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When “Big Pharma” Is Demonized

To be blunt up front –- SBM is not apologetic about the pharmaceutical industry. We get zero funding from any company, and have no ties of any kind to “big pharma.” In today’s world I have to spend time making that clear, because despite the reality critics are free to assume and falsely claim that our message is coming straight from the bowels of hell (a.k.a. the pharmaceutical industry).

We promote science-based medicine and criticize pharmaceutical companies along with everyone else when they place other concerns ahead of scientific validity, or promote bad science, for whatever reason.

It has become fashionable, however, to not only criticize the pharmaceutical industry but to demonize them –- and the term “big pharma” has come to represent this demonization. Cynicism is a cheap imitation of skepticism –- it is the assumption of the worst, without careful thought or any hint of fairness. Read more »

*This blog post was originally published at Science-Based Medicine*

HRT And The “Window Hypothesis”: Hope Or Hype?

It’s only Wednesday, and so far three patients have come to their office visits carrying Cynthia Gorney’s article from Sunday’s New York Times entitled “The Estrogen Dilemma.”

The article explores the stories of three women who found relief from perimenopausal symptoms by using hormone replacement, framing the discussion in the larger context of what is being called the “window hypothesis” — the idea that starting estrogen replacement in the perimenopause and continuing it into later life may be neuroprotective and even cardioprotective, in contrast to beginning its use 10 or more years after menopause, where it can trigger heart disease, stroke and dementia. Read more »

*This blog post was originally published at The Blog that Ate Manhattan*

Who Follows Big Pharma On Twitter?

Do “normal” people – patients, doctors, nurses, pharmacists, life scientists, etc – follow Big Pharma on Twitter? I’ve long had a hunch that most of the followers (and by followers I mean people who are actually paying attention) of Pharma accounts are primarily consultants, marketers, PR pros, social media evangelists and others interested in Pharma’s use of the Web (including myself).

So I decided to gather the key words in the profiles of a select group of Pharma companies. I used the service TwitterSheep to generate tag clouds of these profiles. This isn’t a purely scientific approach, but it’s reasonable enough to provide some insight into whose following Pharma. My friends Silja Chouquet (@Whydotpharma) and Andrew Spong (@AndrewSpong) each provided great insight into Pharma and Twitter. You can read their posts here and here, respectively.

Based on the tag clouds, here are the top ten key words in the profiles of followers of selected Pharma companies: Read more »

*This blog post was originally published at Phil Baumann*

Are Free Drug Samples A Good Idea?


Most doctors have a closet in their office filled with various pharmaceutical samples. The pharmaceutical industry has had “drug reps” or account reps or pharmaceutical sales staff making the rounds on doctors offices in every city and town across the United States for decades. The industry spent $33.5 billion promoting drugs and sending reps to doctors offices with samples in 2004. That is a lot of samples!

Most of us thought we were doing the right thing for our patients when we accepted drug samples. I was able to give patients a month (or more) free to make sure it worked and that they tolerated it. Other patients had no insurance and I supplied them with all of their medication for free from my sample closet. I had a good relationship with the rep and they kept my office stocked with the medication my patients needed. It seemed like a win-win for everyone. Read more »

*This blog post was originally published at EverythingHealth*

What’s Big Pharma’s Position On Healthcare Reform?

Today I participated in a conference call with Billy Tauzin, CEO of PhRMA (the Pharmaceutical Research and Manufacturers of America). The goal of the call was to let bloggers know about PhRMA’s position on healthcare reform. I counted at least 12 bloggers on the call, and I was the only physician. It pains me to see how few physicians participate in reform discussions and I’d like to get more of us involved.

The salient points, as I understood them, were:

1.    PhRMA would like all Americans to have health insurance. They believe that Medicare Part D is a model health insurance program. They do not support a single payer system because it would likely attempt to cut costs by rationing care and denying options to patients. They don’t believe that insurance coverage mandates are a good idea unless the insurance is subsidized to the point of being affordable for all. They favor the current public (Medicare and Medicaid for the elderly, poor, or disabled) private blend of insurance, with roughly 50% of the population in each category.
2.    PhRMA would like to support “precision medicine” where treatments are tailored more effectively to the individual. Mr. Tauzin suggested that some FDA-approved drugs are only effective for 30% of the patients in a given disease class. He’d like to see more research devoted to figuring out why that is, and supports comparative clinical effectiveness research insofar as it furthers this agenda.
3.    PhRMA wants to preserve the unique features of the American healthcare system – to maintain our leadership in biomedical research and new drug development, and to protect the sacred shared decision-making between physicians and patients (to shield it from government intervention).
4.    PhRMA wants to support IT infrastructure that would track patient medication compliance and let physicians know when/if they fill their prescriptions.

Now, the business case for all four of these positions is clear – the pharmaceutical industry benefits from having everyone able to afford medications (i.e. universal coverage), personalized medicine would reward the development of new and innovative drugs and establish a consumer base for many different treatments, protecting the doctor-patient relationship allows for off-label use of medications and a broader array of similar drugs, and IT infrastructure would help to increase drug purchase and compliance with treatment regimens, thus increasing overall sales.

However, the truth is that PhRMA’s positions on healthcare reform – beneficial as they are to themselves – also happen to be beneficial to patients. Increasing the number of insured improves access to medical care, personalized medicine could create more effective treatments with fewer failure rates and side effects, shared-decision making empowers patients to make the right decisions for their circumstances (with their physician’s guidance), and IT solutions that facilitate medication adherence, tracking, and reminder systems could improve patient health outcomes and keep them out of the hospital.

So, in a way pharmaceutical companies, advocacy groups, and physicians are fairly well aligned on many aspects of healthcare reform. Now if certain members of Big Pharma would please give up on those “me-too” drugs, stop creating more expensive medicines by simply combining two perfectly good ones into a new pill, stop hiding negative research studies, and refrain from aggressive direct-to-consumer marketing tactics, we might all really be on the same page.

***

Interesting factoids from call:

  • Medicines only account for 10% of total healthcare costs (unchanged from the 1960s), but they “feel” like a larger cost driver because health insurance doesn’t cover their cost as completely as they do hospital fees.
  • There are about 750 new cancer drugs in the research pipeline.
  • Half of all prescriptions remain unfilled.
  • Physicians provide 30 billion dollars a year in free care.
  • The United States conducts 70% of the world’s research in biomedicines.

Please check out Billy Tauzin’s amazing story of triumph over cancer.

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