Latest Drugwonks' Blog
The always astute (and sometimes ascerbic) Steve Usdin of BioCentury has written an important and stimulating article on the road to PDUFA reauthorization.
Must reading.
Here's the link:
Download file
And many thanks to BioCentury for their permission to post this article in its entirety.
Must reading.
Here's the link:
Download file
And many thanks to BioCentury for their permission to post this article in its entirety.
I've been getting a bunch of calls in the wake of the announcement that Alex Azar will resign as Deputy Secretary of HHS. People want to know what will it mean for this, what will it mean for that. But here's what's important: Alex brought the power of both compassion and intellect to HHS. His departure doesn't mean we'll see any particular shift for any given industry or issue, but it does mean that HHS will lose a certain dimension of thought leadership and sophistication.
Good Luck Alex.
Good Luck Alex.
Here's the story according to AP
"Cancer deaths in the United States have dropped for a second straight year, confirming that a corner has been turned in the war on cancer.
After a decline of 369 deaths from 2002 to 2003, the decrease from 2003 to 2004 was 3,014 — or more than eight times greater, according to a review of U.S. death certificates by the American Cancer Society.
The drop from 2002 to 2003 was the first annual decrease in total cancer deaths since 1930. But the decline was slight, and experts were hesitant to say whether it was a cause for celebration or just a statistical fluke.
The trend seems to be real, Cancer Society officials said.
"It's not only continuing. The decrease in the second year is much larger," said Ahmedin Jemal, a researcher at the organization.
Cancer deaths dropped to 553,888 in 2004, down from 556,902 in 2003 and 557,271 in 2002, the Cancer Society found.
Experts are attributing the success to declines in smoking and to earlier detection and more effective treatment of tumors. Those have caused a fall in the death rates for breast, prostate and colorectal cancer — three of the most common cancers."
In the wake of this good news, the Dems are seeking to price control unique drugs -- breakthrough medicines in otherwords.
Which means medicines like those that helped reduce dying due to cancer.
Which means medicines from biotech firms that create these miracles.
The Clintons tried proposing a breakthrough drug pricing trigger in 1994 that would hammer and yammer about the price of first in class meds and whether they were all so cost effective or not. It caused biotech stocks to tank and venture capital to vanish.
I hope the D's listen to the Ron Pollacks of the world again and go ahead and do just that. As the Penn and Schoen poll shows, when people find out that price controls also mean an end to miracle cures, they hate price controls. But the D's are driven by their Beltway advisers and power brokers more than they are what people and patients truly want.
"Cancer deaths in the United States have dropped for a second straight year, confirming that a corner has been turned in the war on cancer.
After a decline of 369 deaths from 2002 to 2003, the decrease from 2003 to 2004 was 3,014 — or more than eight times greater, according to a review of U.S. death certificates by the American Cancer Society.
The drop from 2002 to 2003 was the first annual decrease in total cancer deaths since 1930. But the decline was slight, and experts were hesitant to say whether it was a cause for celebration or just a statistical fluke.
The trend seems to be real, Cancer Society officials said.
"It's not only continuing. The decrease in the second year is much larger," said Ahmedin Jemal, a researcher at the organization.
Cancer deaths dropped to 553,888 in 2004, down from 556,902 in 2003 and 557,271 in 2002, the Cancer Society found.
Experts are attributing the success to declines in smoking and to earlier detection and more effective treatment of tumors. Those have caused a fall in the death rates for breast, prostate and colorectal cancer — three of the most common cancers."
In the wake of this good news, the Dems are seeking to price control unique drugs -- breakthrough medicines in otherwords.
Which means medicines like those that helped reduce dying due to cancer.
Which means medicines from biotech firms that create these miracles.
The Clintons tried proposing a breakthrough drug pricing trigger in 1994 that would hammer and yammer about the price of first in class meds and whether they were all so cost effective or not. It caused biotech stocks to tank and venture capital to vanish.
I hope the D's listen to the Ron Pollacks of the world again and go ahead and do just that. As the Penn and Schoen poll shows, when people find out that price controls also mean an end to miracle cures, they hate price controls. But the D's are driven by their Beltway advisers and power brokers more than they are what people and patients truly want.
A federal court judge has imposed a temporary injunction against the FDA over the agency's drug pedigree requirements, on the basis that the regulations leave sections of the supply chain unguarded and threaten the survival of smaller drug distributors.
Here’s a link to the complete story:
The Prescription Drug Marketing Act (PDMA), originally put into force in 1988, outlines the requirement for a drug pedigree – a statement of origin that identifies each prior sale, purchase or trade of a drug right back to the manufacturer. However, Authorized Distributors (ADs) are exempt from having to provide pedigrees for the drugs they provide, thus leaving sections of the supply chain unmonitored and pedigrees hard to establish further down the line. Authorized distributors are somewhat hazily defined as those who have ongoing relationships with manufacturers, identifiable by evidence of repeated transactions with the manufacturer. Over 90 per cent of the drug wholesale industry in the US is controlled by a handful of companies who are authorized distributors. This group is commonly referred to as the Big Five, made up of McKesson, Bergen Brunswig, AmeriSource, Cardinal Health and Bindley Western.
The exemption means that ADs tend not to maintain or pass on pedigrees for the products they obtain from manufacturers. This becomes problematic when those further down the supply chain, ‘unauthorized’ distributors for example, are required to provide pedigrees right back to the manufacturer. It also means that over 90 per cent of the prescription drugs in the US are essentially uncovered by the PDMA’s security measures.
This issue is further exacerbated by the fact that ADs are not required to provide a pedigree even if they themselves obtained the products from a secondary wholesaler. The FDA themselves noted that some drugs may go through several transaction cycles involving multiple primary and secondary wholesalers before arriving at their retail destination. According to the National Wholesale Druggists’ Association, the Big Five purchase 2-4 per cent of their products from sources other than manufacturers, and one of the group reported that $350 million of their total inventory came from non-manufacturer vendors.
Here’s a link to the complete story:
The Prescription Drug Marketing Act (PDMA), originally put into force in 1988, outlines the requirement for a drug pedigree – a statement of origin that identifies each prior sale, purchase or trade of a drug right back to the manufacturer. However, Authorized Distributors (ADs) are exempt from having to provide pedigrees for the drugs they provide, thus leaving sections of the supply chain unmonitored and pedigrees hard to establish further down the line. Authorized distributors are somewhat hazily defined as those who have ongoing relationships with manufacturers, identifiable by evidence of repeated transactions with the manufacturer. Over 90 per cent of the drug wholesale industry in the US is controlled by a handful of companies who are authorized distributors. This group is commonly referred to as the Big Five, made up of McKesson, Bergen Brunswig, AmeriSource, Cardinal Health and Bindley Western.
The exemption means that ADs tend not to maintain or pass on pedigrees for the products they obtain from manufacturers. This becomes problematic when those further down the supply chain, ‘unauthorized’ distributors for example, are required to provide pedigrees right back to the manufacturer. It also means that over 90 per cent of the prescription drugs in the US are essentially uncovered by the PDMA’s security measures.
This issue is further exacerbated by the fact that ADs are not required to provide a pedigree even if they themselves obtained the products from a secondary wholesaler. The FDA themselves noted that some drugs may go through several transaction cycles involving multiple primary and secondary wholesalers before arriving at their retail destination. According to the National Wholesale Druggists’ Association, the Big Five purchase 2-4 per cent of their products from sources other than manufacturers, and one of the group reported that $350 million of their total inventory came from non-manufacturer vendors.
House-passed drug price bill has very little clout
By David Nicklaus
ST. LOUIS POST-DISPATCH
In any negotiation, the power lies with the person who's willing to walk away. That simple truth is obvious to anyone who's ever bought a car or a house, but somehow it escapes a majority of members of the House of Representatives.
When the House passed the Medicare Prescription Drug Price Negotiation Act last week, it ordered the government to lean on the big, bad pharmaceutical companies to get lower prices. But it also prohibited Medicare from establishing a formulary that would pay for some drugs and not others.
In other words, Medicare would have to ask drug companies to cut their prices, but it would have no leverage. It would have to cover all drugs, regardless of price. This is a change from current law, which bars the government from negotiating prices, but it's a change without substance.
You don't have to take my word for it. You can read a letter that the Congressional Budget Office sent to Rep. John Dingell, D-Mich. It says that the Price Negotiation Act "would have a negligible effect" and predicts that the government "would be unable to negotiate prices … more favorable than those obtained by prescription drug plans under current law."
Why would Congress ask Medicare to dicker with drug companies while banning the one tool that would really give Medicare some clout? The politicians apparently want to curry favor with elderly voters and with lobbying groups like AARP.
Senior citizens may worry about high prescription costs, but they certainly don't want any bureaucrat telling them which medications they can or cannot take.
A truly low-cost drug plan would have to look something like the one available to military veterans. The Department of Veterans Affairs formulary covers only 1,300 drugs, compared with 4,300 available in the typical Medicare Part D plan, says Peter Pitts, director of the Center for Medicine in the Public Interest. Thirty percent of veterans, he says, would like to switch to Part D, but they're not eligible because they already have VA coverage.
Part D plans are offered by private insurance companies, which have the option of using restrictive formularies. Most of them keep their coverage broad in order to attract customers, but just having the right to drop a drug — like threatening to walk away even though you really like the car — gives the insurers clout.
The Congressional Budget Office says insurance companies have "both the incentives and the tools to negotiate drug prices that the government, under the legislation, would not have."
If Congress really wants to reduce health care costs, it's looking in the wrong place. Prescription drugs account for just 11 cents of each health care dollar, compared with 32 cents spent at hospitals. By giving senior citizens easier access to the drugs that help manage chronic conditions, one could argue that Medicare Part D has kept many people out of hospitals.
Pitts, a former associate commissioner of the Food and Drug Administration, says Part D has surprised critics by becoming enormously popular with the over-65 crowd.
"The premiums are coming in below expectations, the cost to government is below expectations and the coverage is very good. That sounds to me like a program that is working," he said.
Congress, unfortunately, has never shied away from fixing things that are not broken.
By David Nicklaus
ST. LOUIS POST-DISPATCH
In any negotiation, the power lies with the person who's willing to walk away. That simple truth is obvious to anyone who's ever bought a car or a house, but somehow it escapes a majority of members of the House of Representatives.
When the House passed the Medicare Prescription Drug Price Negotiation Act last week, it ordered the government to lean on the big, bad pharmaceutical companies to get lower prices. But it also prohibited Medicare from establishing a formulary that would pay for some drugs and not others.
In other words, Medicare would have to ask drug companies to cut their prices, but it would have no leverage. It would have to cover all drugs, regardless of price. This is a change from current law, which bars the government from negotiating prices, but it's a change without substance.
You don't have to take my word for it. You can read a letter that the Congressional Budget Office sent to Rep. John Dingell, D-Mich. It says that the Price Negotiation Act "would have a negligible effect" and predicts that the government "would be unable to negotiate prices … more favorable than those obtained by prescription drug plans under current law."
Why would Congress ask Medicare to dicker with drug companies while banning the one tool that would really give Medicare some clout? The politicians apparently want to curry favor with elderly voters and with lobbying groups like AARP.
Senior citizens may worry about high prescription costs, but they certainly don't want any bureaucrat telling them which medications they can or cannot take.
A truly low-cost drug plan would have to look something like the one available to military veterans. The Department of Veterans Affairs formulary covers only 1,300 drugs, compared with 4,300 available in the typical Medicare Part D plan, says Peter Pitts, director of the Center for Medicine in the Public Interest. Thirty percent of veterans, he says, would like to switch to Part D, but they're not eligible because they already have VA coverage.
Part D plans are offered by private insurance companies, which have the option of using restrictive formularies. Most of them keep their coverage broad in order to attract customers, but just having the right to drop a drug — like threatening to walk away even though you really like the car — gives the insurers clout.
The Congressional Budget Office says insurance companies have "both the incentives and the tools to negotiate drug prices that the government, under the legislation, would not have."
If Congress really wants to reduce health care costs, it's looking in the wrong place. Prescription drugs account for just 11 cents of each health care dollar, compared with 32 cents spent at hospitals. By giving senior citizens easier access to the drugs that help manage chronic conditions, one could argue that Medicare Part D has kept many people out of hospitals.
Pitts, a former associate commissioner of the Food and Drug Administration, says Part D has surprised critics by becoming enormously popular with the over-65 crowd.
"The premiums are coming in below expectations, the cost to government is below expectations and the coverage is very good. That sounds to me like a program that is working," he said.
Congress, unfortunately, has never shied away from fixing things that are not broken.
Remember when we suggested that polls showing the American public strongly in favor of "government pricing" for Part D might be, er, influenced by the way the questions were posed("The Big Muscle," drugwonks.com, December 8, 2006)?
Well according to Mark Penn (aka: Hillary's new chief campaign strategist), that's precisely the case.
And the "Her" is Speaker Pelosi.
Penn, Schoen & Berland Associates and The Tarrance Group recently conducted a joint national poll measuring public opinion on the current legislative proposal that would require Congress to negotiate Medicare prescription drugs prices with pharmaceutical companies.
The summary below is really a summary judgement against "government pricing."
When Downsides are Understood, Voters Oppose Government Negotiation
While voters offer initial support for the current proposal that would require Congress to negotiate Medicare prescription drug prices with pharmaceutical companies, once voters are educated about the potential implications of the proposal, the public overwhelmingly opposes it.
* Initially, 76% of voters support government negotiation and 24% oppose it. However, when this question is asked, voters have received no details about the proposal or its possible consequences.
* After being asked about the negative implications of the proposal, opinion flips – only 35% support government negotiation and 65% oppose it. There is majority opposition across Democrats, Republicans and Independents.
Fear of the Government Limiting Access to Prescription Drugs Shifts Public Opinion
Learning that the proposal could limit access to prescription drugs dramatically erodes support for government negotiation.
* 89% oppose the proposal when they learn it could limit access to new prescription drugs.
* 87% oppose the proposal when they learn it could restrict choice of prescription drugs.
* 86% oppose the proposal when they learn similar proposals in other countries like Great Britain and Australia have restricted access to prescription drugs.
* 77% oppose the proposal when they learn that it give the government the right to create a single list of government-approved prescription drugs.
* 80% of voters judge the proposal as “not worth it†after learning that the Congressional Budget Office has reported that granting the federal government the power to negotiate drug prices will not save enough money to fill gaps in coverage.
Voters Have Clear Reservations about Government Negotiation
Voters were asked a series of questions about their opinions of government negotiation, which collectively suggest deep reservations about the proposal.
* 81% agree that the government is not a good price negotiator
* 78% agree that government negotiation would limit access to prescription drugs
* 75% agree that the market should set prescription drug prices, not the government
* 66% agree that government negotiation gives the federal government too much authority and is a dangerous precedent
Medicare Part D is Currently Well Received
Currently, opinion on the Medicare Part D prescription Drug program is very positive and improving.
* 55% of voters nationally have a favorable opinion of the program
* 61% of voters nationally say enrollees are saving money
* 68% of voters nationally say the program a step in the right direction
Other public surveys have repeatedly reported that satisfaction levels among enrollees are much higher; roughly eight-in-ten enrollees expressing satisfaction with their plans.
In conclusion, any legislation that jeopardizes the success of the Medicare Part D Prescription Drug Program would likely have a negative impact on the general public’s opinion of Congress.
Methodology
Penn, Schoen & Berland Associates and The Tarrance Group conducted 1,098 national interviews between December 19 - 22, 2006.
Interviews were conducted among Americans who voted in the 2006 midterm elections.
The overall margin of sampling error is +/-2.96% and larger among subgroups.
Well according to Mark Penn (aka: Hillary's new chief campaign strategist), that's precisely the case.
And the "Her" is Speaker Pelosi.
Penn, Schoen & Berland Associates and The Tarrance Group recently conducted a joint national poll measuring public opinion on the current legislative proposal that would require Congress to negotiate Medicare prescription drugs prices with pharmaceutical companies.
The summary below is really a summary judgement against "government pricing."
When Downsides are Understood, Voters Oppose Government Negotiation
While voters offer initial support for the current proposal that would require Congress to negotiate Medicare prescription drug prices with pharmaceutical companies, once voters are educated about the potential implications of the proposal, the public overwhelmingly opposes it.
* Initially, 76% of voters support government negotiation and 24% oppose it. However, when this question is asked, voters have received no details about the proposal or its possible consequences.
* After being asked about the negative implications of the proposal, opinion flips – only 35% support government negotiation and 65% oppose it. There is majority opposition across Democrats, Republicans and Independents.
Fear of the Government Limiting Access to Prescription Drugs Shifts Public Opinion
Learning that the proposal could limit access to prescription drugs dramatically erodes support for government negotiation.
* 89% oppose the proposal when they learn it could limit access to new prescription drugs.
* 87% oppose the proposal when they learn it could restrict choice of prescription drugs.
* 86% oppose the proposal when they learn similar proposals in other countries like Great Britain and Australia have restricted access to prescription drugs.
* 77% oppose the proposal when they learn that it give the government the right to create a single list of government-approved prescription drugs.
* 80% of voters judge the proposal as “not worth it†after learning that the Congressional Budget Office has reported that granting the federal government the power to negotiate drug prices will not save enough money to fill gaps in coverage.
Voters Have Clear Reservations about Government Negotiation
Voters were asked a series of questions about their opinions of government negotiation, which collectively suggest deep reservations about the proposal.
* 81% agree that the government is not a good price negotiator
* 78% agree that government negotiation would limit access to prescription drugs
* 75% agree that the market should set prescription drug prices, not the government
* 66% agree that government negotiation gives the federal government too much authority and is a dangerous precedent
Medicare Part D is Currently Well Received
Currently, opinion on the Medicare Part D prescription Drug program is very positive and improving.
* 55% of voters nationally have a favorable opinion of the program
* 61% of voters nationally say enrollees are saving money
* 68% of voters nationally say the program a step in the right direction
Other public surveys have repeatedly reported that satisfaction levels among enrollees are much higher; roughly eight-in-ten enrollees expressing satisfaction with their plans.
In conclusion, any legislation that jeopardizes the success of the Medicare Part D Prescription Drug Program would likely have a negative impact on the general public’s opinion of Congress.
Methodology
Penn, Schoen & Berland Associates and The Tarrance Group conducted 1,098 national interviews between December 19 - 22, 2006.
Interviews were conducted among Americans who voted in the 2006 midterm elections.
The overall margin of sampling error is +/-2.96% and larger among subgroups.
We are often criticized for being too critical of people in the public eye. So I will try and be extra careful in my remarks about Jo Ann Emerson of Missouri. She stood with Democrats to sponsor HR 4 the bill that would have required price controls for prescription drugs in the Medicare program. And she is a co-sponsor of a bill that would require reimportation of drug from foreign countries, a bill that would make it a criminal activity for companies to determine which wholesalers they want to sell to and would turn the FDA into a parcel service for European middlemen. Ms. Emerson has been vocal, indeed eloquent in her support for price controls on drugs and for allowing the importation of drugs that are cheaper from other countries due to government price controls and not because of any ingenious production method or competitive practice of another company.
Ms. Emerson says "The high cost of prescription drugs in the U.S. demands that we improve Americans' market access to safe, affordable supplies of medicines."
One of the medicines Ms. Emerson is so concerned about?
"Prilosec, they use it for gas and that sort of thing..."
Setting aside Ms. Emerson's deep knowledge of phamacotherapy, it appears her concern about the high cost of products and free trade does not extend to steel or wheat or . fertilizer from Mother Russia...
She, supported American steel companies seeking duties up to 40 percent on imported metal products and sought to ban the importation of low priced Canadian wheat. At the same time. she has opposed an International Trade Commission ruling that Russia was dumping fertilizers into America at predatory prices, because the resulting tariffs would hurt farmers.
So she opposes the importation of low priced products when it comes to wheat and steel, supports the importation of fertilizers because it helps farmers.
And she supports signficant increases in agricultural subsidies, most of which go to large corporate farms on grounds of national security....
"Re-authorizing the farm bill is the best thing to do right now," she said. "Because if we want to be dependent on countries in the world who hate us for our nation's food, then we might as well fold up shop."
But being depending on countries who hate us for our medicines is ok? Does she know who works at most of the major ports in Europe and Canada by the way?
If you find no logic or consistency to this voting -- if you smell rank opportunism as opposed to intellect driving these decisions you are not alone. For more evidence, I offer the following quote from Ms. Emerson herself explaining why she is voting with the Democrats, now that they’re in the majority, rather than with her leadership (from the NY Times):
"You're freer to vote your conscience," said Rep. Jo Anne Emerson (R-Mo.), who received an 88 percent voting record from the American Conservative Union in 2005 but has so far sided with Democrats on new budget rules, Medicare prescription-drug negotiations, raising the minimum wage and funding stem cell research. "Or, really, I feel free to represent my constituents exactly as they want me to be."
Translation: My principles. They use it for gas and that sort of thing.
Ms. Emerson says "The high cost of prescription drugs in the U.S. demands that we improve Americans' market access to safe, affordable supplies of medicines."
One of the medicines Ms. Emerson is so concerned about?
"Prilosec, they use it for gas and that sort of thing..."
Setting aside Ms. Emerson's deep knowledge of phamacotherapy, it appears her concern about the high cost of products and free trade does not extend to steel or wheat or . fertilizer from Mother Russia...
She, supported American steel companies seeking duties up to 40 percent on imported metal products and sought to ban the importation of low priced Canadian wheat. At the same time. she has opposed an International Trade Commission ruling that Russia was dumping fertilizers into America at predatory prices, because the resulting tariffs would hurt farmers.
So she opposes the importation of low priced products when it comes to wheat and steel, supports the importation of fertilizers because it helps farmers.
And she supports signficant increases in agricultural subsidies, most of which go to large corporate farms on grounds of national security....
"Re-authorizing the farm bill is the best thing to do right now," she said. "Because if we want to be dependent on countries in the world who hate us for our nation's food, then we might as well fold up shop."
But being depending on countries who hate us for our medicines is ok? Does she know who works at most of the major ports in Europe and Canada by the way?
If you find no logic or consistency to this voting -- if you smell rank opportunism as opposed to intellect driving these decisions you are not alone. For more evidence, I offer the following quote from Ms. Emerson herself explaining why she is voting with the Democrats, now that they’re in the majority, rather than with her leadership (from the NY Times):
"You're freer to vote your conscience," said Rep. Jo Anne Emerson (R-Mo.), who received an 88 percent voting record from the American Conservative Union in 2005 but has so far sided with Democrats on new budget rules, Medicare prescription-drug negotiations, raising the minimum wage and funding stem cell research. "Or, really, I feel free to represent my constituents exactly as they want me to be."
Translation: My principles. They use it for gas and that sort of thing.
Rahm Emanuel has probably never been called an "imperialist." But that's about to change. Now that he (along with Representative Emerson and Senators Snowe and Dorgan) are calling for legalizing "drugs from Canada," the Canadian Pharmacists Association, the Ontario Pharmacists' Association, the Best Medicines Coalition and the Canadian Association for Pharmacy Distribution have called on Canadian Health Minister Tony Clement to implement "an immediate ban on the export, both bulk and retail, of prescription drugs from Canada."
Here's the story from today's Toronto Globe and Mail:
http://www.theglobeandmail.com/servlet/story/LAC.20070115.PHARMACY15/TPStory/?query=pharmacists
In short, they're saying "hands off our medicines, imperalist American."
Here's the story from today's Toronto Globe and Mail:
http://www.theglobeandmail.com/servlet/story/LAC.20070115.PHARMACY15/TPStory/?query=pharmacists
In short, they're saying "hands off our medicines, imperalist American."
Want to know how the health care system operates...read Vanessa Furhman's article in Friday's Wall Street Journal " A Novel Plan Helps Hospital Wean Itself Off Pricey Tests" (The headline is a bit misleading) which describes how health care financing discourages ways to pay doctors and use technologies that prevent disease and keep people healthy.
http://online.wsj.com/article/SB116857143155174786-search.html
In a perfect world we shouldn't expand access to health care in ways that sustain this stupidity. We should give the money to providers and plans that actually will demonstrate they will improve health. That means expanding SCHIP or access to adult health care through Medicaid or Medicare is just flushing money down the toilet...
http://online.wsj.com/article/SB116857143155174786-search.html
In a perfect world we shouldn't expand access to health care in ways that sustain this stupidity. We should give the money to providers and plans that actually will demonstrate they will improve health. That means expanding SCHIP or access to adult health care through Medicaid or Medicare is just flushing money down the toilet...
Merrill Goozner of the Center for Science in the Public Interest (not to be confused with us) is in meltdown mode over the Washington Post editorial warning about government run medicine.
Here's his post on Huffington Post
http://www.huffingtonpost.com/merrill-goozner/the-right-prescription_b_38579.html
Fun to watch, but let try to make a couple of serious points here to demonstrate the faulty logic of the left...Clearly a case of their rhetoric on pharma jumping the shark.
Gooz claims that the VA is restrictive because is it not tainted by prescribing guidelines shaped by industry. All the guidelines are written by industry? Let's say that's the case. Fact is, the VA docs follow EVERY specialty association guideline in terms of treatment steps. So I guess that the industry should be given credit for something.. Then again the VA only differs in terms of drug selection and therapeutic approach.
Then again, not all government guidelines meet the Goozner standard. Hypertension guidelines and ALLHAT yes. Cholesterol guidelines that encourage earlier use of statins no. The latter were the tainted in his opinion because the doctors on the committee had industry ties. But so did everyone on the ALLHAT steering committee. What's the the difference? Gooz likes the fact that an ALLHAT rump section spun the results as generic drugs worked just as well as newer meds.
He claims that the VA does a great job weeding out pricey me too drugs...Again, he should thank the industry for creating competition among therapeutic choices based on value otherwise there would only be one in a class drugs which the VA keeps off formulary for at least 1-3 years. What will the VA do in an era of personalized medicine?
I won't even respond to the claim that the VA is doing all this great research. Sorry, it's all process measures.(Who get's what test and when) There are no studies compariing outcomes by drug and other variables. It has the ability to do that research but it never does...instead it supports studies that claim that the likelihood of suffering permanent nerve damage from older schizophhrenia drugs is ok and that old drugs are just as good as new. The fact is comparative effectiveness studies wind up showing that some people always do better on drug A than on drug B or vice versa. So the question is: how do get the right drug to the right patient first time every time? Goozner does not care and neither does the VA for that matter because it restricts formularies to save money on drugs not to improve outcomes.
Meanwhile, the real problem is that consumers are just too stupid or brainwashed to know any better. Or at least they are not as smart as Gooz. Consumers are being reprogrammed into new drug zombies that march into physician offices under the spell of pharmaceutical TV ads demanding inferior and expensive drugs which is why they want open formularies instead of the narrow ones offered by the wise and all-seeing pharmacy boards.
Here is the Gooz, oozing at his most hyperbolic:
"Consumers are going to police the system through their individual choices? Are these the same consumers who are bombarded daily with direct-to-consumer ads touting the latest me-too drug on television, in the pages of their daily newspapers and in weekly magazines? Such poorly informed consumers will likely gravitate over time to the least restrictive formularies precisely because they include drugs that are no better than generics." (Meanwhile consumers in these open formularies are stampeding over to generics.)
Yeah, we are just too stupid and too brainwashed. Teach us Merrill. Show us the light, the truth and the way.
Here's his post on Huffington Post
http://www.huffingtonpost.com/merrill-goozner/the-right-prescription_b_38579.html
Fun to watch, but let try to make a couple of serious points here to demonstrate the faulty logic of the left...Clearly a case of their rhetoric on pharma jumping the shark.
Gooz claims that the VA is restrictive because is it not tainted by prescribing guidelines shaped by industry. All the guidelines are written by industry? Let's say that's the case. Fact is, the VA docs follow EVERY specialty association guideline in terms of treatment steps. So I guess that the industry should be given credit for something.. Then again the VA only differs in terms of drug selection and therapeutic approach.
Then again, not all government guidelines meet the Goozner standard. Hypertension guidelines and ALLHAT yes. Cholesterol guidelines that encourage earlier use of statins no. The latter were the tainted in his opinion because the doctors on the committee had industry ties. But so did everyone on the ALLHAT steering committee. What's the the difference? Gooz likes the fact that an ALLHAT rump section spun the results as generic drugs worked just as well as newer meds.
He claims that the VA does a great job weeding out pricey me too drugs...Again, he should thank the industry for creating competition among therapeutic choices based on value otherwise there would only be one in a class drugs which the VA keeps off formulary for at least 1-3 years. What will the VA do in an era of personalized medicine?
I won't even respond to the claim that the VA is doing all this great research. Sorry, it's all process measures.(Who get's what test and when) There are no studies compariing outcomes by drug and other variables. It has the ability to do that research but it never does...instead it supports studies that claim that the likelihood of suffering permanent nerve damage from older schizophhrenia drugs is ok and that old drugs are just as good as new. The fact is comparative effectiveness studies wind up showing that some people always do better on drug A than on drug B or vice versa. So the question is: how do get the right drug to the right patient first time every time? Goozner does not care and neither does the VA for that matter because it restricts formularies to save money on drugs not to improve outcomes.
Meanwhile, the real problem is that consumers are just too stupid or brainwashed to know any better. Or at least they are not as smart as Gooz. Consumers are being reprogrammed into new drug zombies that march into physician offices under the spell of pharmaceutical TV ads demanding inferior and expensive drugs which is why they want open formularies instead of the narrow ones offered by the wise and all-seeing pharmacy boards.
Here is the Gooz, oozing at his most hyperbolic:
"Consumers are going to police the system through their individual choices? Are these the same consumers who are bombarded daily with direct-to-consumer ads touting the latest me-too drug on television, in the pages of their daily newspapers and in weekly magazines? Such poorly informed consumers will likely gravitate over time to the least restrictive formularies precisely because they include drugs that are no better than generics." (Meanwhile consumers in these open formularies are stampeding over to generics.)
Yeah, we are just too stupid and too brainwashed. Teach us Merrill. Show us the light, the truth and the way.
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.
