Latest Drugwonks' Blog
Sicko open last week in 300 theaters and took in $4.5 mill. This past week it took in $3.6 in over 700 theaters.
More people saw Moore get the crap kicked out of him by Sanjay Gupta on Larry King Live than went to see his movie.
More people saw Moore get the crap kicked out of him by Sanjay Gupta on Larry King Live than went to see his movie.
In another blow to those who want keep Americans taking old medicines by banning access to free samples, marketing, continuing medical education, off label use and other methods that increase new drug use, this from my former perch at the Manhattan Institute and Frank Lichtenberg:
"It is no surprise that Americans are living longer today than in previous generations. A typical baby born in 1900 was expected to live to about age 45. Today, life expectancy at birth is about 78. Less well known, however, is the fact that the gains in life expectancy have not been uniform across the country. In his new study—the first of its kind—Columbia University researcher Frank Lichtenberg set out to find out which states are the leaders, which ones are the laggards, and why.
Lichtenberg then set out to examine why this “longevity increase gap†exists by measuring the impact of several factors that researchers agree could affect life expectancy. He found that, although some obvious suspects—obesity, smoking, and the incidence of HIV/AIDS—played a role, the most important factor was “medical innovation.â€
Specifically, Lichtenberg found that longevity increased the most in those states where access to newer drugs—measured by mean “vintage†(FDA approval year)—in Medicaid and Medicare programs has increased the most. In fact, about two-thirds of the potential increase in longevity—the longevity increase that would have occurred if obesity, income, and other factors had not changed—is attributable to the use of newer drugs. "
Here's a link to the study:http://www.manhattan-institute.org/html/mpr_04.htm
"It is no surprise that Americans are living longer today than in previous generations. A typical baby born in 1900 was expected to live to about age 45. Today, life expectancy at birth is about 78. Less well known, however, is the fact that the gains in life expectancy have not been uniform across the country. In his new study—the first of its kind—Columbia University researcher Frank Lichtenberg set out to find out which states are the leaders, which ones are the laggards, and why.
Lichtenberg then set out to examine why this “longevity increase gap†exists by measuring the impact of several factors that researchers agree could affect life expectancy. He found that, although some obvious suspects—obesity, smoking, and the incidence of HIV/AIDS—played a role, the most important factor was “medical innovation.â€
Specifically, Lichtenberg found that longevity increased the most in those states where access to newer drugs—measured by mean “vintage†(FDA approval year)—in Medicaid and Medicare programs has increased the most. In fact, about two-thirds of the potential increase in longevity—the longevity increase that would have occurred if obesity, income, and other factors had not changed—is attributable to the use of newer drugs. "
Here's a link to the study:http://www.manhattan-institute.org/html/mpr_04.htm
By the looks of it and the typical Moore reaction (attacking his critics personally) CNN's Sanjay Gupta's look at the fudgy facts of Moore's movie have really hit a nerve. Moore was really steaming as Gupta continued to point out that links to MSNBC web sites are not real citations and projected numbers are not actual dollars spent.
Even when Moore's acolytes and staffers try to defend him they step in it. For example, Deborah Burger, the head of the California Nurses Association claims that Aetna CEO Troy Brennan claimed that " recent statistics from the Institution of Healthcare Improvement document "that people are waiting an average of about 70 days to see a provider."
http://www.michaelmoore.com/sicko/news/article.php?id=10023
Uh, actually the Institution FOR Healthcare Improvement document was referring to the Amarillo VA Health Care System which reorganized Primary Care in January 2000 based on the principles of Advanced Clinic Access. It had a waiting time for 76 days and reduced the time to 20 days by using the new software system. And the system is designed to reduce the backlog of no-show appointments which is unrelated to excess demand.
It took them one month to cut the waiting time by two thirds. Meanwhile, primary care waiting time for first appointments in the UK are, what, 3 months at a minimum?
And don't give me the crap from the Commonwealth Fund...that compared Medicaid recipients (government care) and the unisured poor to middle class and rich people who supplement their care with private health insurance in other countries. And Commonwealth failed to sample in rural areas internationally where health and access disparities show up. And even then, Americans did as well or better than less diverse and urbanized countries in getting prompt care. Oh, they never told you that? Neither does Michael Moore.
Read here
Even when Moore's acolytes and staffers try to defend him they step in it. For example, Deborah Burger, the head of the California Nurses Association claims that Aetna CEO Troy Brennan claimed that " recent statistics from the Institution of Healthcare Improvement document "that people are waiting an average of about 70 days to see a provider."
http://www.michaelmoore.com/sicko/news/article.php?id=10023
Uh, actually the Institution FOR Healthcare Improvement document was referring to the Amarillo VA Health Care System which reorganized Primary Care in January 2000 based on the principles of Advanced Clinic Access. It had a waiting time for 76 days and reduced the time to 20 days by using the new software system. And the system is designed to reduce the backlog of no-show appointments which is unrelated to excess demand.
It took them one month to cut the waiting time by two thirds. Meanwhile, primary care waiting time for first appointments in the UK are, what, 3 months at a minimum?
And don't give me the crap from the Commonwealth Fund...that compared Medicaid recipients (government care) and the unisured poor to middle class and rich people who supplement their care with private health insurance in other countries. And Commonwealth failed to sample in rural areas internationally where health and access disparities show up. And even then, Americans did as well or better than less diverse and urbanized countries in getting prompt care. Oh, they never told you that? Neither does Michael Moore.
Read here
The Priesthood of Pharmaceutical Purists use trial attorney winnings to in part finance their attack on industry. One of their meal tickets is going to three squares behind bars.....
"Milberg Weiss' Bershad Pleads Guilty to Conspiracy in Kickback Plan
Name partner at securities plaintiffs law firm agrees to cooperate and to forfeit $7.75 million"
David J. Bershad, a name partner at securities plaintiffs law firm Milberg Weiss & Bershad, has pleaded guilty to federal charges that he conspired in the payment of illegal kickbacks to individual class action plaintiffs.
The guilty plea by Bershad, entered Monday afternoon in federal court in Los Angeles, raises the stakes for his co-defendants, former fellow name partner Steven G. Schulman and the Milberg Weiss firm itself, as well as the other major Milberg Weiss figures, Melvyn I. Weiss and William S. Lerach, who have so far escaped indictment.
http://www.law.com/jsp/article.jsp?id=1183971987057&rss=newswire
Now Millberg Weiss is part of the Prescription Access Litigation Project (PAL). But PAL conveniently leaves the firm off it's website. But since drugwonks is all about transparency, here is a reminder of their close connection, courtesy of MassPIRG
http://masspirg.org/MA.asp?id2=5318&id3=MA& and PAL itself
http://www.prescriptionaccess.org/press/pressreleases?id=0013
"Milberg Weiss' Bershad Pleads Guilty to Conspiracy in Kickback Plan
Name partner at securities plaintiffs law firm agrees to cooperate and to forfeit $7.75 million"
David J. Bershad, a name partner at securities plaintiffs law firm Milberg Weiss & Bershad, has pleaded guilty to federal charges that he conspired in the payment of illegal kickbacks to individual class action plaintiffs.
The guilty plea by Bershad, entered Monday afternoon in federal court in Los Angeles, raises the stakes for his co-defendants, former fellow name partner Steven G. Schulman and the Milberg Weiss firm itself, as well as the other major Milberg Weiss figures, Melvyn I. Weiss and William S. Lerach, who have so far escaped indictment.
http://www.law.com/jsp/article.jsp?id=1183971987057&rss=newswire
Now Millberg Weiss is part of the Prescription Access Litigation Project (PAL). But PAL conveniently leaves the firm off it's website. But since drugwonks is all about transparency, here is a reminder of their close connection, courtesy of MassPIRG
http://masspirg.org/MA.asp?id2=5318&id3=MA& and PAL itself
http://www.prescriptionaccess.org/press/pressreleases?id=0013
Trevor Butterworth sums up the sad state of Steve Nissen, the NEJM and the media in his post. And the Priesthood of Pharmaceutical Purists, trial attorneys and assorted Whack Packers want to entrust the public health to these sort of people???
http://www.huffingtonpost.com/trevor-butterworth/a-crusading-doctor-stumbl_b_55681.html
http://www.huffingtonpost.com/trevor-butterworth/a-crusading-doctor-stumbl_b_55681.html
I wanted to call attention to my recent piece in the Florida Sun-Sentinel about insomnia, and its related health issues. The piece centers on the recent excellent Alan Berliner documentary Wide Awake on HBO.
I am what i would call a self-induced insomniac, i use it to get my writing done and meet deadlines. Unfortunately, this establishes a pattern of middle of the night wakefulness which persists even when i have no deadline. This is not good for my health. I don't currently take sleeping pills, but many of my patients find them useful - and in fact Ambien is one of those examples of good drugs that to from panacea to panic whenevever a media report focuses on the rare sleepwalker. All drugs should be managed or monitored by the doctors who prescribe them, but they are not good guys or bad guys, they are useful arrows in our medical quiver.
http://www.sun-sentinel.com/news/opinion/sfl-forum06insomnianbjul06,0,5107682.story?coll=sfla-news-opinion
I am what i would call a self-induced insomniac, i use it to get my writing done and meet deadlines. Unfortunately, this establishes a pattern of middle of the night wakefulness which persists even when i have no deadline. This is not good for my health. I don't currently take sleeping pills, but many of my patients find them useful - and in fact Ambien is one of those examples of good drugs that to from panacea to panic whenevever a media report focuses on the rare sleepwalker. All drugs should be managed or monitored by the doctors who prescribe them, but they are not good guys or bad guys, they are useful arrows in our medical quiver.
http://www.sun-sentinel.com/news/opinion/sfl-forum06insomnianbjul06,0,5107682.story?coll=sfla-news-opinion
The Journal of Life Science provides a great weekly brief of health care and medical innovation news and opinion. This week is no different.
http://www.tjols.com/wb/07jul06.html#diabetes
What I find striking is that so many of the incremental advances in medicine -- those that will lead to more predictive and preventive care -- will depend on future investment to both test the validity and reliability of new information as real products. To quote Robert Solow many if not most innovations need to be embodied in new kinds of ..... equipment before they can be made effective. Improvements in technology affect output only to the extent that they are carried into practice either by net capital formation or by the replacement of old-fashioned equipment by the latest models…â€
Of course, that process of commercialization requires profit, risk taking, marketing, industrial-academic relationships, patent protection. In short, everything need to make this world a better place through technological advancement most of what I will call the Whack Pack either opposes, makes money critcizing or suing.
Now nothing's perfect and change is constant. Compassion, trust and honesty should inform all social relations. But to suggest ridding science of commercialism will bring about a better and brave new world is...in a word, whacky and dangerous.
http://www.tjols.com/wb/07jul06.html#diabetes
What I find striking is that so many of the incremental advances in medicine -- those that will lead to more predictive and preventive care -- will depend on future investment to both test the validity and reliability of new information as real products. To quote Robert Solow many if not most innovations need to be embodied in new kinds of ..... equipment before they can be made effective. Improvements in technology affect output only to the extent that they are carried into practice either by net capital formation or by the replacement of old-fashioned equipment by the latest models…â€
Of course, that process of commercialization requires profit, risk taking, marketing, industrial-academic relationships, patent protection. In short, everything need to make this world a better place through technological advancement most of what I will call the Whack Pack either opposes, makes money critcizing or suing.
Now nothing's perfect and change is constant. Compassion, trust and honesty should inform all social relations. But to suggest ridding science of commercialism will bring about a better and brave new world is...in a word, whacky and dangerous.
That oft repeated question by the proponents of drug importation. Sadly, today's answer is, in Vancouver.
Here's the news from Canada's newspaper of record, the Toronto Globe & Mail.
ONLINE PHARMACIES
Counterfeit drugs caused woman's death, coroner concludes
ARMINA LIGAYA
July 6, 2007
VANCOUVER -- Shoddy pills from a bogus online pharmacy are to blame for the death of a 58-year-old woman from Vancouver Island, a coroner's report says.
Yesterday's conclusion makes Marcia Bergeron the first clear-cut case of a death stemming from counterfeit drugs bought on the Internet, but it likely won't be the last, said Rose Stanton, regional coroner for Vancouver Island.
"The quantity of seized counterfeit medication is huge," she said. "And so, what we have is the first person [for whom] we have all the facts, who we know died as a result of these drugs.
"But what we also know is lots of people are buying these drugs. So the potential for more deaths is high."
Ms. Bergeron was found by a friend on Dec. 28, 2006, in her bed in a normal sleeping position. Emergency services were called, but it was clear she had been dead for some time.
Three types of pills were found at Ms. Bergeron's home. One contained Zolpidem, a powerful hypnotic not available in Canada. Another contained the anti-anxiety medication Alprazolam, which is available with a prescription, and the third contained acetaminophen.
These drugs were later determined to be laced with extremely high quantities of metal. The acetaminophen pill had 15 times the amount of aluminum that would be fatal, Ms. Stanton said.
An autopsy showed that Ms. Bergeron died of cardiac arrhythmia stemming from metal toxicity.
In the weeks and months leading up to her death, she complained of flu-like symptoms. Ms. Bergeron said, in e-mails to a friend, that her hair was falling out, and she suffered from nausea, diarrhea, aching joints and blurry vision.
When the pills were tested, they were of such poor quality, the ingredients seemed "mashed together" Ms. Stanton said. The mixture of drugs and metal in each pill would vary depending on which portion was examined, she said.
The metal contaminants were likely part of the filler materials used to make the pills, the coroner's report said.
On Ms. Bergeron's computer, records showed she had been visiting websites from which medication could be purchased.
When U.S. Food and Drug Administration investigators examined her hard drive, it showed Ms. Bergeron bought Zolpidem - a powerful sedative available by prescription in the U.S. but not in Canada.
The website she used, which purported to be Canadian but has since gone offline, was previously flagged by the FDA concerning counterfeit Zolpidem.
Because of all these elements - computer records, e-mails, drugs found on scene and a subsequent autopsy - investigators were able to definitively link the online drugs to Ms. Bergeron's death.
It's an FDA first, Ms. Stanton said.
She said the website Ms. Bergeron used is one of thousands that claim to be reputable pharmacies.
"The site that she purchased from is one of a group of sites that the FDA says use the tactic of phoning people after they get the first order," she said. "They phone for the renewal so there isn't a computer record."
Marnie Mitchell, CEO of the B.C. Pharmacy Association said that Canada has a very regulated and monitored pharmacy system, and stepping away from it has risks.
"Online sources are very difficult to assess their legitimacy and their safety," she said. "This is a very tragic episode and illustration of the problems that stem from going to those kinds of places."
Cracking down on these websites, however, would be a difficult endeavour, she said, because they change and shift very quickly and are hard to trace.
Instead, she recommended the federal government launch a public-awareness campaign to warn people of the potential dangers.
Alain Desroches, spokesperson for Health Canada said the agency regularly flags counterfeit products and issues public advisories. It also works with RCMP in investigating counterfeit drugs. However, he could not comment on any policy changes that would stem from the coroner's findings.
"We welcome the report and it's going to be reviewed carefully," he said.
Here's the news from Canada's newspaper of record, the Toronto Globe & Mail.
ONLINE PHARMACIES
Counterfeit drugs caused woman's death, coroner concludes
ARMINA LIGAYA
July 6, 2007
VANCOUVER -- Shoddy pills from a bogus online pharmacy are to blame for the death of a 58-year-old woman from Vancouver Island, a coroner's report says.
Yesterday's conclusion makes Marcia Bergeron the first clear-cut case of a death stemming from counterfeit drugs bought on the Internet, but it likely won't be the last, said Rose Stanton, regional coroner for Vancouver Island.
"The quantity of seized counterfeit medication is huge," she said. "And so, what we have is the first person [for whom] we have all the facts, who we know died as a result of these drugs.
"But what we also know is lots of people are buying these drugs. So the potential for more deaths is high."
Ms. Bergeron was found by a friend on Dec. 28, 2006, in her bed in a normal sleeping position. Emergency services were called, but it was clear she had been dead for some time.
Three types of pills were found at Ms. Bergeron's home. One contained Zolpidem, a powerful hypnotic not available in Canada. Another contained the anti-anxiety medication Alprazolam, which is available with a prescription, and the third contained acetaminophen.
These drugs were later determined to be laced with extremely high quantities of metal. The acetaminophen pill had 15 times the amount of aluminum that would be fatal, Ms. Stanton said.
An autopsy showed that Ms. Bergeron died of cardiac arrhythmia stemming from metal toxicity.
In the weeks and months leading up to her death, she complained of flu-like symptoms. Ms. Bergeron said, in e-mails to a friend, that her hair was falling out, and she suffered from nausea, diarrhea, aching joints and blurry vision.
When the pills were tested, they were of such poor quality, the ingredients seemed "mashed together" Ms. Stanton said. The mixture of drugs and metal in each pill would vary depending on which portion was examined, she said.
The metal contaminants were likely part of the filler materials used to make the pills, the coroner's report said.
On Ms. Bergeron's computer, records showed she had been visiting websites from which medication could be purchased.
When U.S. Food and Drug Administration investigators examined her hard drive, it showed Ms. Bergeron bought Zolpidem - a powerful sedative available by prescription in the U.S. but not in Canada.
The website she used, which purported to be Canadian but has since gone offline, was previously flagged by the FDA concerning counterfeit Zolpidem.
Because of all these elements - computer records, e-mails, drugs found on scene and a subsequent autopsy - investigators were able to definitively link the online drugs to Ms. Bergeron's death.
It's an FDA first, Ms. Stanton said.
She said the website Ms. Bergeron used is one of thousands that claim to be reputable pharmacies.
"The site that she purchased from is one of a group of sites that the FDA says use the tactic of phoning people after they get the first order," she said. "They phone for the renewal so there isn't a computer record."
Marnie Mitchell, CEO of the B.C. Pharmacy Association said that Canada has a very regulated and monitored pharmacy system, and stepping away from it has risks.
"Online sources are very difficult to assess their legitimacy and their safety," she said. "This is a very tragic episode and illustration of the problems that stem from going to those kinds of places."
Cracking down on these websites, however, would be a difficult endeavour, she said, because they change and shift very quickly and are hard to trace.
Instead, she recommended the federal government launch a public-awareness campaign to warn people of the potential dangers.
Alain Desroches, spokesperson for Health Canada said the agency regularly flags counterfeit products and issues public advisories. It also works with RCMP in investigating counterfeit drugs. However, he could not comment on any policy changes that would stem from the coroner's findings.
"We welcome the report and it's going to be reviewed carefully," he said.
In today's New York Times, Paul Krugman calls for universal health care in the United States, calls those who oppose it all sorts of nasty names, and points to SiCKO as his proof of concept.
Note to Paul: Read the ads for SiCKO in your own paper -- it's billed as a comedy.
To get a feel for his general position, consider this statement, "Medicare ... is being undermined by privatization."
What he doesn't say is that ... it's working. Every poll shows that seniors are very pleased with the Part D benefit-- and by huge margins. And every government report shows that the program is coming in significantly below cost projections.
Imagine that, a government program that people like and comes in under budget. Privatization may seem like a frightening concept to Mr. Krugman, but it sure works.
But why let facts get in the way when you've got an agenda to pursue?
And here's the agenda, summed up in one sentence:
"Universal health care would save thousands of American lives each year, while actually saving money."
Really? All the statistics from Europe and other nations with government-run health care say different. Having just returned from a conference of European health care experts, regulatory officials, and legislators, I can attest to the many problems European government are facing as they try to reinvent their own national systems for the 21st Century.
Paul -- come with me to Europe and let's film a documentary of not only care denied but care unavailable. I'm sure we could make it as "entertaining" as SiCKO. It's easy to prove an argument when you cherry-pick the facts. We can call our movie "MaLADE-O."
Ooh-la-la!
Mark Twain wrote, "For every complex problem there is a simple solution -- and it is usually wrong."
Alas, there is no perfect, easy solution to the American health care miasma. That only happens in the movies.
For a more balanced view of how to advance the cause of health care in America, read what HHS Secretary Mike Leavitt has to say ...
http://www.washingtontimes.com/article/20070709/EDITORIAL/107090020/1013
And -- see you at the movies.
Note to Paul: Read the ads for SiCKO in your own paper -- it's billed as a comedy.
To get a feel for his general position, consider this statement, "Medicare ... is being undermined by privatization."
What he doesn't say is that ... it's working. Every poll shows that seniors are very pleased with the Part D benefit-- and by huge margins. And every government report shows that the program is coming in significantly below cost projections.
Imagine that, a government program that people like and comes in under budget. Privatization may seem like a frightening concept to Mr. Krugman, but it sure works.
But why let facts get in the way when you've got an agenda to pursue?
And here's the agenda, summed up in one sentence:
"Universal health care would save thousands of American lives each year, while actually saving money."
Really? All the statistics from Europe and other nations with government-run health care say different. Having just returned from a conference of European health care experts, regulatory officials, and legislators, I can attest to the many problems European government are facing as they try to reinvent their own national systems for the 21st Century.
Paul -- come with me to Europe and let's film a documentary of not only care denied but care unavailable. I'm sure we could make it as "entertaining" as SiCKO. It's easy to prove an argument when you cherry-pick the facts. We can call our movie "MaLADE-O."
Ooh-la-la!
Mark Twain wrote, "For every complex problem there is a simple solution -- and it is usually wrong."
Alas, there is no perfect, easy solution to the American health care miasma. That only happens in the movies.
For a more balanced view of how to advance the cause of health care in America, read what HHS Secretary Mike Leavitt has to say ...
http://www.washingtontimes.com/article/20070709/EDITORIAL/107090020/1013
And -- see you at the movies.
Word on the Hill is that Rahm Emanuel is going to try to tag sound FDA reform legislation with an unsound amendment on -- yes, you guessed it -- drug importation. Is anyone out there shocked? Probably not. After all, for Mr. Emanuel politics is more important than the public health.
Here's a new Chicago Tribune op-ed on why drug importation is a bad idea:
http://www.chicagotribune.com/news/opinion/chi-oped0708taintjul08,0,1697228.story?coll=chi-newsopinioncommentary-hed
You can't be for drug safety one day and against it the next. You can't rant against counterfeit tainted toothpaste and embrace the importation of foreign drugs. It's intellectually dishonest and contrary to the best interests of the public health.
Here's a new Chicago Tribune op-ed on why drug importation is a bad idea:
http://www.chicagotribune.com/news/opinion/chi-oped0708taintjul08,0,1697228.story?coll=chi-newsopinioncommentary-hed
You can't be for drug safety one day and against it the next. You can't rant against counterfeit tainted toothpaste and embrace the importation of foreign drugs. It's intellectually dishonest and contrary to the best interests of the public health.
Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.
