Latest Drugwonks' Blog
Medical schools train doctors to resist marketers' siren songs
The Associated Press By David B. Caruso
2 November 2006
NEW YORK (AP) - Medical schools in several states are strengthening programs that warn doctors and students not to be dazzled by drug company marketing practices.
DRUGWONKS TRANSLATION: Put on these sunglasses and place a wreath of garlic cloves in all examination rooms.
The Mount Sinai School of Medicine announced Wednesday that it would use a $400,000 grant to remind doctors to question sophisticated sales presentations and rely on solid science when deciding which medications to give patients.
DRUGWONKS TRANSLATION: So tell me, is your new product really more effective? Wow – did you see that shot! These are great seats.
The program is one of five receiving $1.9 million from the Attorney General Consumer and Prescriber Education Grant Program, which has awarded $11 million to 28 institutions interested in cautioning health care workers about pharmaceutical sales techniques.
DRUGWONKS TRANSLATION: Pharmaceutical sales representatives are really minions of Satan.
The Center for Evidence Based Policy at Oregon Health & Science University administers the grants.
DRUGWONKS TRANSLATION: When it comes to “evidence-based policy†we don’t really need evidence – and if you don’t agree you can give us back the check. That’s our policy.
One of the programs being implemented at Mount Sinai will be a new type of class at its Morchand Education Center, famous for training exercises in which actors play patients. For these new sessions, though, the actors will be playing pharmaceutical company sales representatives.
DRUGWONKS TRANSLATION: STELLAAAAA!!!!!!
Another part of Mount Sinai's program will advise health care providers how to tactfully deal with patients who see a drug on television and demand a prescription.
DRUGWONKS TRANSLATION: Hey – did you go to medical school too?
Money for the education programs comes from a $430 million settlement that resolved charges that pharmaceutical giant Pfizer Inc. illegally paid doctors to prescribe its drug Neurontin for uses that had not been approved by the U.S. Food and Drug Administration.
DRUGWONKS TRANSLATION: Providing better medical education is Job One. Actually, that’s wrong, sorry – demonizing the pharmaceutical industry is Job One. My bad.
The next $6.5 million in grants will be used to inform consumers on how drugs are prescribed and marketed, said the Center for Evidence Based Policy
DRUGWONKS TRANSLATION: And the third traunch will be used to fund a program on better health outcomes through collective farming.
The Associated Press By David B. Caruso
2 November 2006
NEW YORK (AP) - Medical schools in several states are strengthening programs that warn doctors and students not to be dazzled by drug company marketing practices.
DRUGWONKS TRANSLATION: Put on these sunglasses and place a wreath of garlic cloves in all examination rooms.
The Mount Sinai School of Medicine announced Wednesday that it would use a $400,000 grant to remind doctors to question sophisticated sales presentations and rely on solid science when deciding which medications to give patients.
DRUGWONKS TRANSLATION: So tell me, is your new product really more effective? Wow – did you see that shot! These are great seats.
The program is one of five receiving $1.9 million from the Attorney General Consumer and Prescriber Education Grant Program, which has awarded $11 million to 28 institutions interested in cautioning health care workers about pharmaceutical sales techniques.
DRUGWONKS TRANSLATION: Pharmaceutical sales representatives are really minions of Satan.
The Center for Evidence Based Policy at Oregon Health & Science University administers the grants.
DRUGWONKS TRANSLATION: When it comes to “evidence-based policy†we don’t really need evidence – and if you don’t agree you can give us back the check. That’s our policy.
One of the programs being implemented at Mount Sinai will be a new type of class at its Morchand Education Center, famous for training exercises in which actors play patients. For these new sessions, though, the actors will be playing pharmaceutical company sales representatives.
DRUGWONKS TRANSLATION: STELLAAAAA!!!!!!
Another part of Mount Sinai's program will advise health care providers how to tactfully deal with patients who see a drug on television and demand a prescription.
DRUGWONKS TRANSLATION: Hey – did you go to medical school too?
Money for the education programs comes from a $430 million settlement that resolved charges that pharmaceutical giant Pfizer Inc. illegally paid doctors to prescribe its drug Neurontin for uses that had not been approved by the U.S. Food and Drug Administration.
DRUGWONKS TRANSLATION: Providing better medical education is Job One. Actually, that’s wrong, sorry – demonizing the pharmaceutical industry is Job One. My bad.
The next $6.5 million in grants will be used to inform consumers on how drugs are prescribed and marketed, said the Center for Evidence Based Policy
DRUGWONKS TRANSLATION: And the third traunch will be used to fund a program on better health outcomes through collective farming.
The Families USA report claims to demonstrate that fewer seniors will have to stand alone drug plans that offer meaningful coverage through the doughnut hole. In fact, the report either deliberately ignores or fails to acknowledge a fundamental shift in the design of stand-alone plans for 2007. Namely, lower out of pocket spending for a larger number of medicines for seniors. And the number of plans who offer such an approach has actually doubled from last year.
Most plans actually fill the doughnut hole and eliminate the coverage gap before it even starts by encouraging seniors to use generic medicines instead of brand drugs when available. In turn, most plans have added more drugs to their formularies and kept co-pays for newer medicines low. As a result, more seniors – most of whom never had drug coverage before – will have a wider choice of drugs and lower out of pocket expenses.
Ironically, for all its concern about providing seniors with meaningful doughnut hole coverage the FUSA proposal to use the VA system of price controls and drug formularies would create another kind of drug donught hole. It would create a gap in essential medicines. Only 38% of the drugs approved in the 1990s, and 19% of the drugs approved by the FDA since 2000, are on the VA National Formulary. Only 22% (17) of the 77 priority-review drugs approved since 1997 are on the 2005 National Formulary. By comparison, 100 percent of both types of FDA approved medicines are on the AARP Medicare formulary.
Most plans actually fill the doughnut hole and eliminate the coverage gap before it even starts by encouraging seniors to use generic medicines instead of brand drugs when available. In turn, most plans have added more drugs to their formularies and kept co-pays for newer medicines low. As a result, more seniors – most of whom never had drug coverage before – will have a wider choice of drugs and lower out of pocket expenses.
Ironically, for all its concern about providing seniors with meaningful doughnut hole coverage the FUSA proposal to use the VA system of price controls and drug formularies would create another kind of drug donught hole. It would create a gap in essential medicines. Only 38% of the drugs approved in the 1990s, and 19% of the drugs approved by the FDA since 2000, are on the VA National Formulary. Only 22% (17) of the 77 priority-review drugs approved since 1997 are on the 2005 National Formulary. By comparison, 100 percent of both types of FDA approved medicines are on the AARP Medicare formulary.
The Washington Post gets it.
Big Time.
And just in time.
Here's the first paragraph of an editorial from today's paper:
An Election on Drugs
The Democrats oversell a Medicare solution.
Thursday, November 2, 2006; Page A16
ONE OF the Democrats' election talking points is a promise to revamp the Medicare prescription drug benefit. They paint the 2003 legislation as a sellout to pharmaceutical firms: Rather than having Medicare officials use the government's bargaining power to keep drug prices down, the law left the job of negotiating prices to private insurers. The Medicare drug benefit has actually turned out to be cheaper than projected, and most beneficiaries say they are satisfied with it. But the House Democratic leader, Nancy Pelosi (Calif.), nonetheless accuses Republicans of "putting pharmaceutical companies and HMOs first at the expense of America's seniors."
And here's the last graph:
It's fair to object that consumers may not be equipped to make smart decisions; the market signals they send may reflect the success of gauzy drug commercials rather than clinical evidence. The attraction of the market-based model depends on consumers being guided more by science-based Web sites created by universities or other groups. It's an open question whether consumers, led perhaps by their insurers, will learn to make sophisticated drug choices, but the fact that Medicare patients already buy more generic medications than other Americans is an encouraging sign of the capacity for smart purchasing. A switch to government purchasing of Medicare drugs would choke off this experiment before it had a chance to play out, and it would usher in its own problems. For the moment, the Democrats would do better to invest their health-care energy elsewhere.
To read the entire editorial, go to http://www.washingtonpost.com
Will someone with Nancy Pelosi's e-mail address please forward this article to her office ASAP.
Big Time.
And just in time.
Here's the first paragraph of an editorial from today's paper:
An Election on Drugs
The Democrats oversell a Medicare solution.
Thursday, November 2, 2006; Page A16
ONE OF the Democrats' election talking points is a promise to revamp the Medicare prescription drug benefit. They paint the 2003 legislation as a sellout to pharmaceutical firms: Rather than having Medicare officials use the government's bargaining power to keep drug prices down, the law left the job of negotiating prices to private insurers. The Medicare drug benefit has actually turned out to be cheaper than projected, and most beneficiaries say they are satisfied with it. But the House Democratic leader, Nancy Pelosi (Calif.), nonetheless accuses Republicans of "putting pharmaceutical companies and HMOs first at the expense of America's seniors."
And here's the last graph:
It's fair to object that consumers may not be equipped to make smart decisions; the market signals they send may reflect the success of gauzy drug commercials rather than clinical evidence. The attraction of the market-based model depends on consumers being guided more by science-based Web sites created by universities or other groups. It's an open question whether consumers, led perhaps by their insurers, will learn to make sophisticated drug choices, but the fact that Medicare patients already buy more generic medications than other Americans is an encouraging sign of the capacity for smart purchasing. A switch to government purchasing of Medicare drugs would choke off this experiment before it had a chance to play out, and it would usher in its own problems. For the moment, the Democrats would do better to invest their health-care energy elsewhere.
To read the entire editorial, go to http://www.washingtonpost.com
Will someone with Nancy Pelosi's e-mail address please forward this article to her office ASAP.
I find it incredible that the media slams drug companies for marketing medicines that undergo years of rigorous clinical testing yet fail to investigate schlockmeister's like Kevin Trudeau or the most recent peddler of pharmaceutical porn, Joseph Mercola. Mercola is supposedly an osteopath who has a book entitled the Great Bird Flu Hoax on the NY Times Best seller list. The book claims that world wide concern about avian flu was concocted to gin up huge profits for companies that Rumsfeld and Cheney had ties to. I guess that means the WHO and UN were also on the take but no matter.
Ironically, the way Mercola got the book onto the best seller list was by getting people to preorder the book in massive enough quantities to qualify as a best seller. You might say that's a way of manufacturing a hoax to generate massive profits as well but perhaps that is too fine a distinction.
In fairness to Mercola, some of the products he peddles -- krill oil tablets -- have a modicum of clinical research to support claims that they help reduce cholesterol or alleviate PMS. But he hypes them endlessly, asserting without substantial evidence beyond smaller clinical studies that products such as coconut oil or krill oil can prevent infections, arthritis, etc. And he promotes a study claiming that neptune krill oil "alleviate symptoms caused by rheumatoid arthritis and osteoarthritis, including joint pain, stiffness and functional impairment and significantly inhibit inflammation as shown by a decrease in C-Reactive Protein (CRP) -- a biomarker for inflammation." There is no such study in the medical literature...
Mercola has also been cited by the FDA on a couple of occasions for making medical claims for products without any evidence.
All the while he flogs drugs and vaccines as dangerous and deadly, using newspaper accounts for he source material.
Despite overwhelming evidence that mercury does not cause neurological damage he continues to whip up conspiracy sentiment that it does. And now, though scientific evidence overwhelmingly demonstrates that aspartame is extremely safe for the vast majority of consumers, Mercola is about to come out with a book called "Sweet Deception" that -- of course -- will conclude that the government and corporations colludes to cover up the TRUTH about artificial sweeteners and the mind numbering and cancer causing effects they have.
And of course Mercola will have a NY Times best seller ready to be pre-sold.
Along with a sugar alternative that he will be hawking as well.
Sometimes coincidences are sweet too.
Ironically, the way Mercola got the book onto the best seller list was by getting people to preorder the book in massive enough quantities to qualify as a best seller. You might say that's a way of manufacturing a hoax to generate massive profits as well but perhaps that is too fine a distinction.
In fairness to Mercola, some of the products he peddles -- krill oil tablets -- have a modicum of clinical research to support claims that they help reduce cholesterol or alleviate PMS. But he hypes them endlessly, asserting without substantial evidence beyond smaller clinical studies that products such as coconut oil or krill oil can prevent infections, arthritis, etc. And he promotes a study claiming that neptune krill oil "alleviate symptoms caused by rheumatoid arthritis and osteoarthritis, including joint pain, stiffness and functional impairment and significantly inhibit inflammation as shown by a decrease in C-Reactive Protein (CRP) -- a biomarker for inflammation." There is no such study in the medical literature...
Mercola has also been cited by the FDA on a couple of occasions for making medical claims for products without any evidence.
All the while he flogs drugs and vaccines as dangerous and deadly, using newspaper accounts for he source material.
Despite overwhelming evidence that mercury does not cause neurological damage he continues to whip up conspiracy sentiment that it does. And now, though scientific evidence overwhelmingly demonstrates that aspartame is extremely safe for the vast majority of consumers, Mercola is about to come out with a book called "Sweet Deception" that -- of course -- will conclude that the government and corporations colludes to cover up the TRUTH about artificial sweeteners and the mind numbering and cancer causing effects they have.
And of course Mercola will have a NY Times best seller ready to be pre-sold.
Along with a sugar alternative that he will be hawking as well.
Sometimes coincidences are sweet too.
Here is the official response to my article in the Daily News. It does not address the substance of my concerns: that Breast Cancer Action discourages women from obtaining mammograms and from using medicines that can actually treat breast cancer when detecting and instead urges women to wait till we identify and eliminate every evironmental toxin that in the judgement of Breast Cancer Action causes breast cancer to get well....
http://www.nydailynews.com/news/ideas_opinions/story/466935p-392909c.html
Cancer research
San Francisco: Robert Goldberg's Op-Ed, "End sick crusade against breast cancer research" (Oct. 29), was full of factual errors. It also mischaracterized Breast Cancer Action and our 16 years of supporting the voices of those affected by the disease. We encourage pink-ribbon consumers to get informed, provide women with the facts so they can make informed choices about their health and organize people to do something about breast cancer besides worry. We also call for research to focus on key unanswered questions about breast cancer. We value transparency and are highly regarded in the cancer world, Goldberg's diatribe notwithstanding.
Barbara A. Brenner Executive Director
http://www.nydailynews.com/news/ideas_opinions/story/466935p-392909c.html
Cancer research
San Francisco: Robert Goldberg's Op-Ed, "End sick crusade against breast cancer research" (Oct. 29), was full of factual errors. It also mischaracterized Breast Cancer Action and our 16 years of supporting the voices of those affected by the disease. We encourage pink-ribbon consumers to get informed, provide women with the facts so they can make informed choices about their health and organize people to do something about breast cancer besides worry. We also call for research to focus on key unanswered questions about breast cancer. We value transparency and are highly regarded in the cancer world, Goldberg's diatribe notwithstanding.
Barbara A. Brenner Executive Director
Should Representative Pelosi become Speaker Pelosi we can almost certainly expect another round of absurdity surrounding the issue of drugs "from Canada." (Again and as always, please note the quotation marks.)
I had dinner last night with some Canadian policy wonks who are very concerned about the sanctity of their own legitimate supply of pharmaceuticals -- and rightly so. Legalized importation would create a giant sucking sound, the end result being the Great White North being drug-free -- and not in a good way.
There is, at present at least one private member's bill that I know of in Ottawa that would ban bulk exports of pharmaceuticals to the US (thus making it illegal for whole states -- like California and Illinois -- and programs -- like Part D -- to source their medicines supply from Canada). But it's an opposition member and not likely to go anywhere.
Prime Minister Harper had better wake up to the reality that, should Mrs. Pelosi's 100 Hour Reign of Terror become reality it won't be "Just say no to drugs," it'll be "Just say no drugs."
Oh Canada!
I had dinner last night with some Canadian policy wonks who are very concerned about the sanctity of their own legitimate supply of pharmaceuticals -- and rightly so. Legalized importation would create a giant sucking sound, the end result being the Great White North being drug-free -- and not in a good way.
There is, at present at least one private member's bill that I know of in Ottawa that would ban bulk exports of pharmaceuticals to the US (thus making it illegal for whole states -- like California and Illinois -- and programs -- like Part D -- to source their medicines supply from Canada). But it's an opposition member and not likely to go anywhere.
Prime Minister Harper had better wake up to the reality that, should Mrs. Pelosi's 100 Hour Reign of Terror become reality it won't be "Just say no to drugs," it'll be "Just say no drugs."
Oh Canada!
Here's a link to my commentary in Commentary on Peter Huber's article "Of Pills and Profits: In Defense of Big Pharma." (Peter's excellent article can be accessed via the Manhattan Institute website: http://www.manhattan-institute.org
Click below and please let me know your thoughts and comments.
http://www.cmpi.org/viewstddoccontent.asp?detailid=181&contenttypeid=2
Click below and please let me know your thoughts and comments.
http://www.cmpi.org/viewstddoccontent.asp?detailid=181&contenttypeid=2
I have a son in the Israeli army. He deferred attending George Washington U (with a scholarship) to do so. John Kerry's remark might have been targeted at Bush in his own mind but his reference point was a stereotype of why people join the military. His comments reflect the elitism and hollow intellect of many in his party. They impugn those who voluntarily perform military service because they believe that supporting a democracy in a war against terror is a just and noble purpose.
Similarly, I believe that Democrats -- until proven otherwise -- are a danger to medical innovation. (Not that they won't have the help of some Republicans). Quick to invoke the stereotype that any involvement with corporations stink, their very rhetoric demoralizes and discourages those who engage in research because they care and hope to cure. And their actions -- as I blogged on the exodus of NIH scientists -- based on that rhetoric has consequences.
Talk is not cheap. Talk imposes a heavy cost on those who actually seek a newer and brighter world. I thought politicians were supposed to empower those with such intentions instead of embarassing and attacking them.
Similarly, I believe that Democrats -- until proven otherwise -- are a danger to medical innovation. (Not that they won't have the help of some Republicans). Quick to invoke the stereotype that any involvement with corporations stink, their very rhetoric demoralizes and discourages those who engage in research because they care and hope to cure. And their actions -- as I blogged on the exodus of NIH scientists -- based on that rhetoric has consequences.
Talk is not cheap. Talk imposes a heavy cost on those who actually seek a newer and brighter world. I thought politicians were supposed to empower those with such intentions instead of embarassing and attacking them.
The biggest savings in the Democrats' plan would be a pledge to give the federal government the authority to negotiate lower drug prices for Medicare. Sen. Edward M. Kennedy (D-Mass.) and Rep. Henry A. Waxman (D-Calif.) have estimated that Medicare could save $190 billion over the next decade if the seniors' program adopted the price-negotiating model of the Department of Veterans Affairs.
Let's translate: "The price negotiating model" is the one 40 percent of veterans want to LEAVE but can't, robs seniors of half the drugs now they choose from, forces them to buy from government run pharmacies, and denies them access to 90 percent of the 80 or more drugs the FDA gave priority approval to since 1997. Oh, and the whole process shortens the lives of seniors.
If seniors want many of the medicines they now depend on for their health, they will have to pay for them out of pocket to the tune of billions of dollars a year. And the loss of profits -- yes profits -- over ten years will hurt biotech firms and their investments, reducing the number of new medicines for fatal and degenerative illnesses by 50 percent.
Let's translate: "The price negotiating model" is the one 40 percent of veterans want to LEAVE but can't, robs seniors of half the drugs now they choose from, forces them to buy from government run pharmacies, and denies them access to 90 percent of the 80 or more drugs the FDA gave priority approval to since 1997. Oh, and the whole process shortens the lives of seniors.
If seniors want many of the medicines they now depend on for their health, they will have to pay for them out of pocket to the tune of billions of dollars a year. And the loss of profits -- yes profits -- over ten years will hurt biotech firms and their investments, reducing the number of new medicines for fatal and degenerative illnesses by 50 percent.
Research, as the saying goes, is like a bikini. What it shows you is interesting – but what it conceals is essential.
Today’s case-in-point is a new study by AHRQ. The headline on the UPI wire is “Study: Brand-name drugs fuel cost increase."
The lede graph reads as follows:
WASHINGTON, Oct. 31 (UPI) -- U.S. brand-name drug spending helped fuel a doubling of spending on outpatient prescription drugs from 1999 to 2003, a new study says. During those years, total consumer spending on drugs purchased outside of hospitals increased to $178 billion per year, according to a new report by Health and Human Services' Agency for Healthcare Research and Quality.
Interesting numbers, big numbers – but without any real context. For example, what percentage of that spend is for medicines not previously available? What’s the breakdown between new and existing scripts? How does that increase corelate to reduced costs in, for example, hospitalization?
And what about improved patient outcomes?
Minus these important variables, all this new report will do is aid and abet the Evangelists of Evidence-Based Medicine and fuel the fire of those pundits and politicians for whom the crisis in American health care can be simplistically summed in the four words, “drugs are too expensive.â€
Today’s case-in-point is a new study by AHRQ. The headline on the UPI wire is “Study: Brand-name drugs fuel cost increase."
The lede graph reads as follows:
WASHINGTON, Oct. 31 (UPI) -- U.S. brand-name drug spending helped fuel a doubling of spending on outpatient prescription drugs from 1999 to 2003, a new study says. During those years, total consumer spending on drugs purchased outside of hospitals increased to $178 billion per year, according to a new report by Health and Human Services' Agency for Healthcare Research and Quality.
Interesting numbers, big numbers – but without any real context. For example, what percentage of that spend is for medicines not previously available? What’s the breakdown between new and existing scripts? How does that increase corelate to reduced costs in, for example, hospitalization?
And what about improved patient outcomes?
Minus these important variables, all this new report will do is aid and abet the Evangelists of Evidence-Based Medicine and fuel the fire of those pundits and politicians for whom the crisis in American health care can be simplistically summed in the four words, “drugs are too expensive.â€
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.
