't just give people potentially dangerous drugs
and see what happens. You're a Fortune 500 company,
not a white guy with dreadlocks at Burning Man.
Now, AstraZeneca denied any wrongdoing,
but it paid half a billion dollars to settle the lawsuit.
And if you're thinking that's just one company with one drug,
you should know that just about every major drug company
has paid money to settle similar charges.
Johnson & Johnson paid $2.2 billion,
Eli Lilly paid $1.4 billion,
Pfizer and its subsidiary paid $2.3 billion
and GlaxoSmithKline
paid out a record $3 billion
to settle accusations that it had, among other things,
pushed Wellbutrin, an antidepressant,
as a cure for weight gain and sexual dysfunction,
or as one former drug rep describes the pitch...
It was a quick zinger for your doc--
to tell your doctor, "Hey, Doc, remember Wellbutrin.
"It's the happy, horny, skinny drug."
Okay, that's not just irresponsible,
that's copyright infringement,
because there is only one happy, horny, skinny drug,
and that is crystal meth. That's a fact.
That's a fact right there.
And for the increasing number of doctors
who will refuse even to see drug reps,
the companies have one other trick up their sleeve--
simply paying doctors to talk to other doctors
about their products over dinner.
And that sounds ridiculous, but not as ridiculous
as the special ego-boosting title they use.
I essentially say to a doctor,
"Hey, our company has identified you to be a thought leader.
"Would you like to be a thought leader for our company? "
The doctor will normally, almost every time, say yes.
Of course they say yes.
That's an appealing phrase.
Doctors like to be called thought leaders
the same way that Brendan Fraser
likes being called two-time Academy Award winner Brendan Fraser.
It's clearly not true,
but it's got a lovely ring to it,
and look how happy it makes him.
Look. Give the guy a gold.
Look how happy he is.
In fact, the problem is
for a position described as "thought leader,"
not a lot of thought goes into the job.
In many cases, the slides, and the content,
and the script are actually prepared by the drug company.
It's not always clear to the audience
that this is material that was really scripted
completely by the drug company
that was paying the doctor to give the talk.
Okay, so if you're a doctor just regurgitating a script,
you're not really a "thought leader"
so much as you are a "thought sayer."
Abraham Lincoln was a thought leader.
You're more like the animatronic Lincoln at Disneyland.
Now to be fair, again,
GlaxoSmithKline will no longer pay for thought leaders,
and the industry in general claims they're reforming.
In fact, a spokeswoman for PhRMA,
the drug industry's trade group,
has even bragged about the tough, new restrictions they've put in place.
In our PhRMA Code, we say that pharmaceutical representatives
can bring an occasional meal--
a modest meal--
turkey sandwiches, pizza...
I don't wanna just focus on turkey.
Maybe we could have ham sandwiches.
But... modest meals,
not steak in a restaurant.
Oh, no, no, no, no. Not in a restaurant,
although we'd probably allow a steak at an Outback Steakhouse,
because, come on, that's not a great steak.
That's basically a chunk of horse meat
with grill marks drawn on it with a Sharpie,
so no one's getting ethically compromised by that.
That's what we're saying.
This voluntary PhRMA Code is,
I guess, a step in the right direction,
so let's see how one of their members
have been abiding by it.
The Justice Department filed a civil fraud lawsuit
against the Swiss drug maker Novartis,
accusing it of paying kickbacks
and lavishly spending on doctors,
including taking some out to Hooters
in exchange for prescribing its drugs.
Don't worry. Research has shown
the best medical decisions are always made
with an Arizona State college football game
blasting in the background.
But at least Hooters qualifies as a "modest meal."
They allegedly also paid doctors
to speak at places like L2O in Chicago,
a restaurant whose Zagat review reads, and I quote...
I'm guessing at the end of the meal,
the waiter came over and asked,
"Separate checks, or is one person buying your influence?
"Just one, is it? Oh, that's very nice of him.
"There you go." And at least they were there for that one.
The suit says many doctors took payments for speeches
they never even gave.
All of which Novartis has denied,
saying that everything they did
had a legitimate business purpose,
and besides, speaker programs like this,
"are an 'accepted and customary practice in the industry,'"
which is kind of the whole point.
Even in its best form,
hiring doctors as paid spokesmen
seems like a conflict of interest.
And multiple reports have found that many drugs'
top prescribers are also often getting money
from that drug's company, which is worrying,
because we trust doctors.
When you see Rihanna trying to get you to drink coconut water,
you know she's getting money to do that,
and you take that into account. You think to yourself,
"I'm glad you're getting paid, RiRi,
"but... I'm actually not going to drink that,
"because you and I both know that coconut water
"tastes like cereal milk mixed with bull semen.
"We both know that, so I'm gonna take that into account
"when I make this decision for myself."
I know this has all been disheartening,
but luckily, there is actually some good news here.
A new clause in the Affordable Care Act
will, for the first time ever,
allow average citizens to search a federal web site
to see all of the perks given to physicians
by pharmaceutical companies.
Now, I know what you're thinking.
"What? A federal web site
"made up of a list of doctors?
"Hold on, let me Command-T, open new tab, right now."
But look, this web site is actually kind of fascinating.
The first batch of numbers are now online,
covering the last five months of 2013,
and you can-- and absolutely should--
go online and look up your doctor
at this address and see what you find.
Maybe you'll find your doctor did a little research
for a drug company, which is probably fine,
Or maybe, as ProPublica did when they looked at Pharma payments,
you'll find a doctor who's earned more than a million dollars
delivering promotional talks and consulting.
Or maybe, like we did,
you'll find a doctor who got food and beverages
one day worth 4Â¢.
4Â¢! I have to know what that meal was!
Because the only way a 4Â¢ meal makes sense
is if that doctor is a mouse.
That's the only way it makes sense.
Wipe the Cheez-It dust off your whiskers
before you prescribe me anything.
The point is, there is information
on this database you should know,
and this should really be just the beginning.
If drug companies really want to regain our trust,
maybe they should let us know
the effect that their money has on doctors
in the only way they know how.
Announcer: Have you noticed anything strange about your doctor?
Does he seem happier than usual these days?
Is he quick to prescribe drugs you think you might not need?
You know what? One more, actually.
Announcer: Does his waiting room frequently feature
surprisingly attractive, not-sick-looking people?
Well, that may be because your doctor's been taking...
Pharmaceutical Money takes many forms,
from free lunches to speaking fees.
Here's how it works.
Money combines with the cash receptors
in your doctor's wallet
to create fast-acting financial relief,
so your doctor can rest easy
and enjoy life.
(laughs)
Announcer: Common side effects of doctors taking money
may include chronic overprescription,
unusually heavy cash flow,
dependency on free samples,
inflammation of confidence,
affluenza, and an increased tendency
to suggest off-label prescriptions
which in turn can cause heart attack, stroke,
loss of feeling in arms and legs,
seizures, blurred vision,
grinding of the teeth, temporary deafness,
total blindness, numbness,
sudden bursts of rage, reduction of trust,
angry erections lasting over 17 hours,
and death.
Ask your doctor today
if he's taking Pharmaceutical Company Money,
then ask your doctor what the money is for.
Ask your doctor if he's taken any money
from the companies who make the drugs
he just prescribed for you,
then ask yourself
if you're satisfied with that answer.
Pharmaceutical Money.
Ask your doctor if his taking it
is right for you.
Finally-- Finally, tonight,
a quick word about Ecuador.
Ecuador's president is Rafael Correa,
a charismatic leader who, once a week,
does an address to the nation
he calls Citizen Link, where, as you'll see,
some amazing things can happen.
(speaking Spanish) (laughter)
*
(singing)
Yes!
That is how a president should address a nation.
In fact, every presidential speech, from now on,
should have somewhere within it, in brackets,
"clown enters."
Now-- So look, these addresses
can clearly be pretty fun.
Unfortunately, they can also take a darker turn.
Yes, darker even than a clown,
because Correa frequently uses them
as a platform to attack people he feels insulted by.
On more than one occasion, he's ripped up newspapers
that have criticized him, because, I guess,
he doesn't realize that newspapers
tend to print more than one copy.
And last week, it actually got even worse,
when, for some reason, he decided to start
calling out individuals by name
who had been abusing him on Twitter.
(speaking Spanish)
Translator: Another little angel,
he's a Twitter bandito.
His real name is Johan Arturo Caicedo Rovira.
So young, what a shame.
He's 18 years old. Very young.
"Oh, 18. So young. So immature.
"Unlike me, the 51-year-old head of state
"who is currently attacking him in public."
Now-- Now to be fair to him,
that 18-year-old had expressed the hope
that Correa would die,
but-- but Correa should have people
who take care of that sort of thing for him,
rather than spending, like he did,
nearly 15 minutes calling out online trolls,
even attacking one individual's Facebook page.
(speaking Spanish)
Translator: The little angel--
and I didn't even know his name--
he was just... (speaks Spanish)
He's got a whole bunch of trash on his page.
Yeah, of course he has.
That's what Facebook is.
It's pages full of trash.
Stop Googling yourself.
You're President of Ecuador.
He even explicitly encouraged his supporters
to tweet back at his attackers.
(speaks Spanish)
Translator: We are more, many more.
We will respond in the exact same way, my friends.
If they send one tweet,
we'll send 10,000,
because we are 10,000 to one.
How are you now getting involved
in a Twitter war?
You do know no one has ever won one of those, right?
It's impossible. Look, look,
President Correa, if you're this sensitive,
then Twitter and Facebook might not be for you.
And to be honest,
being a world leader might not be for you
unless you can build up your tolerance for personal abuse.
Trust me. I've been through this.
I used to be very sensitive,
then I became a comedian,
and I got insulted so much,
I can't feel anything anymore.
It's made me stronger as a person--
emptier and stronger.
So you don't need less abuse, you need more!
You need more abuse to tip you over the edge,
so allow me to help you right now.
(clears throat) Hey.
President Correa,
nice smug smile you've got.
You look like a used Jeremy Piven salesman.
You look like every "Real Housewives'" third husband.
In fact, you're the only president for whom this
might be the single, most dignified moment of your presidency.
Oh, and by the way,
what the hell is happening here?
That's a necklace made out of penises.
That's not even a joke. That's a dick-lace around your neck.
And don't get offended by this, President Correa,
because if your skin was any thinner,
you'd be a taint.
So don't get offended! *
Uh-oh. I think we all know what that music means.
A psychotic clown is about to tell me our time is up.
But I would encourage all of you
to tweet insults directly
to President Correa's Twitter handle
all this week to help him get over his over-sensitivity.
That's our show!
Thank you so much for watching!
Good night! Yes!
Look at him! Look at him!
*
(coughing) Okay.
All right.
So you don't feel good. That's what I'm getting.
(grunts) There we go.
How strong are your teeth?
So when I had my color scheme done,
I found out that I'm actually an autumn
and not a winter.
So that's why I changed my whole wardrobe,
just to answer your question.
(clapping rhythmically) *