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.