Tag Archives: prescription drugs

“Transparency Hasn’t Stopped Drug Companies From Corrupting Medical Research”

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NY Times Commentary by Marcia Angell: Transparency Hasn’t Stopped Drug Companies From Corrupting Medical Research

Dr. Angell, a former editor of the New England Journal of Medicine examines the recent outrage regarding Dr. José Baselga who resigned from his position as chief medical officer at Memorial Sloan Kettering Cancer Center after “ProPublica and The New York Times revealed that he’d received millions of dollars from drug and device companies … Most of his outside income was not disclosed to the journals in which he published, in violation of their requirements.”  Dr. Baselga has had a huge impact in cancer research; his work led to the discovery of Herceptin, a widely used treatment for breast cancer.

  • She argues that disclosure alone is not sufficient to prevent pharmaceutical companies from corrupting research:
  • “Drug company involvement biases research in ways that are not always obvious, often by suppressing negative results. A review of 74 clinical trials of antidepressants, for example, found that 37 of 38 positive studies — that is, studies that showed that a drug was effective — were published. But 33 of 36 negative studies were either not published or published in a form that conveyed a positive outcome.”
  • “Bias can also be introduced through the design of a clinical trial. For example, the sponsor’s drug may be compared with another drug administered at a dose so low that the sponsor’s drug looks more powerful.”
  • “Disclosure is better than no disclosure, but it does not eliminate the conflict of interest. It’s simply a way of … leaving it to readers to decide whether the research was biased. But most people — even doctors and science reporters — aren’t really equipped to make those judgments, particularly when data are suppressed.”
  • She argues that drug companies should have “no control over the design, interpretation and publication of trial results” and that “doctors should not accept gifts from drug companies, even small ones, and they should pay for their own meetings and continuing education, as is standard in other professions.”

My take (borrowed from author): “we should not let drug companies buy the hearts and minds of researchers. The cost of this is high, and not just in drug prices. It means both doctors and patients believe prescription drugs are better and safer than they really are.”

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Pharmaceutical Prescription Practices Tied to Pharmaceutical Payments to Doctors

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A recent buzz has developed regarding a ProPublica study showing an association between the amount of money physicians receive from pharmaceutical companies and their likelihood of recommending brand (rather than generic) prescription drugs.

Here’s a link to the full story: Now There’s Proof: Docs Who Take Company Cash Tend to Prescribe More Brand-Name Meds

“The more money doctors receive from drug and medical device companies, the more brand-name drugs they tend to prescribe, a new ProPublica analysis shows. Even a meal can make a difference.”

Here’s a link to NPR’s summary:  Drug-Company Payments Mirror Doctors’ Brand-Name Prescribing  An excerpt:

“A ProPublica analysis has found that doctors who receive payments from the medical industry do indeed prescribe drugs differently on average than their colleagues who don’t. And the more money they receive, the more brand-name medications they tend to prescribe.

We matched records on payments from pharmaceutical and medical device makers in 2014 with corresponding data on doctors’ medication choices in Medicare’s prescription drug program.

Doctors who got money from drug and device makers prescribed a higher percentage of brand-name drugs overall than doctors who didn’t, our analysis showed. Even those who simply got meals from companies prescribed more brand-name drugs, on average.”

My take: Prescription patterns vary widely among physicians and often for good reason.  At the same time, it is likely that in many cases variation in prescription patterns is influenced by frequent contact with pharmaceutical companies.  As a consequence, this has the potential to make patients question whether their physician always has their best interest in mind and the potential to increase healthcare costs.

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Law Library Ceiling, Univ Michigan

Law Library Ceiling, Univ Michigan

Buyer Beware: Online Pharmacy Problems

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“It always seems impossible until it’s done.”  –Nelson Mandela

From NY Times:

http://well.blogs.nytimes.com

Though technically illegal, millions of Americans buy prescription drugs from overseas pharmacies to save money.  But the practice can be a huge gamble.

The National Association of Boards of Pharmacy, a professional group, reviewed over 10,000 Internet drug outlets and found that many sold fake or unapproved drugs. Some that claimed to be Canadian pharmacies actually sold medicines from developing countries where regulations are weak and counterfeit drugs are common.

Roger Bate, a pharmaceutical expert at the American Enterprise Institute, estimates that 2 to 3 percent of online pharmacies are legitimate. When buying Canadian, he said, look for outlets certified by the Canadian International Pharmacy Association, a trade group of Canadian pharmacies, or those certified by PharmacyChecker.com, a free website that verifies that the foreign sites it approves protect consumer information and meet quality standards.

Last year, Mr. Bate and his colleagues published a study analyzing 372 orders of five popular prescription drugs – Lipitor, Celebrex, Viagra, Nexium and Zoloft – that they purchased from 79 domestic and foreign online drug outlets. Products bought from Canadian or other foreign sites certified by C.I.P.A. or PharmacyChecker.com were of high quality. So were products ordered from American sites verified by either the N.A.B.P. or LegitScript.com, a certification agency founded by a former White House aide on drug policy issues.

But that was not the case for sites that were not certified by any of these four groups. Many of the drugs they sold were fakes, including about a quarter of the Viagra samples, which largely appeared to have originated in China.

“You can’t be 100 percent certain with any sites, frankly,” Mr. Bate said. “But you are running a much lower risk if you buy from a credentialed site.”