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http://www.cnn.com/2008/HEALTH/04/16/vioxx.articles.ap/index.html

Just another reason why I don't trust the literature that comes along with a new prescription....



"While Merck is singled out, the practices are not uncommon, according to JAMA's editors. In an editorial, they urge strict reforms, including a ghostwriting crackdown and requiring all authors to spell out their specific roles.

Dr. Catherine DeAngelis, JAMA's editor-in-chief, said those are already policies at JAMA but not at many other journals.

"The manipulation is disgusting. I just didn't realize the extent," she said.

The practices outlined in JAMA can lead editors to publish biased research that can result in doctors giving patients improper and even harmful treatment, she said."

*hooping makes the world go round*
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HORRORS! Big Pharma playing free and loose with the facts and the data? And doing it for profit-driven reasons? Who would have ever expected that? ANSWER: I would and so would anyone who has followed the sleazy practices lately uncovered in the dark world of Big Pharma!

Let the right-wing advocates of overpriced medications rant and rave about the free market system and the allegedly huge costs of product development (some of which, in early stages, is paid for by the federal government--another story worth telling sometime). No amount of such stale eructations will change the fact that Big Pharma is being exposed--finally--for the scheming and unethical practices with which much of that industry is riddled!
I'll uncharacteristically agree with beternu this time. I have ABSOLUTELY NO FRICKING IDEA why my medication costs so much here, but in other parts of the globe is much less costly. Perhaps the cost of lawsuits, which are more rampant here than elsewhere.

However, in fairness, ghost writing in the place of physicians (who are generally too busy to write) is not a terribly bad practice. It's simply a matter of economics. If you're going to pay a research physician several thousand dollars per day, would you rather have him doing research, or sitting in front of a computer writing? As a RA in graduate school, I wrote a lot of papers that were ultimately published under the professor's name. Whether or not the papers were actually read is another story, and at times fodder for amusing speculation.
Zip,

Here is an article from the New Yorker:

http://www.newyorker.com/archive/2004/10/25/041025crat_atlarge

It addresses the costs of prescription drugs specifically with Nexium/Prilosec as an example.

I 100% agree with the author because I witnessed this on 2 different levels. First, most of my customers at the pharmacy were paying out the ### for Nexium and still complained of symptoms while on it for months.

Also, my husband took (in order) Prevacid, Nexium, the generic for Nexium Omeprazole, and lastly Prilosec.

He is to the point where he only uses Prilosec minimally. We save TONS of money considering he also is uninsured at the moment (another issue I won't get into). He has also changed dieting habits, watches the timing that he eats/drinks before bed and early in the morning (usually the worst for acid reflux flairs up because you are laying down and raising up).

But I promise if you go to a doctor and say "I am having acid reflux" and tell of the symptoms he will write you Nexium (not something generic or even suggest Prilosec first). You will get to your pharmacy thinking "Hey I have insurance", they fill it and you start to pay and it is 128.95. You freak out and scream "BUT I HAVE INSURANCE!" and the technician will say "Sorry but your insurance will not pay for this unless you first try prilosec, generic omeprazole and the doctor documents that none of these things work for you."

The problem is that most of these customers (I had tons in situations like this) would go back to the doctor or call and ask why he didn't just recommed Prilosec or write for the generic because even paying cash it was 10 times cheaper. The doctor would almost always tell them they NEEDED Nexium and not to try prilosec. They would also tell the patient that the generic was risky because you might not be on the same brand as pharmacies switch often.
(This is true for some drugs, i.e. cancer drugs, insulins, heart medications, REALLY IMPORTANT medications) But for an acid reflux medication, it's got the same basic ingredient. And if a patient wanted a particular brand of generic, the pharmacist can also put in a request with the wholesaler and try to demand it for a patient. Also, they can check with other local pharmacies and locate it, if they are really a good pharmacist.

Just a rant, but it was my experience with this Nexium/Prilosec battle going on between insurance and patients.

Some people do need something more than prilosec, like for a hernia or ulcer. But most doctors know that Nexium and Prilosec have the same basic ingredient-omeprazole-just in different strengths. In addition to a generic being available. A patient could still save money by for instance doubling prilosec as opposed to being stuck with $120+\- Nexium or Prevacid or Zegerid while accomplishing the same thing.

It's all about money baby! Sell those pills, get a reward check later.
Several years ago I went to a med conference and was listening to a company man tell the effectiveness of using a drug in the treatment of colon cancer. That same drug is used as an anti-parasitic in sheep. Interestingly, the drug is pretty effective and has become a staple in the treatment of colon cancer.
An older doctor in the back stood up and asked the company straight out why the drug costs $100 per pill to treat his patients, yet the same drug was being given to sheep and costs about $2 per dose, after about a mintue of uncomfortable silence, the drug rep said, "well to be perfectly honest, we have never been sued by a sheep".

Most uninformed people out there think that doctors get some type of payback for their prescriptions, which is totally BS. First it is illegal, and second unethical. They write prescriptions for what they are comfortable in prescribing. The PDR which is published annually lists the contraindications and side effects of the medicines which are prescribed, slight as they may be. Currently that book is about 4 inches thick and has almost 3000 pages of data, in very small type I must say.
Drugs are cheaper in other countries typically because they do not go thru the same FDA regulation and approval that they do here in the US. It takes about 5-7 years of study before a drug will make it to the market here. By that time the cost of the drug has to include the cost of approval, the study, the development, and lastly it usually includes the absolute assurance that somewhere down the line a lawsuit will be brought against that line of drug and the necessary funds to cover it. Very few every escape that fact.
Saying that however, do I want to see some type of arrangement whereby drug producers are not liable for their product? Absolutely not, but there needs to be some type of tort reform and amendments made to the current approval scheme in order to save these companies some money. Very rarely do you get a drug that will make a company tons and tons of money. For instance take Viagra. Do you know where Viagra got its start? It was originally being used to treat pulmonary hypertension, but the researchers noted a common side effect in all the men who were using it. It is now being used more for than side effect than for its orignal intent, pulmonary hypertention. For a while Viagra was king, now you have Levitra and a host of other little blue pills which are vying for a share of the market.
The more common drugs (ie, penicillin, pain meds) can be purchased very cheaply, their market shares have been recovered, and the generic forms can be purchased for $4-$5 at some stores. There is nothing wrong with them, but their rampant use has made them not as effective as they once were, so development has to continue on new drugs.

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