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Sent: Saturday, January 04, 2003 7:30
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Subject: [Futurework] How Pharma Took
Over Medicine: Research and Practice_ BMJ / NYT
From: "VERACARE" <[EMAIL PROTECTED]>
To:
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Subject: How Pharma Took Over Medicine: Research
and Practice_ BMJ / NYT
Date: Fri, 3 Jan 2003 10:16:10 -0600
(CST)
To: Tommy Thompson; Thomas Laughren; Rosemary Roberts MD;
Robert
Temple MD; Richard Nakamura; Lester Crawford MD; Kathryn Zoon;
Janet
Woodcock MD; Eve Slater MD; Elias Zerhouni; Duane Alexander;
Dianne
Murphy MD;
David LePay; Christine Whitman; Charles Curie;
Bernard A. Schwetz;
Anthony Fauci; Janet Rehnquist
ALLIANCE FOR
HUMAN RESEARCH PROTECTION (AHRP) http://www.ahrp.org
Contact: Vera Hassner
Sharav 212-595-8974 e-mail: [EMAIL PROTECTED]
FYI
In today's New
York Times Dr. Erin Marcus writes:
"Medicines aren't like shampoo or
perfume."
But they're being hawked on TV as if they were just
another
'enhancer'--when in fact, they come with glossed over risks of
harm.
1997 was a watershed for the pharmaceutical i! ndustry: it
succeeded
in redirecting medicine from its scientific evidence based
practice
to one driven by marketing.
The drug industry launched an
aggressive advertising campaign
directed at consumers.
The FDA, the
agency that is supposed to regulate the industry, sat
idly by as fraudulent
claims, lies and disinformation spread over
the air waves. Indeed when a
judge recently tried to pull a Pfizer
advertisement, the U.S. Justice
Department intervened, claiming FDA
has jurisdiction, not the courts! The
US government thereby exempted
drug companies from "truth in advertising
statutes."
In 1997 drug companies also embarked on a collaboration with
academic
researchers set about creating "diseases" for their products.
They
labeled fleeting problems as "dysfunctional conditions",
and
pre-emptively labeled people--including children-- as "at risk" of
a
"condition" for which a prescription drug was either in need of
a mar! ket
or about to be launched.
And the drug industry took over the function
of "educating" doctors
about drugs.
This marketing strategy has
trivialized, if not debased the practice
of medicine, undermined the
physician-patient relationship, depleted
healthcare budgets with drugs
whose advertising costs was passed
on to consumers. But the strategy has
reaped enormous riches to the
pharmaceutical industry. No wonder this
industry spends billions
on bringing physicians into the fold and billions
more to influence
consumers:
"A recent report by the General
Accounting Office estimates that
every year at least 8.5 million Americans
request and obtain specific
prescriptions after seeing or hearing ads for
particular drugs. In
2001 drug companies spent about $2.7 billion on such
advertising,
a 150 percent increase since 1997, when the F.D.A. loosened
its
rules on advertising.
An investigative report in The British
Medical! Journal sheds light
on one example of the collaborative effort
between drug companies
and doctors who can't say no to $$$.
This
unholy alliance conceived of a scheme to convince women they've
sexually
dysfunctional and in need of a pill:
"The Making of a Disease: Female
Sexual Dysfunction" by Ray Moynihan,
journalist BMJ 2003;326:45-47 ( 4
January ):
http://bmj.com/cgi/reprint/326/7379/45.pdf
" Perhaps the
greatest concern comes from the flip side of inflated
estimates of disease
prevalence the ever-narrowing definitions of
"normal"
which help
turn the complaints of the healthy into the conditions
of the sick. These
revelations about female sexual dysfunction
should spark a more widespread
and rigorous investigation into the
role of drug companies in defining and
promoting new diseases and
disorders."
In an Op Ed article in The
New York Times (below), Dr. Erin Marcus,
a University of Miami internist
decr! ies FDA's relaxing of the drug
advertising rules in
1997.
----------------------------------------------------------------------------
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http://www.nytimes.com/2003/01/03/opinion/03MARC.html?pagewanted=print&posit
ion=top
THE NEW YORK TIMES January 3, 2003 When TV Commercials Play
the Doctor By
ERIN N. MARCUS
MIAMI Several months ago, a woman walked into a clinic
where I
work and asked for Prempro, a hormone replacement drug. She
wasn't
bothered by hot flashes or interested in preventing bone loss
the
usual reasons we would have prescribed this drug. She just wanted
to
look like Patti LaBelle. Back then Ms. LaBelle, along with Lauren
Hutton,
was an official Prempro spokesperson, promoting the drug
in television
advertisements in which she sang of her "new attitude."
Last summer,
Wyeth, the manufacturer of Prempro, stopped running
the ads after a major
federal study found that women taking the
drug for four ye! ars or more had
a higher risk of breast cancer than
those who took a
placebo.
Patients have stopped asking for Prempro but they continue to
ask
about other heavily promoted drugs, like Vioxx, a pain
medicine
whose ads feature Dorothy Hamill skating lithely around a
rink.
Since the Food and Drug Administration relaxed its rules
governing
advertising of prescription drugs five years ago, I've seen a
steady
increase in the number of patients asking for certain expensive
new
medicines. Often these patients don't really know the purpose
of
these drugs or their risks or side effects they've just seen a
nice
ad on TV or in a magazine. While I've usually found that I can
convince
patients that they don't need these drugs (if they're
inappropriate), it
can be very hard to persuade patients to try
pain relievers other than
Vioxx and Celebrex, since often patients
in pain are looking for anything
that will help, and these drugs
are e! ffective and well known.
A
recent report by the General Accounting Office estimates that
every year at
least 8.5 million Americans request and obtain specific
prescriptions after
seeing or hearing ads for particular drugs. In
2001 drug companies spent
about $2.7 billion on such advertising,
a 150 percent increase since 1997,
when the F.D.A. loosened its
rules on advertising. This is still less than
the amount drug
companies spent promoting their drugs to doctors (and I'll
admit,
I've listened to their talks and eaten their sandwiches). But
most
doctors, unlike patients, make their decisions based on
clinical
experience, and at least where I work, doctors usually greet
these
drug promotions with a dose of skepticism.
Perhaps the most
unsettling finding of the accounting office report
is that many of the
prescription drug ads are misleading and are
seen by millions before the
government even considers stopping them.
The F.D.! A. is not required to
review the ads before they hit the
airwaves. Often, by the time the agency
sends out letters telling
companies to stop a particular ad, it has already
run for months
and been taken off the air.
Some have blamed a new
step in the F.D.A.'s review procedure for
the slowdown in removing
misleading advertisements from the airwaves.
Even so, the regulation of
prescription drug ads aimed at consumers
was limited already. The agency
requires that these ads include
balanced information about a drug's risks
and benefits but allows
them to greatly summarize side effects.
The
new director of the F.D.A., Dr. Mark B. McClellan, has said he
plans to set
new standards for the ads and toughen enforcement. But
many of us who have
to answer patients' questions every day wonder
whether these commercials
should be on the air at all.
Medicines aren't like shampoo or perfume.
They're things people
need to maintain healt! h, not discretionary products
a person can
use or throw away on a whim. I'm all for educating patients so
they
can make informed decisions about treatment. But these ads
aren't
educational tools, they're sales pitches and as hard as we
doctors
try, it's tough to compete with the likes of Patti LaBelle
and
Dorothy Hamill.
Erin N. Marcus is a general internist and
assistant professor of
clinical medicine at the University of Miami School
of Medicine.
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