Latest Drugwonks' Blog

My oped today in the NY Dailly News

End sick crusade against breast cancer research
Saturday, October 28th, 2006

Every October, as Breast Cancer Awareness Month rolls around, we wear pink ribbons and focus our attention on a terrible disease that takes the lives of some 40,000 American women every year. But this year, a group known as Breast Cancer Action has seized the stage - and, claiming to speak on behalf of breast cancer patients themselves, is making conspiratorial, offensive and irresponsible statements. They must be exposed as the fearmongers they are.
In a national media campaign that includes newspaper and TV ads, the upstart organization is advising women to "think before you pink" because - get this - they consider corporate donations to fight cancer research tainted by the profit motive. The group warns women against the breakthrough treatments corporate-funded research might yield.

And most alarmingly, the organization has advised against mammograms, apparently believing that they too are part of some corporate conspiracy. According to Barbara Brenner, executive director of the group, "benefit of routine mammograms for healthy premenopausal women is unproven."

This is a blatant lie that threatens women's lives. The scientific consensus is that routine mammography reduces the risk of dying of breast cancer in women 50 and older by up to 30%.

And in their crusade against corporate-funded research, what kind of breakthroughs is Breast Cancer Action targeting? Work by people like Northwestern University's Dr. Boris Pasche. By identifying women with variations of two specific genes that have been linked to an increased risk of cancer, Pasche and his colleagues are approaching a breakthrough that could successfully test for cancer risk in 30% of women. That could spare mothers needless trips to the doctor, exhausting rounds of chemotherapy and hospitalitzation.

In the perverse world of Breast Cancer Action, Dr. Pasche's research is suspect - because part of his financial support comes from the Avon Foundation. What's wrong with the Avon Foundation? Well, it seems the mere fact that it's linked to a profit-making company is cause enough for concern: "Breast cancer has become the poster child of corporate cause-related marketing campaigns, as companies try to boost their image and their profits by connecting themselves to a good cause," Breast Cancer Action complains on its Web site.

Perversely, this organization blames corporations for doing too much - and, at the very same time, not enough. As Brenner recently explained, "I understand that people want to do something, but if shopping could cure breast cancer, it would be cured by now." Brenner apparently isn't aware that over the last decade, thanks to countless researchers and millions of dollars in funding, the death rate from breast cancer has declined by 2.3% per year for all women. And it could go down much further, much faster, if research accelerates.

Breast Cancer's Action's twisted crusade would have corporations forget research funding and have women forgo potentially livesaving treatments. And what should replace research and science? A fight for a cleaner environment. In particular, the group insists there is irrefutable proof that chemicals called PCBs - pollutants that were in some manufactured goods before being banned in 1977 - cause breast cancer. There's no biological evidence to support such a link.

During Breast Cancer Awareness Month, this terrible disease is a formidable enough target for America to fight. We shouldn't also have to contend with the lies and hysteria being peddled by Breast Cancer Action.
Here are some of the more interesting headlines from this week's health and medical breakthrough news:


Elderly Men With Low Testosterone Levels More Likely To Fall
Low testosterone levels may be associated with a higher risk of falling in older men, according to a report in the October 23 issue of Archives of Internal Medicine, one of the JAMA/Archives journals....

Punchlines are welcome

And then there's this from that cutting edge healthcare system North of the border

Unique Bra Eases Women's Recovery From Heart Surgery
A national clinical trial led by a University of Calgary researcher has found that wearing a specialized compression bra significantly reduces women's breast pain following heart surgery.

So let's get this straight. HealthCanada will pay for this but not Plavix or Herceptin...

The autism aliens will not be convinced that mercury (the element, not the planet) does not cause that disease not matter how much scientific evidence is amassed and no matter how many death threats they send to scientists and public health officials...

Government rejects vaccine petition
By ANDREW BRIDGES, Associated Press Writer

A group called the Coalition for Mercury-free Drugs petitioned the Food and Drug Administration in 2004 seeking the restrictions on thimerosal, citing concerns that the preservative is linked to autism. In a reply dated Sept. 26 but made public only Tuesday, the FDA rejected the petition.

Federal health officials won't put new restrictions on the use of a mercury-based preservative in vaccines and other medicines, denying a petition that sought the limits because of health concerns.

"We're not accepting that answer," said Dr. Mark Geier, one of the petitioners.

Gee, what a surprise.

And speaking of not pleasing the paranoid, here's a headline that will make Steve Nissen, Curt Furberg and Ariana Huffington (who would ever think to see them in the same sentence?) miserable:

From Medical News Today

Popular ADHD Drug Safe And Effective For Pre-schoolers But Monitor Youngsters Closely For Side Effects, Researchers Caution

No heart problems guys. However, the study shows that in some kids side effects can include weight loss limits on height. It did not compare the impact of Ritalin with Strattera which is not a stimulant and does not have the same effect on appetite...
In case your copy of the People's Daily didn't arrive this morning, some important news ...

Chinese get genetic tests to determine disease risk

More than 300 Chinese have undergone genetic testing to determine their odds of developing cancers and other diseases. According to China's first and only genetic testing clinic at the No.1 hospital affiliated with Zhejiang University School of Medicine, more than 300 Chinese have had their DNA sampled at the center since it opened last October. "We look at a patient's medical history and family history, take their blood to analyze their DNA to look for genes that would possibly cause diseases," said Qi Ming, director of the center and professor at the university. Such tests help identify people more likely to get a disease and allow patients to take action to reduce their risk, he said. More than 1,000 genes have been found to relate to diseases. Breast cancer, colon cancer, abnormal heart rate, amyotrophic lateral sclerosis and other diseases can be detected by the DNA tests, Qi said. The tests cost between 75 U.S. dollars and several hundred dollars, he said.

This needs to become standard practice in the US if we are to successfully scale the Great Wall of EBM (evidence-based medicine).
On the heels of a report that a state legislator in NY wants to make it illegal to drive while under the influence of Ambien, this piece of chilling news....

There is a massive increase in the number of people who have cars in developing countries where road traffic accidents are the fourth leading cause of death in adults aged 15-59.

Can't you see the connection? It's the Ambien, stupid. Where is Senator Grassley when we need him?
In the November issue of Commentary I make the point that Big Pharma needs to be seen as focusing more on promoting the public health than they do on promoting products.

Pfizer has just taken a significant step in that direction.

The world's biggest pharmaceutucal company has announced a collaboration that gives access to its library of medicinal compounds – the world’s largest – and also brings scientists from developing countries into Pfizer’s laboratories for training in drug discovery techniques.

The collaboration with The Special Program for Research and Training in Tropical Diseases of the WHO (WHO/TDR) is part of a new effort to link the research resources of a major pharmaceutical company to a global network of discovery research, and speed the search for new drugs to combat some of the world’s most deadly parasitic diseases, including malaria, leishmaniasis, African trypanosomiasis, onchocerciasis, schistosomiasis and Chagas' disease.

Under the arrangement, scientists in institutes affiliated with the WHO/TDR-sponsored Compound Evaluation Network are testing thousands of compounds from the Pfizer library. In a process called “screening”, the researchers are seeking to identify “hits” – compounds that show initial activity against a range of tropical parasites.

Well done!
The WSJ reported a day ago that if the Dems take over control of Congress they plan to investigate Republicans who went to work or lobby for drug interests. No limit on how far back they will go. I guess that means William Seward (Lincoln) and Harvey WIley (first FDA commissioner under TR) are fair game.

I think I have a good idea just who ever made this threat had in mind. Let's be clear: this is either settling personal scores or a way to shakedown the GOP leaning lobbying firms in DC to create jobs for Democrat types. As in, we will call off the dogs if you hire our friends. The Republicans did the same thing when Delay pressured lobbying firms to hire more GOPers. The D's are adding a new thuggist wrinkle to the game by using the congressional supeona power as a job search engine for their pals.
According to Mikhail Zurabov, the Russian Health and Social Protection Minister, the number of counterfeit drugs has "significantly" decreased, and now amounts to 3-4% of the Russian drug market. Mr. Zurabov relayed this information at a meeting with Russian President Vladimir Putin at the Kremlin earlier this week.

Most international organizations put the rate of counterfeits in the Russian health care system at 12%. Reducing this exposure to 3-4% is an exaggeration of truly Soviet agitprop proportions.

How did the Comrade Minister accomplish such a feat? Why he changed the law! (And we all know how much the Russian Mafia believes in the rule of law.)

Mr. Zurbov commented, "The penalties for such drugs has been defined and the decision was made to revoke the license of a company producing counterfeit drugs.”

That’s right, they reduced counterfeit medicines almost entirely by threatening to “revoke” the license of counterfeiters.

Surprisingly, the Minister neglected to mention the number of "licenses revoked," people arrested, or counterfeit medicines seized (and to reduce the Russion national volume from 12% to 3% there must have been quite a lot.) Maybe he's just really modest.

In any event, now that Russian drugs are so safe, maybe we should introduce legislation to allow importation into the US market.
I had the opportunity to be briefed by the chair and staff of the IOM committee responsible for the drug safety report that came out recently. I was pretty rough on the study when it first came out and was hoping that a second pass might lead me to a sunnier set of conclusions.

But the thrust of the IOM report -- increasing the amount of time and money the FDA spends on claims data from HMOs to search for safety signals in order to generate post market studies to seek out rare safety problems -- is simply asking for troubling instead of eliminating it in the first place. And worse, it smacks of self dealing: after all once the IOM group decided to have nothing to do with anyone who had expertise in the science of drug development it was left with people that had ties to HMOs and the CERTs who just happen to rely on the purchase of claims data and contracts for data dredging to form the "expert" panel.

And the idea of increasing the number of safety reviews and adding people from the Office of Drug Safety to "restore the balance" between efficacy and safety as IOM safety chair Sheila Burke stated is overkill. What is preclinical, Phase I and Phase II dosing studies but safety related research? Or am I missing something? Maybe Ms. Burke could point to some evidence apart from the so -called culture gap she kept on referring to in her meeting and in the report since it was not to be found.

Finally, the IOM folks claimed that they did not believe that their recommendations would slow down drug approvals in any way and that they were not responsible for the actions of members of Congress who used the IOM report to support their pet regulations....Fat chance. It is already happening.

Following on the heels of Senator Grassley and Congressman Waxman beating up on the FDA for using non-inferiority trials to approve antibiotics we now see the FDA rejecting two new antibiotics just after asking sponsors to provide data that they were as effective as existing drugs. Now the FDA is asking Replidyne for example to conduct four additional trials to demonstrate faropenem's superiority - compared to a placebo or existing drug right after the company had completed 11 late-stage clinical trials and a safety database of more than 5,000 patients. The additional research will take at least two years and require millions more.

The company said it was disappointed. What it was cannot be published on a family blog. And unfortunately it is a harbinger of what will happen when the folks from the Office of Drug Safety empowered and encouraged by Grassley et al make their way on to the committees reviewing drugs will be doing. Drug development, even in those areas where medicines are badly needed, will become more expensive and more time consuming. And why in the world would a company take the Critical Path seriously after a stunt like this?
No matter which party controls Congress, the effort to impose price controls (let's stop pretending that the government negotiates) on drug companies and money losing biotech firms (yes, most drug and biotech companies are not profitable) will be blocked by one the few people in Washington who gets it, President Bush:

October 22, 2006 -- "Who should be making decisions for consumers? Obviously, there's
a group of folks that feel like the government can do a better job than
the consumers themselves. We strongly believe that empowering
consumers is the appropriate way to promote quality in health care. As
a matter of fact, we will resist any changes to weaken the program."
- President Bush on Friday, urging Republican candidates
to talk up his administration's Medicare drug-benefit plan
If you want to know why people would whine about corporate sponsorship of breast cancer awareness and's the reason: they don't like the emphasis on pharmaceutical intervention. To them -- and by them I specifically mean the group Breast Cancer INAction headed up by Barbara Brenner, it's all about the environment.

Brenner had made some of the silliest and emptiest statements about breast cancer or any disease for that matter. Here are two:

"We have to keep in mind that with all of this 'light a candle,' that people are dying," Brenner of Breast Cancer Action explained.

"We have got to just stop throwing money at it. We have been throwing money at it since the early 1970s and we still have no answers.

And her she is on the campaign of linking a share of retail sales to breast cancer research: "I understand that people want to do something," she said. But "if shopping could cure breast cancer, it would be cured by now."

All of these gems pale in comparison to Brenner's claim that regular mammograms for women are actually dangerous and cause cancer.

“The benefit of routine mammograms for healthy premenopausal women is unproven,” Brenner’s group asserts in a Web page entitled “What You Should Know About Mammograms.”

This is a lie. The scientific consensus is that routine mammography -- until something better comes along (and it will) -- reduces the risk of dying of breast cancer in women 50 and older by up to 30 percent.

But here is what Brenner claims:

“Healthy premenopausal women should not have mammograms as a routine matter. The risk of radiation, combined with the high incidence of both false negatives and positives, means that routine mammography for premenopausal women may well do more harm than good,” Breast Cancer Action asserts.

Of course she leaves out the increase chance of survival due to new drugs. That's because Breast Cancer Action endorses the "Prevention First" principle. The group opposes reliance on drugs and stresses the right to safe water, air and food. It claims irrefutable proof that PCBs cause breast cancer. In fact there is no mechanistic or biological evidence and the body of epidemiology work -- including that which has been refined by genotype -- shows an association.

Hence Brenner and her group advise women to avoid mammograms and the medicines that can save their lives and instead ask them -- instead of shopping for products that might contribute to such activities -- to donate to their twisted and life denying movement.

Such a deal.

Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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