db's Medical Rants

Gimme an Rx! Cheerleaders Pep Up Drug Sales
As an ambitious college student, Cassie Napier had all the right moves – flips, tumbles, an ever-flashing America’s sweetheart smile – to prepare for her job after graduation. She became a drug saleswoman.
At game time, Onya cheers on the Washington Redskins. But she saves some of her energy [...]

Health Officials Hail Battle Against TB
Health officials hailed a global partnership against tuberculosis on Thursday that is providing developing countries with $70 million in investments and technology to help them produce low-cost drugs to fight the disease.
The project, led by the World Health Organization, pools the resources of drug companies, universities and international organizations to [...]

Big Drug Makers See Sales Decline With Their Image
The drug industry’s image problems are beginning to hurt pharmaceutical companies where it matters most – at the bottom line.
A year after Merck’s withdrawal of its arthritis medicine Vioxx led to an industrywide credibility crisis, the Food and Drug Administration is blocking new medicines that might previously [...]

Why are we taking so many pills?
That might not matter if there were no downside. But even as direct-to-consumer advertising has drummed up unprecedented demand for drugs, two defenders of America’s health – physicians and the Food and Drug Administration (FDA) – have let down their guard.
The result, he says, has been tragic, with unsafe [...]

1. I was asked if there is an existing generic statin. Lovastatin is available as a generic. It does seem to have inferior properties to simvastatin and atorvastatin.
2. My commenting friend – Chlorthalidone man – comments:
Don’t forget the “me too” drugs like ARBs. They work essentially the same way.
Of course even Medrants gets [...]

Medication costs are one problem (amongst many) which plague our current health care system. We (physicians) often look forward to the time when medications lost patent protection. Simvastatin (Zocor) loses protection very soon – Lipitor or Generic? Billion-Dollar Battle Looms
Starting next June, insurers and government agencies will have the opportunity to save billions [...]

Doctors can find cheap or free drugs for patients (Americal Medical News subscription required)
Many physicians are aware that hundreds of public and private programs throughout the U.S. offer free or discounted medications to patients with low incomes. Now several medical organizations and the nation’s drug industry are teaming up to let doctors know that they [...]

Roy Poses, over at Health Care Renewal, has written an outstanding piece on pharmaceutical costs – Most Drug Expenditures for “Me-Too” Drugs. Roy has written a wonderful important piece – please go read it.
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Tense? Lonely? There’s Promise in a Pill
In his hilarious stand-up routine, Chris Rock talks about the ubiquitous television drug commercials that “keep naming symptoms till they get one that” the viewer’s got. Sometimes, he says, the ads don’t even tell you what the pill does: “You see a lady on a horse or a man [...]

A reader writes a challenging comment – which includes this statement:
Dr. Avorn suffers from an aversion to letting patients and their physicians decide how their medications should be prescribed
I disagree greatly with that asssessment. As I read the entire article, I believe that Dr. Avorn wants stricter standards for drugs which have less clinical [...]

Jerry Avorn is one of the most important researchers of pharmaceuticals, their appropriate use and how to influence that use. He clearly understands the FDA, drug marketing and the problems of drug side effects.
This weeks’ NEJM features a perspective which he wrote on the FDA. This perspective is available without subscription – and [...]

I have previously written that I would like standard national pricing of drugs. Publish the wholesale prices for each drug – and then free markets could work. Free markets do not work, because the companies charge everyone something different. This example appears most egregious – California Accuses Drug Companies of Fraud
The suit [...]

Survey: Brand name drug prices rising
The analysis by the nation’s largest lobbying group for the elderly, AARP, measured the prices drug manufacturers charge wholesale distributors for 195 medicines many elderly patients use, including those to treat high cholesterol, high blood pressure, arthritis pain and osteoporosis.
Wholesalers then distribute medicines to pharmacies, who set their own prices [...]

Detailing, samples, prescribing, and outcomes
I don’t rely on drug reps or promotional material to keep current, nor should anyone. There’s no need. Present day information technology makes it unnecessary. We can easily get good quality unbiased information at the point of care. However, a sweeping prohibition against drug reps, samples and industry supported CME [...]

I wrote about this drug a couple of months ago – Natrecor – an interesting controversy. One of the main parties to that controversy, Eric Topol (a very well known cardiologist) has a “perspective” piece in yesterday’s NEJM. My friend, Roy Poses, has summarized the article and given the references, so rather than [...]

WOW! This is a new one for me. Study Links Parkinson’s Drug to Gambling
oe Neglia was a retired government intelligence worker with Parkinson’s disease when he suddenly developed what he calls a gambling habit from hell. After losing thousands of dollars playing slot machines near his California home several times a day for [...]

Senators Ask Drug Giant to Explain Grants to Doctors
The Senate Finance Committee yesterday began an inquiry into whether Johnson & Johnson used educational grants to promote the pediatric use of its former heartburn medication, Propulsid, even as internal company concerns mounted during the 1990’s about the drug’s safety in some children.
The inquiry follows a June [...]

A.M.A. to Study Effect of Marketing Drugs to Consumers
ADD another voice to the list of groups questioning how drugs are pitched to consumers.
The American Medical Association, the nation’s largest organization of physicians, agreed yesterday to study whether consumer drug advertising leads to unnecessary prescriptions, potentially harming patients and driving up health costs.
The A.M.A.’s decision, during [...]

From the LA Times – Wary, and weary, of drug ads
But at a time when the safety and cost of such medications have become hot-button political issues, politicians, patients and those who tend to the nation’s health are viewing these ads with a new wariness. The result is a simmering national debate over how, when [...]

A Self-Imposed Ban on Drug Ads
THE drug maker Bristol-Myers Squibb said yesterday that it had imposed a ban on advertising its new drugs to consumers in their first year on the market, adopting voluntary restrictions that go further than what is anticipated in an industrywide advertising code to be announced next month.
The company said it [...]

Dr. Centor:
To assert that DTC ads caused the market for Vioxx (or any other pharmaceutical) to expand greatly is simply puerile nonsense. The last I heard, physicians, for the most part, are the only medical professionals who retain the right to prescribe.
Any physician who prescribes a drug simply because a patient saw a DTC ad [...]

I received this email:
You equate tobacco ads with DTC ads for medicines for HIV, cancer, ADD, heart disease? Have you read the case law on the tobacco ad ban and the subsequent Supreme Court rulings that take note of the differences? You would ban these ads — which in some instances are [...]

I suspect that most bloggers would like to have an editorial published. Two weeks ago I received a phone call from USA today inviting me to write an opposing viewpoint. Since the topic was DTC drug advertising, I jumped at the chance. Today my thoughts appear in print!
Here is their argument in [...]

Lucrative Drug, Danger Signals and the F.D.A.
Dozens had died and more than 100 patients had suffered serious heart problems by March 1998 after taking Propulsid, a popular medicine for heartburn. Infants, given the drug to treat acid reflux, seemed particularly at risk. Federal officials told Propulsid’s manufacturer, Johnson & Johnson, that the drug might have [...]

I am writing an op-ed about DTC advertising. Please nominate an example of a DTC ad which really grates on you. My top two are Nexium and the old Vioxx ads (although Cialis, Levitra and Viagra also get on my nerves).
Thanks in advance for your help.
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Bernie’s back with some good thoughts. However, I fear it really is not as simple (nor cheap) as it appears. We will probably get to online publishing in the future – but the cost savings are not that impressive. We need independent review of research to help sort out the relative [...]

Drug Industry Is Said to Work on an Ad Code
The chief lobbyist for the pharmaceutical industry said Monday that drug companies were trying to develop a voluntary code of conduct for the advertising of prescription medicines on television and in print.
The lobbyist, Billy Tauzin, president of the Pharmaceutical Research and Manufacturers of America, said he [...]

Jonathan Sackner-Bernstein, an author of the Natrecor meta-analysis, took time to comment today. Please read his remarks.
Responses to “Natrecor – an interesting controversy”
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