January 9th, 2010 by Peggy Polaneczky, M.D. in Better Health Network, Opinion
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This post is in response to Jane Brody’s recent NY Times article on the FRAX fracture risk calculator. FRAX is a clinical decision tool devised by the World Health Organization that allows physicians to account for the myriad of risk factors, including bone density, to determine a patient’s risk for osteoporotic fracture.
Now about 20 years into the practice of medicine, I have evolved from what they call an “early adopter” of new drugs, through a time of cautious use of new drugs, to what I am now – highly skeptical of most new medications and suspicious of Big Pharma, medical thought leaders and anyone else trying to “educate” me about a disease. I am also disappointed in my medical societies for failing to cut the ties between themselves and industry, but hopeful that we are slowly but finally starting to emerge from of an era of industry-dominated health care and into a time of patient-centered medicine. Read more »
*This blog post was originally published at The Blog that Ate Manhattan*
January 6th, 2010 by Bryan Vartabedian, M.D. in Better Health Network, Opinion
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This was the year that Pharma disclosed the names and payments of their physician consultants. Look here for physicians speaking and consulting with Merck, GlaxoSmithKline, Lilly, and Pfizer.
Physician disclosure of conflict is important. It helps put a physician’s opinion and point of view into a context. Disclosure has long been the standard in the academic world. This represents the first time that such information has been made available to the general public.
But how will patients use this information and how will it affect care and outcomes? Should patients flatly avoid physicians or others who have a relationship with a pharmaceutical company? And should patients routinely screen physicians for conflict?
I don’t know the answer to these questions. I’m not sure patients know the answer to these questions. I suspect patients may not like the idea but would be willing to overlook a pharma connection when the reputation of the physician is impeccable.
Transparency is all the rage. Expect more. But I’m wondering how the average health consumer will practically process the information.
*This blog post was originally published at 33 Charts*
December 29th, 2009 by Happy Hospitalist in Better Health Network, Health Policy, True Stories
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I have yet another example of how third party insurance rules obstruct efficient patient care. I was asked to see a patient with fibromyalgia who was asking about about the drug Lyrica she heard about on television (one example of how direct to consumer marketing increases health care expenses). Lyrica is about the only medication approved by the FDA to treat fibromyalgia. I don’t know if it really works or if it’s just an expensive placebo effect.
Maybe fibromyalgia is all in the head, and that’s why this medication works. I don’t really care. I know it’s FDA approved, which means it has more going for it than most pharmaceuticals used for off label purposes. At least doctors who prescribe Lyrica for fibromyalgia aren’t going to get charged with homicide for prescribing medications for unapproved reasons. Read more »
*This blog post was originally published at The Happy Hospitalist Blog*
December 21st, 2009 by Toni Brayer, M.D. in Better Health Network, Health Tips
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Just when you thought it was safe…now there is another article in the NewYorkTimes about the pharmaceutical industry pushing hormones for post menopausal women. It is a long and somewhat “shocking” article about how women have been sold a bill of goods regarding estrogen and progesterone after menopause and Wyeth Pharmaceutical paying multimillion dollar claims for women who took hormones and developed breast cancer.
Let me say…don’t believe everything you read. As readers of EverythingHealth know, I am not a shill for big Pharma and have written critiques of their corporate tactics many times. But when it comes to Estrogen replacement it isn’t just doctors and Pharma pushing drugs on unsuspecting women.
The link between breast cancer and endometrial cancer and estrogen (ERT) has been open dialog for decades. The pharmaceutical companies have had it listed in their marketing literature and good physicians make it part of the risk/benefit discussion. I have never felt pushed to prescribe ERT when it was not indicated and good evidence remains about the benefits of female hormones for bone strength and symptom control. Patients should know that for every 10,000 women who take estrogen, 8 more cases of breast cancer are seen. Other factors influence breast cancer like smoking, radiation (excessive chest X-rays, cat scans or mammograms), alcohol etc etc etc. Read more »
*This blog post was originally published at EverythingHealth*
December 14th, 2009 by Toni Brayer, M.D. in Better Health Network, Opinion
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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*
