Latest Drugwonks' Blog

The FDA has been pursuing the Critical Path Initiatve and developing a scientific foundation for personalized medicine with little money and lots of effort for nearly three years...as today's FDA Week notes:

"Deputy Commissioner for Operations Janet Woodcock said Monday FDA should not concern itself with determining which drug works better for a greater portion of the population. Instead, FDA needs to facilitate development of biomarkers that can tell physicians who will respond best to which drug. '

So you would think that the pols would pay attention to growing scientific evidence and support this trend and the Critical Path withh funding to promote the public health instead of underpowered one size fits all comparative effectiveness trials pushed by Tom Cruise Health Policy Scholar Marcia Angell

No such luck.

According to FDA Week...

"Rachel Sher, Waxman's health counsel, said Waxman believes federal funding should be allotted for comparative effectiveness studies, keeping in mind any studies by industry would be biased. "

Right and ALLHAT and CATIE were models of objectivity and have told us so much. Five years and $100s of millions of dollars later. Say goodbye to all new medicines.

Henry Waxman and Tom Cruise...perfect together.
We all know Tom Cruise "jumped the shark" when he jumped Oprah's couch in a demonstration of his love for Katie Holmes and started his one person tour disgrace against psychiatry. So now Tom is known for one note, unscientific attack on psychopharmacology and his effort to resurrect his career appears be Mission Impossible

Now meet Marcia Angell, the Tom Cruise of Health Care Policy. Ms. Angell's career had clearly jumped the shark with the publication of a poorly written and scientifically indefensible book "The Truth About Drug Companies" which had one main point: most drugs developed by pharmaceutical firms are just copycats that have no real clinical value to patients and those that do were developed by the government or academics without any biotech or pharmaceutical company input.

Now in the face of mechanistic evidence that different drugs in a therapeutic not only provide clinical benefit to different groups of people based on genetic variation but will be the foundation of drug development in the future, Angell persists in pushing her outdated and dangerous message. Thus, her uncomfortably silly letter in the New York Times this weekend.

To the Editor:

You refer to ''me too'' drugs as offering ''a merely incremental advance over some existing therapy,'' but there is no reason to think that they offer any advance at all.
In the clinical trials required for approval by the Food and Drug Administration, manufacturers do not have to compare ''me too'' drugs with old drugs in the same class, only with placebos.
For all we know, then, each new ''me too'' drug may be worse than existing ones. "

Yes, Marcia that's exactly what the body of clinical evidence shows. The first medicine developed was great and all the rest are incrementally worse than the next and actually make people sicker.

Does being a pathologist mean you are pathetic?

Gottleaves

  • 12.11.2006
News from today's Pink Sheet is that FDA Deputy Commissioner Scott Gottlieb will leave the agency in January. Bad news for the agency. But the good news is that Scott Unteathered will remain a potent force for the advancement of America's health through, we are sure, many important new endeavors.

The Big Muscle

  • 12.08.2006
On the same topic of “it’s all about the way you ask the question.” How do you think Americans would respond to these polling queries:

Q: Do you want the government to use its muscle to lower the price of gasoline?
Q: Do you want the government to use its muscle to lower the price of foreign imports?
Q: Do you want the government to use its muscle to lower the price of cars?
Q: Do you want the government to use its muscle to lower the price of meat?
Q: Do you want the government to use its muscle to lower the price of box seats at Yankee Stadium?

It’d be pretty easy to get an 85% “yes” rate to any of those questions – unless, per the last one, you’re a Red Sox fan.

So, rather than asking, as the Kaiser Family Foundation did, “Do you think the government should use its buying power to negotiate drug prices,” perhaps we should ask …

Q: Do you favor government price negotiations if it means you will not be able to receive the medicine your doctor has prescribed?

Q: Do you favor price negotiations if it means reducing investment in stem cell research and cures for cancer?

or ...

Q: Do you favor price negotiations even though the non-partisan GAO has reported that government price negotiations will not lower drug prices?

Field our own survey? Maybe we’ll do just that.

Kaiser Rolls

  • 12.08.2006
Expect stories this weekend in the MSM with headlines like "Americans support government price negotiations for Medicare."

That's going to be the talking point most reporters will swallow from the new poll by the Kaiser Family Foundation. Drugs from Canada too! Quelle surprise.

But here's the real story, buried at the end of the report:

When asked what overall message about the drug benefit they would "send to Washington," 12 percent of seniors said the benefit is working well and no real changes are needed, while 41 percent said it could be improved with some minor changes. Meanwhile, 28 percent said it's not working well and needs major changes. Ten percent said the program should be repealed.

Here's how I'd cume that: 53% say Part D needs some minor changes. 28% say "big changes." 10% say "ditch it."

But the "headline" finding of the report says that about 85 percent of seniors want to let the government use its buying power to negotiate drug prices, including 65 percent who said they strongly favor such negotiations.

It's all in the way you phrase the question.

Remember: Research is like a bikini. What it shows you is interesting, but what it conceals is essential.

Who do you think has the mandate?

And what do you think Robert Pear will write? Hmm.
When torcetrapib clinical trial results were presented to Pfizer chairman Jeff Kindler, he did not equivocate. Despite the financial implications, the trials were stopped immediately.

Tough choice? Yes. But, more importantly, principled choice.

The principle? Patient safety. And, as my father used to say, it’s not a principle unless it hurts to stand by it.

Bravo.

I must have missed the words of congratulations from the IOM, Senator Grassley, and Sidney Wolfe.
Patrick Clinton, of Pharmaceutical Executive Magazine, reminds us of the following old joke -- A patient goes to the doctor and learns he needs surgery that will cost $10,000. "I can't pay it, Doc," he says. "That's OK," responds the doctor. "For a hundred bucks I can retouch your X-rays.

Fantasy or Evidence-based Medicine? You make the call.

Clinton uses this joke as a lead-in to an excellent opinion piece on AWP (Average Wholesale Price) and Medicare. He says what he means and it’s a worthwhile read.

Here’s the link:

http://www.pharmexec.com/pharmexec/article/articleDetail.jsp?id=382530

And here's the background: In the US District Court for the District of Massachusetts, Judge Patti Saris is hearing MDL 1456, a multi-jurisdiction case that charges 42 pharmaceutical companies (and likely more to come) with violating various RICO and deceptive-trade-practice acts by artificially inflating the Average Wholesale Price (AWP) they reported to Medicare.

Enjoy.
With all the self-indulgent holds removed, Andy von Eschenbach finally gets confirmed. If Andy's defense of the integrity of the scientific process and the FDA during the last Grassley contretremps is a signal of what we are in for, it suggests that he see his ultimate responsibility to the employees of the agency, to patients and the scientific community. And it suggests that he will seek to generate more respect for the scientific enterprise that undergirds FDA's activities and transformation. Finally, the FDA will have someone who can set an intelligent and responsible course for the future, one that integrates the Critical Path with post market safety concerns, something that neither Congress or the IOM panel seems interested in or capable of.

EU Tube

  • 12.08.2006
Just got back from two very stimulating events. One was in Brussels, the other in Stockholm. Both were launch events for "Coincidence or Crisis," our new book on the issue of counterfeit medicines.

The Brussels event, as you might suppose, was attended by many NGOs, EU commission members, WIPO, government representatives from around the world (Cyprus, the US, Lithuania, etc.), the EAEPC (the association of parallel traders), members of the euro-press (Le Figaro, Le Soir, the Daily Mail etc.), and Bill Newton Dunn, MEP (Member of the European Parliament). Mr. Dunn also contributed an introduction to "Coincidence or Crisis" along with Congressman Mark Souder. The counterfeiting of prescription medicines is, after all, a global problem.

The Stockholm event took a different direction, attended by the media too, but also by members of the Swedish medical media, Swedish regulators, pharmacists, and patient groups. Mr. Finn Bengtsson, a member of the Swedish parliament and a professor of pharmacology also spoke at the event -- and promised to raise this issue within the government.

Here is one of the media reports of the Stockholm event:

http://www2.unt.se/avd2/1,3908,MC=3-AV_ID=558953,00.html

And, as always, more information on the issue of counterfeit drugs, as well as on "Coincidence or Crisis" can be found at http://www.cmpi.org.

Why is the book called "Coincidence or Crisis" -- because there is no such thing as a coincidence.

It's von-derful

  • 12.07.2006
That's Commissioner von Eschnebach, folks.

And it's about time.

We here at drugwonks.com certainly hope that the out-to-sea Ocean 11 senators who voted "nay" got the message that the American public wants action on real 21st century FDA reform -- and not just politicking as usual.
CMPI

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.

Blog Roll

Alliance for Patient Access Alternative Health Practice
AHRP
Better Health
BigGovHealth
Biotech Blog
BrandweekNRX
CA Medicine man
Cafe Pharma
Campaign for Modern Medicines
Carlat Psychiatry Blog
Clinical Psychology and Psychiatry: A Closer Look
Conservative's Forum
Club For Growth
CNEhealth.org
Diabetes Mine
Disruptive Women
Doctors For Patient Care
Dr. Gov
Drug Channels
DTC Perspectives
eDrugSearch
Envisioning 2.0
EyeOnFDA
FDA Law Blog
Fierce Pharma
fightingdiseases.org
Fresh Air Fund
Furious Seasons
Gooznews
Gel Health News
Hands Off My Health
Health Business Blog
Health Care BS
Health Care for All
Healthy Skepticism
Hooked: Ethics, Medicine, and Pharma
Hugh Hewitt
IgniteBlog
In the Pipeline
In Vivo
Instapundit
Internet Drug News
Jaz'd Healthcare
Jaz'd Pharmaceutical Industry
Jim Edwards' NRx
Kaus Files
KevinMD
Laffer Health Care Report
Little Green Footballs
Med Buzz
Media Research Center
Medrants
More than Medicine
National Review
Neuroethics & Law
Newsbusters
Nurses For Reform
Nurses For Reform Blog
Opinion Journal
Orange Book
PAL
Peter Rost
Pharm Aid
Pharma Blog Review
Pharma Blogsphere
Pharma Marketing Blog
Pharmablogger
Pharmacology Corner
Pharmagossip
Pharmamotion
Pharmalot
Pharmaceutical Business Review
Piper Report
Polipundit
Powerline
Prescription for a Cure
Public Plan Facts
Quackwatch
Real Clear Politics
Remedyhealthcare
Shark Report
Shearlings Got Plowed
StateHouseCall.org
Taking Back America
Terra Sigillata
The Cycle
The Catalyst
The Lonely Conservative
TortsProf
Town Hall
Washington Monthly
World of DTC Marketing
WSJ Health Blog