New drugs (part II)

25 Oct
2004

Kevin MD alerted me to this excellent discussion – Just because it’s new doesn’t mean it’s best

In September, the American Council for Continuing Medical Education issued new regulations ensuring that information transmitted in a format acceptable for CME credit is as free from commercial bias as possible.

So how can doctors protect their patients in this imperfect world?

* Remember that doctors, not industry, have the responsibility to make decisions in the best interests of patients.
* Consider information from the drug industry as advertising with inherent bias.
* Use the least expensive therapeutically equivalent drug.
* Be wary of industry gifts. Follow accepted national guidelines.
* Read the literature with critical judgment. Look at the disclosures of the authors. Read the best journals.
* Utilize practice guidelines issued by major national specialty societies.
* When possible, obtain information from sources that offer CME.

Using the above criteria, I suspect the answer to our question remains the same as the one common sense originally dictated — don’t switch.

As Malcolm Gladwell suggests in his piece which I cited on Friday, we physicians must take responsibility for our prescriptions. We can easily blame “Big Pharma”, but I believe that argument akin to blaming McDonald’s for ones obesity!

My frequent and often brilliant commentor – Roaring Remy – argued that Gladwell was a shill for Big Pharma. I argue that we physicians must stop blaming Big Pharma for the cost of drugs and take responsibility for practicing the best possible medicine at the lowest possible costs. Big Pharma cannot shower me with gifts – because I do not accept them. They cannot influence me at dinner meetings, because I refuse to attend.

I read the Medical Letter to get unbiased information about new drugs. I refuse to meet with drug reps (and have been know to insult them).

Big Pharma has a goal of making profits. I have no problem with that. I must take responsibility for my own drug decisions. Blaming them is disingenuous. Supply and demand works. They will lower prices if that would increase sales.

So I remain cautious of new drugs, unless the data overwhelmingly support their advantage. I sit on the sidelines using the “tried and true”, while awaiting the seemingly inevitable reports of side effects.

viagra
free viagra
buy viagra online
generic viagra
how does viagra work
cheap viagra
buy viagra
buy viagra online inurl
viagra 6 free samples
viagra online
viagra for women
viagra side effects
female viagra
natural viagra
online viagra
cheapest viagra prices
herbal viagra
alternative to viagra
buy generic viagra
purchase viagra online
free viagra without prescription
viagra attorneys
free viagra samples before buying
buy generic viagra cheap
viagra uk
generic viagra online
try viagra for free
generic viagra from india
fda approves viagra
free viagra sample
what is better viagra or levitra
discount generic viagra online
viagra cialis levitra
viagra dosage
viagra cheap
viagra on line
best price for viagra
free sample pack of viagra
viagra generic
viagra without prescription
discount viagra
gay viagra
mail order viagra
viagra inurl
generic viagra online paypal
generic viagra overnight
generic viagra online pharmacy
generic viagra uk
buy cheap viagra online uk
suppliers of viagra
how long does viagra last
viagra sex
generic viagra soft tabs
generic viagra 100mg
buy viagra onli
generic viagra online without prescription
viagra energy drink
cheapest uk supplier viagra
viagra cialis
generic viagra safe
viagra professional
viagra sales
viagra free trial pack
viagra lawyers
over the counter viagra
best price for generic viagra
viagra jokes
buying viagra
viagra samples
viagra sample
cialis
generic cialis
cheapest cialis
buy cialis online
buying generic cialis
cialis for order
what are the side effects of cialis
buy generic cialis
what is the generic name for cialis
cheap cialis
cialis online
buy cialis
cialis side effects
how long does cialis last
cialis forum
cialis lawyer ohio
cialis attorneys
cialis attorney columbus
cialis injury lawyer ohio
cialis injury attorney ohio
cialis injury lawyer columbus
prices cialis
cialis lawyers
viagra cialis levitra
cialis lawyer columbus
online generic cialis
daily cialis
cialis injury attorney columbus
cialis attorney ohio
cialis cost
cialis professional
cialis super active
how does cialis work
what does cialis look like
cialis drug
viagra cialis
cialis to buy new zealand
cialis without prescription
free cialis
cialis soft tabs
discount cialis
cialis generic
generic cialis from india
cheap cialis sale online
cialis daily
cialis reviews
cialis generico
how can i take cialis
cheap cialis si
cialis vs viagra
levitra
generic levitra
levitra attorneys
what is better viagra or levitra
viagra cialis levitra
levitra side effects
buy levitra
levitra online
levitra dangers
how does levitra work
levitra lawyers
what is the difference between levitra and viagra
levitra versus viagra
which works better viagra or levitra
buy levitra and overnight shipping
levitra vs viagra
canidan pharmacies levitra
how long does levitra last
viagra cialis levitra
levitra acheter
comprare levitra
levitra ohne rezept
levitra 20mg
levitra senza ricetta
cheapest generic levitra
levitra compra
cheap levitra
levitra overnight
levitra generika
levitra kaufen

Related posts:

  1. Drugs ads – Bristol-Myers Squibb shows caution
  2. The dark side of Sermo and Medscape physician connect
  3. An email and a response
  4. Do anti-pharmaceutical groups inhibit new HIV drugs?
  5. The media and prescription drugs

Related posts brought to you by Yet Another Related Posts Plugin.

4 Responses to New drugs (part II)

Avatar

RGL

October 25th, 2004 at 2:05 pm

Hats off to DB for his admirable attitude in evaluating new drugs and eschewing the corrupting influence of incessant drug detailing often masquerading as “medical education.” That is, unfortunately, not what we see in the real world. In that respect, Malcolm Gladwell was right in faulting physicians for not exercising better judgment about their prescribing practices (a point I don’t dispute), which is not to say Big Pharma should be free of blame.

The opinions rendered by Dr. Karatansky and Dr. Fleming are what we should expect – a balance of “economic concern, diagnostic elegance, and therapeutic parsimony.” I could not have expressed it any better.

With a few exceptions, the proliferation in the past two decades of “me-too” drugs should have alerted us to a self-evident truth: None of those drugs within a class is better than the others. Clincial trials leading to their production were all placebo-controlled, with none being tested against each other. The drug companies merely have to show that they are “effective,” not a stringent standard at all when they are promoting “superiority” of these new drugs.

Indeed, it’s important for physicians to be assiduous in acquiring their therapeutic information. The incestuous relationships among drug companies, medical centers, and medical experts (including authors) have become so pervasive that conflicts of interests have become commonplace, raising the question of bias on what is being fed to us. Hardly any CME meeting, as I previously observed, is held nowadays without sponsorship money from Big Pharma, or speakers with ties to the industry. Some medical journals bear that taint, too.

While I agree physicians need to exercise more prudence in prescribing drugs, the bigger burden still rests on the drug companies to make their products priced more reasonably. With as much money as they make, close to $40 billion yearly, that is not too much to ask for.

Avatar

Gary Anderson

October 26th, 2004 at 2:11 pm

I wonder what would happen if all physicians refused to see drug reps, even if it was only for a few days or weeks?

Avatar

RGL

October 26th, 2004 at 3:38 pm

Gary, please don’t tell John Kerry about that one week before the election. The army of the unemployed will get bigger. And that would be bad for the president.

Avatar

arf

October 26th, 2004 at 3:50 pm

Think of all those poor stickypad and novelty pen manufacturers you would put out of work.

Comment Form