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Old 06-02-2003, 02:45 PM
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Cool Alternative medicine or The Big Fix :)

Hola! Alternative medicine source

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The Big Fix How the Pharmaceutical Industry Rips
> Off American Consumers
> Katherine Greider
> Public Affairs, $14, pp 189 ISBN 1 58648 185 1
> Reviewed by Ray Moynihan
> The Big Fix opens with feisty 77 year old Melva
> McCuddy from Ohio struggling to
> find more than $6000 a year to pay for her multiple
> medications. We learn that
> she travels across the United States border to
> Canada, where her breast cancer
> drug, tamoxifen, is eight times cheaper than in her
> local pharmacy. Then we
> meet her son and grandson, both with medical
> troubles of their own, and
> discover that the family has three generations
> without any insurance cover for
> pharmaceuticals, and three generations forced to
> rely on handouts from their
> doctors. "The worst thing," Melva told the audience
> at the book's launch in
> Washington DC this month, "is being forced to beg
> doctors for free samples."
> Written in a plain, clear, direct style, and with
> its research funded in part
> by the AFL-CIO-the umbrella labour organisation in
> the United States-The Big
> Fix is an attempt to educate working Americans about
> the dirty tricks of the
> pharmaceutical industry. With the soaring costs of
> drugs and health care set to
> become the biggest domestic issue in next year's US
> presidential election, the
> book is certainly timely.
> Anyone familiar with the industry's antics won't
> find much that's new in The
> Big Fix. It is, however, a remarkably accessible
> round-up of the best evidence
> and the sharpest analysis about key issues,
> including drug pricing, patent
> battles, excessive profiteering, misleading
> marketing, disease mongering and
> doctor-drug company entanglement. Author Katharine
> Greider has distilled much
> scientific research, interviewed many key academics
> and activists, and made her
> way through bulky reports from Congressional
> hearings and other investigations.
> Full text
> http://bmj.com/cgi/content/full/326/7400/1218?etoc
> The Big Fix: How the Pharmaceutical Industry Rips
> Off American Consumers
> by Katharine Greider
> Paperback: ; Dimensions (in inches): 0.60 x 8.27 x
> 5.50
> Publisher: PublicAffairs; 1st edition (May 6, 2003)
> ISBN: 1586481851
A meticulously reported expose uncovers exactly how
> the drug industry boosts
> sales and bilks consumers in the most lucrative
> prescription drug market in the
> world.
> As the pharmaceutical industry invests more and more
> in the development of new
> drugs, true breakthroughs are few and far between.
> Into the breach comes a
> panoply of product-line extensions and me-too drugs
> aimed at grabbing market
> share. The industry plows its high profits back into
> research, but invests an
> equal or greater sum in flogging its products in
> every imaginable venue.
> Research studies are designed to support marketing
> claims. Many doctors all
> over the country get their first information about
> new drugs from a
> salesperson. And, increasingly, prescription drugs
> are pitched to consumers on
> TV and the internet with images of hope, terror, or
> chic. Evidence-based
> practice guidelines, which endeavor to get the right
> medicines to those who
> will benefit most, can't be heard over the din.
> Having created an unprecedented number of
> "megabrands"--blockbuster drugs with
> huge sales--and undergone an extraordinary wave of
> consolidation, some drug
> companies now find themselves in a precarious
> position. Patents are expiring on
> flagship products. In order to sustain the growth
> Wall Street has come to
> expect, these companies must produce billions of
> dollars worth of new
> revenue--fast. But can Americans continue to
> bankroll Operation Grow Big
> Pharma? Must we swallow the bad with the good?
> About the Author
> Katharine Greider has worked as a newspaper reporter
> and freelance magazine
> writer. Her articles, often focusing on health and
> medical topics, have
> appeared in a dozen publications from Self to Mother
> Jones. She lives in New
> York City with her family.
Howard D Trachtman <hdt@MIT.EDU>
> Subject: [SCI-psych] [ian.pitchford@scientist.com:
> [psychiatry-research] Research sponsored by drug
> companies is biased]
Please remember to credit the BMJ as source when
> publicising an
> article and to tell your readers that they can read
> its full text on the
> journal's web site (http://bmj.com).
> If your story is posted on a website please include
> a link back to
> the source BMJ article (URL's are given under
> titles).
> ______________________________
> ______________________________
> (Pharmaceutical industry sponsorship and research
> outcome and quality: systematic review)
> http://bmj.com/cgi/content/full/326/7400/1167
> Research funded by drug companies is more likely to
> produce results that favour the sponsor's product
> than
> research funded by other sources, claim researchers
> in
> this week's BMJ.
> They reviewed 30 studies that analysed research
> sponsored by a pharmaceutical company. Research
> funded by drug companies was less likely to be
> published than research funded by other sources.
> Studies
> sponsored by drug companies were also more likely to
> have outcomes favouring the sponsor than studies
> with
> other sponsors.
> However, none of the 13 studies that analysed
> methods
> reported that studies funded by industry were of
> poorer
> quality.
> These results apply across a wide range of diseases,
> drugs, and drug classes, over at least two decades
> and
> regardless of the type of research being assessed,
> say
> the authors. This suggests that there is some kind
> of
> systematic bias to the outcome of published research
> funded by the pharmaceutical industry.
> Possible explanations include the selection of an
> inappropriate comparator to the product being
> investigated and publication bias, they conclude.
> Contact:
> Joel Lexchin, Associate Professor, School of Health
> Policy and Management, York University, Toronto,
> Canada
> Email: joel.lexchin@utoronto.ca
> (Evidence b(i)ased medicine - selective reporting
> from
> studies sponsored by pharmaceutical industry: review
> of
> studies in new drug applications)
> http://bmj.com/cgi/content/full/326/7400/1171
> Drug treatment is likely to be founded on biased
> evidence because drug companies tend to publish
> studies
> with more favourable results, suggest researchers in
> this
> week's BMJ.
> They identified 42 studies submitted to the Swedish
> drug
> regulatory authority to secure marketing approval
> for five
> antidepressant drugs. These studies were then
> compared
> with studies actually published between 1983 and
> 1999.
> They found evidence of three sources of bias:
> duplicate
> publication, selective publication, and selective
> reporting.
> For instance, 21 studies contributed to at least two
> publications each, and three studies contributed to
> five
> publications. Studies showing significant effects of
> a drug
> were published as stand alone publications more
> often
> than studies with non-significant results. The
> tendency to
> report the more favourable results only, in studies
> actually published, was a major cause for bias.
> These results should not be used to dispute the
> value of
> analysing the medical literature, say the authors.
> However, they are likely to be valid for other
> classes of
> drugs, so for anyone who relies on published studies
> alone to choose a specific drug, they should be a
> cause
> for concern.
> Without access to all studies (positive as well as
> negative, published as well as unpublished) any
> attempt
> to recommend a specific drug is likely to be based
> on
> biased evidence, they conclude.
> Contact:
> Hans Melander, Senior Biostatistician, Medical
> Products
> Agency, Uppsala, Sweden
> Email: hans.melander@mpa.se
> (Characteristics of general practitioners who
> frequently
> see drug industry representatives: national cross
> sectional
> study)
> http://bmj.com/cgi/content/full/326/7400/1178
> General practitioners who see drug industry
> representatives at least once a week are more likely
> to
> express views that will lead to unnecessary
> prescribing
> then those who report less frequent contact, finds a
> study
> in this week's BMJ.
> Over 1,000 general practitioners randomly selected
> from
> 200 practices in England completed a questionnaire
> about their personal and practice characteristics,
> and
> their prescribing attitudes and behaviour.
> After analysing the responses, the research team
> found
> that frequent contact with a drug industry
> representative
> was significantly associated with a greater
> willingness to
> prescribe new drugs and to agree to patients'
> requests to
> prescribe a drug that is not clinically indicated.
> Those who reported frequent contact were also more
> likely to be dissatisfied with consultations ending
> in
> advice only, and were more receptive to drug
> advertisements and promotional literature from drug
> companies.
> General practitioners who saw drug representatives
> most
> often tended to be singlehanded practitioners and
> working in deprived areas.
> More research on the nature of this relationship
> would
> help primary care trusts to adopt policies
> encouraging
> more cost effective prescribing, conclude the
> authors.
> Contact:
> Chris Watkins, General Practitioner, Backwell and
> Nailsea Medical Group, Bristol, UK
> Email: chris.watkins@Bristol.ac.uk
> (Who pays for the pizza? Redefining the
> relationships
> between doctors and drug companies. 1: Entanglement
> 2: Disentanglement)
> http://bmj.com/cgi/content/full/326/7400/1189
> As entanglement between doctors and drug grows, a
> two-part article by journalist Ray Moynihan in this
> week's BMJ explores the brewing conflicts at one of
> the
> world's leading medical institutions over how to
> redefine
> relations with big pharmaceutical companies.
> Across the United States, drug companies sponsor
> close
> to 300,000 events for doctors every year as part of
> their
> promotional efforts.
> Against this background, the University of
> California San
> Francisco (UCSF) is considering plans to end free
> lunches sponsored by drug companies and to remove
> drug representatives. Elsewhere, medical reform
> groups
> and student associations are also calling for
> disentanglement from drug companies and independent
> education and sources of information.
> "Relationships with industry are critical, but they
> need
> redefining," says Professor Haile Debas, Dean of
> Medicine at UCSF. "We have to make sure our
> relationships are more appropriate."
> "In some ways we are all addicts to big pharma's
> money," argues Chief Executive Officer of UCSF
> Medical Center, Mark Laret, "but we are going to
> have
> to wean ourselves off a dependency that is generally
> inappropriate. This relationship is one of those
> things we
> need to clean up. The sooner the better."
> Responding to the view that drug company funded
> education is necessary, Drummond Rennie, Professor
> of
> Medicine at UCSF says, "Nonsense. That argument
> presupposes that some of the most well off in our
> society
> can't afford to pay for their lunches, their
> education, or
> their conference."
> Many individual doctors, and their professional
> associations, are facing difficult choices about
> whether
> they remain part of the industry's extended
> promotional
> machinery or seek real distance in their
> relationships, to
> give prescribing, teaching, and advice that is truly
> independent, writes Moynihan. Growing moves toward
> genuine separation may well make previously
> acceptable
> conflicts of interest untenable, he concludes.
> Contact:
> Ray Moynihan, Journalist, Washington DC, USA
> Email: raymond.moynihan@verizon.net
> (Relationships between the pharmaceutical industry
> and
> patients' organisations)
> http://bmj.com/cgi/content/full/326/7400/1208
> Relationships between the pharmaceutical industry
> and
> patients' organisations must be at arm's length and
> transparent, and not affect the agenda and
> priorities of
> these groups, argues a senior doctor in this week's
> BMJ.
> Advertising drugs to patients in the United Kingdom
> is
> not allowed, so drug companies try to inform
> patients
> through partnerships with self help groups and
> patients'
> organisations, writes Dr Andrew Herxheimer of the UK
> Cochrane Centre.
> The Long Term Medical Conditions Alliance offers
> guidelines to voluntary health organisations on
> relations
> with the pharmaceutical industry. However, many
> organisations volunteer minimal information about
> their
> structure and funding, and some are reluctant to
> discuss
> the subject.
> If industry directly or indirectly funds a large
> part of the
> budget, say over 20%, the organisation comes to
> depend on it and this, if nothing else, will
> influence
> policies, he says.
> Most patients' organisations are poor and have
> little
> independent funding. Grants and joint projects with
> pharmaceutical companies can help them grow and be
> more influential, but can also distort and
> misrepresent
> their agendas. Relationships must therefore be
> acknowledged and open, without public relations
> flummery, stresses the author.
> Some modest public funding for patients'
> organisations
> should also be considered, and regulatory agencies
> have
> to distinguish between independent and extensively
> funded patient groups, he concludes.
> Contact:
> Andrew Herxheimer, Emeritus Fellow, UK Cochrane
> Centre, London, UK
> Email: andrew_herxheimer@compuserve.com
> News in Brain and Behavioural Sciences - Issue 96 -
> 19th May, 2003
> http://human-nature.com/nibbs/issue96.html

james m nordlund
Addressing, not addressing them
have costs, the former is individual, and
the latter is global, as well.

Matutinally Yours,

james m nordlund reality (aja)
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