Have you heard about the blockbuster new drug, Havidol?
Its creators say that HAVIDOL is for the treatment of Dysphoric Social Attention Consumption Deficit Anxiety Disorder (DSACDAD). And they say it is the only known medication available for this newly recognized disorder.
Details at Havidol.com.
It's also a spoof.
The creator of the campaign, an Australian artist, tells Reuters that many people don't get the fact this is a parody or satire. This reminds me of the spoof a few years ago on Motivational Deficiency Disorder mentioned on this blog.
I am pumped. The Havidol website tells me: "No prescription drug can promise endless happiness. However given HAVIDOL's track record, and Future PHARMS (the manufacturer) commitment to perfecting life through chemistry, terminal happiness has become a real possibility."
The Integrity in Science Project of the Center for Science in the Public Interest reports:
"The Food and Drug Administration's latest report on the make-up of its advisory panels reveals that little has changed in the 15 months since Congress required the agency to document its efforts to find scientists without ties to industry. In a report sent to Capitol Hill on Jan. 31, FDA Commissioner Andrew von Eschenbach reported that 24 percent of advisers to the agency’s seven centers and offices received conflict-of-interest waivers between November 2005 and January 2007. The Center for Drug Evaluation and Research (CDER) had the worst performance, with 146 of 417 advisers, or 35 percent, requiring waivers because they owned stock in, consulted for, or served on the speakers' bureaus of firms with products up for approval or their competitors.
The agency's ability to identify advisers without conflicts of interest has not budged since Congress acted. ...
When questioned about the agency's failure to reduce its reliance on outside advisers with ties to industry, acting deputy commissioner Randall Lutter said that 'it is very difficult to get the quality of the expertise we want without going to people who have some sort of relationship with industry related to product development.' But as a Lancet editorial noted in 2005 shortly before Congress passed its law, 'it is hard to believe that in a country with 125 medical schools – not to mention the pool of international experts – the FDA cannot find experts who do not have financial ties with companies whose products are under review.' A New York Times editorial has pointed out that 'unless the FDA makes a more aggressive effort to find unbiased experts or medical researchers start severing their ties with industry, a whiff of bias may taint the verdicts of many advisory panels.' "
The headline above is the headline of a piece in The Economist, in the February 22 edition. Excerpts:
"People born under the astrological sign of Leo are 15% more likely to be admitted to hospital with gastric bleeding than those born under the other 11 signs. Sagittarians are 38% more likely than others to land up there because of a broken arm. Those are the conclusions that many medical researchers would be forced to make from a set of data presented to the American Association for the Advancement of Science by Peter Austin of the Institute for Clinical Evaluative Sciences in Toronto. At least, they would be forced to draw them if they applied the lax statistical methods of their own work to the records of hospital admissions in Ontario, Canada, used by Dr Austin.
Dr Austin, of course, does not draw those conclusions. His point was to shock medical researchers into using better statistics, because the ones they routinely employ today run the risk of identifying relationships when, in fact, there are none. He also wanted to explain why so many health claims that look important when they are first made are not substantiated in later studies.
The confusion arises because each result is tested separately to see how likely, in statistical terms, it was to have happened by chance. If that likelihood is below a certain threshold, typically 5%, then the convention is that an effect is “real”. And that is fine if only one hypothesis is being tested. But if, say, 20 are being tested at the same time, then on average one of them will be accepted as provisionally true, even though it is not. ...
So, the next time a newspaper headline declares that something is bad for you, read the small print. If the scientists used the wrong statistical method, you may do just as well believing your horoscope."
On HealthNewsReview.org, one of the 10 criteria we apply to our review of news stories is whether the story adequately explains the quality of the evidence. Journalists may feel this is too "academic" - too detailed for most readers. If what one is reporting is likely to be flawed, we think it is an excellent criterion to apply.
TIME magazine this week has an article on what it calls "medicine's secret stat," NNT or number needed to treat. The magazine uses the example of a study that might show that statin drugs lower the risk of heart attacks by 30%.
"But that number is meaningless unless you take into account the percentage of men in both groups who have heart attacks in the first place. If those people represent only a tiny fraction of the two populations, an improvement of 30% isn't much--maybe one heart attack fewer in a group of thousands.
The effort to handicap those odds is where NNT comes in. It answers the question, How many people have to take this drug to avoid one heart attack? The same principle can be applied to avoiding one recurrence of cancer or stroke or whatever end point you choose to measure. In healthy men, the NNT for statins is about 50 (depending on which of dozens of statins is taken, age, family history, lifestyle and so on). So 50 men have to take these drugs in order to prevent a single--not necessarily fatal, heart attack.
Presented that way, taking statins sounds like less of a no-brainer--especially given that the drugs cost hundreds of dollars a year, side effects could include liver and muscle damage and you have to take twice-yearly blood tests just in case. Still, factored out over the entire U.S. population, even a 1-in-50 figure means many thousands of heart attacks are avoided every year.
Since public-health officials want to save lives, they focus on the thousands and avoid the NNT. Since pharmaceutical companies are in business to sell drugs, they do the same. Those two forces have kept NNT from being a big part of medical education. We could all help change that by doing nothing more than asking for the number up front the next time we're handed a prescription."
But the TIME article didn't discuss how journalists could be and should be using NNT in their reporting.
That's why we put a little primer on the topic on our HealthNewsReview.org website. More consumers would understand the topic, and ask their doctors about it, if more journalists put the concept in more stories about research studies.
For anyone worried about the bogeyman of big-government and a single-payer health care system, a Wall Street Journal article (subscription required) reminds us that we're approaching such a system already. The story reflects on a study published in this week's Health Affairs.
Story excerpts:
"As pressure grows for the government to pick up more of the nation's health-care tab, new data show its contribution is already at 45% and is expected to approach 50% within 10 years.
The government's widening role in financing health care stems from the recent expansion of Medicare to include prescription drugs, the growth of relatively new initiatives like the State Children's Health Insurance Program, increased spending by enrollees in programs like Medicaid -- which covers many of the sickest patients -- and cutbacks in employer-sponsored health coverage.
Overall, health spending in the U.S. is expected to double to $4.1 trillion by 2016, consuming 20% of the nation's gross domestic product, up from the current 16%, according to a new federal study. By then, the study predicts, the government will be paying 48.7% of the nation's health-care bill, up from 38% in 1970 and 40% in 1990.
The stark projections come amid increasing ferment over health care in the states and Washington. They could bolster the argument of some analysts that the U.S. is creeping toward a single-payer system in a disorganized, piecemeal way. Under such a system, the government essentially pays for health care and covers the cost by collecting taxes and premiums."
You may have heard about the 15-year old Florida girl who started hiccuping a month ago and hasn't stopped. If you watch the network morning shows, your chances of knowing about her are better.
What you may not know is the level of harassment applied to book guests like her. The St. Petersburg Times reports: "The competition for her story became so frenzied over the weekend that NBC's Today show changed Jennifer and her mother's New York hotel after another network's exhaustive attempts to get an interview.
'You really never know what is going to gain that sort of attention,' said John Trevena, a Largo lawyer who has represented some high-profile clients. 'It seems once it starts, it spreads like wildfire. It becomes very exhausting for all involved.'
Representatives from ABC's Good Morning America called Jennifer's home 57 times on Sunday and slipped notes under her hotel room door, her family said.
On Monday, Jennifer and her mother did another interview with Today and one with Inside Edition before flying home.
Waiting for her were calls from the Ellen DeGeneres Show, and television stations from as far away as Canada and Britain."
Another chapter in the misplaced priorities of network news decision-makers.
Broadcasting & Cable magazine reports:
"The sponsorship of a PBS program on obesity by diet drug maker GlaxoSmithKline has one veteran noncom TV watcher a bit exercised, but PBS says it is by the book.
Jeff Chester, executive director of the Center for Digital Democracy, and a frequent critic of what he sees as the increasingly commercialization of noncommercial broadcasting, has written to PBS ombudsman Michael Getler to complain about what he sees as too lax sponsorship policies.
Glaxo is underwriting the April broadcast of 'Fat: What No One is Telling You' ...
'We note that funding comes in part from GlaxoSmithKline,' Chester wrote Getler. 'The drug giant just happens to have a recently approved for over-the-counter drug on the market-under the brand name Alli, that is for 'use by overweight adults along with a reduced calorie, low-fat diet.' ...
PBS program executives need to 'cut the fat' out of their sloppy review of what's appropriate for underwriting,' said Chester."
Getler responded on his PBS ombudsman blog: "My view is that Chester’s eagle-eye provides a continuing, very useful challenge to PBS, a challenge that I agree with even though I sympathize with PBS’s constant search for funding, the difficulty of finding sponsorships to bolster more traditional funding, and that fact that some funders simply have an interest in seeing subjects aired and are willing to take their chances on how the program will come out. But in this case, there is little doubt how a program about obesity is going to turn out. Even though GlaxoSmithKline came in late and, under PBS policy, has no say in any of the content, this kind of possible conflict can undermine credibility and, without knowing the financial details, doesn’t seem worth it. "
(GS note: Thanks to one of my blog readers for tipping me off to this controversy.)
The Wall Street Journal reports: "Despite a pledge from the pharmaceutical industry to be more careful with prescription-drug advertising, impotence-drug makers are sliding back to tactics that drew widespread criticism from patients, doctors and regulators. A pediatricians' organization is calling for no impotence ads during hours when children are likely to be watching, and a major AIDS group has expressed concern that ads have become too suggestive again, encouraging people who aren't suffering from erectile dysfunction to use the drugs recreationally." ...
"The American Academy of Pediatrics has called for the erectile-dysfunction commercials to be restricted to after 10 p.m. so that children wouldn't view sex as 'a recreational sport.' ...
In December alone, an ad for impotence drug Viagra aired at around 9 p.m. during 'Prancer,' a G-rated movie about a young girl who nurses one of Santa's reindeers back to health; another spot for rival medicine Levitra appeared during an afternoon showing of the comedy 'Pee-wee's Big Adventure;' and another for Cialis graced an early-evening presentation of the holiday classic 'Miracle on 34th Street.' "
Last week it was NBC's hype of a drug for restless leg syndrome.
This week it was NBC using some of its airtime to promote a new "laser hair comb" for baldness. You figure a network newscast has about 22 minutes for real news. It chose to give a chunk of that time to this. The video can be seen on the MSNBC site.
What's going on with the NBC newscast? Is it cheerleading-in-TV news month? Perhaps, given that we're in the midst of a ratings-sweeps period.
On the HealthNewsReview.org site, we wrote: "There is an underlying tone of disease-mongering whenever a national TV network uses some of its precious 22 minutes of airtime to promote an expensive new product to "treat" - or as the story says at one point, "cure" - baldness - a condition that is a normal part of aging for many men.
The story didn't quantify benefits. People thinking of paying $550 for such a device should be given some estimate of how well it works.
But the bigger failing of the story was that it missed an opportunity to point out how such devices are approved by the FDA. Such new devices must only pass a test of "substantial equivalence" to products already on the market. The FDA lists 10 such products. So not only did the story fail to tell how well the device works, it failed to put the new idea into the context of existing alternatives.
No sources were cited.
Anchor Brian Williams' comment - "..when you use the expression "potential cure for baldness" in this country, you're going to be a multimillionaire overnight..." - is more cheerleading than reporting. If this story had to be reported as one of the few stories of the day in a network newscast, it should have offered more evidence and context than boosterism."
One wonders what the 47-million Americans without health insurance would think if they saw a story like this on the network news.
Karen Davis of the Commonwealth Fund writes in this week's BMJ that the problems of the US healthcare system are growing. She reminds that the US is the only major industrialized nation without universal health insurance, and that the number of uninsured people has increased from 40 million in 2000 to nearly 47 million in 2005.
Excerpt: "The consequences are increasingly well known: inequities in access to care, avoidable mortality and poor quality care, financial burdens on people who are uninsured or underinsured, and lost economic productivity. The US spends twice as much on health care as the median industrialised nation but does not systematically achieve the best quality care..... If the US hopes to achieve a high performance health system that is value for money, it will have to tackle the perplexing problems of access, quality, and cost and overcome considerable political and economic obstacles, as well as institutional resistance to change."
The cover story of Minnesota Medicine is “The Medical Arms race: how many high-priced robots and scanners can we afford?”
Excerpt: “How many children’s hospitals, heart centers, bariatric centers, robotic surgery systems, PET scanners, MRI scanners, and so on does a given population area need to serve its genuine health care requirements, as opposed to the maximum convenience of patients or the economic interests of physicians and hospitals?
Former U.S. Sen. David Durenberger, chair of the National Institute of Health Policy (NIHP) at the University of St. Thomas in Minneapolis, is one of the more vocal critics. …
As an example, he points to the CyberKnife, a radiosurgery system that enables treatment of intracranial and extracranial tumors previously considered inoperable. According to news reports, a CyberKnife lists for more than $3.5 million. In 2003, St. Joseph’s Hospital in St. Paul was the only center in the Upper Midwest that had one. Now there is another CyberKnife at Miller-Dwan Hospital in Duluth. ‘Where did all the extra patients come from?’ Durenberger asks. ‘Was there a long waiting line at St. Joseph’s? I suspect not.’
Another case in point: the da Vinci robot, a $1 million-plus system used for laparoscopic surgeries such as gallbladder removals, prostatectomies, and bariatric surgery. In 2004, three Minnesota hospitals (the University of Minnesota Medical Center, HealthEast St. John’s, and Mayo Clinic in Rochester) had da Vinci systems. By 2006, the robots were in six hospitals, including facilities in Duluth and St. Cloud, according to manufacturer Intuitive Surgical Systems of Sunnyvale, California. Surgeons report a number of benefits these systems provide, such as an improved view of the surgical field and the elimination of tremor in movement. But a study of the 202 initial robotic abdominal surgery cases performed at Johns Hopkins University Hospital in Baltimore found that ‘clinical data demonstrating improved [patient] outcomes are lacking.’
The concern is that the proliferation of CyberKnifes and da Vincis and free-standing $2-million MRI scanners and $1-million CT scanners may be driven less by patient need than by market share or providers’ desire to use the latest technology to attract specialists who do procedures that pay well: gastroenterologists, cardiologists, and neurosurgeons, for example. A claim on the Web site of Sunnyvale, California-based Accuray, CyberKnife’s maker, is that buyers say the device ‘attracts new patients and increases their practice volumes.’
…
But the issue of cost-effectiveness is nowhere addressed, he says.
‘In any other industry,’ Durenberger says, ‘when someone invents something new, market mechanisms determine whether it catches on and to what extent.’ For instance, if someone invents a video game, ‘there is a market that tells you this is something that X number of people want and are willing to pay X dollars for. That analogy applies practically everywhere except in health care.’ “
Ray Moynihan reports in the BMJ (subscription required) that a controversial proposal to have drug companies “patient compliance” programs declared legal in France has failed.
Excerpts:
“Critics described the proposal as a backdoor attempt to introduce into France direct to consumer drug advertising, which is currently banned throughout Europe.
Compliance support programmes organised by drug companies can include telephone reminders to consumers, personalised information for patients, and even home visits from nurses. The drug industry defends public health programmes as valuable for boosting adherence to treatment; others argue the programmes are Big Brother-style marketing strategies intended to boost profits.
A recently formed advocacy group called the Medicines in Europe Forum, which comprises patients, professionals, and others, successfully lobbied French politicians last month to reject the proposal. The group claims that compliance programmes are often little more than advertising stunts, designed to build brand loyalty and "increase the quantity of drugs consumed."
The controversy is part of the wider debate over whether aggressive United States-style drug advertising should be allowed on the other side of the Atlantic, an idea firmly rejected by the European parliament. Despite the ban, industry in Europe is continuing to push to liberalise restrictions on communications with the public, arguing that drug companies can provide patients with valuable health information.
Although the French plan to legalise company compliance programmes was defeated last month, it will be debated again in the French parliament later this year.”
A commentary in the Journal of the American Medical Association (subscription required), "Potential Health and Economic Consequences of Misplaced Priorities," by Dr. Steven Woolf of Virginia Commonwealth University, addresses some important themes for the public and for health journalists.
Woolf writes: "The United States spends more on health care—16% of its gross domestic product—than does any other country, yet its health outcomes are below average on major indices. One reason for the enormous health budget—$2.0 trillion in 2005—is that society overspends on unnecessary tests and treatments, many of which lack evidence of effectiveness and some of which induce net harm. ... Society invests heavily in medical advances (eg, breakthrough drugs and technologies), but such advances hold little promise for improving health if patients cannot receive them."
My research project, the website HealthNewsReview.org, evaluates news stories about new tests and treatments. It grades stories on how well they explore the evidence of effectiveness and of harms. After the first 300 stories reviewed, there are some troubling trends. And if the public forms its impressions of the health care system from such news coverage, then the public may be getting a very skewed picture.
It is also my belief that stories about medical advances may take time, space, or attention away from stories about how to control costs and improve access to care.
That would represent misplaced priorities in health journalism.
Much of the coverage of the death of Anna Nicole Smith represented another low point in journalism.
CNN, which has billed itself as “the world’s most important network,” asked its senior medical correspondent, Dr. Sanjay Gupta, to comment on the death.
Wolf Blitzer introduced Gupta, saying, “Talk a little bit about what we know. A lot we don't know, Sanjay, about the cause of her death.”
Gupta led off saying, “There's a lot we don't know as well.”
Talk about a reason to stay tuned! But if you stayed tuned, you heard Gupta jumble together conjecture about “the heart as being the most likely culprit” – followed by “Why she would have heart problems? Not exactly sure.”
He continued: “Also lung problems. Could there have been some sort of a clot?... Could it have been some sort of medication problem?”
Blitzer and Gupta then speculated about the flu, about her weight problem, about her addiction to painkillers, about a diet plan called Trimspa, about ephedra – much of it followed up with the reminder, “Whether that had anything to do with this, we don't know as well.”
So there you have it: virtual autopsy from long distance via speculation, rumors, and no direct knowledge of anything.
I am disappointed that Vioxx, Viagra, and the Virus of the West Nile were never mentioned.
As Blitzer introduced CNN anchor Jack Cafferty for another segment, Cafferty said: “Is Anna Nicole Smith still dead, Wolf?”
BLITZER: “Yes, we're going to -- updating our viewers coming up shortly on...”
CAFFERTY: “I can't wait for that.”
A San Antonio Express-News columnist reminds us that we're in the middle of the February TV ratings or sweeps period. And she laments the hype, including that of health news. Excerpt:
"Oh no, I woke with a headache. Boy, do I feel tired! Does that mean I'm at risk for a stroke?
I moved around extra slowly and carefully just in case.
What got me worrying was Monday night's Tanji Patton report on WOAI's 10 p.m. news: "A warning for women." It told how two women suffered a stroke — out of the blue — at widely different ages — one was 49; the other was 15 when she had her first — and suggested that women who show any similar health signs (like that nagging headache) might want to get their blood levels checked and consider lifestyle changes.
Yikes! I immediately made plans for earlier bedtimes and better food choices.
But before doing anything drastic like throw away my chocolate bars, I remembered something. And my mind was put at ease, at least a bit.
It's one of those months, I realized, when TV news operations try to put viewers on edge, make us fearful, a bit jumpy, so as to compel us to watch their newscasts.
It's February sweeps — a fact I almost forgot because of the many other biggies of the month: the Super Bowl, the many awards shows, such as the upcoming Grammys and Oscars."
I'd like to hear from anyone else around the country about their favorite TV sweeps pieces this month.
The Wall Street Journal (subscription required) reports on the growing opposition to state moves to mandate use of a new cervical cancer vaccine in preteen girls.
The paper reports: "Bills being drafted in some 20 U.S. states that would make a cervical-cancer vaccine mandatory for preteen girls are sparking a backlash among parents and consumer advocates.
The bills coincide with an aggressive lobbying campaign by Merck & Co., the maker of the only such vaccine on the market. Called Gardasil, the three-shot regimen provides protection against the human papillomavirus, a sexually transmitted virus that is responsible for the majority of cases of cervical cancer.
If the state bills become law, they would guarantee the Whitehouse Station, N.J., drug maker billions of dollars in annual revenue from the vaccine."
A Vancouver Sun story is a good example of an imbalanced story that fails to address health policy issues with context and completeness. The story reports on an advocacy group report and, in so doing, takes a flawed advocacy stance itself.
The story begins: "Cancer patients are increasingly having to pay for important new drugs administered in public hospitals, the latest symptom of Canada's inconsistent and often inadequate funding of cancer treatment, an advocacy group reported Monday."
The story says, "One breakthrough leukemia drug is paid for by just a single province, (British Columbia)." The story didn't explain what qualifies as a breakthrough.
Then the story dipped into the language that is usually used when cost-effectiveness decisions are made by government officials - "rationing." The story says, " 'Essentially, we will continue to ration life-saving cancer treatment, and some Canadians will live and some will die simply because of where they live,' said the report."
Late in the story, it finally disclosed that the advocacy group was financed largely by pharmaceutical companies.
The report also looked at the availability of PET (positron emission tomography) scans and mammograms for cancer patients, raising questions about what the report said was underuse of the two technologies.
But overuse of PET and other scanning technologies is generally a bigger concern than underuse. And who's to say that women aren't choosing to forego mammography after weighing the evidence? The story certainly didn't look into that possibility.
Journalists will not contribute to a meaningful discussion on health care reform if they take the party line of a pharma-funded advocacy group as gospel.
NBC News anchor Brian Williams delivered an awkward and unusual story lead-in last Wednesday, one which has touched off a firestorm of criticism of him even on his own blog.
Williams said, on the air: "If you watch this newscast with any frequency, then you've seen it - this ad playing behind me here on the screen - for a medication for something called restless leg syndrome. A lot of us had frankly never heard of the condition but we figured people must suffer terribly from it for there to be a medication to treat it. And so,motivated by a commercial by one of our own sponsors, we asked NBC News correspondent Josh Mankiewicz to do some checking. "
Mankiewicz’s story begins: “They show you the problem, and the solution. The syndrome, known commonly as RLS, affects millions and has been known to some for at least 60 years. But until recently, most people — even many physicians — had never heard of it. The drug company GlaxoSmithKline changed that.”
The story then quoted a doctor who said: "I'm not generally a big fan of direct-to-consumer TV ads. However, for this particular disorder, I think they've done a great service by spending most of the time identifying the problem." (You can read Williams' blog later to see what some viewers dug up about this "expert" source.)
The story went on to brag about Glaxo’s earnings from the drugs. And cited a single patient who said the drug “worked like a charm.”
The NBC hype didn’t end there. Brian Williams went on his blog to brag about the story.
But viewers went to the blog as well, many of them to criticize NBC and Williams, saying things like:
“Brian,
You said "We commissioned last night's story...."
And with whom did you commission that biased story?
(GlaxoSmithKline - the maker of the restless leg drug in the story)? I thought NBC was trying to cut commercials so we get more news. Does this integraded (sic) ad then count as news or advertising.”
Or
“This is only one of numerous examples of drug companies, trying to invent a disease or malady, or whatever, just to sell prescription drugs.”
OR
“it seemed to me the majority of writers were upset (as was I) about the blatant commercial you ran for for an advertiser”
OR
“Give anything a name, initials and a drug to "cure" it and you'll become a millionaire. Goes to show how gullible we have become in this country. And think about it, Brian, you're part of the problem/solution?”
OR
“This time you've really crossed the fine line between journalism and advertising, and you owe your viewers an explanation and an apology.”
Had NBC, Williams or Mankiewicz done even a little research, they would have found, free on the web, an article entitled, “Giving Legs to Restless Legs: A Case Study of How the Media Helps Make People Sick.” Which is just what NBC did with this egregious example of disease-mongering. I am at least comforted that an intelligent viewing audience is starting to catch on to such examples of shoddy journalism.
You get a half hour on an international news network to report on health news and you use it to:
1. Tell people if you want to avoid the flu, "try to avoid getting too close to sick people."
2. Feature a doctor who lost 70 pounds by using lots of hot sauce, even though you admit "it doesn't really have any science behind it."
3. Promote a "permanent" wrinkle filler, while minimizing evidence - and failing to quantify potential benefits or harms.
That's what CNN did this weekend with its "House Call With Dr. Sanjay Gupta" program.
The first two were just laughable. The last was more dangeous.
The story described "ArteFill, billed as the first permanent filler." It said "known side effects are minimal."
But it's easy to find the following on the FDA website:
Side effects of ArteFill® include:
* Lumpiness at injection area more than one month after injection
* Persistent swelling or redness
* Increased sensitivity
* Rash, itching more than 48 hours after injection
Let's let consumers decide if those sound "minimal" or not. The story never mentioned that one of the conditions of FDA approval last fall was that a five-year study for safety be done after approval, a clear sign that reviewers were not convinced that all the evidence on safety was yet in.
Meantime, the story profiled a woman who had the injections: "In less than 30 minutes, (she) was sold. She thought she looked fresh with, if anything, her wallet, not her face, showing fatigue."
Let's let consumers decide if this sounded like a news story or a commercial.
Molly Ivins used to call Texas governor Rick Perry, "Governor Good Hair," or Governor Rick "Good Hair" Perry.
But Molly would have had a field day with this news: Texas on Friday became the first state to require school-age girls to be vaccinated against a sexually transmitted virus that has been shown to cause cervical cancer.
The LA Times reports that Perry "signed an executive order mandating that most girls, starting in September 2008, receive the vaccination against the human papillomavirus before entering sixth grade. ... By sidestepping the Texas Legislature, Perry — a conservative Republican — avoided a showdown with GOP lawmakers and Christian organizations that oppose mandatory HPV vaccinations."
In so doing, Governor Good Hair was praised by some liberals and public health advocates. But, the Times reports, "the move drew criticism from conservative groups, which noted that the governor had accepted campaign contributions from the vaccine's manufacturer, Merck & Co.
'All Merck wanted was a mandate so the insurance companies would have to pay for this. Follow the money,' said Cathie Adams, president of the Texas Eagle Forum, an organization that promotes socially conservative government policies. ...
Merck has been pushing for laws mandating its Gardasil vaccine in numerous states. It has also launched a TV ad campaign featuring girls and the slogan 'One less,' to signify one fewer cancer patient for each person vaccinated.
The New Jersey-based drug company donated $6,000 to Perry's reelection campaign last year, Texas campaign finance records show. One of its top Texas lobbyists, Mike Toomey, is Perry's former chief of staff."
The explosion in the use of diagnostic imaging - particularly high-tech, high cost scans such as CT, MRI and PET scans - has led to many questons about appropriateness of all these scans. I've blogged about some of these concerns as recently as last week.
In Minnesota, the Medica health plan claims that 15 to 20 percent of the scans it pays for are not appropriate for the condition being treated, according to a story in the Star Tribune.
But the real news the paper reports is that three insurers have begun (or will soon) to require third-party review by an outside evaluator of all requests for such high tech scans. And doctors don't like it.
The paper reports: "In a letter obtained by the Star Tribune, the 11,000-member Minnesota Medical Association (MMA) asserts that the new third-party consultation places a burden on patients and clinics alike and will 'interfere with the patient-physician relationship. Physicians throughout Minnesota, whether practicing in urban or rural, primary care or specialty, large or small group practices, along with health care leaders in the community, agree this is the wrong direction to take,' said the letter."
This is an important issue.
Why, for example are there something like 20 CT or MRI machines within a two-mile radius of one medical center in metropolitan Minneapolis?
Who says all of those machines are needed? Who knows if all the scans are warranted? And who pays when those machines go unused?
Some may claim that insurers are denying appropriate care, but I think they're asking legitimate questions that may answer some of the questions above.
Whenever I think about premature enthusiasm for new drugs, when I hear doctors talking about putting statins in the water supply, when I hear news reports that a drug is safe -- I think of Baycol. The statin drug was approved about ten years ago, but pulled from the market about five years ago after being linked to 31 deaths.
The Houston Business Journal now reports:
"Bayer Corp. will pay $8 million to 30 states, including $200,000 to Texas, as part of a settlement requiring the company to fully disclose when drugs pose risks for patients with specific health conditions.
According to the settlement, Bayer failed to adequately warn physicians, pharmacies and patients of clinical studies revealing serious consequences of taking Baycol, a cholesterol-lowering drug. The company pulled the drug from the market in August 2001 due to its muscle-weakening side effects.
The terms also extend to the disclosure of clinical studies involving other Bayer drugs with possibly harmful side effects. ...
The terms of the judgment require that Bayer register its clinical studies and, upon the completion of each study, post the results on the Internet. The marketing, sale and promotion of Bayer's pharmaceutical and biological products must comply with the law and cannot include false or misleading claims."