As we start the countdown to a new decade, I have a question for you: why doesn't the US media run comprehensive stories like this piece in The Guardian about our youth's dangerous dependence on prescription drugs? Sure, there were a few short news stories noting that a plethora of legal drugs had been found in the bedroom of Brittany Murphy, the 32-year-old actress found dead in her home last week. But the mainstream media here seems averse to putting the pieces together, as The Guardian did, not only by pointing out that "prescription drugs are becoming America's new addiction," but examining why that is so.
Sure, a few bloggers (myself included) have tackled the subject. But as one of only two nations in the developed world that allow the pharmaceutical industry to advertise directly to consumers, perhaps it's time to more widely re-examine our cavalier approach to popping pills. Brittany Murphy's untimely death is one more poignant example of the truism: just because a doctor prescribes something does not mean it is safe, particularly when taken in combination with other powerful drugs. As one professor of clinical pharmacology noted in The Guardian piece: "Many of these people simply do not realize that all drugs – no matter how beneficial – are poisonous at some level."
On another note, I'm taking a short break from blogging. Will be back Jan. 11.
Monday, December 28, 2009
Monday, December 21, 2009
Christmas comes early for 3,700 US doctors on GlaxoSmithKline's payroll
GlaxoSmithKline became the third pharmaceutical giant to start disclosing all the speaking and consulting payments it makes to US doctors, and its list is an eye-popping illustration of the rampant corruption that runs through our current system of medical research. While the majority of the doctors on Glaxo's payroll, which covers a mere three months in the second quarter of 2009, received between $1,000 and $6,000 for speaking gigs, 134 doctors netted payments of $15,000 or more, and a goodly number received very handsome payouts indeed. (In all, GSK paid out a princely sum of $14.6 million to 3,700 doctors in just three months; one can only wonder how much they dispensed for the entire year).
The highest-paid doctor on this list is Dr. Lawrence DuBuske, a clinical instructor in medicine at Harvard Medical School and director of the Immunology Research Institute of New England. DuBuske specializes in allergies and works with medical researchers throughout Eastern Europe on clinical studies of new allergy drugs. He received a whopping $99,375 from GSK in the second quarter of 2009.
For what, you might ask? That's a question better put to DuBuske, but I can tell you that a quick scrutiny of journal articles published this past year reveals that he was the lead author of a review article published in March 2009 in a respected medical journal (Current Allergy and Asthma Reports), which extolled the effectiveness of several drugs for the treatment of allergic rhinitis (the running nose and other bothersome symptoms that occur when you breathe in something you're allergic to).
Surprise, surprise, one of the drugs given an enthusiastic thumb's up in this review is Xyzal, an antihistamine made by GlaxoSmithKline. The other two are drugs made by Schering-Plough (now owned by Merck) and Sanofi-Aventis. And sure enough, DuBuske is not only on Glaxo's speaker bureau; he is also getting speaking bucks from Schering-Plough, Merck and Sanofi-Aventis. Indeed, as the disclosures in his March review indicate, DuBuske is basically on the speaking payroll of every pharmaceutical company that makes or markets allergy drugs in this country.
Gee, I wonder what Harvard Medical School or Brigham & Women's Hospital, where DuBuske is coordinator of the allergy fellowship program and a consultant, have to say about the good doctor's conflicts of interest.
Here's another example of the way Big Pharma has corrupted the way doctors get their information about new drugs: Another well-paid physician on GSK's stocking list this year was Dr. Timothy Beard, a general surgeon and director of research for Bend Memorial Clinic in Bend, Oregon. Beard received $61,380 from GSK in the second quarter of 2009 (and he's not even one of the five highest paid). As a quick Google search reveals, Dr. Beard has done clinical research on a drug called ENTEREG, made by GlaxoSmithKline, and in August 2009, he gave a presentation to the annual meeting of the Northwest Society of Colon and Rectal surgeons about how well ENTEREG works in aiding the recovery of patients who have had bowel resection surgery. Not a bad day's work for $61,380.
Now, as an unpaid blogger, I only had time to connect a few dots, but I have a feeling there is much more to be gleaned from the treasure trove of doctor payments that Glaxo and other drug companies are now disclosing (in anticipation that Congress, as part of health reform, will pass the Physician Payment Sunshine Act and require such disclosures in the future). So I hope that some of the journalists who get paid to do this will take a closer look at more of the happy beneficiaries of the pharmaceutical industry's largesse.
In the meantime, take a minute and check to see if your doctor is on Glaxo's Christmas list. Ho ho ho.
Hat tip to Pharmalot for alerting me to the GSK list.
The highest-paid doctor on this list is Dr. Lawrence DuBuske, a clinical instructor in medicine at Harvard Medical School and director of the Immunology Research Institute of New England. DuBuske specializes in allergies and works with medical researchers throughout Eastern Europe on clinical studies of new allergy drugs. He received a whopping $99,375 from GSK in the second quarter of 2009.
For what, you might ask? That's a question better put to DuBuske, but I can tell you that a quick scrutiny of journal articles published this past year reveals that he was the lead author of a review article published in March 2009 in a respected medical journal (Current Allergy and Asthma Reports), which extolled the effectiveness of several drugs for the treatment of allergic rhinitis (the running nose and other bothersome symptoms that occur when you breathe in something you're allergic to).
Surprise, surprise, one of the drugs given an enthusiastic thumb's up in this review is Xyzal, an antihistamine made by GlaxoSmithKline. The other two are drugs made by Schering-Plough (now owned by Merck) and Sanofi-Aventis. And sure enough, DuBuske is not only on Glaxo's speaker bureau; he is also getting speaking bucks from Schering-Plough, Merck and Sanofi-Aventis. Indeed, as the disclosures in his March review indicate, DuBuske is basically on the speaking payroll of every pharmaceutical company that makes or markets allergy drugs in this country.
Gee, I wonder what Harvard Medical School or Brigham & Women's Hospital, where DuBuske is coordinator of the allergy fellowship program and a consultant, have to say about the good doctor's conflicts of interest.
Here's another example of the way Big Pharma has corrupted the way doctors get their information about new drugs: Another well-paid physician on GSK's stocking list this year was Dr. Timothy Beard, a general surgeon and director of research for Bend Memorial Clinic in Bend, Oregon. Beard received $61,380 from GSK in the second quarter of 2009 (and he's not even one of the five highest paid). As a quick Google search reveals, Dr. Beard has done clinical research on a drug called ENTEREG, made by GlaxoSmithKline, and in August 2009, he gave a presentation to the annual meeting of the Northwest Society of Colon and Rectal surgeons about how well ENTEREG works in aiding the recovery of patients who have had bowel resection surgery. Not a bad day's work for $61,380.
Now, as an unpaid blogger, I only had time to connect a few dots, but I have a feeling there is much more to be gleaned from the treasure trove of doctor payments that Glaxo and other drug companies are now disclosing (in anticipation that Congress, as part of health reform, will pass the Physician Payment Sunshine Act and require such disclosures in the future). So I hope that some of the journalists who get paid to do this will take a closer look at more of the happy beneficiaries of the pharmaceutical industry's largesse.
In the meantime, take a minute and check to see if your doctor is on Glaxo's Christmas list. Ho ho ho.
Hat tip to Pharmalot for alerting me to the GSK list.
Monday, December 14, 2009
Too many overdrugged kids, or the story of a dead-eyed little boy in Chelsea
In Chelsea (a stone's throw from Boston Harbor), there lives a nine-year-old boy with curly black hair whose eyes are dead because he is on drugs, the legal kind. His single mother, who is on welfare and long-term disability (she has serious health problems) can't control her son, so she feeds him a cocktail of powerful psychoactive drugs that include an anti-psychotic (Seroquel), a stimulant for attention deficit disorder (Vyvanse), and a mood stabilizer (Depakote), along with two other drugs. His mouth is purple-black from all the drugs he has to take every day.
I was reminded of this little boy when I read The New York Times article about a new finding that children covered by Medicaid are given anti-psychotics four times as often as children whose parents have private insurance. The study, by researchers at Columbia and Rutgers universities, also found that children on Medicaid are more likely to receive these drugs for less severe conditions than children whose parents are privately insured.
As the NYT reporter noted, these findings, published online in Health Affairs, "are almost certain to add fuel to a long-running debate: Do too many children from poor families receive powerful psychiatric drugs not because they actually need them — but because it is deemed the most efficient and cost-effective way to control problems that may be handled much differently for middle-class children?"
The answer is an unequivocal yes. Children from poor families, whether they live in Chelsea, New York City or rural Appalachia, are much less likely to get the kind of care and attention they need to forestall problems at home and in school. Many of them live in chaotic households headed by single mothers who are overwhelmed and sometimes on drugs (legal and illicit) themselves. The fathers, for the most part, are out of the picture, and even if the mother (as was the case in Chelsea) tries to get her child intensive therapy, Medicaid won't pay for it. So the only other solution is to give such unruly children powerful psychoactive drugs that often have dangerous long-term side effects, such as weight gain and diabetes (in the case of anti-psychotics) and permanent stunted growth (in the case of Ritalin and other stimulants).
Now let me make this crystal-clear: I am not blaming the Chelsea mom for this state of affairs or any single mother who is trying to hold her family together against all odds. I am blaming the system, a system that turns a blind eye to the problems of children in the poorest nooks and crannies of our country, a system that allows pharmaceutical giants to market and sell dangerous drugs as the answer for broken families and inadequate services, a system that favors drug cocktails over the kind of intensive therapy and attention that could really make a difference in some children's lives.
With all this over-prescribing going on, is it any wonder so many American teenagers are lost every day to illegal drugs such as heroin, crack or meth? Big Pharma, after all, got them hooked early on, and how are they to tell the difference between a legal or illegal substance? Indeed, as any forensic expert will tell you, the abuse of legal drugs like Ritalin and Oxycontin are a fast- growing corner of the street market. (According to a fascinating analysis by British researchers, reported in The Boston Globe yesterday, there is evidence that some legal drugs are far more dangerous than some illicit drugs -- like pot -- for the consuming public. It seems our public policy with regard to drug enforcement is also seriously skewed).
But getting back to the little boy in Chelsea, what can we do? These are complex problems and they won't be solved overnight. But we as taxpayers can start demanding our government provide more of the right kind of resources to help poor families and troubled children. And we can push back against a pharmaceutical industry that profits from dead-eyed little boys. In the meantime, if you know of an overstressed family or child in need, refer them to the Children's Emotional Health Link, where the first order of business won't be a hastily written prescription for Depakote.
I was reminded of this little boy when I read The New York Times article about a new finding that children covered by Medicaid are given anti-psychotics four times as often as children whose parents have private insurance. The study, by researchers at Columbia and Rutgers universities, also found that children on Medicaid are more likely to receive these drugs for less severe conditions than children whose parents are privately insured.
As the NYT reporter noted, these findings, published online in Health Affairs, "are almost certain to add fuel to a long-running debate: Do too many children from poor families receive powerful psychiatric drugs not because they actually need them — but because it is deemed the most efficient and cost-effective way to control problems that may be handled much differently for middle-class children?"
The answer is an unequivocal yes. Children from poor families, whether they live in Chelsea, New York City or rural Appalachia, are much less likely to get the kind of care and attention they need to forestall problems at home and in school. Many of them live in chaotic households headed by single mothers who are overwhelmed and sometimes on drugs (legal and illicit) themselves. The fathers, for the most part, are out of the picture, and even if the mother (as was the case in Chelsea) tries to get her child intensive therapy, Medicaid won't pay for it. So the only other solution is to give such unruly children powerful psychoactive drugs that often have dangerous long-term side effects, such as weight gain and diabetes (in the case of anti-psychotics) and permanent stunted growth (in the case of Ritalin and other stimulants).
Now let me make this crystal-clear: I am not blaming the Chelsea mom for this state of affairs or any single mother who is trying to hold her family together against all odds. I am blaming the system, a system that turns a blind eye to the problems of children in the poorest nooks and crannies of our country, a system that allows pharmaceutical giants to market and sell dangerous drugs as the answer for broken families and inadequate services, a system that favors drug cocktails over the kind of intensive therapy and attention that could really make a difference in some children's lives.
With all this over-prescribing going on, is it any wonder so many American teenagers are lost every day to illegal drugs such as heroin, crack or meth? Big Pharma, after all, got them hooked early on, and how are they to tell the difference between a legal or illegal substance? Indeed, as any forensic expert will tell you, the abuse of legal drugs like Ritalin and Oxycontin are a fast- growing corner of the street market. (According to a fascinating analysis by British researchers, reported in The Boston Globe yesterday, there is evidence that some legal drugs are far more dangerous than some illicit drugs -- like pot -- for the consuming public. It seems our public policy with regard to drug enforcement is also seriously skewed).
But getting back to the little boy in Chelsea, what can we do? These are complex problems and they won't be solved overnight. But we as taxpayers can start demanding our government provide more of the right kind of resources to help poor families and troubled children. And we can push back against a pharmaceutical industry that profits from dead-eyed little boys. In the meantime, if you know of an overstressed family or child in need, refer them to the Children's Emotional Health Link, where the first order of business won't be a hastily written prescription for Depakote.
Wednesday, December 9, 2009
Medical groups' conflicts of interest under Congressional spotlight
Mere days after several bloggers (including myself) spotlighted the conflicts of interest among medical societies criticizing the new mammography guidelines, Senator Charles Grassley (R-Iowa) has asked these groups (and quite a few others) for information about the financial backing they get from the pharmaceutical, medical device and insurance industries.
As my blog noted, the most vociferous critics of the new breast screening guidelines included top officers at organizations like the American College of Radiology and the American Cancer Society, which receive substantial funding from the makers of mammography machines, including Johnson & Johnson, Siemens and Hologic. Grassley's inquiry includes these two prominent medical societies along with 31 others, according to the The New York Times.
Grassley's latest inquiry comes amidst the growing realization that many medical associations receive substantial funding from industry and that this often undisclosed largesse sways such groups to lobby on industry's behalf. Consider, as another example, the influence that the pharmaceutical industry has long held over the nation's largest advocacy group for people with mental illness, NAMI. As I was the first to report in Side Effects, drug industry donations to NAMI accounted for at least half of this group's annual revenues, a fact that NAMI never bothered to share with its constituents. A few months after my book was released, Grassley's team asked NAMI for a detailed accounting of its corporate funding, and NAMI publicly acknowledged that more than two-thirds of its donations do indeed come from the pharmaceutical industry.
I look forward to similar eye-opening disclosures now that Grassley, the ranking Republican on the Senate Finance Committee has turned his spotlight onto other groups like the American Medical Society, the American Cancer Society, the American Academy of Orthopedic Surgeons and the American Academy of Family Physicians (which was in the headlines recently because of all the money it's getting from Coca Cola); you can find the full list of groups Grassley is gunning for here.
This is scary stuff. We rely on these physician groups for unbiased and informed medical judgments about all aspects of our health care. After all, if you can't trust the American Cancer Society and the American College of Radiology when it comes to the truth about the benefits and risks of mammography screening, who can you trust? Certainly not your doctors, who get most of their information from the medical societies they belong to. This is a scary state of affairs indeed.
As my blog noted, the most vociferous critics of the new breast screening guidelines included top officers at organizations like the American College of Radiology and the American Cancer Society, which receive substantial funding from the makers of mammography machines, including Johnson & Johnson, Siemens and Hologic. Grassley's inquiry includes these two prominent medical societies along with 31 others, according to the The New York Times.
Grassley's latest inquiry comes amidst the growing realization that many medical associations receive substantial funding from industry and that this often undisclosed largesse sways such groups to lobby on industry's behalf. Consider, as another example, the influence that the pharmaceutical industry has long held over the nation's largest advocacy group for people with mental illness, NAMI. As I was the first to report in Side Effects, drug industry donations to NAMI accounted for at least half of this group's annual revenues, a fact that NAMI never bothered to share with its constituents. A few months after my book was released, Grassley's team asked NAMI for a detailed accounting of its corporate funding, and NAMI publicly acknowledged that more than two-thirds of its donations do indeed come from the pharmaceutical industry.
I look forward to similar eye-opening disclosures now that Grassley, the ranking Republican on the Senate Finance Committee has turned his spotlight onto other groups like the American Medical Society, the American Cancer Society, the American Academy of Orthopedic Surgeons and the American Academy of Family Physicians (which was in the headlines recently because of all the money it's getting from Coca Cola); you can find the full list of groups Grassley is gunning for here.
This is scary stuff. We rely on these physician groups for unbiased and informed medical judgments about all aspects of our health care. After all, if you can't trust the American Cancer Society and the American College of Radiology when it comes to the truth about the benefits and risks of mammography screening, who can you trust? Certainly not your doctors, who get most of their information from the medical societies they belong to. This is a scary state of affairs indeed.
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