Latest Drugwonks' Blog
News from today's Pink Sheet is that FDA Deputy Commissioner Scott Gottlieb will leave the agency in January. Bad news for the agency. But the good news is that Scott Unteathered will remain a potent force for the advancement of America's health through, we are sure, many important new endeavors.
On the same topic of “it’s all about the way you ask the question.†How do you think Americans would respond to these polling queries:
Q: Do you want the government to use its muscle to lower the price of gasoline?
Q: Do you want the government to use its muscle to lower the price of foreign imports?
Q: Do you want the government to use its muscle to lower the price of cars?
Q: Do you want the government to use its muscle to lower the price of meat?
Q: Do you want the government to use its muscle to lower the price of box seats at Yankee Stadium?
It’d be pretty easy to get an 85% “yes†rate to any of those questions – unless, per the last one, you’re a Red Sox fan.
So, rather than asking, as the Kaiser Family Foundation did, “Do you think the government should use its buying power to negotiate drug prices,†perhaps we should ask …
Q: Do you favor government price negotiations if it means you will not be able to receive the medicine your doctor has prescribed?
Q: Do you favor price negotiations if it means reducing investment in stem cell research and cures for cancer?
or ...
Q: Do you favor price negotiations even though the non-partisan GAO has reported that government price negotiations will not lower drug prices?
Field our own survey? Maybe we’ll do just that.
Q: Do you want the government to use its muscle to lower the price of gasoline?
Q: Do you want the government to use its muscle to lower the price of foreign imports?
Q: Do you want the government to use its muscle to lower the price of cars?
Q: Do you want the government to use its muscle to lower the price of meat?
Q: Do you want the government to use its muscle to lower the price of box seats at Yankee Stadium?
It’d be pretty easy to get an 85% “yes†rate to any of those questions – unless, per the last one, you’re a Red Sox fan.
So, rather than asking, as the Kaiser Family Foundation did, “Do you think the government should use its buying power to negotiate drug prices,†perhaps we should ask …
Q: Do you favor government price negotiations if it means you will not be able to receive the medicine your doctor has prescribed?
Q: Do you favor price negotiations if it means reducing investment in stem cell research and cures for cancer?
or ...
Q: Do you favor price negotiations even though the non-partisan GAO has reported that government price negotiations will not lower drug prices?
Field our own survey? Maybe we’ll do just that.
Expect stories this weekend in the MSM with headlines like "Americans support government price negotiations for Medicare."
That's going to be the talking point most reporters will swallow from the new poll by the Kaiser Family Foundation. Drugs from Canada too! Quelle surprise.
But here's the real story, buried at the end of the report:
When asked what overall message about the drug benefit they would "send to Washington," 12 percent of seniors said the benefit is working well and no real changes are needed, while 41 percent said it could be improved with some minor changes. Meanwhile, 28 percent said it's not working well and needs major changes. Ten percent said the program should be repealed.
Here's how I'd cume that: 53% say Part D needs some minor changes. 28% say "big changes." 10% say "ditch it."
But the "headline" finding of the report says that about 85 percent of seniors want to let the government use its buying power to negotiate drug prices, including 65 percent who said they strongly favor such negotiations.
It's all in the way you phrase the question.
Remember: Research is like a bikini. What it shows you is interesting, but what it conceals is essential.
Who do you think has the mandate?
And what do you think Robert Pear will write? Hmm.
That's going to be the talking point most reporters will swallow from the new poll by the Kaiser Family Foundation. Drugs from Canada too! Quelle surprise.
But here's the real story, buried at the end of the report:
When asked what overall message about the drug benefit they would "send to Washington," 12 percent of seniors said the benefit is working well and no real changes are needed, while 41 percent said it could be improved with some minor changes. Meanwhile, 28 percent said it's not working well and needs major changes. Ten percent said the program should be repealed.
Here's how I'd cume that: 53% say Part D needs some minor changes. 28% say "big changes." 10% say "ditch it."
But the "headline" finding of the report says that about 85 percent of seniors want to let the government use its buying power to negotiate drug prices, including 65 percent who said they strongly favor such negotiations.
It's all in the way you phrase the question.
Remember: Research is like a bikini. What it shows you is interesting, but what it conceals is essential.
Who do you think has the mandate?
And what do you think Robert Pear will write? Hmm.
When torcetrapib clinical trial results were presented to Pfizer chairman Jeff Kindler, he did not equivocate. Despite the financial implications, the trials were stopped immediately.
Tough choice? Yes. But, more importantly, principled choice.
The principle? Patient safety. And, as my father used to say, it’s not a principle unless it hurts to stand by it.
Bravo.
I must have missed the words of congratulations from the IOM, Senator Grassley, and Sidney Wolfe.
Tough choice? Yes. But, more importantly, principled choice.
The principle? Patient safety. And, as my father used to say, it’s not a principle unless it hurts to stand by it.
Bravo.
I must have missed the words of congratulations from the IOM, Senator Grassley, and Sidney Wolfe.
Patrick Clinton, of Pharmaceutical Executive Magazine, reminds us of the following old joke -- A patient goes to the doctor and learns he needs surgery that will cost $10,000. "I can't pay it, Doc," he says. "That's OK," responds the doctor. "For a hundred bucks I can retouch your X-rays.
Fantasy or Evidence-based Medicine? You make the call.
Clinton uses this joke as a lead-in to an excellent opinion piece on AWP (Average Wholesale Price) and Medicare. He says what he means and it’s a worthwhile read.
Here’s the link:
http://www.pharmexec.com/pharmexec/article/articleDetail.jsp?id=382530
And here's the background: In the US District Court for the District of Massachusetts, Judge Patti Saris is hearing MDL 1456, a multi-jurisdiction case that charges 42 pharmaceutical companies (and likely more to come) with violating various RICO and deceptive-trade-practice acts by artificially inflating the Average Wholesale Price (AWP) they reported to Medicare.
Enjoy.
Fantasy or Evidence-based Medicine? You make the call.
Clinton uses this joke as a lead-in to an excellent opinion piece on AWP (Average Wholesale Price) and Medicare. He says what he means and it’s a worthwhile read.
Here’s the link:
http://www.pharmexec.com/pharmexec/article/articleDetail.jsp?id=382530
And here's the background: In the US District Court for the District of Massachusetts, Judge Patti Saris is hearing MDL 1456, a multi-jurisdiction case that charges 42 pharmaceutical companies (and likely more to come) with violating various RICO and deceptive-trade-practice acts by artificially inflating the Average Wholesale Price (AWP) they reported to Medicare.
Enjoy.
With all the self-indulgent holds removed, Andy von Eschenbach finally gets confirmed. If Andy's defense of the integrity of the scientific process and the FDA during the last Grassley contretremps is a signal of what we are in for, it suggests that he see his ultimate responsibility to the employees of the agency, to patients and the scientific community. And it suggests that he will seek to generate more respect for the scientific enterprise that undergirds FDA's activities and transformation. Finally, the FDA will have someone who can set an intelligent and responsible course for the future, one that integrates the Critical Path with post market safety concerns, something that neither Congress or the IOM panel seems interested in or capable of.
Just got back from two very stimulating events. One was in Brussels, the other in Stockholm. Both were launch events for "Coincidence or Crisis," our new book on the issue of counterfeit medicines.
The Brussels event, as you might suppose, was attended by many NGOs, EU commission members, WIPO, government representatives from around the world (Cyprus, the US, Lithuania, etc.), the EAEPC (the association of parallel traders), members of the euro-press (Le Figaro, Le Soir, the Daily Mail etc.), and Bill Newton Dunn, MEP (Member of the European Parliament). Mr. Dunn also contributed an introduction to "Coincidence or Crisis" along with Congressman Mark Souder. The counterfeiting of prescription medicines is, after all, a global problem.
The Stockholm event took a different direction, attended by the media too, but also by members of the Swedish medical media, Swedish regulators, pharmacists, and patient groups. Mr. Finn Bengtsson, a member of the Swedish parliament and a professor of pharmacology also spoke at the event -- and promised to raise this issue within the government.
Here is one of the media reports of the Stockholm event:
http://www2.unt.se/avd2/1,3908,MC=3-AV_ID=558953,00.html
And, as always, more information on the issue of counterfeit drugs, as well as on "Coincidence or Crisis" can be found at http://www.cmpi.org.
Why is the book called "Coincidence or Crisis" -- because there is no such thing as a coincidence.
The Brussels event, as you might suppose, was attended by many NGOs, EU commission members, WIPO, government representatives from around the world (Cyprus, the US, Lithuania, etc.), the EAEPC (the association of parallel traders), members of the euro-press (Le Figaro, Le Soir, the Daily Mail etc.), and Bill Newton Dunn, MEP (Member of the European Parliament). Mr. Dunn also contributed an introduction to "Coincidence or Crisis" along with Congressman Mark Souder. The counterfeiting of prescription medicines is, after all, a global problem.
The Stockholm event took a different direction, attended by the media too, but also by members of the Swedish medical media, Swedish regulators, pharmacists, and patient groups. Mr. Finn Bengtsson, a member of the Swedish parliament and a professor of pharmacology also spoke at the event -- and promised to raise this issue within the government.
Here is one of the media reports of the Stockholm event:
http://www2.unt.se/avd2/1,3908,MC=3-AV_ID=558953,00.html
And, as always, more information on the issue of counterfeit drugs, as well as on "Coincidence or Crisis" can be found at http://www.cmpi.org.
Why is the book called "Coincidence or Crisis" -- because there is no such thing as a coincidence.
That's Commissioner von Eschnebach, folks.
And it's about time.
We here at drugwonks.com certainly hope that the out-to-sea Ocean 11 senators who voted "nay" got the message that the American public wants action on real 21st century FDA reform -- and not just politicking as usual.
And it's about time.
We here at drugwonks.com certainly hope that the out-to-sea Ocean 11 senators who voted "nay" got the message that the American public wants action on real 21st century FDA reform -- and not just politicking as usual.
The FDA panel reviewing the safety of drug eluding stents found that in high risk patients there was a greater incidence of clotting but that the rate was still quite rare and that the benefits greatly outweighed the risks. Sid Wolfe and Charles Grassley should take the comments of FDA's Andrew Farb to heart and recite them daily: "When we have rare events in relatively small numbers, to come up with sweeping conclusions can raise issues." Such sanity and reason is welcome at a time when the the pols and the IOM Drug Safety amateurs come up with sweeping conclusions about rare events in relatively small numbers.
Two great articles about Pfizer's drug torcetrapib. One in the Wall Street Journal the describes the inner workings of the Drug Safety Board -- capturing both the integrity of the scientists who led it and statistical methods that are applied to determine drug safety.
http://www.ifpma.org/PressReviewEmail/PressReviewDetail.aspx?nID=6250&SD=CG1aUlOgoSyl7sR5NDAc%2fA%3d%3d
The other is in Nature.com assessing whether the problem with torcetrapib is rooted in the way the drug itself elevates LDL or the fact that as Moti Kashyap, who directs atherosclerosis research at the VA Medical Center in Long Beach, California points out "When HDLs excrete cholesterol in the liver, they actually rely on LDLs for part of this process. So inhibiting CETP, which prevents the transfer of cholesterol from HDL to LDL, might actually cause an abnormal and irreversible accumulation of cholesterol in the body. "You're blocking a physiologic mechanism to eliminate cholesterol and effectively constipating the pathway," says Kashyap.
http://www.nature.com/news/2006/061204/full/061204-8.html
These articles are well-written, well-researched, balanced and thoughtful. Taken together it raises an important question: wouldn't drug development be helped by developing models that incorporate the off-target effects of medicines earlier in the clinical testing process? And that raises another question. Given the small difference in mortality is it possible to target the drug to people based on genotype variation? Can torcetrapib be retooled?
http://www.ifpma.org/PressReviewEmail/PressReviewDetail.aspx?nID=6250&SD=CG1aUlOgoSyl7sR5NDAc%2fA%3d%3d
The other is in Nature.com assessing whether the problem with torcetrapib is rooted in the way the drug itself elevates LDL or the fact that as Moti Kashyap, who directs atherosclerosis research at the VA Medical Center in Long Beach, California points out "When HDLs excrete cholesterol in the liver, they actually rely on LDLs for part of this process. So inhibiting CETP, which prevents the transfer of cholesterol from HDL to LDL, might actually cause an abnormal and irreversible accumulation of cholesterol in the body. "You're blocking a physiologic mechanism to eliminate cholesterol and effectively constipating the pathway," says Kashyap.
http://www.nature.com/news/2006/061204/full/061204-8.html
These articles are well-written, well-researched, balanced and thoughtful. Taken together it raises an important question: wouldn't drug development be helped by developing models that incorporate the off-target effects of medicines earlier in the clinical testing process? And that raises another question. Given the small difference in mortality is it possible to target the drug to people based on genotype variation? Can torcetrapib be retooled?
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.
