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Medical Papers By Ghostwriters Pushed Hormone Therapy

krou writes "The New York Times reports on newly released court documents that show how pharmaceutical company Wyeth paid a medical communications firm to use ghost writers in drafting and publishing 26 papers between 1998 and 2005 backing the usage of hormone replacement therapy in women. The articles appeared in 18 journals, such as The American Journal of Obstetrics and Gynecology and The International Journal of Cardiology. The papers 'emphasized the benefits and de-emphasized the risks of taking hormones to protect against maladies like aging skin, heart disease and dementia,' and the apparent 'medical consensus benefited Wyeth ... as sales of its hormone drugs, called Premarin and Prempro, soared to nearly $2 billion in 2001.' The apparent consensus crumbled after a federal study in 2002 'found that menopausal women who took certain hormones had an increased risk of invasive breast cancer, heart disease and stroke.'"

60 of 289 comments (clear)

  1. Here come the Lawyers by BigGar' · · Score: 2, Insightful

    Well at least the ones that don't stroke out over the nearly endless possibilities...

    --


    Shop smart, Shop S-Mart.
    1. Re:Here come the Lawyers by Anonymous Coward · · Score: 5, Insightful

      Good! This is one of those cases where the pharmaceutical companies should be held accountable over and above the slap on the wrist the FDA will give them - if that.

    2. Re:Here come the Lawyers by Desler · · Score: 5, Insightful

      Why shouldn't they be sued? They willfully defrauded people into buying their products by lying to them about the risks. Isn't this something they should have to pay retribution to their customers for?

    3. Re:Here come the Lawyers by DrLang21 · · Score: 3, Insightful

      I'm curious to know if these journals are real respected peer reviewed publications. If so, they should be reviewing their peer review policies and/or looking at whether or not they were defrauded by the authors.

      --
      I see the glass as full with a FoS of 2.
    4. Re:Here come the Lawyers by MightyMartian · · Score: 2, Interesting

      Agreed. I think say, fining them two hundred times their gross worth and imprisoning their board of directors and corporate officers until every penny has been paid off ought to do the trick.

      --
      The world's burning. Moped Jesus spotted on I50. Details at 11.
    5. Re:Here come the Lawyers by timeOday · · Score: 3, Insightful
      Actually, lawyers are the ones who brought the truth to light in the first place:

      The documents on ghostwriting were uncovered by lawyers suing Wyeth and were made public after a request in court from PLoS Medicine, a medical journal from the Public Library of Science, and The New York Times.

      I do hope they win money from Wyeth. Heck, I don't even mind Wyeth pushing their agenda in the literature, if the science is good it should stand on its own. But being evasive and publishing with a hidden financial agenda is not cool, especially when lives are at stake.

    6. Re:Here come the Lawyers by Walter+White · · Score: 2, Informative

      I'm curious to know if these journals are real respected peer reviewed publications.

      It turns out that a lot of the studies being reported in the peer reviewed medical journals are funded by pharmaceutical companies. The studies that don't favor their products are simply not published.

    7. Re:Here come the Lawyers by Fallen+Kell · · Score: 4, Insightful

      No, no , no, no. You got it all wrong. They should be fined $80,000 for each $1 of product they sold, just like the RIAA got.

      --
      We were all warned a long time ago that MS products sucked, remember the Magic 8 Ball said, "Outlook not so good"
    8. Re:Here come the Lawyers by Bragador · · Score: 3, Informative

      A peer reviewed journal doesn't tell you that the article has real unfalsified results. The job of the journal is to see if the methodology is serious. So, if you fake your results and have a very well thought out methodology, you can be published. The burden of double checking the results is given to the readers, other scientists who would like to disprove the claims. That costs money and time so most people don't do it. They prefer to publish new discoveries instead.

    9. Re:Here come the Lawyers by ChefInnocent · · Score: 5, Insightful

      I think suing isn't going far enough. I think the person/team behind this and the board of directors should be criminally prosecuted. To fabricate data in pursuit of a few extra dollars while willfully allowing people to die because of the fabrication is wrong on a very fundamental level.

    10. Re:Here come the Lawyers by Korin43 · · Score: 3, Interesting

      Destroying the company wouldn't be helpful. I think a better solution would be to fine the board of directors (and anyone else in on this) for 100% of the money they've ever made while working there + all of their shares in the company + jail time.

    11. Re:Here come the Lawyers by ioshhdflwuegfh · · Score: 2, Informative

      I'm curious to know if these journals are real respected peer reviewed publications.

      You betcha. From the web site of one of them:

      With a 2008 impact factor of 3.453 (previously 2.917 or an 18% increase), the American Journal of Obstetrics & Gynecology [AJOG] (The Gray Journal) is now ranked 7th of 61 journals in the Obstetrics & Gynecology category, according to the latest Journal Citation Reports(r) 2008, published by Thomson Reuters.

      from [AJOG]

    12. Re:Here come the Lawyers by Anonymous Coward · · Score: 5, Insightful

      I respectfully disagree; I think corporate death penalty is the appropriate route to go.

      All assets of the company are seized by the government, all patents are made public domain, liquid assets (cash and similar instruments) are distributed amongst the victims, the rest is auctioned off to pay for court costs.

      Then, the former shareholders of the company can sue the board of directors and anybody else who no longer has corporate immunity, for causing all of their investment to go away because the company committed crimes against humanity.

      This would put every single company on notice: You exist to serve the people; you are allowed to eck out a profit insofar that you do not commit crimes against us. Companies are only people on paper, and I have no compunctions about putting them to death for crimes against the people they are supposed to serve.

    13. Re:Here come the Lawyers by Trepidity · · Score: 4, Interesting

      That's true, but journals' reputations still do depend on a perception that the studies they publish are generally high-quality and honest. So I could see a case for these journals suing Wyeth for the damage to their reputations that these papers have caused.

    14. Re:Here come the Lawyers by davester666 · · Score: 2, Informative

      Yes, each article was reviewed, in that the reviewer made sure the sponsor company had purchased the proper number of pages of advertising with them to support the costs of including the article in their periodical.

      --
      Sleep your way to a whiter smile...date a dentist!
    15. Re:Here come the Lawyers by ioshhdflwuegfh · · Score: 2, Interesting

      That's true, but journals' reputations still do depend on a perception that the studies they publish are generally high-quality and honest. So I could see a case for these journals suing Wyeth for the damage to their reputations that these papers have caused.

      Science just does not work that way. You don't establish reputation of your journal in court. It's too late now.

    16. Re:Here come the Lawyers by HangingChad · · Score: 5, Insightful

      This is one of those cases where the pharmaceutical companies should be held accountable over and above the slap on the wrist the FDA will give them...

      Then there are insurance companies hauling bus loads of loud, fat people to public meetings on health care. Industry busy trying to undermine public discussion and fudge research results. Big oil has been doing the same thing only a lot longer. When I was doing research for DoE they were paying for research later used to undermine the conservation programs put in place in the wake of the '74 oil embargo. And it worked. Between the push by the oil companies and the Saudis increasing production, DoE's direction on oil policy was changing rapidly by '82. Less than 10 years after lines at the gas pump people were buying vehicles the size of a Bangladesh apartment.

      There's a fine line between engaging in freedom of speech and manipulation. Actually, it's not all that fine. At some point we're going to need to take a hard look at whether the artificial person that is a corporation has the same right to free speech as an individual. Unless you're fabulously wealthy, corporations have a major advantage in getting their free speech packaged and delivered to market. Then there are efforts, like this one, of deliberate deception. Where are the consequences? Why aren't there stunning, quarterly number tanking, breath-taking fines for this kind of behavior? If one of us got caught doing something similar, we could face fraud charges.

      --
      That's our life, the big wheel of shit. - The Fat Man, Blue Tango Salvage
    17. Re:Here come the Lawyers by e9th · · Score: 4, Informative

      Some the the journals are published by Elsevier, which cropped up here last May for publishing entire bogus journals!

      Last time they pimped for Merck, now Wyeth. If anyone needs to be punished, it's Elsevier.

    18. Re:Here come the Lawyers by ObsessiveMathsFreak · · Score: 5, Interesting

      They willfully defrauded people into buying their products by lying to them about the risks.

      Defrauded. Falsified. Lied. But what does that even mean anymore?

      The reality is our society is so mired in exaggeration, misrepresentations, doublespeak, non-denial denials, irrelevant conclusions, marketing lies, cover your ass language and general bullshit that we, as a culture, have probably lost the ability or even the inclination to discriminate truth and lies.

      And by discriminate, I don't mean being able to tell one from the other. I mean we have actually lost much of our capacity to actually care whether anyone is telling the truth or lying to us. Truthfulness is no longer rewarded. Indeed it is often punished. Falsehood is conversely rarely, if at all punished and is most often rewarded. This is the culture we live in, so why should people recognize any intrinsic ethic in telling the truth or unethical in lying? Even organizations that are supposed to deal in disclosing the truth are widely recognized and accepted to be mostly peddling lies.

      Did Wyeth actually lie? Do you think you would be able to "prove" in a court of law that a single thing they paid to have printed was in fact a lie, rather than a simple massaging of data or a case of being liberal with the truth. The latter won't be enough to secure a conviction as well the Wyeth layers know. And besides, who care if people lie anyway.

      Companies don't have honor or morals or ethics. If they break their word, even on a signed contract, no one is going to come after them. There's not going to be a permanent black mark on their reputations. With the world the size it is, the same holds true for people as well. Sure, some of us might get indignant about it all, but most people will never even hear about it, and most of those that do will forget about it by the next morning.

      This is the society we, as democracies, have chosen for ourselves. The fruits of our decision should come as no surprise to anyone.

      --
      May the Maths Be with you!
    19. Re:Here come the Lawyers by nedlohs · · Score: 2, Interesting

      Surely the doctors who put their names on the papers are the ones who should both be sued and also have their reputations for research completely trashed.

    20. Re:Here come the Lawyers by Will.Woodhull · · Score: 5, Insightful

      I disagree with the idea of fining the perpetrators.

      These are white collar RICO Act violations involving fraud by mail and conspiracies that cross state lines. The individuals involved should be identified by the FBI and charged by the US Attorney General. Each one of them has conspired to defraud healthcare providers and bona fide researchers, in a manner that has caused the deaths of some USA citizens and placed many more at high risk of cancer or other diseases.

      There is no way in hell that the USA is going to get decent health care, no matter what Congress does, until these kinds of white collar crimes in the healthcare industry are addressed for what they are: felonies that indirectly cause death and suffering to the general public.

      --
      Will
    21. Re:Here come the Lawyers by Areyoukiddingme · · Score: 2, Insightful

      I have mod points, but I want to answer this one because there is no +1 Unvarnished Truth option.

      I'm sad now.

    22. Re:Here come the Lawyers by ragefan · · Score: 2, Insightful

      ...and take their own "medicines".

    23. Re:Here come the Lawyers by erroneus · · Score: 5, Insightful

      I'd like to see murder or similar charges placed against the people involved. If I did anything that indirectly caused the death of any single individual, I doubt anyone would have any problems with charging me with some sort of death related crime. Why are these jackholes immune? Corporate officers gave orders and directions and approval for these acts that ultimately resulted in the deaths of people. Had they not done so, they would not be responsible.

    24. Re:Here come the Lawyers by Anonymous Coward · · Score: 3, Insightful

      They are immune because they are insanely wealthy and big time political donars/bribers.

  2. Who ya gonna call? by Anonymous Coward · · Score: 3, Funny

    When there's something weird
    In your study results
    Who you gonna call?
    Ghostwriters!

  3. Wyeth isn't alone by Lurker2288 · · Score: 4, Insightful

    Wyeth may have gotten caught, but don't kid yourself that every major pharma company isn't doing the exact same thing.

    1. Re:Wyeth isn't alone by wizardforce · · Score: 2, Insightful

      This is precisely why in science, real science, we have the scientific method which requires that experiments/studies etc. be repeatable. All it would take is for these fraudulent claims to be tested and it is over for the fools who tried to usurp the system.

      --
      Sigs are too short to say anything truly profound so read the above post instead.
    2. Re:Wyeth isn't alone by Nightspirit · · Score: 4, Insightful

      Unless the people retesting are the same ones who submitted it in the first place (either via ghost writers, sham corporations, etc). Then it becomes like artificial sweeteners, where you have a mountain of evidence stating that it is safe (from the corporations, or people funded by the industry) and some research stating that it isn't safe, and the end result is people are confused and no one knows what to really believe.

    3. Re:Wyeth isn't alone by drunken_boxer777 · · Score: 3, Informative

      It's not that the notepads and pens they handed out to doctors cost too much, it's that the trade group representing drug companies voluntarily agreed to stop the practice.

      And not only has ghostwriting been around forever, but the drug companies have long hired well-respected doctors as consultants (at high rates), or paid for them to give lectures (again, at high rates). These well-respected doctors (called 'Key Opinion Leaders') have considerable influence within their specialty.

      Disclosure: I arrange for doctors to work as consultants for drug companies.

    4. Re:Wyeth isn't alone by ColdWetDog · · Score: 4, Interesting

      I read that they, as a whole, stopped giving free notepads and clocks and pens and ice cream and subs to doctors at hospitals in person cuz it was costing too much. Geeeee, I wonder what they re-routed the money towards! I doubt they just completely cut out that form of marketing and didn't replace it. Contracted astroturfing apparently had better results so they dumped the pens and hired more writers. That's my theory at least.

      No, the reason they dropped the pens / pencils / paper AND the cruises to the Bahamas AND the free golf AND the fancy dinners wasn't cost. The costs were cheap compared to the benefits they wrought. They stopped them because of the noise and bad press (and the belated 'ethics' whitepaper by the AMA and other trade groups).

      The ghost writing and the funding of spurious research is / was one step removed from this in the public's eye. Now the heat is one here and big Pharma will paper over this issue and continue some other way of pushing their agenda. Look to lobbying for the next big push. If you take away an individual doctor's role in deciding which drug or treatment to prescribe and bump it up to a committee or better yet, a legislator, then you can pay a K Street firm a couple of times per year and not worry about having an army of drug reps running around.

      Big Pharma has it's strategy mapped out for any possible occasion. They're smart, cunning and have been playing this game for a long time. Resistance is futile....

      --
      Faster! Faster! Faster would be better!
    5. Re:Wyeth isn't alone by GooberToo · · Score: 2, Interesting

      Then it becomes like artificial sweeteners, where you have a mountain of evidence stating that it is safe (from the corporations, or people funded by the industry)

      As for the oldest of artificial sweeteners (Saccharin), there is actually mountains of evidence that it is safe. The "evidence" which shows it to be unsafe was originally sponsored by sugar growers (direct competition). In fact, research clearly shows sugar to be far, far, far, far, far more dangerous, bringing horrible disease to every culture to which it is introduced and yet law required a cancer warning on the product which is actually far safer.

  4. Perhaps now people will isten? by Kokuyo · · Score: 3, Insightful

    Yeah right...

    This happens when you trust people who make money when you don't feel well. When will people learn that doctors do not profit from you being healthy? Neither do pharmaceutical companies. Taking medicine in the belief that whoever gave it to you wanted you to feel better is very naive.

    It's stuff like this, and many personal experiences, that make me so cynical toward doctors. It's a sad state of things, but there you have it.

    1. Re:Perhaps now people will isten? by geekoid · · Score: 3, Insightful

      Your an idiot.
      I know quite a few doctors, and all of them want to see their patients get healthy. It's not like they don't have enough business.

      What does a Doctor gain by prescribing you a treatment that isn't needed?

      I am of course tlkaing about science based medicine, Natural path, homeopaths, acupuncturist and others of there ilk are a different matter. They charge of treatments that do no damn good.

      --
      The Kruger Dunning explains most post on /. http://en.wikipedia.org/wiki/Dunning%E2%80%93Kruger_effect
    2. Re:Perhaps now people will isten? by Rakishi · · Score: 2, Insightful

      Not curing disease, not curing underlying causes... but maintenance treatment of symptoms, and underlying causes of those symptoms.

      This isn't star trek, you can't take out a magical pill out of your pocket that makes a woman grow a new kidney. Hell, you we most of the time can't even make drugs to cure simple symptoms without causing horrible side effects. Don't blame pharmaceutical companies for the simple fact that science doesn't understand most of what's going on.

      The job of the pharmaceutical companies isn't to choose the best treatment plan for patients, that's what doctors are for. Quite often that treatment plan involves things such as lifestyle changes, surgery, therapy and so on that have nothing to do with drugs companies.

      Most drugs aren't cures for the simple fact that if a cure exists you don't need other drugs. If a cure doesn't exist you do need drugs. If you need drugs then you should try to make them the best and most pleasant drugs possible. You can't blame drug companies any more than you can blame high crime neighborhoods on police for having too many officers assigned to them.

    3. Re:Perhaps now people will isten? by Chris+Burke · · Score: 3, Insightful

      This happens when you trust people who make money when you don't feel well. When will people learn that doctors do not profit from you being healthy? Neither do pharmaceutical companies. Taking medicine in the belief that whoever gave it to you wanted you to feel better is very naive.

      Yeah, that's why my doctor has encouraged me to eat better and exercise so that I don't have to take anti-cholesterol or blood pressure medication.

      --

      The enemies of Democracy are
    4. Re:Perhaps now people will isten? by Mr.+Slippery · · Score: 2, Interesting

      What does a Doctor gain by prescribing you a treatment that isn't needed?

      Your money? In a fee-for-service scheme, the more treatments my doctor gives me, the more she gets paid. Fortunately, my own physician is a person of high moral character; and an office visit with a family practitioner doesn't get the sort of payments from an insurance company that drug therapies or surgeries do.

      I am of course tlkaing about science based medicine

      As this incident proves, "science" and "medicine" are often far apart.

      Natural path, homeopaths, acupuncturist and others of there ilk are a different matter. They charge of treatments that do no damn good.

      My physical therapist took my money for months, and did me less good than my acupuncturist. As an Asian Bodywork therapist I use some of the same techniques as acupuncturists, and my clients pay me and come back and refer their friends, because my treatments do some good. And I even have some science to back that up.

      Placebo effect? Perhaps. It plays a role in any treatment, including surgery. My mom used the placebo effect to help relieve people's suffering when she was a nurse, she got paid for that. If someone can put on a little show that gets my brain to release endorphins and stop the pain, I don't see a problem with paying for that performance, whether it's a nurse's "beside manner" or a shaman's ritual.

      (Hey, I just found yet another case where a surgical technique was found no more effective than a placebo surgery. That makes 5. I have yet to find a trial where a surgical intervention was compared to a sham in a blinded trail and proved superior.)

      --
      Tom Swiss | the infamous tms | my blog
      You cannot wash away blood with blood
    5. Re:Perhaps now people will isten? by ndege · · Score: 2, Funny

      Don't you mean, "[not] eat butter"???

      --
      Sig Return: 204 No Content
  5. Ugh by Ardaen · · Score: 5, Insightful

    Just what we need, drug companies further muddling the waters so not even doctors can tell which treatments are useful or necessary. No wonder we see large movements away from things like vaccinations, which save lives. People are left with too many doubts and questions, fear doesn't lead to good decision making.

  6. Re:"Scientific Consensus" by Desler · · Score: 2, Insightful

    Sounds kind of like global warming, where the people screaming most loudly about scientific consensus are also the ones that stand to benefit the most greatly financially.

    Or the ones who scream that there isn't are almost always getting the funding for their research from oil companies.

    Just look at Al Gore and his carbon trading investments.

    What a fucking red herring. What Al Gore and other non-scientists do or don't do have no bearing on the veracity of the research done by the actual climate scientists.

    It all screams conflict of interest.

    But having your funding come from someone like Exxon isn't?

  7. Re:"Scientific Consensus" by geekoid · · Score: 2, Insightful

    This isn't consensus.
    It's people signing of on biased meta-studies.

    No, the people screaming the loudest don't have the most to gain from global warming.

    --
    The Kruger Dunning explains most post on /. http://en.wikipedia.org/wiki/Dunning%E2%80%93Kruger_effect
  8. Re:"Scientific Consensus" by wizardforce · · Score: 2, Insightful

    You could say the opposing side has a lot to gain from AGW not being true. After all, the cost of reducing carbon emissions is significant to those who produce the most CO2. The difference between AGW and this nonsense is that *climatologists would have to be wrong [climate models and ice cores etc.] *physicists would have to be wrong [infared absorbsion spectrum of CO2] etc. In short, there would need to be a massive conspiracy of thousands of scientists all in on it.

    --
    Sigs are too short to say anything truly profound so read the above post instead.
  9. Re:"Scientific Consensus" by Desler · · Score: 3, Informative
    Oh and that doesn't even address such things like that famous list that is touted around of alleged scientists that supposedly signed some document against the scientific consensus that not only didn't even verify the identity or credentials of the supposed signers, but that it also falsely listed people who don't even agree with the document.

    On April 29, 2008, environmental journalist Richard Littlemore revealed that a list of "500 Scientists with Documented Doubts of Man-Made Global Warming Scares"[26] distributed by the Heartland Institute included at least 45 scientists who neither knew of their inclusion as "coauthors" of the article, nor agreed with its contents.[27] Many of the scientists asked the Heartland Institute to remove their names from the list.

    From here.

  10. The list by aaandre · · Score: 5, Insightful

    I wonder if there's a list pharmaceutical company CEOs distribute to their immediate families...

    Dear Mom, here's a list of medications made by pfeiser that I wouldn't take, even if my doctor recommended them.

    Your loving son, Jeff.

    That would be a great read on wikileaks.

  11. Re:"Scientific Consensus" by MightyMartian · · Score: 4, Insightful

    It's odd that the anti-climate change crowd will essentially assert that climatologists are part of some even cabal to destroy the economy, and yet essentially are siding with a group of multinational corporations whose vested interest is in keeping everyone vomiting as much CO2 into the atmosphere for as long as possible.

    --
    The world's burning. Moped Jesus spotted on I50. Details at 11.
  12. Re:Unfortunately... by ioshhdflwuegfh · · Score: 3, Informative

    Here are few links:
    Philadelphia Inquirer,
    UPI (Two quotes: "Ghostwriters paid by U.S. pharmaceutical giant Wyeth worked on dozens of articles published in medical journals under doctors' names, court documents indicate." and "A Wyeth spokesman said the ghostwritten articles were scientifically sound and subject to peer review by the journals that published them.")
    NYT

  13. Re:Protecting investment ... by MightyMartian · · Score: 2, Interesting

    But the law should, and should make the *criminal* and *civil* penalties so utterly destructive to any business that they don't dare do it. I'm talking life imprisonment, seizure of assets, massive awards for those injured, and so forth. I mean, basically make such behavior a recipe for extinction of the company, utter destruction of share value, imprisonment of researchers who colluded, seizures of every asset of every member of the board, every officer of the company, and so forth.

    --
    The world's burning. Moped Jesus spotted on I50. Details at 11.
  14. I am a physician by Dunbal · · Score: 5, Insightful

    And I can tell you frankly that the medical profession is split in two. There are people who are in it for the human aspect - usually the doctors. Then there's the people who are in it for the money: The pharmaceutical companies.

    This is not surprising, coming off another recent study done by (and now we learn that it was paid for) and published in a magazine owned by a subsidiary of Merck.

    Just the fact that these companies are allowed to advertise on TV directly to patients is disgusting. But ask your doctor if XYZ is right for you, because you don't need it at all, or there's probably some cheaper similar drug whose patent has expired and costs 1/4 the price, but if you waste your doctor's time enough he'll write the prescription just to get you out of his office with a smile on your face. After all if he says "NO", you might not come back.

    Just the fact that an HIV patient will literally die bankrupt, at $1000+ per month for the meds. Unless you're very rich, you won't be able to keep THAT up for very long, and when you run out of money - so sorry, we can recommend a hospice for you.

    Pharmaceutical companies scream about billions of dollars in research, yet they can afford all that printed material for doctors, 5 star hotels for doctors for "seminars", pens, calculators, TV air time, etc. Yet some companies still make money with Aspirin - yes the name belongs to Bayer, but anyone can make and sell acetyl-salicylic acid - the patent expired years ago.

    No, big pharma loves the protections patent law gives them, and if they can completely distort the market and throw actual science out of the window WHO CARES so long as it increases sales.

    That's why we have Cochrane studies, where we DOCTORS look back at what we're doing and seeing if it REALLY IS effective. A new study from my country published by a close friend of mine suggests that having your blood pressure at 140/90mmHg gives NO INCREASED RISK of heart disease or stroke. But studies paid for by big pharma INSIST (and they've convinced the American Heart Association) that your blood pressure has to be UNDER 120/80. In fact, they want TEENAGERS to start taking blood pressure medication. Hey, at $100-200 per patient per month, SO WOULD I. But we know full well where the unethical branch of the medical sciences is...

    The above comment is my opinion as a 3rd world physician, since I have to watch people die because they can't afford the few medications that DO work as advertised (and are thus even MORE expensive).

    --
    Seven puppies were harmed during the making of this post.
    1. Re:I am a physician by MMC+Monster · · Score: 5, Insightful

      I am a physician, and my mother has hypertension. Damn straight I'm going to medicate her. I'm giving her a diuretic and an ACE inhibitor. $4 per drug per month, for a total of $96 per year. Just like I prescribe to my patients. Treating hypertension prevents strokes. It's not one study. It's dozens of studies, over decades of statistics. A since study may have a P value of .95, stating that it is statistically significant. That means that there's a 1 in 20 chance that it is just plain wrong. I'm banking on the decades of data. Wake me up when the UKPDS changes their recommendations to not treat hypertension.

      The fact of the matter is, my patients are as cost conscious as I am, since they know what it's like to pay for trade name drugs when the generic equivalents are covered by the insurance companies. They love that after a first visit with me they can cut there monthly bills by $100 or more. They tell their friends, and I get more patients.

      Big Pharma has screwed the medical industry. Us doctors (as a group) are doing it, too, as are the trial lawyers.

      And the general public, who feels that docs should be sued into oblivion for the littles mistakes. You know what? Mistakes happen. Deal with it. If you would rather docs retire early rather than pay ridiculously high malpractice premiums, so be it.

      My wife required a high risk OB during her last pregnancy. Pretty hard to find in our state, since the malpractice for obstetricians is ridiculously high here.

      --
      Help! I'm a slashdot refugee.
    2. Re:I am a physician by Dunbal · · Score: 2, Interesting

      Where does that leave the HMOs from the USA?

            I don't practice in the USA so it wouldn't be appropriate for me to make a detailed post about that. However I know a lot of professionals who have quit for just that reason - they don't enjoy being told how to practice medicine by an accountant.

            From my perspective, working in a country that has both a mandatory (ie, it gets docked from your paycheck every month) health care system BUT ALSO offers private medicine for those rich enough to afford to skip the waiting lists, working for the government can't be much different than an HMO. Which is why I no longer work for the government.

            All the drugs are generics - which isn't too bad except that every year or so they have new biddings to fill their purchasing contracts for the following year, and usually switch labs. Now a pharmacologist will talk a lot of BS about the area under the curve and "bioequivalence", but the truth is that even the same drug in the same dose from a different lab will have different rates of absorption, etc. So every year or so all the chronic patients become uncompensated, but all "administration" sees is that they saved $50k or so on their purchase of Atenolol... job well done. Who cares if all the medical beds are full of hypertensives who were taking their medication as usual and suddenly started having hypertensive crises.

            The problem is that medicine is no longer practiced by doctors. We just follow the guidelines established by HMO's or pen pushers (give that patient a CT scan and we'll make next week hell for you if you can't think of a cheaper exam that would have been just as good), try to avoid the shark infested pools of lawyers swimming on the other side of the ledge just waiting for a chance to SETTLE (read: free money), and just do what everyone else does.

            And yet in most countries it is a CRIME to practice medicine without a license. How did we let this happen? It's a WORLDWIDE phenomenon.

      --
      Seven puppies were harmed during the making of this post.
    3. Re:I am a physician by MMC+Monster · · Score: 4, Informative

      From one doc to another, stop using atenolol. :-) Atenolol is not a particularly good beta blocker. It's advertised as a QD drug, but really should be given BID. In addition, it is renally cleared.

      I can't count the number of times the following happened: Patient's renal clearance decreases transiently for some reason. The atenolol buildy up in the system and causes hypotension and bradycardia, causing a further drop in renal clearance. And the cycle continues until the patient ends up in the ER in complete heart block and renal failure or dead.

      Use metoprolol ER (generic equivalent to toprol xl) or carvedilol. Both generic and with proven cardioprotective effects.

      --
      Help! I'm a slashdot refugee.
    4. Re:I am a physician by Anonymous Coward · · Score: 2, Interesting

      Say what you will about our patent system, but 85% of medical research in the world is funded by the United States, and the vast majority of that is funded by the private sector. Pharmaceutical companies spend disproportionately large amounts of their budgets on research compared to other industries or to the government.

      Quite frankly, all the countries with "socialized medicine" are not paying their fair share for medical research. We should be encouraging our friends abroad to contribute their fair share, rather than looking for ways to reduce our spending on medical research.

      Of course, all this assumes that you have the goal of continuing to increase the quality of health care available worldwide through more medical research. If you wish to slow the advance of medical technology, then sabotaging our current system may be the way to go.

  15. Defensive Medicine by rcb1974 · · Score: 2, Insightful

    What does a Doctor gain by prescribing you a treatment that isn't needed?

    Defensive Medicine (CYA for doctors)

  16. Suggested Remedy by eddy · · Score: 3, Insightful

    Beyond any direct fines or other remedies, just halve the patent times on all their patents across the board for each infraction. Sixteen years of protection left on Xyliklopper? Now it's eight.

    --
    Belief is the currency of delusion.
  17. What... would be the point? by Lead+Butthead · · Score: 5, Interesting

    Good! This is one of those cases where the pharmaceutical companies should be held accountable over and above the slap on the wrist the FDA will give them - if that.

    Except that nobody is really being held accountable, unless you're talking about SERIOUS jail time for the officers and forfeiture of profit + interest (at credit card rate no less.) Let's be honest here, the worse that can be expected is that FDA will slap some fine on the companies, and the companies will just happily pass the cost onto its paying customers (you and I.) There is NO ACCOUNTABILITY.

    --
    ELOI, ELOI, LAMA SABACHTHANI!?
    1. Re:What... would be the point? by budgenator · · Score: 2, Insightful

      Why fine the company? The science was very probably accurate;

      Michael Platt, the president of DesignWrite, wrote that the company âoehas not, and will not, participate in the publication of any material in which it does not have complete confidence in the scientific validity of the content, based upon the best available data.â

      of course they left out that the content glorified the reduction of trivial symptoms and the consideration of potentially fatal side effects were beyond the scope of the paper part. A PR/ghostwriting company can't get published if a respected clinician doesn't sign-on as an author, the real answer is to tell someone like Dr. Gloria Bachmann, she's not going to be published anymore for being a drug company's whore.

      --
      Apocalypse Cancelled, Sorry, No Ticket Refunds
  18. Ghost writers.... by EventHorizon_pc · · Score: 2, Funny

    Ya know, the unemployment rate is bad enough right now without ghosts taking jobs from living writers.

    But, how would they feel if the living started haunting each other? Turnabout is fair play. Oh wait, we do... it's called stalking.

  19. +1, and don't forget the plain economic stupidity by Jamie+Lokier · · Score: 2, Interesting

    I wish there was more study and awareness of the economic idiocy and need for regulation to resolve it, too.

    In the UK, the NHS (national health service) cannot afford to treat everyone with certain life-saving drugs because those drugs are too expensive, so they don't, or do so only for a few people.

    The drug companies lobby the NHS to include those drugs, and the NHS refuses because the money is better spent on cheaper treatments for more people. Some newspapers and some people side with the drug companies.

    Those drug companies justify high prices due to the cost of research, trials and so on, and the patents enable them to maintain the prices.

    To be fair, the cost of research etc. is high, and investing in the next drug is needed.

    The stupid, awful paradox though, is that if the NHS enforced a lower price, by having the power to override company patents and threaten to make them generically (but only if the company does not agree to sell them at that price itself), then the companies involved could be guaranteed a higher profit for helping more people, while reducing the cost of treatment and care to the NHS.

    [All prices in UK pounds - Slashdot does not handle the £ sign properly.]

    It's quite simple: Let X be the cost of R&D to the company. Let HP be the high price per person, say 20,000, that the company chooses currently. Let's say 10,000 people choose to use the drug privately. (Revenue = 200 million). Let's say the company believes that strategy makes it's R&D sustainable for future developments. Let's say the marginal cost of production is HP/200 = 100 - after all they say it's dominated by the cost of R&D. (Production cost = 1 million, leaving 199 million for R&D and profits).

    Clearly if the NHS agrees to take 1,000,000 person's worth of the drug while enforcing a far lower price of LP = HP/100 = 299 (very affordable per person), then the company will make exactly the same profit, and that's not counting the benefit of scaling up production.

    If the NFS takes 1,000,000 person's worth while enforcing a price of 498 (still very affordable compared with 20,000), the company will make guaranteed at least twice the profit, at the same time as helping 100 times as many people.

    (* - It's "at least twice" because it's between two and infinity times the profit, depending on the cost of R&D which is somewhere between zero and 199 million, established earlier).

    Now will someone explain to me why helping 100 times as many people, while making more profit and/or doing more research, doing more business, with guaranteed long-term business, getting a better reputation and becoming more well known, and yes the individual reps, executives and shareholders can all reap rewards... Why is this something the drug companies negotiate against??!

    Simple greed cannot explain it, because everyone in the company stands to benefit personally in the scenario where drugs are cheaper and given to more people, if done properly.

    I believe the scenario we're currently seeing is not a result of "evil" corporations and/or individuals in them, nor a result of rational collective greed, but instead is a result of systemic idiocy...

  20. I've taken a cue from my own mother by beadfulthings · · Score: 3, Interesting

    Who had these drugs pushed at her with a great deal of pressure to take them. She finally said, "I'm almost seventy, for chrissake. I'm SUPPOSED to be old. She also clued me in as to how these drugs are harvested or manufactured or whatever you would call it. They're extracted from the urine of pregnant mares. In order to do that, the horses are made pregnant. Then they are confined to their stalls, 24/7, so that the urine can be collected. They're never allowed outside, never allowed even to move around in the stalls--just made to stand there without a break for their rather lengthy gestation terms. When the foals are born, they are taken away from the mothers immediately and are often slaughtered. That kind of confinement would be torture for any animal--it is doubly so for a horse which needs to be able to move about and use its legs.

    A few wrinkles in the fullness of time were much preferable to her, and so they will be to me.

    --
    "Here's what's happening. You're starting to drive like your Dad..." - Red Green
  21. Re:I agree. by Eivind+Eklund · · Score: 4, Insightful

    It's not "fuck the investors over" - it is "ensure that the pressure is towards behaving ethically". With anything like decent risk management, you shouldn't have more than some low, single digit percentage in this anyway; investors often lose all their investment when a company goes bankrupt.

    I'm also somewhat disturbed that you feel that what you should be thinking about after you find you've invested in murdering people is "What's going to happen to my money?"

    --
    Doubting the existence of evolution is like doubting the existence of China: It just shows that you're uninformed.