An excerpt from White Coat, Black Hat.
by Carl Elliott
Many of us have a relatively simple, commonsense view of the way that drug development and marketing work.
People get diseases; scientists develop drugs to treat those diseases; and marketers sell the drugs by showing that the drugs work better than their competitors. Sometimes, however, this pattern works in reverse. Drug company scientists develop a drug …
Create a disease to market a new drug
An excerpt from Tabloid Medicine: How the Internet is Being Used to Hijack Medical Science for Fear and Profit.
by Robert Goldberg, PhD
From the beginning, there were two problems with the connection between thimerosal and autism. The first problem with was that thimerosal, while about half mercury, contains ethyl mercury, for which there were no exposure guidelines. So the scientists used the ones for methyl mercury. However, the ethyl mercury …
Problems with the connection between thimerosal and autism
Many people are already aware that marijuana is now legal in some states in the US with a medical prescription.
What many people may not realize is that cocaine is also used in medical care, especially in the ENT world.
Cocaine is one of the most potent anesthetic and vasoconstrictor. These two characteristics make it an ideal medication for use during sinus surgery as well as any nasal procedure where bleeding and …
How cocaine can be used in sinus surgery
Hold onto your hats. I am about to enter dangerous territory. I am about to suggest maybe doctors should profit from dispensing medications from their office to offset declining reimbursements and rising expenses by using prescriptions as a source of ancillary revenues.
Why dangerous? For a number of reasons.
One, physicians still grapple with the perception that it is improper for a physician to make money from …
Why doctors should profit from dispensing medications
Most parents and all pediatricians are aware of the 1998 study published in The Lancet by Dr. Andrew Wakefield that mentioned a causal link between measles, mumps, rubella (MMR) vaccine and the increased incidence of childhood autism. It shook the medical community and created an international movement of parents questioning the extensive combination of immunizations that are given to children. Could these immunizations be the cause of the increase in …
How the vaccine and autism scare was a fraud to make money
by John Horton
When the FDA was created in 1906, not even Nostradamus could have predicted the medical advances that would come to extend and improve our lives: childhood vaccines, insulin, and the use of lasers in surgery were all unimaginable a century ago.
While many future advances are beyond our imaginations’ reach, it seems certain that the advances in biologics — medicines made from living organisms — will stand out as …
The safety of biosimilars and FDA regulation
There is a lot of press about a study recently published in the New England Journal of Medicine that shows that adding tiotropium (Spiriva) to an inhaled steroid might have benefit in asthmatic patients. This study is creating a lot of buzz due to recent concerns of ICS/LABA safety and might prompt doctors and patients to start switching (some already have before this study came out). However, this …
Adding tiotropium (Spiriva) to an inhaled steroid a mistake?
Part 3 of a series. Please read part 1, DTC advertising, and its history with the FDA, and part 2, Economic and commercial impact of DTC advertising.
In the first two parts of this article, we explored the historical and legal contexts of direct-to-consumer (DTC) advertising, the effects of these ads on prescribing behavior, and the economic incentives to advertise.
In this final installment, we will …
Minimize the potentially harmful effects of DTC advertising
New medicines are like new fashions in clothing. They are introduced with great fanfare. Most turn out to seem fairly ordinary after a few years. Some are quickly forgotten or discarded and make us say: “What was I thinking?”
Evaluating a new drug is difficult, for the pharmaceutical and scientific communities as well as for us clinicians. It often takes years of general use before a drug can really prove its …
Evaluating a new drug is difficult for the pharmaceutical community
As a primary care doctor, I have figured out many tricks for helping patients save money on prescriptions. Some of them I am sure you have never heard of, and others, well — you might have, but they bear repeating.
All of the prices quoted here are from Costco, unless otherwise specified.
1. Price compare between pharmacies. Can’t stress enough the potential differences in medicine prices between pharmacies. Generic medicine prices vary more than branded/trademarked …
Tricks for helping patients save money on prescriptions
What’s happened to psychiatry over the last 15 to 20 years? That’s a big subject, discussed in many recent and excellent books. One of those books is by Daniel Carlat, author of Unhinged: The Trouble with Psychiatry – A Doctor’s Revelations about a Profession in Crisis
One of the problems Carlat readily acknowledges is that psychiatry is excessively focused on psychopharmaceuticals at the …
How the pharmaceutical industry changed psychiatry
With the darker days upon us, it may be tempting to try to fight fatigue with energy drinks.
Ever wonder what’s really in them and what they might be doing to you? I just came across an article in the November issue of the Mayo Clinic Proceedings that broke it down nicely.
Here’s the summary.
Caffeine. No brainer. Interestingly, it is on the list of substances banned by the International Olympic Committee (which is …
Energy drinks are unregulated and can be dangerous
Antibiotics for viral infections are a big pet peeve of mine. No. Make that a huge pet peeve.
Some doctors prescribe antibiotics for coughs and stuffy noses because the patients want them. If you’re one of those patients who think that antibiotics make your coughs go away, or clear up your stuffy noses, or somehow make your sinus headaches vanish, or if you’re a doctor who prescribes antibiotics for these symptoms, …
Antibiotics need to become controlled substances and regulated
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Physicians hate acid. But, hey, who doesn’t hate acid? It burns things. It corrodes. It’s that after-pizza punishment.
We prescribe antacid medications by the ton in this country, not because people’s stomachs have developed increased acidity, but because people in our modern society are generally overweight, like to eat large meals, and prefer fatty foods and things like alcohol, chocolate, and tobacco, all of which tend to worsen acid reflux.
Physicians like …
Concerns about long term acid suppressive therapy
by Nancy Walsh
The recent report of the deliberate infection of Guatemalans with syphilis in the 1940s to see if penicillin could cure and prevent transmission of the disease was a reminder of just how short the time has been since most infectious diseases were untreatable. Penicillin — discovered by Scottish biologist Alexander Fleming in 1928 but not available for clinical use until the 1940s — …
Penicillin and the Cocoanut Grove fire in Boston
An excerpt from White Coat, Black Hat.
by Carl Elliott
[Michael] Oldani worked as a rep in the late 1980s and the 1990s, a period when the drug industry was undergoing key transformations. Its ethos was changing from that of the country-club establishment to the aggressive, new-money entrepreneur.
Impressed by the success of AIDS activists in pushing for faster drug approvals, the drug industry increased pressure …
Drug reps know what doctors are prescribing
A recent study published in the journal Sleep Medicine revealed that most child psychiatrists prescribe medication for sleep at least once a month, despite the fact that no sleep medications are approved for use in children. The study was funded by Sanofi-Aventis, makers of Ambien.
Managing sleep is one of the greatest challenges of being a parent. It represents the first major separation and can be fraught with complex ambivalent feelings. …
Routine use of sleep medication for children
An excerpt from Sustaining Life: How Human Health Depends on Biodiversity.
by Eric Chivian, MD and Aaron Bernstein, MD
Ethnobotany, that is, the scientific study of the use of plants by native cultures, including their use as medicines, can be said to have begun with Carl Linnaeus, who in the 1730s published Flora Lapponica, his detailed account of plant use by the Lappish, or Sami, people, …
Quinine, artemisinin and our debt to traditional medical healers
Side effects. Every medication has them. Some are mild, some are annoying, and some are downright dangerous.
When doctors write a prescription, they mention that some people experience side effects, and if certain bizarre things happen, the patient should phone the doctor.
How do we keep track?
If you get one antibiotic to take for two weeks, it isn’t so hard. First, because it’s for a short time period, and also because it’s …
Side effects of medication sometimes confuse patients
Here’s the scenario: on the 2nd of the month, a patient with diabetes on metformin and high blood pressure on benazepril sees her family physician for a routine follow up.
The patient’s blood pressure is elevated and the decision is made to add carvedilol to help get the blood pressure to goal. The patient’s metformin and benazepril “drop” (are renewed) at the pharmacy on the 18th of every month, a date …
Help patients synchronize their prescription drugs
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