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05/25/2007 07:46 AM |
“Of course, a guy like me who’s living on Lipitor is in a hard place to criticize the drug companies.â€
-- Bill Clinton Read More & Comment...
-- Bill Clinton Read More & Comment...
05/25/2007 06:52 AM |
Today's furor, as reported in the New York Times, comes from Italy where consumer groups are decrying high prices, calling them "absurd and shameful."
What they're upset about are ticket prices for the Barbara Streisand concert on June 15. (Prices range from $200 to $1200.)
The horror!
And we concur. After all, comparatively speaking, pretty good seats for the Dylan concert at Jones Beach cost under $200.
And since they're both music concerts by solo artists -- aren't they really the same thing?
Sure. Just like medicines.
That being said, consider the following from Democratic Presidential candidate, Senator Hillary Clinton, "A lot of these so-called blockbuster drugs are no more effective, and sometimes less effective, in treating conditions than old standbys."
In a speech at George Washington University, Senator Clinton said research is finding some drugs aren't worth the cost.
Really? Are some lives not worth saving?
Folks, the battle over the heart and soul of evidence-based medicine is crucial. The battle over what "comparative effectiveness" means is crucial. The battle over measurement tools is crucial.
Why? Because it's a battle between cost and care. Pols, pundits and payors are bashing life-saving medicines by using misleading metrics. And unless and until sound science raises its voice (and the media pays attention to the details) get ready for more of the same.
Ladies and gentlemen, political rhetoric is not the way to address the issue.
Unfortunately, it's rhetoric that is drving the debate and it's rhetoric that the MSM loves to report about.
But nobody said it was going to be easy. Read More & Comment...
What they're upset about are ticket prices for the Barbara Streisand concert on June 15. (Prices range from $200 to $1200.)
The horror!
And we concur. After all, comparatively speaking, pretty good seats for the Dylan concert at Jones Beach cost under $200.
And since they're both music concerts by solo artists -- aren't they really the same thing?
Sure. Just like medicines.
That being said, consider the following from Democratic Presidential candidate, Senator Hillary Clinton, "A lot of these so-called blockbuster drugs are no more effective, and sometimes less effective, in treating conditions than old standbys."
In a speech at George Washington University, Senator Clinton said research is finding some drugs aren't worth the cost.
Really? Are some lives not worth saving?
Folks, the battle over the heart and soul of evidence-based medicine is crucial. The battle over what "comparative effectiveness" means is crucial. The battle over measurement tools is crucial.
Why? Because it's a battle between cost and care. Pols, pundits and payors are bashing life-saving medicines by using misleading metrics. And unless and until sound science raises its voice (and the media pays attention to the details) get ready for more of the same.
Ladies and gentlemen, political rhetoric is not the way to address the issue.
Unfortunately, it's rhetoric that is drving the debate and it's rhetoric that the MSM loves to report about.
But nobody said it was going to be easy. Read More & Comment...
05/25/2007 05:49 AM |
Here's the press release ...
Grassley, Baucus bill would enhance research on pharmaceutical safety and effectiveness
WASHINGTON — Responding to growing concerns about the safety of pharmaceuticals, Sens. Chuck Grassley and Max Baucus introduced legislation today to improve the study of medical treatments, including the effectiveness and safety of drugs.
Their proposal would give researchers at federal agencies and university-based and other research organizations highly controlled access to data on hospital, physician and prescription drug benefits that are provided to Medicare beneficiaries.
“The situation that’s unfolding this week with the popular diabetes drug Avandia emphasizes the value of making this sort of rich source of information available to experienced and credentialed researchers,†Grassley said. “The drug trials that go on before the Food and Drug Administration approves a drug are no match for the wealth of information that’s available after a drug is on the market and millions of people start taking it. This legislative initiative will tap that valuable information on behalf of public safety and public health. And, it does so in a way that makes sure the strongest safeguards are in place to protect privacy and confidentiality.â€
“Knowledge is power, and this bill will empower our health system to serve Americans better,†said Baucus. “The secure and efficient sharing of Medicare’s vast data among a number of Federal agencies will enable researchers to accurately examine the safety and effectiveness of many treatments patients receive. The data this bill would make available provides information that can create more watchdogs. More eyes might have helped us spot a situation like we learned about just this week with the FDA’s handling of the diabetes drug Avandia. This bill provides for this information-sharing with no other goal than to promote the public’s health and the public good.â€
Medicare processes 500 million claims for benefits every year, and millions of prescriptions are filled annually through the new Medicare prescription drug benefit. Grassley said information about these benefits would be a tremendous resource for qualified health services researchers, and it would help them conduct rigorous studies on the safety and effectiveness of various medical treatments.
Grassley and Baucus said that researchers could help policy makers better understand why services that we know can help people maintain good health are not being used and to develop policies to promote their use, for example.
Indeed, knowledge is power. But information without context and power without perspective is dangerous.
Let's watch this one and see where it goes. Read More & Comment...
Grassley, Baucus bill would enhance research on pharmaceutical safety and effectiveness
WASHINGTON — Responding to growing concerns about the safety of pharmaceuticals, Sens. Chuck Grassley and Max Baucus introduced legislation today to improve the study of medical treatments, including the effectiveness and safety of drugs.
Their proposal would give researchers at federal agencies and university-based and other research organizations highly controlled access to data on hospital, physician and prescription drug benefits that are provided to Medicare beneficiaries.
“The situation that’s unfolding this week with the popular diabetes drug Avandia emphasizes the value of making this sort of rich source of information available to experienced and credentialed researchers,†Grassley said. “The drug trials that go on before the Food and Drug Administration approves a drug are no match for the wealth of information that’s available after a drug is on the market and millions of people start taking it. This legislative initiative will tap that valuable information on behalf of public safety and public health. And, it does so in a way that makes sure the strongest safeguards are in place to protect privacy and confidentiality.â€
“Knowledge is power, and this bill will empower our health system to serve Americans better,†said Baucus. “The secure and efficient sharing of Medicare’s vast data among a number of Federal agencies will enable researchers to accurately examine the safety and effectiveness of many treatments patients receive. The data this bill would make available provides information that can create more watchdogs. More eyes might have helped us spot a situation like we learned about just this week with the FDA’s handling of the diabetes drug Avandia. This bill provides for this information-sharing with no other goal than to promote the public’s health and the public good.â€
Medicare processes 500 million claims for benefits every year, and millions of prescriptions are filled annually through the new Medicare prescription drug benefit. Grassley said information about these benefits would be a tremendous resource for qualified health services researchers, and it would help them conduct rigorous studies on the safety and effectiveness of various medical treatments.
Grassley and Baucus said that researchers could help policy makers better understand why services that we know can help people maintain good health are not being used and to develop policies to promote their use, for example.
Indeed, knowledge is power. But information without context and power without perspective is dangerous.
Let's watch this one and see where it goes. Read More & Comment...
05/24/2007 04:16 PM |
Bernie Sanders, the Senator from Ben & Jerry's, described Secretarial Certification of foreign drug importation as a "poison pill."
Oddly enough, Senator Sanders' flip comment hits at the very heart of this issue.
Despite the fact that many lawmakers have been advocating drug importation for years, it is precisely the threat of poisonous, counterfeit, and unregulated drugs flooding America that has kept such legislation from passing.
Here's what we have to say about it in today's edition of The New York Sun:
http://www.nysun.com/article/55114
I prefer Cherry Garcia but wonder what the House brand, Dingellberry, may yet bring. Read More & Comment...
Oddly enough, Senator Sanders' flip comment hits at the very heart of this issue.
Despite the fact that many lawmakers have been advocating drug importation for years, it is precisely the threat of poisonous, counterfeit, and unregulated drugs flooding America that has kept such legislation from passing.
Here's what we have to say about it in today's edition of The New York Sun:
http://www.nysun.com/article/55114
I prefer Cherry Garcia but wonder what the House brand, Dingellberry, may yet bring. Read More & Comment...
05/24/2007 06:02 AM |
John Bridges that is.
We are pleased to share the good news that Dr. John F.P. Bridges (a CMPI senior fellow) has been named Founding Editor of a new medical journal that's designed specifically to offer insight into patient-centered medicine.
The Patient - Patient Centered Outcomes Research, will be an important new medical journal that puts the spotlight on patient-centered medicine. It will be the first
international medical journal dedicated to using the scientific method for accessing patient perspective of therapy and medical technology. The premier issue is due later this year and will initially be published on a quarterly basis.
According to Dr. Bridges, "At the most fundamental level, our goal is to empower the patient. In the past, we simply looked at ways to make the patient well. Today, there's a shift to a
more holistic approach that looks at the process of treating the patient rather than solely at the outcome. In the end, we're going to help make medicine better for the patient."
Interest in patient-centered approaches is growing at a rapid pace, as is the body of scientific research on the topic. According to a recent study by Dr. Bridges, there has been exponential growth in the number of studies focusing on patient preferences in medicine over the last decade. For example the number of conjoint analyses published in medical journals has grown from one every couple of years a decade ago, to over 20 per year today. The Patient was created to address an unmet area of outcomes research by providing a specialized forum and outlet to help the field flourish.
"The Patient is a unique journal in the field of outcomes research in that it creates a new vehicle for patient-centered research," said Ellen J. MacKenzie, Ph.D., Chair of the Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health.
Congratulations John, and we look forward to reading (and contributing) to the life of The Patient. Read More & Comment...
We are pleased to share the good news that Dr. John F.P. Bridges (a CMPI senior fellow) has been named Founding Editor of a new medical journal that's designed specifically to offer insight into patient-centered medicine.
The Patient - Patient Centered Outcomes Research, will be an important new medical journal that puts the spotlight on patient-centered medicine. It will be the first
international medical journal dedicated to using the scientific method for accessing patient perspective of therapy and medical technology. The premier issue is due later this year and will initially be published on a quarterly basis.
According to Dr. Bridges, "At the most fundamental level, our goal is to empower the patient. In the past, we simply looked at ways to make the patient well. Today, there's a shift to a
more holistic approach that looks at the process of treating the patient rather than solely at the outcome. In the end, we're going to help make medicine better for the patient."
Interest in patient-centered approaches is growing at a rapid pace, as is the body of scientific research on the topic. According to a recent study by Dr. Bridges, there has been exponential growth in the number of studies focusing on patient preferences in medicine over the last decade. For example the number of conjoint analyses published in medical journals has grown from one every couple of years a decade ago, to over 20 per year today. The Patient was created to address an unmet area of outcomes research by providing a specialized forum and outlet to help the field flourish.
"The Patient is a unique journal in the field of outcomes research in that it creates a new vehicle for patient-centered research," said Ellen J. MacKenzie, Ph.D., Chair of the Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health.
Congratulations John, and we look forward to reading (and contributing) to the life of The Patient. Read More & Comment...
05/23/2007 05:13 PM |
one issue which is once again being overlooked amid the outcry against an unexpected possible side effect of a drug is the efficacy of the drug itself. The reason I am not stopping Avandia on every patient I have who is taking it is not just that the possible deleterious effect on the heart remains unproven, that the association, as Bob Goldberg has said, is not at the level of cause/effect. there is another problem - that the glitazones are great drugs, that we already saw Rezulin tarred and feathered and ultimately hung from a tree until dead. Is Avandia to be the new Rezulin, followed by Actos, arguably the most effective of the three.
By the way, how many lives did Rezulin save because it was an effective diabetes drug verses how many liver deaths were associated with its use? This is not a rhetorical question - it was removed after a handful of possible cases of severe liver damage.
Believe me, I am not championing drug side effects, nor am i against the idea of widening post market initiatives. It is clear that unexpected side effects need to be watched out for, and that drug safety is an ongoing concern that involves more than just the target organ.
But drug safety and cost/benefit analyses mean looking at more than just a weakly observed mathematically determined association. These shadows will be found in many more places the harder we look for them. And great drugs will be unfairly targeted and destroyed. The cost is too high. Two TZDs down. One left to go. By the way, did I forget to mention that these drugs are perhaps the best drugs we have for type 2 diabetes - i see that I began my post this way - so I've come full circle. Read More & Comment...
By the way, how many lives did Rezulin save because it was an effective diabetes drug verses how many liver deaths were associated with its use? This is not a rhetorical question - it was removed after a handful of possible cases of severe liver damage.
Believe me, I am not championing drug side effects, nor am i against the idea of widening post market initiatives. It is clear that unexpected side effects need to be watched out for, and that drug safety is an ongoing concern that involves more than just the target organ.
But drug safety and cost/benefit analyses mean looking at more than just a weakly observed mathematically determined association. These shadows will be found in many more places the harder we look for them. And great drugs will be unfairly targeted and destroyed. The cost is too high. Two TZDs down. One left to go. By the way, did I forget to mention that these drugs are perhaps the best drugs we have for type 2 diabetes - i see that I began my post this way - so I've come full circle. Read More & Comment...
05/23/2007 06:46 AM |
I spent two days in Brazil late last week. Gave a speech in Sao Paulo and another in Rio.
Wonderful country. Smart people.
And especially smart when it comes to the issue of compulsory licensing of pharmaceuticals.
The people I met with (from a wide variety of professions) all agreed that the Brazilian government's move towards expropriating patents was nothing more than a media stunt that might save a few political lives -- but no real ones.
More importantly, the people I met with agreed that, in the long run, such unethical moves were unwise for the future of Brazilian health care -- because what their nation needs are partnerships in health care -- not meaningless confrontations. Allies not adversaries.
So, don't believe everything you hear from certain NGOs. All this running dog lackey health care imperialism blather is nothing more than anti-pharma agitprop.
I was there. I heard it.
(Hear that, Jamie?) Read More & Comment...
Wonderful country. Smart people.
And especially smart when it comes to the issue of compulsory licensing of pharmaceuticals.
The people I met with (from a wide variety of professions) all agreed that the Brazilian government's move towards expropriating patents was nothing more than a media stunt that might save a few political lives -- but no real ones.
More importantly, the people I met with agreed that, in the long run, such unethical moves were unwise for the future of Brazilian health care -- because what their nation needs are partnerships in health care -- not meaningless confrontations. Allies not adversaries.
So, don't believe everything you hear from certain NGOs. All this running dog lackey health care imperialism blather is nothing more than anti-pharma agitprop.
I was there. I heard it.
(Hear that, Jamie?) Read More & Comment...
05/22/2007 08:27 AM |
US hearing set on FDA handling of Glaxo drug
By Reuters | May 21, 2007
WASHINGTON (Reuters) - A House committee will hold a hearing on June 6 on the Food and Drug Administration's oversight of the safety of GlaxoSmithKline Plc's diabetes drug, Avandia, the panel's chairman said in a statement Monday.
In a statement, Rep. Henry Waxman, a California Democrat who chairs the House Oversight and Government Reform Committee, said the hearing was called following publication of study that reported Avandia may be associated with an increase in heart attacks and deaths. Read More & Comment...
By Reuters | May 21, 2007
WASHINGTON (Reuters) - A House committee will hold a hearing on June 6 on the Food and Drug Administration's oversight of the safety of GlaxoSmithKline Plc's diabetes drug, Avandia, the panel's chairman said in a statement Monday.
In a statement, Rep. Henry Waxman, a California Democrat who chairs the House Oversight and Government Reform Committee, said the hearing was called following publication of study that reported Avandia may be associated with an increase in heart attacks and deaths. Read More & Comment...
05/22/2007 08:01 AM |
It is becoming clear that the Nissen article in the NEJM is part of larger effort on the part of a tort lawyer sponsored group of academics who oppose PDUFA. The editorial in support of the Nissen article was written by Curt Furberg and Bruce Psaty who, as this blog has noted in the past, have participated in the efforts of the The Project on Scientific Knowledge and Public Policy (SKAPP), based at the George Washington University to undo current PDUFA legislation. Major support for SKAPP is provided by the Common Benefit Trust, a fund established pursuant to a court order in the Silicone Gel Breast Implant Products Liability litigation.
It's time for the FDA to stand up to the bullying if it wants to retain authority... Read More & Comment...
It's time for the FDA to stand up to the bullying if it wants to retain authority... Read More & Comment...
05/22/2007 06:11 AM |
The Congress is expected to begin debating SCHIP right after the Memorial Day recess, but final decisions are being made now about the legislative proposals that will be considered.
Here are some important things to think about and consider from the Health Policy Consensus Group (of which we are a proud participant) ...
Download file
Have a look and feel free to share. Read More & Comment...
Here are some important things to think about and consider from the Health Policy Consensus Group (of which we are a proud participant) ...
Download file
Have a look and feel free to share. Read More & Comment...
05/21/2007 12:07 PM |
Speaking of which...the online publication of Effect of Rosiglitazone on the Risk of Myocardial Infarction and Death from Cardiovascular Causes
Steven E. Nissen, M.D., and Kathy Wolski, M.P.H. signals a new low for both the NEJM and Nissen who's campaign to be FDA commissioner in a Democrat administration makes him look craven and small. http://www.nejm.org
The article proves no direct causal association. As the authors admit "these findings are based on limited access to trial results from publicly available sources, not on patient-level source data." Which means they cannot control for previous risks of heart disease or prior events.
Worse, the authors ignore the extensive literature demonstrating an association between diabetes and death from heart problems. Here's one article it failed to mention.
Diabetes mellitus: the major risk factor in unstable coronary artery disease even after consideration of the extent of coronary artery disease and benefits of revascularization.
Am Coll Cardiol. 2004 Feb 18;43(4):585-91.
Nissen has trawled for trouble before in the area of drugs for ADHD where he was rebuked by people who know better about the medicines benefit/risk profile. Here, he just did some data dredging of the worst sort and then even failed to cover his rear by citing literature about the link between diabetes and heart disease.
We know the NEJM is no longer a credible source of objective information on medicine. The question regarding Nissen is: Is he a real doctor or just playing one in the media? Read More & Comment...
Steven E. Nissen, M.D., and Kathy Wolski, M.P.H. signals a new low for both the NEJM and Nissen who's campaign to be FDA commissioner in a Democrat administration makes him look craven and small. http://www.nejm.org
The article proves no direct causal association. As the authors admit "these findings are based on limited access to trial results from publicly available sources, not on patient-level source data." Which means they cannot control for previous risks of heart disease or prior events.
Worse, the authors ignore the extensive literature demonstrating an association between diabetes and death from heart problems. Here's one article it failed to mention.
Diabetes mellitus: the major risk factor in unstable coronary artery disease even after consideration of the extent of coronary artery disease and benefits of revascularization.
Am Coll Cardiol. 2004 Feb 18;43(4):585-91.
Nissen has trawled for trouble before in the area of drugs for ADHD where he was rebuked by people who know better about the medicines benefit/risk profile. Here, he just did some data dredging of the worst sort and then even failed to cover his rear by citing literature about the link between diabetes and heart disease.
We know the NEJM is no longer a credible source of objective information on medicine. The question regarding Nissen is: Is he a real doctor or just playing one in the media? Read More & Comment...
05/21/2007 10:31 AM |
CMPI Board member Fred Goodwin is on a unbalanced panel (in more ways than one) at the APA entitled Uneasy Partners: The Pharmaceutical Industry and the Psychiatric Profession..The point of the panel is to show that clinical studies used to develop clinical guidelines for shrinks have been corrupted by industry, are unscientific and can't be trusted.
The response to that should be twofold: Does that mean no drug is really safe or efficacious given the limits of clinical trials. Second, , why not do head to head studies of treatment approaches developed by "purists" and those "corrupted" by industry and see who does better? We actually have some examples.. ALLHAT and CATIE were run by purists, the UK's NICE system of comparative effectiveness is too.
For the most part, purists are lazy. They simply do meta-analyses of selective group of clinical trials that have exclusion critiera that will produce outcomes they support.
Meanwhile, are the purists, who take money from trial lawyers, left wing foundations funded by George Soros, agenda driven organizations and have their own biases really pure? Read More & Comment...
The response to that should be twofold: Does that mean no drug is really safe or efficacious given the limits of clinical trials. Second, , why not do head to head studies of treatment approaches developed by "purists" and those "corrupted" by industry and see who does better? We actually have some examples.. ALLHAT and CATIE were run by purists, the UK's NICE system of comparative effectiveness is too.
For the most part, purists are lazy. They simply do meta-analyses of selective group of clinical trials that have exclusion critiera that will produce outcomes they support.
Meanwhile, are the purists, who take money from trial lawyers, left wing foundations funded by George Soros, agenda driven organizations and have their own biases really pure? Read More & Comment...
05/21/2007 05:23 AM |
Here's some comic relief ...
Representative Maurice "Slo Mo" Hinchey (D, NY) has introduced legislation that would direct pharmaceutical firms to deposit their PDUFA fees into a general fund of the U.S. Treasury rather than paying them directly to the FDA.
According to Mr. Hinchey, such a relationship would provide an "arms length relationship" between the agency and drug companies.
Hey, Mo -- would the actual applications also be sent from "anonymous?" (Because, er, the names on the NDAs might give the FDA a hint as to whose applications they were reviewing.)
Would meetings between pharmaceutical companies and the FDA take place with FDA employees wearing blindfolds? No, that wouldn't work. After all, how could they take notes or watch PowerPoint presentations? We should probably do away with those earplugs too.
Maybe in mark-up the bill's language could change to require drug company employees attending such meetings to wear dark glasses, wigs, and fake Groucho moustaches.
Slo Mo also wants to create a "Center for Postmarket Drug Safety and Effectiveness" -- which would be apart and independent from the initial drug approval process.
Hey Mo -- that's a good one -- separating safety from effectiveness.
Take my legislation -- please. Read More & Comment...
Representative Maurice "Slo Mo" Hinchey (D, NY) has introduced legislation that would direct pharmaceutical firms to deposit their PDUFA fees into a general fund of the U.S. Treasury rather than paying them directly to the FDA.
According to Mr. Hinchey, such a relationship would provide an "arms length relationship" between the agency and drug companies.
Hey, Mo -- would the actual applications also be sent from "anonymous?" (Because, er, the names on the NDAs might give the FDA a hint as to whose applications they were reviewing.)
Would meetings between pharmaceutical companies and the FDA take place with FDA employees wearing blindfolds? No, that wouldn't work. After all, how could they take notes or watch PowerPoint presentations? We should probably do away with those earplugs too.
Maybe in mark-up the bill's language could change to require drug company employees attending such meetings to wear dark glasses, wigs, and fake Groucho moustaches.
Slo Mo also wants to create a "Center for Postmarket Drug Safety and Effectiveness" -- which would be apart and independent from the initial drug approval process.
Hey Mo -- that's a good one -- separating safety from effectiveness.
Take my legislation -- please. Read More & Comment...
05/18/2007 10:41 AM |
Can a guy who took a stretch limo to a $3000/day fat farm do a credible movie about health care in America? He can if he plays to people's deeply held stereotypes about scummy business practices and twists the truth in the process....
But Moore is claiming, again, that every fact in his movies are true. Sicko being no exception. So here's a reminder for those of you Sicko-phants about how much Moore has to lie to make his point.
http://www.slate.com/id/2102723/ Read More & Comment...
But Moore is claiming, again, that every fact in his movies are true. Sicko being no exception. So here's a reminder for those of you Sicko-phants about how much Moore has to lie to make his point.
http://www.slate.com/id/2102723/ Read More & Comment...
05/18/2007 06:34 AM |
Members of Congress telling the FDA to relabel Oxy for only those with severe pain. No mention if having to endure lethal doses of stupidity from legislators and their staff qualifies. http://www.forbes.com Read More & Comment...
05/17/2007 02:48 PM |
Oped this past Monday by CMPI board member Mark Thornton about the demise of the Office of Cancer Drugs at the FDA....When is the new commish going to inject some science and sanity into the agency?
http://online.wsj.com/article/SB117911315709601659.html Read More & Comment...
http://online.wsj.com/article/SB117911315709601659.html Read More & Comment...
05/17/2007 09:14 AM |
Was the point to help the uninsured or simply stick it to the drug companies?
From http://www.fiercehealthcare.com
Arkansas Cancels Prescription Drug Discount Program Because of Lack of Interest
[May 16, 2007]
The Arkansas Department of Health and Human Services has decided to cancel Arkansas Rx, a state prescription drug discount program scheduled to begin enrolling uninsured state residents this year, according to department spokesperson Julie Munsell, the Arkansas Democrat-Gazette reports. Supporters of the program in 2005, when the program received funding approval, said that as many as 400,000 uninsured state residents would have qualified for the program.
However, only 2,800 uninsured Arkansas residents have expressed interest in the program, a number that would not have allowed the state to negotiate bulk discounts on prescription drugs, Munsell said. She attributed the lack of interest in the program, which the state promoted with a radio and newspaper advertising campaign, to the increased number of alternatives -- such as the Medicare prescription drug benefit, discounts on generic medications offered by Wal-Mart Stores pharmacies and discount programs sponsored by pharmaceutical companies. About 21 states have established or authorized prescription drug discount programs for low-income adults, according to Richard Cauchi, health program director for the National Conference of State Legislatures (Manthey, Arkansas Democrat-Gazette, 5/15). Read More & Comment...
From http://www.fiercehealthcare.com
Arkansas Cancels Prescription Drug Discount Program Because of Lack of Interest
[May 16, 2007]
The Arkansas Department of Health and Human Services has decided to cancel Arkansas Rx, a state prescription drug discount program scheduled to begin enrolling uninsured state residents this year, according to department spokesperson Julie Munsell, the Arkansas Democrat-Gazette reports. Supporters of the program in 2005, when the program received funding approval, said that as many as 400,000 uninsured state residents would have qualified for the program.
However, only 2,800 uninsured Arkansas residents have expressed interest in the program, a number that would not have allowed the state to negotiate bulk discounts on prescription drugs, Munsell said. She attributed the lack of interest in the program, which the state promoted with a radio and newspaper advertising campaign, to the increased number of alternatives -- such as the Medicare prescription drug benefit, discounts on generic medications offered by Wal-Mart Stores pharmacies and discount programs sponsored by pharmaceutical companies. About 21 states have established or authorized prescription drug discount programs for low-income adults, according to Richard Cauchi, health program director for the National Conference of State Legislatures (Manthey, Arkansas Democrat-Gazette, 5/15). Read More & Comment...
05/16/2007 08:10 AM |
Effective for patients or effective for budgeteers?
When pols and pundits say that we need a system of comparative effectiveness measures "like the UK," it's important to understand what that means. Consider the following ...
An international study of patient access to cancer drugs has found that the UK is in the lowest category of 25 countries, which were measured on the uptake of 67 treatments. The study, by the Karolinska Institute and the Stockholm School of Economics, found that the overall performance was best in Austria, France, Switzerland and the USA.
The researchers noted that the biggest variations across the different national markets in the study were for bowel and lung cancer groups. In both cases, the UK ranked with Poland among the worst countries for patient access to drugs.
This is a system we want to adopt? When Representative Emerson, for example, points to saving "billions, maybe trillions, of dollars" what she means (whether or not she understands it) is that those savings come from denying care.
Yes -- even for cancer patients.
The Karolinska Institute and Stockholm School of Economics study was published in the Annals of Oncology. Read More & Comment...
When pols and pundits say that we need a system of comparative effectiveness measures "like the UK," it's important to understand what that means. Consider the following ...
An international study of patient access to cancer drugs has found that the UK is in the lowest category of 25 countries, which were measured on the uptake of 67 treatments. The study, by the Karolinska Institute and the Stockholm School of Economics, found that the overall performance was best in Austria, France, Switzerland and the USA.
The researchers noted that the biggest variations across the different national markets in the study were for bowel and lung cancer groups. In both cases, the UK ranked with Poland among the worst countries for patient access to drugs.
This is a system we want to adopt? When Representative Emerson, for example, points to saving "billions, maybe trillions, of dollars" what she means (whether or not she understands it) is that those savings come from denying care.
Yes -- even for cancer patients.
The Karolinska Institute and Stockholm School of Economics study was published in the Annals of Oncology. Read More & Comment...
05/15/2007 04:07 PM |
As if we needed another example of the folly and bias of large studies, the following excerpt from http://www.scientificamerican.com says it all:
Gordon H. Guyatt, a professor of epidemiology and biostatistics at McMaster University in Hamilton, Ontario, who coined the term "evidence-based medicine," collaborated with 16 of his colleagues in an exhaustive survey of existing studies on the outcomes of various medical procedures in both the U.S. and Canada. Their work appears in the inaugural issue of the new Canadian journal Open Medicine, and comes at a time when many in Canada are debating whether or not to move that country's single-payer system toward for-profit delivery of care. The ultimate conclusion of the study is that the Canadian medical system is as good as the U.S. version, at least when measured by a single metric—the rate at which patients in either system died.
Here's what the authors left out to get to their conclusion:
"We included published and unpublished prospective or retrospective observational studies comparing health outcomes (mortality or morbidity) in Canada and the United States for patients of any age with the same diagnosis."
Unpublished? So we have no way of knowing if the study design or results are any good. Ok, next.
"We excluded randomized trials, studies that identified the patients on the basis of the occurrence of one of the adverse health outcomes of interest, and national disease-specific mortality studies that failed to define the population at risk (that is, those with the disease of interest)."
Translation: We excluded anyone who was sick.
"For instance, we excluded studies of national rates of death from cancers because lower mortality may be due either to a lower incidence of cancer or to better care for those with the disease."
That's right folks, better care is not considered a factor in determining which health system is better. Can you say George Orwell?
In otherwords, if you are healthy and "use" the Canadian health system you die at a slower rate than in the US. Wow.
This, from the person who coined the term evidence based medicine.
For those fans of EBM here's the link. Steffie Woolhanler, Canadian health system symp is a co-conspirator on this piece of propaganda.
http://www.openmedicine.ca/article/view/8/1 Read More & Comment...
Gordon H. Guyatt, a professor of epidemiology and biostatistics at McMaster University in Hamilton, Ontario, who coined the term "evidence-based medicine," collaborated with 16 of his colleagues in an exhaustive survey of existing studies on the outcomes of various medical procedures in both the U.S. and Canada. Their work appears in the inaugural issue of the new Canadian journal Open Medicine, and comes at a time when many in Canada are debating whether or not to move that country's single-payer system toward for-profit delivery of care. The ultimate conclusion of the study is that the Canadian medical system is as good as the U.S. version, at least when measured by a single metric—the rate at which patients in either system died.
Here's what the authors left out to get to their conclusion:
"We included published and unpublished prospective or retrospective observational studies comparing health outcomes (mortality or morbidity) in Canada and the United States for patients of any age with the same diagnosis."
Unpublished? So we have no way of knowing if the study design or results are any good. Ok, next.
"We excluded randomized trials, studies that identified the patients on the basis of the occurrence of one of the adverse health outcomes of interest, and national disease-specific mortality studies that failed to define the population at risk (that is, those with the disease of interest)."
Translation: We excluded anyone who was sick.
"For instance, we excluded studies of national rates of death from cancers because lower mortality may be due either to a lower incidence of cancer or to better care for those with the disease."
That's right folks, better care is not considered a factor in determining which health system is better. Can you say George Orwell?
In otherwords, if you are healthy and "use" the Canadian health system you die at a slower rate than in the US. Wow.
This, from the person who coined the term evidence based medicine.
For those fans of EBM here's the link. Steffie Woolhanler, Canadian health system symp is a co-conspirator on this piece of propaganda.
http://www.openmedicine.ca/article/view/8/1 Read More & Comment...
05/15/2007 12:20 PM |
Representatives Tom Allen (D-ME) and Jo Ann Emerson (R-MO) held a press conference this morning to announce the introduction of their Enhanced Health Care Value for All Act of 2007.
Representatives of interest groups supporting the legislation and congressional staff out-numbered reporters.
Allen and Emerson mentioned the $3 billion over five years that would be turned over to the Agency for Healthcare Research and Quality (AHRQ) to conduct comparative effectiveness studies.
They did not mention that only one third of this funding would be allocated from the federal budget; two-thirds of the money would come from taxes on health insurance policies.
Oops.
Emerson said the program is needed to combat pharmaceutical company marketing to physicians. She accused physicians of being on the take and encouraged patients to “challenge prescription decisions†made by their physicians.
Funny, last we encountered Representative Emerson, she was trying to limit the information that patients could get on their medicines.
Emerson claimed that the legislation is solely aimed at providing enhanced evidence, but also said it would save Medicare “billions and billions, maybe trillions of dollars.â€
That's a boatload of "maybe."
David Helms, president of AcademyHealth said that the U.S. lags other countries in evidence-based medicine, and that it could learn a lot from countries like Australia and the U.K.
He didn’t say what the U.S. could learn from countries that routinely deny their citizens access to breakthrough life-saving and life-extending therapies.
That's why this piece of legislation should more appropriately be called "The Denial of Care Act." Read More & Comment...
Representatives of interest groups supporting the legislation and congressional staff out-numbered reporters.
Allen and Emerson mentioned the $3 billion over five years that would be turned over to the Agency for Healthcare Research and Quality (AHRQ) to conduct comparative effectiveness studies.
They did not mention that only one third of this funding would be allocated from the federal budget; two-thirds of the money would come from taxes on health insurance policies.
Oops.
Emerson said the program is needed to combat pharmaceutical company marketing to physicians. She accused physicians of being on the take and encouraged patients to “challenge prescription decisions†made by their physicians.
Funny, last we encountered Representative Emerson, she was trying to limit the information that patients could get on their medicines.
Emerson claimed that the legislation is solely aimed at providing enhanced evidence, but also said it would save Medicare “billions and billions, maybe trillions of dollars.â€
That's a boatload of "maybe."
David Helms, president of AcademyHealth said that the U.S. lags other countries in evidence-based medicine, and that it could learn a lot from countries like Australia and the U.K.
He didn’t say what the U.S. could learn from countries that routinely deny their citizens access to breakthrough life-saving and life-extending therapies.
That's why this piece of legislation should more appropriately be called "The Denial of Care Act." Read More & Comment...
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