1. We receive funding from drug companies.
2. We receive funding from drug companies.
Apparently if we supported comparative effectiveness as a wonderful tool for achieving optimal prescribing and reimbursement decisions our funding from drug companies would not be an issue. But because we criticize it and offer the collection of patient-centered data to support improved outcomes and productivity, our views are both wrong and tainted. I guess taking money from George Soros, trial attorneys and left wing foundations or just hating drug companies -- which some bloggers do -- in no way biases the views of others. So people who receive pharmaceutical firm support are tainted but everyone else is objective. Yeah, right.
Indeed, the biomarker and patient-centric approach we support is now being attacked as..no surprise... as another venue for industry to enrich itself. See our previous posts regarding the unwarranted attack on the Reagan Udall Institute.
Follow this logic. Big Pharma used the FDA to push through me-too drugs of limited efficacy so it could market blockbuster drugs to an unthinking public. Critics clamored that companies should invest in breakthroughs based on new genetic research that targeted important diseases and developed drugs that really advanced care.
So now companies are doing just that or trying. They are now being criticized for investing in efforts to develop targeted medicines using new science. Instead, critics want "hard" evidence that people are actually cured or better before a drug is approved though the predictive accuracy of genetic markers is precisely what is revolutionizing health care.
When someone keeps changing the standards and the goalposts it tells you that what they dislike is not the goal but the target of their criticism. Comparative effectiveness, as applied in every health system, is used to control costs and limit access to new medicines. Meanwhile studies show new medicines improve productivity and extend life.
Those who support comparative effectiveness have yet to show me one study they support they demonstrates the better value of new medicines. That's because for the most part they are design by government agencies and others with a bias towards cost containment and against medical innovation. That goes for the ALLHAT and CATIE studies.
And as for the ALLHAT study, Health Care Renewal does not want to accept the fact that the ALLHAT design was bizarre and structured to produce excess mortality in blacks. Don't believe me, believe Michael Weber who was one of the investigators....
"The reality of ALLHAT â€“ it was poorly designed, the interpretations were disingenuous, it violated appropriate scientific reporting, and most frightening, it did something that was so unethical that if a pharmaceutical company had done it or any of us as individual academics had done it, we would not only be thrown out of our jobs, we would be pilloried and maybe even be facing criminal charges: They exposed African-American patients for several years to treatments they knew would not be effective in controlling their blood pressure.
And one thing that did show up in favor of diuretics, the fact that they cause fewer strokes than one of the other drug classes, was driven entirely by a 40% excess stroke rate in black patients that was predictable before the study began. And they used that as their reason to claim superiority of the diuretic."
I want to know if Health Care Renewal would treat his African American patients with high blood pressure and congestive heart failure without using BiDil and according to the ALLHAT guidelines?
Some proponents of comparative effectiveness might because they are ideologues. And that's the difference. For a lot of people and policymakers comparative effectiveness analysis -- from the design of studies right down to the reimbursement -- it's political and a way to wound drug companies.
Finally, I apologize to all who have tried to post comments and have not been able to. It was not intentional. We are making a technical fix to clear this problem up.