have had all the material you wanted, biased or unbiased, by your own companies in this record, but they have declined to come forward. I think that has to be made clear.

I say again-bring in your companies. I will give them dates. Mr. STETLER. The men I have with me today come from particular companies. They are the qualified experts that you want to hear from. Senator NELSON. Well, let me give you another example of what I

mean.

This is from a speech you made in Montreal, Canada, October 25, 1967:

As you well know, our industry has been under attack from politicians such as Senator Nelson for too many years, and believe me we are getting a little tired of the game. It is also more than a little disconcerting to know, and we certainly do, that the Nelson Subcommittee and Russell Long and his staff have been getting considerable assistance and encouragement from some representatives of pharmacies. This in my opinion is unexplainable, and a most reckless type of activity. Would you like to comment on that?

Mr. STETLER. Yes.

Senator NELSON. Now, you have been under attack by Senator Nelson. Start there, will you?

Mr. STETLER. I did not say I have. I said the industry has. And the industry has. Any casual reading of the transcript of these hearings to date could not be interpreted as anything but an attack on the drug industry.

Also comments that have been made the speech that was given for you in Wisconsin, on August 25, stated a lot of conclusions with respect to the issues before this committee conclusions that I think probably should await the outcome of the hearings when all of these people have had a chance to testify.

Now, as far as pharmacy is concerned, certain elements of pharmacy have been active in helping to draft bills like S. 2299 which we happen to honestly think are not only detrimental to the industry, but to medicine, pharmacy, and the public.

Now, there are different feelings in pharmacy on this particular issue, and I think both sides should be heard.

I made those statements. And until all of the elements and all of the interested parties that were invited on May 15 are heard, I think the hearing is not full and complete.

Senator NELSON. Let me quote a statement of yours given before a meeting of the Texas Medical Association in Austin on January 21, 1967, before the hearings ever began.

It might remind you of a little bit of a slight bias in advance.

We are facing a hydra-headed threat from two directions. Senator Gaylord Nelson of Wisconsin, Chairman of the Senate Monopoly Subcommittee of the Small Business Committee has announced he is going to hold drug hearings during the next couple of months. This will undoubtedly mean side trips into the field of prices, profits-as well as industry marketing and promotion. It sounds like an inquisition in the classic mold, which will test our capacity for taking verbal punishment, our ability to absorb ill-founded accusations and bounce back with reason and truth, and our willingness to stay on our feet fighting for what we believe is right and best for the Nation's health care.

You had us all categorized 3 months before the hearings started.
Or was it 5 months?

I repeat-all sides will be heard as I have said in the beginning. And I cannot hear them all at once.

I suppose Dr. Apple could have complained. I apologized to him. yesterday. I said, "You are the first representative of the pharmacists which I have called, and tomorrow Mr. Stetler will appear. If there is a complaint about the order in which you are called or about how long it has taken, you have the same complaint that Mr. Stetler has expressed all over the United States. But at least I have told Mr. Stetler to have every single company who supports his association to appear before the committee, and we have only had two volunteers.' So I repeat my offer for them to come again. All the viewpoints will be heard. I cannot hear them all at once. I suppose if you were chairman, we would have a different order in which you would call them. But I think we have had a long list of very distinguished witnesses although you may differ with them.

Let us take a look at them.

On the fourth day of the hearings we started with experts in the field. We had Dr. Walter Modell, director, clinical pharmacology, Cornell University. Do you consider him an expert witness?

Mr. STETLER. I consider him to be a well-qualified man in the field. Good man.

Senator NELSON, Dr. Walter Richard Burack, Harvard Medical School; Dr. Melvin D. Small, Georgetown Medical School; Dr. James Haughton, first deputy_administrator, Health Services Administration, New York City; Dr. Harry L. Williams, profesor of pharmacology, Emory University; Dr. D. F. McGee, chairman, Department of Pharmacology, Creighton University; Dr. Lloyd C. Miller, director of revision, United States Pharmacopeia-your organization participates in the standards for establishing the standards for the drugs in the Pharmacopeia-Dr. Solomon Garb, Department of Pharmacology, University of Missouri; Dr. J. Fitelson, drug and therapeutic information, New York; Dr. Leighton Cluff, chairman, Department of Medicine, University of Florida; Dr. Margaret McCarron, Los Angeles County Hospital; Harold W. Burrows, president, Parke-Davis Co., Detroit; W. H. Conzen, president, Schering Corp., New Jersey; Dr. Calvin Kunin, Department of Preventive Medicine, University of Virginia; Dr. Martin Cherkasky, director, Montefiore Hospital, Bronx, N.Y.; Dr. James Goddard, Commissioner of FDA; Henry DeBoest, vice president of the Eli Lilly Co.; Richard Furlough, president, E. R. Squibb & Sons; Dr. Frederick Wolff, director of research, Washington Hospital Center, professor of medicine at George Washington School of Medicine; President Silloway of CIBA; George Callahan, sales projects manager, American Telephone & Telegraph Co.; Dr. James Goddard, again, Commissioner, Food and Drug Administration; Dr. Edward G. Feldmann, director of the National Formulary. Aren't these distinguished people with knowledge in this field?

Mr. STETLER. Some are and some are not.

Senator NELSON. Which ones are not?

Mr. STETLER. Well, some of them are relatively unknown. I am sure they have a right to their own view, and they expressed it. But I make the point there are others who speak for greater numbers, who are

better qualified than many of those witnesses, and whose views have not been telegraphed in advance some of those men were witnesses before the Kefauver committee, 7, 8, 9 years ago.

Senator NELSON. Do you have any suggestions, pharmacists, pharmacologists, doctors, or others who you would like to have appear?

Mr. STETLER. Yes, sir.

Senator NELSON. Who have you?

Mr. STETLER. I could supply you with a list, if you would like.

Senator NELSON. How about Dr. Alfred Gilman; is he distinguished in the field?

Mr. STETLER. Yes, sir.

Senator NELSON. Would you be satisfied that he was scientifically qualified?

Mr. STETLER. I am sure he is well qualified.

Senator NELSON. He had told us he did not want to come, but we will reinvite him.

Mr. STETLER. Of course, that is his personal decision. He is a wellqualified man-I can assure you of that.

Senator, you raised an important issue with respect to the Reader's Digest. Could I comment on that?

Senator NELSON. Sure.

Mr. STETLER. This Reader's Digest program was brought to the PMA's attention something over a year ago. And it was presented to us by the Reader's Digest, and by N. W. Ayer, an advertising agency. It is a new venture for us, and we thought a very fine venture, one which we envisioned as giving us an opportunity to communicate on an institutional basis with the public. And it is something that as an industry and as an association we have not done in the past.

Now, I realize because I have gotten the results of your letters to these agencies of Government-that there now are questions raised about it. I can say this about it-that the format of the publication in the Reader's Digest was presented to us by this magazine and by this ad agency. Very frankly-I am familiar with the format and agreed with it.

Senator NELSON. Was it your ad agency?

Mr. STETLER. No; they came to us with Reader's Digest. It was a joint presentation by the agency and the Reader's Digest. Senator NELSON. Did you approve of the ad?

Mr. STETLER. Yes. I saw the format and I didn't disagree with them. It is an eight-page, detachable insert in Reader's Digest.

As you know, the first page indicates that it is a special advertising section, and the last page indicates that it is sponsored by the PMA. Senator NELSON. As a public service?

Mr. STETLER. That is right. But nobody gets eight pages in the Reader's Digest without paying for it. I think everybody realizes that.

Also, those eight pages are separately numbered from the rest of the book. I believe the paper is the paper they normally use for ad copy. But I can tell you this. And I can say this emphatically, because I had a great deal to do with the decision.

There was definitely no intention of any deception. We have sent this to many, many people. I have yet to receive a letter from any

body that says they were deceived by the format or the lack of any clear identification in the tear-out-other than the people we heard from at your-in response to your letter.

Senator NELSON. You have not received a letter from anybody who said they were deceived?

Mr. STETLER. That is right.

Senator NELSON. Well, if they were deceived, how would they know it?

Mr. STETLER. They could take affront at the format. They could say, "In my opinion, this format is deceptive," as you have said in your letters to the Department. But nobody has called this to our attention and said they had a problem with it.

Senator HATFIELD. Mr. Chairman, I would like to comment that could happen after the fact. They may have been deceived or brainwashed, either one.

Senator NELSON. You are talking about your side of the political field, not mine.

Go ahead.

Mr. STETLER. I can tell you this.

I assure you that we did this in good faith. We thought, and would still believe, that anybody that has as much experience as the Reader's Digest, and this ad agency, which is a nationally known agency, would know what is the proper form of an ad and what is not. We took their approach, and we accepted it. And we still think it is not misleading. As I say I have heard nothing from anybody other than the agencies of the Government that have been asked to comment, that there has been any trouble with it.

I will say this in addition.

Since this question has been raised, I can assure you that in the next issue, on each inside page, there will be a repetition of this special advertising section-just on the chance that somebody has been misled. But that does not mean that when this thing was started there was any concept that that could be a possibility, and I assure you on my part it was not, or on the part of the PMA who is responsible for this. Senator NELSON. Well, a couple of questions about that.

I looked at this ad very carefully, and it says "Special Advertising Section." And then you flip the page and it appears to be the objective is clear-it appears to be just an independent article in the Reader's Digest.

Mr. STETLER. That was not my objective or ours, I can assure you. The table of contents on the front also indicates that there are four articles, and what the titles are for the articles inside this eight-page detachable magazine within a magazine.

Senator NELSON. If you look at every other ad before and afterI have looked at 10 or 15 of them-they are all clearly marked as advertisements. This is the only one that is not. And then opposite the front page it says, "If your copy has been removed, write to Health, Post Office Box 2811." Why not write to the Pharmaceutical Manufacturers Association? Is that your post office number?

Mr. STETLER. Let me comment on that.

First of all, incidentally, this type of a detachable insert did not start with us in the Reader's Digest. There have been many many others and they have handled these in a variety of ways but this was

not the inception of this kind of an approach with this magazine. This magazine goes to something like 17 million people, and I do not know how many others, whose hands it comes into. But we did not want them writing to the PMA for copies of reprints, not for any deceptive reason, but just because it would be very tough to handle our mail if it came that way. I understand it is not unusual in getting a post office box to use some other word than the name of the corpo ration or a long name. Once again, I do not think anybody was deceived by that. And certainly nobody that has written in for a reprint has indicated a problem with it.

But if that creates a problem

Senator NELSON. Do you really mean if an ordinary reader looked at this, and it says "Write to Health," he wouldn't have the impression he is writing to some independent health publication?

Mr. STETLER. I don't know what his impression might be. All I know he is writing for a reprint. When he gets it he will know what this is and what it says. It is clearly indicated.

Senator NELSON. On page 24 it says, "If your copy has been removed," and if it has been removed, there is nothing to tell them anything about an advertisement.

Mr. STETLER. As you would label this as propaganda-there is no propaganda on this page, either. He has to write for the reprint. When he gets the reprint it is clearly identified.

Senator NELSON. No. When he gets the reprint, very carefully the words "Special Advertising Section" have been removed. Why is that done?

Mr. STETLER. It is indicated where it was in the journal-on the back-that it is part of a series from the Pharmaceutical Manufacturers Association.

Senator NELSON. You are saying here that if your copy has been removed write to "Health." On this opening page the words "Special Advertising Section" appear. Then on the reprint that you send them "Special Advertising Section" has been removed, so that you receive a reprint that says "Why have many dread diseases vanished, what is the drug name, what are the drugs that reach troubled minds, where are prescription prices going?" And it says "Medicines and Your Family's Health," reprinted from the November 1967 issue of the Reader's Digest.

Now, Mr. Stetler, you know that every single person in the United States, with the rarest of exceptions, is going to say "Well, this is a very interesting little objective health article." I am not talking about the quality of it. You may defend that or not. But the point is that the reader, the doctor, the pharmacist, the patient, is going to look at that and say "This is a very nice little article about drugs." And he is going to be misled. I think that is clear as a bell.

Mr. STETLER. Well, I hope that is not so. It was not intended. I have had nothing to indicate that that has happened. I think it would have been really in many ways-I suppose it would be difficu't for us to tell our story where somebody would not feel that we were trying to be deceptive. But this was a very honest, sincere effort for the first time to get a message across to the public, and we have not communicated with the public before. I am sure somebody would find fault with it, no matter how we prepared it.

81-280-68-pt. 4- -13