Keep open discussion....

[Guest guest]

Hi Again,

I just want to point out that in light of the recent news about FDA

and Pfzier, MErck, etc..it is valid to keep an open line of

discussion about our kids' meds. If it can't be discussed here,

where can it be discussed?

Katy

[Guest guest]

Hi Katy,

I agree with you 100%. There appears to be many problems within

drug companies that are being uncovered and this subject needs

further discussion.

Jean

>

> Hi Again,

>

> I just want to point out that in light of the recent news about

FDA

> and Pfzier, MErck, etc..it is valid to keep an open line of

> discussion about our kids' meds. If it can't be discussed here,

> where can it be discussed?

>

> Katy

[Guest guest]

Well I will wade into this discussion (give it a Canadian content........in

addition to Leah LOL)

I was behind on my emails so I read all of last week's yesterday and got the

low down.

Then I opened my Sunday newspaper to a review of that book Jill was

referring to. It is scary stuff! I had no idea how " in each other's pocket "

big pharma and government are!

Unfortunately for me, and I'm sure many of you are in the same boat, we do

what we can with the knowledge that we have. Many of you know I struggle

daily with the guilt of Adam having the permanent effects of undiagnosed

infant hypoglycemia. It is a difficult situation and I may find myself in it

down the road (again) in regards to GHT. But I couldn't take the risk of NOT

using it. So I stick my kid with a needle nightly, and as Jodi said, say a

prayer that I have made the right decision with the knowledge that I

currently have.

I tried vainly to copy the article for you all. I *had* a code to access the

web site and now I've misplaced it.

If you are interested, go to www.thestar.ca and click on " books " (top banner

towards the left). It was in yesterday's paper.

I have to be honest though, I thought Jill was blowing the whistle without

cause, but after reading this article I realize this IS common knowledge of

how drug companies work. What she was saying is true. It's scary stuff that

I didn't know. And it has made us all more aware and generated some

interesting thoughts it my mind.

Debby

[Guest guest]

Debbie,

Here is the article from the Toronto newspaper you read. After

reading this we need to really to have and independent evaluation of

drugs taken by RSS kids. Looks like I have another book to read.

Jean

Overdosed America:

The Broken Promise Of American

Medicine

by Abramson, M.D.

Harper, 332 pages, $34.95

The Truth About The Drug Companies:

How They Deceive Us And What To Do About It

by Marcia Angell, M.D.

Random House, 305 pages 34.95

---------------------------------------------------------------------

-----------

The pharmaceutical industry lies about its role in discovering

innovative and lifesaving medicines; rigs the clinical trials it

must conduct to get market authorization; bribes doctors, government

officials and politicians; and pushes unnecessary and sometimes

dangerous drugs on an unsuspecting public.

These are just some of the volleys the authors of both these books

aim at the operations of the U.S.-based and international

pharmaceutical giants — and back up with extensive and compelling

evidence. Both come to the task with establishment credentials:

Marcia Angell is the former editor in chief of the prestigious New

England Journal Of Medicine. Abramson is a faculty member and

researcher at Harvard medical school who spent 20 years in the

trenches as a family doctor, and uses stories from his medical

practice to illustrate some of his arguments. That professionals of

this stature have begun to so publicly criticize this industry

indicates the extent of the growing crisis of confidence concerning

the operations of big pharma (as the critics refer to it).

At risk, both authors argue, is the health of the public, which is

being compromised by a dangerous and unnecessary reliance on

expensive medication that is diverting money from more necessary

health care and, Abramson argues eloquently, from more cost-

effective ways to actually preserve and improve health.

But the books differ in style and content. Angell's book is written

bluntly, with a wide audience in mind. She focuses on many of the

larger political, procedural and financial issues, putting these in

the context of the out-of-this world profit levels of the Fortune

500 drug companies (about three times as high as the median for all

other industries). These companies, she notes, argue that high drug

prices reflect high research costs, yet they rely on publicly-funded

research in the United States for a significant proportion of the

innovative drugs they market, and they spend far more on marketing

than on research.

Big pharma, she points out, employs more Washington lobbyists than

there are members of the U.S. Congress, lobbyists who typically

succeed at convincing legislators to put industry interests above

the interests of the U.S. public. Their latest victory is a new

Medicare prescription drug program that forbids Medicare from using

its purchasing power to bargain for lower drug prices (something

every other large U.S. purchaser, including Veterans Affairs, does).

Meanwhile, fully 77 per cent of the 415 drugs approved by the U.S.

Food and Drug Administration from 1998 to 2002 were no better than

drugs already on the market, Angell notes. These " me-too " drugs are

new versions of existing drugs known as " blockbusters, " which are

profitable since they treat lifelong, chronic or widespread health

problems (such as depression, diabetes and allergies). Companies

then spend huge amounts of money convincing doctors and consumers to

switch to the new, invariably more expensive, less tested,

prescription drugs.

While Angell and Abramson aim at the same target, their approaches

differ: Hers is a broader-brush approach, setting the scene with

enough detail to convince and frighten readers who may not have

previously paid much attention to this industry. The Truth About The

Drug Companies concludes with suggested political and procedural

reforms, and a series of questions patients should ask their doctor.

Abramson, who has also written with a general audience in mind,

provides more detail about the drugs themselves, uses illustrations

based on experiences with his former patients, and demonstrates why

busy doctors are so easily co-opted by drug companies to rely on

marketing instead of evidence. Overdosed America concludes with

suggestions for improving health that lie outside the heavily

marketed " commercial-biomedical " model.

While both authors explain how clinical trials for drugs are rigged

by pharmaceutical companies to promote their drugs, Agnell's focus

is on how the companies now effectively control testing and

reporting. Most clinical trials are now conducted by private

contract research organizations, hired by drug companies, with for-

hire ethics boards, which in turn hire doctors to enrol patients in

trials. This structure is riddled with conflicts of interest.

Abramson, on the other hand, drills down and provides case study

detail of how trials are rigged or otherwise manipulated. His

discussion of the trials conducted on the drugs involved in the

hottest controversy of the moment — the arthritis anti-

inflammatories Vioxx, now pulled from the market, and competitor

Celebrex, under renewed attack for possibly raising heart attack

risks among users — is fascinating and cautionary.

Similarly, his discussion of the advent of widespread bone mass

density testing and the overall lack of efficacy of so-

called " osteoporosis " drugs is disturbing. With osteoporosis, he

argues, the drug industry has once again succeeded — as it did

for

decades with hormone replacement therapy — in reframing normal

aging

into a pathological process.

Both authors also target the growing problem of off-label promotion

of drugs — when companies expand their market by promoting drugs

for

indications that they were not approved to treat. A Canadian example

is Diane 35, a drug approved only for very severe acne that is

promoted as a conceptive, a use not approved by Health Canada.

While both authors focus on the United States, most of their

critiques also apply to Canada. The two key areas of difference are

the significantly higher price of drugs in the United States, since

that country alone among developed nations does not regulate drug

prices, and the prevalence there of consumer advertising for

prescription drugs. (This is formally illegal in Canada, although

Health Canada has turned a blind eye to home-grown contraventions.)

I have minor quibbles with both books. Angell nowhere even

acknowledges the great harm that the drug industry and its U.S.

government backers have done in the developing world by actively

denying life-saving medicines through various procedural and trade

agreement manoeuvres. Nor does Abramson acknowledge the role of

income inequality and poverty.

But he is on the money with this assessment: " The challenge in

providing optimal medical care is to identify the boundary between

the effective care that truly improves health and the commercially-

driven care that at best misdirects our efforts to stay healthy and

at worst is actually harmful. "

> Well I will wade into this discussion (give it a Canadian

content........in

> addition to Leah LOL)

> I was behind on my emails so I read all of last week's yesterday

and got the

> low down.

> Then I opened my Sunday newspaper to a review of that book Jill

was

> referring to. It is scary stuff! I had no idea how " in each

other's pocket "

> big pharma and government are!

> Unfortunately for me, and I'm sure many of you are in the same

boat, we do

> what we can with the knowledge that we have. Many of you know I

struggle

> daily with the guilt of Adam having the permanent effects of

undiagnosed

> infant hypoglycemia. It is a difficult situation and I may find

myself in it

> down the road (again) in regards to GHT. But I couldn't take the

risk of NOT

> using it. So I stick my kid with a needle nightly, and as Jodi

said, say a

> prayer that I have made the right decision with the knowledge that

I

> currently have.

> I tried vainly to copy the article for you all. I *had* a code to

access the

> web site and now I've misplaced it.

> If you are interested, go to www.thestar.ca and click on " books "

(top banner

> towards the left). It was in yesterday's paper.

> I have to be honest though, I thought Jill was blowing the whistle

without

> cause, but after reading this article I realize this IS common

knowledge of

> how drug companies work. What she was saying is true. It's scary

stuff that

> I didn't know. And it has made us all more aware and generated

some

> interesting thoughts it my mind.

>

> Debby

[Guest guest]

Thank you for sharing, Jean. You presented the info in a very

matter-of-fact, non-threatening, non-preaching way. That is the

best thing to do here with this group. We want to share info and

not judge. I appreciate the summaries. They do give us a lot to

think about, but I have to admit that I am so thankful to these

companies for making the medications they do. My son is thriving

because of them. In fact, he is alive because of them.

Jodi Z