Merck finally caves in to more evidence of the risks of Vioxx and pulls it from the market. It's interesting that the data that broke Vioxx's back came while Merck tried to expand the market for the drug. Before the safety of the drug was established for its original intended use for pain and inflammation, Merck was testing it as a preventive for colorectal polyps. That's when the new heart and stroke risks were detailed. (Although there has been mounting evidence of heart risks for years.)
So the drug that never did what it was supposed to do -- treat inflammation and pain while avoiding stomach ulcers -- while costing about 6 times more than ibuprofen, is now gone.
No more ads showing Dorothy Hamill figure skating pain-free.
No more slogans such as "Once Daily Vioxx for Everyday Victories."
But this won't be the last time we hear about a drug's true risk profile not being established until the drug has been on the market and in use for some time.
Caveat emptor.
Is there scientific evidence to support new recommendations that millions of Americans should consider taking statin drugs to reduce their risk of cardiovascular disease?
The Center for Science in the Public Interest was joined by 3 dozen physicians, epidemiologists and other scientists in asking for an independent review of statin research. Harvard physician John Abramson said, "The studies do not demonstrate that statins benefit women of any age." Abramson has just written a book entitled, "Overdo$ed America: The Broken Promise of American Medicine."
Eight of the nine authors of the July National Institute of Health recommendations for broader use of statins have financial ties to drug companies that make statins.
CSPI says the authors -- and journalists who reported the recommendations -- largely ignored lifetsyle recommendations. CSPI says, "The American people are poorly served when government-sanctioned clinical recommendations, uncritically amplified by the media, misdirect attention and resources to expensive medical therapies that may not be scientifically justified."
The New England Journal of Medicine today publishes a study by Harvard's Bob Blendon and colleagues showing that health care is only the fourth most important issue for voters in 2004.
The failure of journalists to report on health care issues in a meaningful, comprehensive, analytical manner in this election year may be an important factor in these findings.
Journalism's agenda-setting capability is well established. I propose that journalism helped put health care in fourth place, instead of higher. Yes, there are excellent exceptions, just not enough and not often enough.
The researchers say their data suggest that voters are not focused heavily on the problem of the nation's 45 million uninsured.
What will it take?
On the PBS "Nightly Business Report," Daniel Henninger of the Wall Street Journal editorial page said: "We all know the war on terror is the number one issue in the campaign. But can you name the real number two? Take my word, number two is the cost of health care. It`s the great white shark swimming below the surface of American politics, eating incomes and jobs. ... Well there`s going to be a presidential debate in two weeks. I think we know where these two stand on terror. Before electing either of them the next four years, let`s hear more, much more, about how they plan to save us from the great white shark of health care costs."
The Kansas City Star reports on a new law that will allow the state to recover health costs for Medicaid beneficiaries in nursing homes by placing liens on the beneficiaries' homes. A supporter of the law said, "Medicaid is supposed to be a program for the poor," but some people consider it to be "free money." Another observer said the new law may discourage some people from applying for Medicaid and receiving necessary health care: "We're trying to balance the budget off the backs of the elderly and disabled."
The Medicare budget blues continue. Now the Office of Management and Budget says that the Medicare Modernization Act will cost nearly $42 billion more over the next 10 years than the previous estimate made by federal actuaries after the law was passed. The Washington Post reports that the new figures were given “privately to some members of Congress.”
Hmmm. Is that anything like the figures given "privately" to former Medicare official Tom Scully by an actuary who says he was told to lie about the true costs?
Medicare officials announced they will begin covering expensive PET brain scans to help figure out whether certain beneficiaries have Alzheimer's disease. But the Washington Post reports the government had no official estimate of how many people would qualify for the scans or how much the scans would cost. It's known that scans can cost as much as $2,000 and the cost of installing a PET scanner can be as much as $2 million.
Weeks ago Medicare announced it would begin covering some obesity treatments for the first time. Now the PET scan announcement. Meantime, Medicare premiums next year will rise a record 17%. Who's doing the budget?
From the St. Louis Business Journal: "The St. Louis Rams have renewed their sponsorship with Bayer Pharmaceuticals and GlaxoSmithKline making prescription drug Levitra a continued sponsor of the team, the Rams said Wednesday." This means promotions for the erectile dysfunction drug will be all over the Rams' stadium: on programs, on rotating signs, on turnstiles and concession TV screens. There will even be a Levitra Play of the Week on the team's Web site. The kick is up and it's.....no good!
The New York Times reports that General Motors is the nation's largest private purchaser of health services and of drugs such as Viagra and Lipitor. The Times says "the projected cost of providing health care benefits to current and future retirees ... is a staggering $63 billion." (http://www.nytimes.com/2004/09/15/business/15retire.html)
The paper points out that GM's rivals in Japan and Germany "have virtually no retirees from their newer operations in the United States and, at home, the expenses are largely assumed by taxpayers through nationalized health care systems."
"To saddle the cash flow of American businesses with an obligation that other competitors do not have creates serious long-run disadvantages," said Uwe Reinhardt, a Princeton University economist specializing in health issues.
According to USA Today, "Unless Congress does something to hold down costs confronting seniors, the official projections suggest that health spending will consume virtually the entire amount of Social Security benefits when children born today reach retirement age."
In the midst of Prostate Cancer Awareness Month, PSA blood test pioneer Dr. Thomas Stamey of Stanford now says the test is not a useful predictor of the amount or severity of prostate cancer.
Stamey, publishing a study in the Journal of Urology, is quoted in a Stanford news release: ''Our study raises a very serious question of whether a man should even use the PSA test for prostate cancer screening any more. Our job now is to stop removing every man's prostate who has prostate cancer,'' said Stamey. ''We originally thought we were doing the right thing, but we are now figuring out how we went wrong. Some men need prostate treatment but certainly not all of them.''
How will urology handle this issue?
How will journalists handle this issue?
Even as a Congressional committee was hearing testimony about the use of antidepressants in children and about FDA and drug companies' decisions not to disclose some negative study results, 11 medical journals announced a new plan for full transparency of ALL trial results, including negative findings.
Just think of how many positive-only trial results were published in the past, without even a wink toward the negative findings that were buried? Just think of how many journalists were duped into accepting and publishing only the positive news? And just think how many news and health care consumers were not told the whole truth? And, as a result, how many people were hurt by making decisions based on incomplete evidence and deception?
The deficit hits $422 billion.
Medicare premiums increase at a record rate (and the government tries to sneak it by us by releasing the news on the Friday before the Labor Day weekend).
One of the reasons Medicare premiums will rise is the new Medicare drug "benefit," which some don't see as much of a benefit. It was engineered by former CMS chief Tom Scully. This week the General Accounting Office says Tom Scully should pay back part of his salary because he threatened to fire the actuary who says he was told to lie about the true cost of the Medicare law.
And a new study shows that four years of double-digit growth in health care premiums is taking a toll on workers: There are at least 5 million fewer jobs providing health insurance in 2004 than there were in 2001.
Do you think we'll have anything to talk about in this blog?