Latest Drugwonks' Blog
1. “Given my personal characteristics, conditions and preferences, what should I expect will
happen to me?”
2. “What are my options and what are the potential benefits and harms of those options?”
3. “What can I do to improve the outcomes that are most important to me?”
4. “How can clinicians and the care delivery systems they work in help me make the best decisions
about my health and healthcare?
How can you argue with that? The problem is, PCORI in investing heavily in the dissemination of research and the use of methods that are NOT patient-centered. PCORI relies upon the US Preventive Services Task Force as the foundational source of CER to determine what screening tools to use.
USPSTF decisions are based on one-size fits all data and demands long term studies that show a screening tool directly reduces all-cause mortality As I have noted before, that means nothing can be proven to be preventive.
Moreover, there is no mention in any PCORI publications or grant propsoals about genomics or personalized medicine. Zero. Check that, one mention in the context of questioning the value of personalized medicine.
Third, (and this my pet peeve) the bias toward chiropractors is rife in research proposals. PCORI implies that chiropractors -- who as a profession oppose vaccinations -- are a cheaper approach to orthopedic problems even though once you go to chiropractor you are expected to keep going and buy all their herbs, vitamins, etc. Could it be that the sop to an industry that combines auto mechanics, biology, New Age babble and anti-vaccination bias is a result of having a chiropractor on the PCORI board has anything to do with it. And by the way, will PCORI issue a statement defending vaccines?
"One of her neighbors is a chiropractor who treated two of her coworkers successfully for on-the-job back injuries. The chiropractor recommended that
she avoid narcotic medications, stay active and try a course of spinal manipulation for a few weeks before considering an MRI or surgery. An acupuncturist whom the worker has consulted for temporary relief of neck pain in the past also recommended a series of treatments. "
And this evidence based statement:
I have a patient who has a knee problem
and, by chance, went to a chiropractor
and was there for four sessions; and
now she is normal. She was in need of
knee surgery, and now she isn’t.
—Cardiologist
Fourth, the questions posed cannot be answered by PCORI or any one else.
Fifth, PCORI cannot keep up with the flood of individualized treatments for diseases such as cancer, multiple scleroris, HIV, hypertension and admits it:
"The rapid pace of introduction of new diagnostics and the diversity of new technologies raise questions about the role and added benefit of these new options for guiding clinical decisions and changing patient outcomes include the role of molecular diagnostics in managing the care of patients with cancer. Some new diagnostic technologies have potential uses for a wide range of conditions, but the evidence base demonstrating benefit for these new indications fails to keep pace with use. For example, there continues to be a desire for evidence to support the use of PET imaging, MRI, and CT for a number of conditions, including oncology and lower back pain. Finally, questions sometimes remain about the long-term safety of well-established modalities, even some modalities perceived traditionally as having relatively little risk, such as dental x-rays. "
Does PCORI really think it or any entity develop an 'evidence base' a la USPTF that will "keep pace with use?" By design and definition then, CER will delay and discourage innovation, no matter how patient-centered PCORI claims to be.
t will by definition and design not only hold up access to these treatments by requiring CER before they are adopted, the studies -- which cannot capture the diversity of experiences and responses it claims it will measure -- will be outdated. In any even PCORI presumes that CER must precede use of new technologies before they are used or paid for.
Finally, the so-called patient-centered processes it claims to be developing are designed to discourage use of new treatments. "Shared decisionmaking" has been show to be biased against intervention by presenting patients the bad news about a treatment -- rare and dramatic risks -- before 'sharing' information about the benefits.
Here's an example of how PCORI frames patient-centered decisionmaking:
It used to be accepted that we screen everyone
for prostate cancer who is a candidate. Now we
don't know what to do.
—Primary care physician
As far as exercise goes, is there something nonmedical like yoga or breathing exercise, or
should [my son] be doing anything? Is there
anything he can do other than take medicine, or
will he be on medicine for the rest of his life?
—Parent of pediatric patient
The theme is less should be more, cheaper is better in most cases. Or at least innovations should be considered guilty before being found -- after years of CER research -- proven effective. Of course PCORI is not measuring the impact of CER on the pace of innovation and how it will affect life expectancy and well-being compared to accelerating personalized medicine.
We have and will continue to do so even though it seems 'stakeholders' have been frightened into not challenging PCORI on that score. Instead of investing in research on the value of their innovations, they are not only playing ball with PCORI, they are buying the equipment and ball field to sustain the stupidity.
U.S. drug recalls common, not well publicized: study
NEW YORK (Reuters Health) - The U.S. Food and Drug Administration (FDA) recalls potentially harmful drugs about once every month, but they could be doing a better job of letting doctors and patients know about them, says a new study.
Over an eight-year span, researchers found that the FDA failed to send notifications for one in five of the most serious recalls through its two electronic systems used to alert doctors and the public.
The so called Class I recalls, according to the FDA, are issued for drugs that, if taken, have the potential to cause "serious adverse health consequences or death."
The 2008 contamination of the blood thinner heparin, one of the most notable and recent examples of a Class I recall, resulted in serious reactions and some deaths in dialysis patients. That recall, according to one of the study's authors, was reported.
"I think a good system would indicate all of the Class I recalls, and it wouldn't necessarily communicate recalls the FDA deems less important, such as Class II and Class III," said Joshua Gagne, from Brigham and Women's Hospital in Boston.
Between 2004 and 2011, Gagne and his fellow researchers counted more than 1,700 drug recalls listed in the FDA's enforcement reports. Of those, 91 were serious Class I recalls.
During that time, the FDA issued about 2,900 announcements through the Recall Alert System, which sends notifications to subscribers about recalled drugs and products. The system, however, only sent alerts for 55 of the 91 Class I recalls.
MedWatch, another system used by the FDA to report drug recall information, sent alerts for 18 of the remaining recalls. Another 18 -- or one-fifth -- of the Class I recalls were never reported through either system.
"Despite recent efforts by the FDA to address the drug recall burden, health care providers may be inadequately informed about clinically important recalls that threaten patient safety," wrote the authors in a letter to the Archives of Internal Medicine on Monday.
An FDA spokesperson told Reuters Health there are a number of ways the agency communicates with doctors, but she wasn't able to say why notifications weren't sent in these 18 cases.
ACTIVE TRACKING
There's no way, according to Gagne, to know if the lack of notifications were linked to any patient harm.
He added that the FDA has moved to address communication problems, including recall notifications.
"It's certainly on their radar and they're constantly starting initiatives to address it, but there is still room for improvement," he said.
Dr. Lisa Schwartz, co-director of the Center for Medicine and Media at the Dartmouth Institute in Lebanon, New Hampshire, told Reuters Health that the FDA should try hard to let everyone know about Class I drug recalls until there is a system that allows the agency to track the recalled drugs.
"It's unclear why it shouldn't be 100 percent of the time they're notifying people on both systems," said Schwartz, who was not involved in the new study.
Gagne and his fellow researchers echoed Schwartz's call for an active tracking system.
"The tracking could all be computerized so pharmacies can know which bottles the recalled products came from," said Gagne.
Until then, he told Reuters Health that there are other ways doctors can find out about recalls. One way is for the drug companies to send letters directly to doctors. His team, however, was not able to look into those methods of notification.
But ultimately, Gagne said, the FDA needs "a more specific system that only communicates all of the Class I information."
Da bomb
Last week I testified in front of the Russian Duma’s committee on non-communicable diseases (NCDs). That committee is preparing (at President Putin’s direction) a series of recommendations to address the many significant health issues that NCDs pose to the Russian Federation (with smoking at the top of the list).
Here are my remarks (as presented):
NCDs (such cancer, diabetes, Alzheimer’s Disease, chronic lung and heart disease) are the leading causes of death and disease worldwide, killing more than 36 million people in 2008, and are projected to increase by 15% globally between 2010 and 2020 due in large part to progress made in combating infectious diseases through economic growth, development, and better treatment options.
But this frightening increase it is also largely linked to lifestyle choices.
For most infectious diseases, rapid access to diagnosis and treatment is an imperative for patient survival.
But for NCDs the “lifecycle” is different, and there may be many actions that can take place, such as prevention, before medicines or other treatments need to be prescribed. A major epidemiological shift is underway.
The bad news is that NCDs sit at the center of a complex series of social and economic factors that it is hard to influence from the top down.
The good news is that there are many inexpensive and proven preventative medical interventions that can significantly reduce the burden of NCDs.
A neglected area of discussion within the NCD debate is medical research and development, which has the very real promise of introducing cures for currently incurable chronic conditions, as well as treatments for diseases where there is currently a lack of pharmaceutical options.
Just as innovation in HIV/AIDS treatment has turned it from a terminal disease into a manageable chronic condition, it is not entirely unfeasible that future innovation will throw up a cure or prophylactic vaccine for many diseases currently considered as “chronic.”
The current trend of increase in Alzheimer’s, for example, threatens to overwhelm health systems in OECD countries because not much can be done beyond labor-intensive care. If a cure were invented, this huge economic burden would be significantly reduced as would much pain and suffering.
Remember that tuberculosis used to be an incurable major chronic disease until the invention of treatments. Innovation is crucial – but it is not the only tool available to us in the war against NCDs.
Fortunately for NCDs, there are plenty of off-patent and widely available preventative medicines (such as statins and medicines for diabetes and hypertension) that can dramatically reduce the overall disease burden
The good news is that half of deaths caused each year by NCDs are preventable and lifestyle choices, such as unhealthy diet and tobacco use, are part of the explanation. Reducing disability or deaths through increased investment in prevention programs will contribute to higher economic growth and allow limited resources to be focused efficiently on patients most in need.
Money is tight everywhere. Before governments agree to increased spending on top-down schemes, it is worth taking a look back at the last major global effort to fight disease: HIV/AIDS.
Some lessons are clear, like the need to focus on prevention. The UN’s big mistake with HIV/AIDS was to prioritize treatment. This neglect of prevention led to new infections piling up more quickly than they could be treated, creating unnecessary suffering and costs. Actions on access and affordability of NCD treatments include promoting the right policy, along with smart regulatory and supply chain environments that secure optimal quality of care for patients.
But in order to accomplish this, there must be a confluence of interests.” And the good news is that there is.
There is no substitute for the power of partnership. It’s not about having pharmaceutical companies write checks, but rather combining the resources of private industry with the expertise of leading global health organizations, to identify new models of patient care that increases access and speed to treatment – and not just medicines.
Part of the role of government is to facilitate partnerships that propel progress. In the United States we’re learning that, in the battle against NCDs our health systems needs to get smarter, specifically:
· Our reimbursement systems need to be less focused on outputs and more on individual patient outcomes;
· Health professional education should be more holistic addressing all issues concerning both acute and chronic conditions;
· Our view of drug safety relative to what is Rx vs. OTC is going to have to change (such as OTC statins and HIV/AIDS preventative medicines);
· Our delivery systems will have to dramatically reform to take advantage of new e-health technologies;
· The partnership between social services and health services will have to become closer (including smoking cessation and weight reduction strategies), and
· Many aspects of our healthcare system need to be decentralized as far as possible to the local level – thus making it easier to deal with complexity of multi-chronic conditions.
Most importantly, we must place personal responsibility at the center of the NCD debate – because it is the most effective way to ensure that early detection and prevention is maximized whenever and wherever possible.
I look forward to working with you in your efforts to create a US/Russian Healthcare Foundation that will help both of our countries and all of its citizens live longer, healthier and more productive lives.
Thank you.
The Healthy Indiana Program was established by Governor Mitch Daniels to provide affordable and comprehensive health insurance to lower income Hoosiers. Using a combination of tobacco taxes and Medicaid dollars, it serves more than 42,000 Hoosiers. The plan requires enrollees to contribute up to 5% of their gross income to a POWER account, which is used to pay for medical expenses. The state covers the balance needed to raise the account to $1,100. People who use preventive services get a reduced premium and get to carry over a portion of the POWER account from one year to the next. The average premium is $130
Unfortunately, Governor Daniels had to freeze HIP enrollment in March 2010 because under Obamacare HIP enrollees will have to go into Medicaid.
Health and Human Services Secretary Kathleen Sebelius told an audience at the Indiana University School of Medicine on May 14, 2010 that the health reform law didn't outlaw Healthy Indiana. "There's no change that [health reform] made that would make this waiver program difficult to pursue in the future."
PS The federal waiver authorizing Healthy Indiana expires at the end of 2012.
PPS In November of 2011, Sebelius rejected Indiana’s request to keep Healthy Indiana and exempt it from Obamacare.
About 25,000 adults without children have been on a waiting list for the program, while adults with kids are still being enrolled.
Unless Obamacare is overturned or dramatically reformed, they will still be waiting. Their only choice will be Medicaid. As the video on Healthy Indiana shows, for those who rely on HIP for coverage, that’s not a choice at all.
http://www.youtube.com/watch?v=qoWothG4b2Y
Too often media coverage of scientific studies are rife with what behavioral economist Daniel Kahenman calls "the availability heuristic." The availability heuristic is a mental shortcut that uses the ease with which examples come to mind to make judgements about the probability of events.
In reporting terms that translates into taking top line results and fitting into a pre-conception or narrative.
Such is the case with reporting on a study comparing the effectiveness of paclitaxel and bevacizumab with a nano-sized form of paclitaxel called Abraxane & Avastin as well as Xyempra and Avastin.
Here's the MedPage account of the study:
"Patients with metastatic breast cancer did just as well -- and maybe better -- with paclitaxel-based chemotherapy compared with two newer, more expensive agents, results of a randomized trial showed.
First-line treatment with weekly paclitaxel and bevacizumab (Avastin) resulted in a median progression-free survival (PFS) of 10.6 months compared with 9.2 months with nanoparticle albumin-bound paclitaxel (nab-paclitaxel or Abraxane) and 7.6 months with ixabepilone (Ixempra), each paired with bevacizumab.
The ixabepilone arm had significantly worse PFS at an interim analysis and was dropped from the trial.
Patients who received paclitaxel also had less peripheral neuropathy than with either of the other drugs, and less hematologic toxicity than those who received nab-paclitaxel, Hope Rugo, MD, reported here at the American Society of Clinical Oncology meeting.
"Neither weekly nab-paclitaxel nor ixabepilone is superior to weekly paclitaxel," Rugo, of the University of California San Francisco, said during an ASCO press briefing. "Weekly paclitaxel appears to offer better progression-free survival than ixabepilone."
"These data suggest that similar patients could be appropriately treated with weekly paclitaxel," she added.
During the discussion that followed her presentation, Rugo described cost issues surrounding cancer therapies as "enormously complicated," but said that generic drugs such as paclitaxel will always be less expensive than newer drugs that are not available as generics.
Funded by the National Cancer Institute (NCI), the trial came about as a result of recent developments in the treatment of metastatic breast cancer."
Of course, the funding had nothing to do with comparative effectiveness research efforts to claim that cheaper is better. But I digress
The study and the Medpage article is yet more evidence -- pouring in at the ASCO meeting as I write -- that targeted therapies or targeted use of therapies based on biomarkers and mechanisms of action implicated in both toxicity and tumor response -- is replacing the one size fits all approaches and comparisions that NCI supports.
The fact that you have to get into the weeds about the study and have to put it into context of other studies looking at Abraxane and Xyempra underscores this point.
For instance: Abraxane was designed to be longer lasting and administered at lower doses and less often.
The study used 150 mg/m2 weekly and has a 30% higher weekly dose intensity than the approved dose of 260 mg/m2 every 3 weeks.
Still Abraxane has been used in weekly fashion, to great effect: "in phase 2, median progression-free survival (PFS) was 18.9 months for 150 mg/m2 weekly nab-paclitaxel vs 8.5-13.8 months for all other regimens. In phase 3, median PFS for q3w nab-paclitaxel and solvent-based paclitaxel were 5.6 months and 3.5 months, respectively. Weekly nab-paclitaxel resulted in less serious adverse events compared with all other regimens.
Breast. 2011 Oct;20(5):468-74.
The outlier in all Abraxane studies is the current one. Why? Abraxane is formulated as a monotherapy for metastatic breast cancer, not in combination with Avastin. It's not just a stronger or smaller form of paclixtel.. it also targets a previously unrecognized tumor upregulated path through the blood vessel wall.
Nearly half of the people enrolled in the study dropped out due to toxicity issues. So in effect, the investigators forced cancer patients to stay on a regimen that was toxic..
Yet, even using Abraxane in an off-label manner, patients who took the combo lived an average (again, a suspect number in cancer trials these days) of 9.6 more months compared to 10.4 months for paclixtel and Avastin.
Did the higher toxicity result from the combination of a higher than prescribed dose and using it with Avastin? They researchers and the media account don't even ask that question. Instead they hew to the availability heuristic:
Rugo described cost issues surrounding cancer therapies as "enormously complicated," but said that generic drugs such as paclitaxel will always be less expensive than newer drugs that are not available as generics.
Well, yes they are. For instance:
1. One smaller dose of Abraxane costs slightly more than the same as four weeks of paclitaxel.
2. Several studies have shown that Abraxane use in women with MBC cuts down on the amount of time and services required to treat toxicity, to administer the drug and enhances quality of life. For isntance: " Nab-paclitaxel had the lowest incidence of grade III/IV toxicity. This translated to lower overall costs for managing the grade III/IV events relative to both docetaxel and paclitaxel ($597 vs. $2626 vs. $1227). Using the median number of cycles administered and the cost impact of grade III/ IV toxicity, the overall cost for nab-paclitaxel would be $15,105 compared to $15,268 for docetaxel and $3557 for paclitaxel. When treatment preferences were assessed, 20 of 24 (83.3%) respondents selected nab-paclitaxel as their preferred choice compared to only 4 who selected docetaxel." J Oncol Pharm Pract. 2009 Jun;15(2):67-78.
3. Then there's the fact that there are severe shortages of paclitaxel:
Chemo Drug Taxol Shortage Puts Cancer Patients at Risk
So is it worth switching breast cancer patients to a drug that incurs more costs and reduces quality of life, a drug that people die waiting for?
No one asked or answered that question.
CBO Estimate of the Statutory Pay-As-You-Go Effects for an Amendment in the Nature of a Substitute to H.R. 5651, the Food and Drug Administration Reform Act of 2012, as posted on the Web site of the Committee on Energy and Commerce on May 25, 2012
Source: Congressional Budget Office.
The bill would modify how the Food and Drug Administration regulates drugs and devices in a broad range of areas. Several provisions of the bill would affect when lower-priced drugs enter the market. Changing the timing of availability of lower-priced drugs affects spending in federal health programs that pay for prescription drugs and biological products. It would also affect the costs of health insurance plans and thus federal subsidies for health insurance purchased through an exchange. On net, the bill would result in a reduction in the deficit of $114 million over the 2012-2017 period, which is the sum of a reduction in direct spending of $113 million and an increase in revenues of $1 million. Similarly, the 10-year net reduction in deficits of $370 million is the sum of a reduction in direct spending of $365 million and an increase in revenues of $5 million.
The CBO chart can be found here.
The mayor will issue a proclamation in honor of the day established by the Salvation Army in 1938 to honor donut lassies who served treats to soldiers in WWI.
Mayor Bloomberg has stirred up controversy by saying he wants to ban the sale of sugary drinks over 16 ounces from establishments that receive a letter grade from the Health Department.
The health commissioner says the ban could make an immediate impact.
"Sugary drinks are not the entire obesity epidemic but they are uniquely strongly associated with the rise in obesity over the last 30 years. There's something about this sugar water product which leads to long term weight gain," said City Health Commissioner Thomas Farley.
The New York City Beverage Association and fast food restaurants are among those sharply criticizing the plan, with a spokesperson for McDonald's calling it "misguided."
The Riverdale Press
May 30, 2012
By Peter J. Pitts
The second anniversary of President Obama’s Affordable Care Act (ACA) just passed. And two years after its enactment, the debate over health care reform is every bit as contentious. The recently released forecast from the Congressional Budget Office (CBO) offers fodder to both sides.
On one hand, the law may cost $50 billion less over the next ten years than projected in January — but the national budget deficit is now projected to be $93 billion higher. Medicare and Medicaid expenditures are projected to more than double over the next decade, despite 4 million fewer Americans getting health insurance.
For anyone in favor of improving our healthcare system, these numbers make clear just how desperately our county’s entitlement programs need real reform.
Unfortunately, the president’s chosen cost-cutting strategy for Medicare — the establishment of the Independent Payment Advisory Board (IPAB), an all-powerful panel of budget enforcers — is one of the most harmful aspects of ACA. Lawmakers must cast this flawed approach to reform aside and focus instead on innovative initiatives that address the program’s real cost-drivers while protecting seniors’ access to care.
IPAB is a board of 15 presidential appointees. Unelected and unaccountable, these bureaucrats are tasked with drawing up budget cuts if Medicare expenditures exceed preset targets.
Those targets will almost certainly be surpassed. Medicare spending is expected to be $575.7 billion this year, jumping to over $1 trillion by 2022, as the country ages. Over the next 75 years, the program is projected to accumulate a $38 trillion budget shortfall.
Much of this enormous price tag goes towards financing Medicare Parts A and B. And yet, IPAB has no authority over either. In fact, the board can’t make any substantive structural changes. Neither the fee-for-service structure nor enrollee premiums and fees can be altered.
The board’s only viable option is to further ratchet down reimbursement rates for Medicare providers, especially doctors, who are already losing money on Medicare patients. Indeed, the financial burden of too-low payments under Medicare has driven 17 percent of doctors and 31 percent of primary care physicians across the country out of the Medicare program altogether, according to a study from the American Medical Association.
If rates fall any lower, seniors will have an increasingly difficult time securing doctor appointments. Visits will be cut short to squeeze in patients and care compromised.
IPAB is even more insidious because it deflects policymakers’ attention from innovative reform efforts with real cost-saving potential.
Last June, the Department of Health and Human Services (HHS) launched two such initiatives.
The first would make $42 million available to improve coordination of care for Medicare enrollees. Consider that just about half of Medicare beneficiaries suffering from congestive heart failure are readmitted to a hospital within six months of discharge. Each readmission costs an average of $7,000. The health and monetary benefits of improved coordination to make such readmissions unnecessary would be huge. Evidence shows that well designed transitional care between providers can dramatically reduce costs and improve health care outcomes.
Limiting preventable Medicare hospital readmissions could save nearly $245 billion over the current ten-year budget window, according to MedPAC. Even a 40 percent reduction could save $100 billion over that same period.
The second HHS initiative combats chronic illness. This has enormous cost-cutting potential, as 75 percent of health care expenditures go towards the treatment of chronic diseases. Diabetes, heart disease and strokes alone cost $1 trillion annually.
Patient coaching and health education could both improve enrollee health and reduce the costs of treating such illnesses. A clinical trial of the Diabetes Prevention Program found that enrolling overweight adults aged 60-64 in a community-based weight loss program could save Medicare between $1.8 and $2.3 billion over ten years.
Both HHS initiatives hold the promise of saving money and lives. The same cannot be said for IPAB. Instead of generating savings by improving the health of beneficiaries, IPAB devalues these efforts, squeezing doctors and providers to the detriment of seniors.
It’s time to support a Medicare cost-saving strategy that encourages long-term strategic thinking. Congress must repeal IPAB and stand up for real Medicare reform.
Peter Pitts is President of the Center for Medicine in the Public Interest and a former FDA Associate Commissioner.
“The health department/City Hall will tomorrow propose that any location that gets a restaurant letter grade will be barred from selling sugar-sweetened beverages over 16 ounces. This would also apply to food trucks.”
And here’s something from the NYC Fox affiliate:
“Get ready to sell smaller containers of soda and other sweetened drinks. The obesity task force with the New York City Department of Health is ready to recommend that containers for sweetened beverages be limited to 16 ounces. The rule would affect drinks sold at delis, fast-food franchises, sports arenas, and sidewalk carts. Anyone who violates the regulation would be fined $200 for every sale.”
I can’t wait for the first 7-11 sting to stop the sale of Big Gulps, the undercover operation to the illegal sale of Mountain Dew refills at movie theaters and the Gatorade bodega/salad bar busts designed to break up multiple bottle sales.
It would also apply to those souvenir soft drink cups at Yankee Stadium, CitiField and Madison Square Garden. But not the 24 ounce beer cups. (As we all know, beer does NOT add weight.)
Or jumbo sno-cones. (I think.) Or coffee with lots of sugar and cream. Then again, will we be allowed to add sugar to our beverages?
I am sure some people actually care if such a regulation will – as Bloomberg claims – reduce obesity. It really doesn’t matter. If obesity rates (using the unreliable measure of Body Mass Index) remain essentially unchanged in The Big Apple(and the have not really budged since 2005 ) since the Mayor started his crack down on sugar and soft drinks ( the consumption of the latter also remains essentially flat) then it will be argued that the assault on serving size is critical.
If Bloomberg claims (incorrectly) – as he has– that the subway ads linking soft drinks to morbid obesity and a ban on soda sales in schools have reduced obesity (and they have not) then a container size crackdown will lead to even greater gains, I mean losses. In fact, sweetened beverage consumption has declined nationwide over the past few years. Do we really know why? No. Does it have any affect on health? No one knows. Are NYC statistics on sweetend-beverage consumption reliable. The data is based on self-reported consumption. For all we know, all the kvetching about soft drinks is just making people lie.. as in telling those conducting surveys what they think they want to know. But who cares? And who in the media has ever looked at the data apart from using it to restate the narrative of evil corporations poisoning our kids. So much for the media being more careful reporting statistics and science after perpetuating the Wakefield vaccine fakery.
We have arrived at this silly place in public policy because the operators of the Nanny State and the media willingly accept the spurious correlation between soda consumption and obesity because it reaffirms pre-existing biases. These biases are reinforced by sloppy “studies” that associate watching TV with drinking soft drinks and both with obesity. Next thing you know NYC is running ads linking soda to leg amputation.
Nagging – by our parents or a billionaire baby sitter with too much time – and one term too many – on his hands has never produced changes in habits, especially eating, drinking and exercise. People – especially in NYC – will find a way to chow and slurp down what they want, when they want.
Which they will. After they stop laughing and ridiculing the latest Bloomberg effort.
The U.S. House of Representatives voted 387-5 on Wednesday to pass its version of PDUFA reauthorization legislation. The bill will now need to be reconciled with a version that passed the Senate last Thursday. Majority Leader Eric Cantor said he hopes to reach an agreement with the Senate by July 4 on a final bill to send to President Obama.