Newtered Gingrich's Congress emasculated the one agency capable of controlling health care costs and improving quality. Time to reverse the procedure Washington Monthly October 2007
------If you've never suffered the agony of low back pain, don't worry—chances are you will. About two-thirds of adults are hit with low back pain at some time in their lives, and for many the pain is sufficiently unbearable to send them hobbling into the doctor's office. Yet although back pain is one of the most common conditions around, and although it costs billions of dollars each year in lost productivity, doctors still disagree over everything from how to diagnose the cause to what to do about it. The vast majority of low back pain—even the excruciating nerve sensation known as sciatica—goes away, inexplicably, on its own. There's little evidence that the two most common surgical treatments, known as spinal fusion and discectomy, are necessarily better than such nonsurgical remedies as over-the-counter painkillers and physical therapy. Practically every aspect of back pain, from the terminology to various treatments to the imaging tests, like MRIs and X-rays, used to diagnose it, is fraught with confusion and controversy. Read more
------With financial ties to nearly two dozen drug and biotech companies, Dr. Charles B. Nemeroff may hold some sort of record among academic clinicians for the most conflicts of interest. A psychiatrist, a prominent researcher, and chairman of the department of psychiatry and behavioral science at Emory University in Atlanta, Nemeroff receives funding for his academic research from Eli Lilly, AstraZeneca, Pfizer, Wyeth-Ayerst--indeed from virtually every pharmaceutical house that manufactures a drug to treat mental illness. He also serves as a consultant to drug and biotech companies, owns their stocks, and is a member of several speakers' bureaus, delivering talks--for a fee--to other physicians on behalf of the companies' products. But it was just three of Nemeroff's many financial entanglements that caught the eye of Dr. Bernard J. Carroll . . . Read more
------In 1986 the Japanese health department launched a campaign to screen infants for neuroblastoma, the second most common form of early-childhood cancer, after leukemia. The test was easy to administer: Parents simply pressed a piece of filter paper to their baby's wet diaper, allowed the paper to dry, and then mailed it to a laboratory. Doctors had known since the 1950s that neuroblastoma tumors cause the body to excrete an unmistakable chemical signature in the urine; in the 1980s analyzing that signature became simple enough to perform on a large scale. With the advent of this simple test, Japanese doctors reasoned that they could detect tumors in their earliest stages, before they began producing symptoms, and thus improve the odds of babies surviving the disease.
There was just one problem: While the cure rate for neuroblastoma rose, the overall death rate--that is, the number of Japanese children per 100,000 who died of the disease--scarcely budged. . . . Read more
-----With the pharmaceutical industry spending around $3 billion a year advertising its products directly to consumers, you can't open a magazine, watch television or read a newspaper without stumbling over a pitch for this or that drug. So when an editor first alerted me to a series of ads being run by the pharmaceutical giant Novartis, I assumed it was just more of the same. Each ad shows a photo of an actual cancer patient, under headlines such as, "Stunning Success. Deadly cancer at 23. Complete remission at 24," or "To life! Novartis and Rabbi Sklarz drove his cancer into remission in just 56 days." I knew the company was touting its new wonder drug, which can snatch certain cancer patients from death's door and put them into remission.
-----But on closer inspection, I realized these ads can't be aimed at consumers, not simply because they never mention the drug, Gleevec, by name, but also because there's not much point in the company spending hundreds of thousands of dollars on marketing a drug that benefits at most only a few thousand patients. . . . Read more
Doctor takes "march of shame" to atone for drug company payments By Jeannie Lenzer and Shannon Brownlee BMJ 2008;336:20-21 (5 January)
-----One US doctor has severed all his ties to drug companies and come out in a blazing public attack on industry funding of medical education. Jeanne Lenzer and Shannon Brownlee report A US psychiatrist has vowed to go on a "march of shame" for payments he received from a drug company in return for medical education talks he gave to other doctors. He now promises to give free "undrug" talks to reverse the effects of the "inappropriate prescribing" he may have caused. -----Writing in the New York Times (www.nytimes.com, 25 Nov 2007, "Dr Drug Rep"), Daniel Carlat, assistant clinical professor of psychiatry at Tufts School of Medicine in Boston, has given a candid account of his role promoting the antidepressant venlafaxine (marketed as Effexor XR in the United States by Wyeth Pharmaceuticals). Carlat was flattered when a Wyeth drug representative asked him in 2001 to give talks to doctors about the drug for the treatment of depression. It didn’t hurt that he would be paid $500 (£250; 350) for a one hour talk over a free lunch—and $750 if he had to drive for an hour. -----Carlat, who specialises in psychopharmacology, says he didn’t believe at first that he was doing anything wrong when he agreed to give the talks. He was familiar with studies showing that venlafaxine, a dual reuptake inhibitor that increases concentrations of serotonin and noradrenaline (norepinephrine), might be more effective than the selective serotonin reuptake inhibitors. As he had already prescribed the drug to a few patients with some success, he reasoned that he would be doing nothing unethical by talking about the drug’s benefits. Read more
- TALK OF THE NATION SCIENCE FRIDAY October 12, 2007 HOST: Ira Flatow Interview with Matthew Holt on The Health Care Blog http://www.thehealthcareblog.com/ Fair Game Public Radio International Guest host Michael Ian Black September 25, 2007 http://radiotime.com/ Wisconsin Public Radio October 02, 2007 http://www.wpr.org/ NPR Talk of the Nation, Science Friday Host: Ira Flatow http://www.npr.org/ The People's Pharmacy, with Joe and Terry Graedon November 5, 2007 http://www.peoplespharmacy.com/
