> [EMAIL PROTECTED] wrote:
> Marcial Angell's perspectives on "me too" drugs.
>
> The former editor in chief of The New England
> Journal of Medicine, Marcia
> Angell is currently a senior lecturer in social
> medicine at Harvard Medical
> School. She disputes the pharmaceutical companies'
> argument that they need a
> high profit margin to fund the research and
> development of new medicines. In
> fact, she says, the industry piggybacks off publicly
> funded research at the
> National Institutes of Health and other academic
> institutions. She also
> argues that most of the companies' profits are not
> derived from new drugs,
> but rather from "me too" drugs, or imitations of
> drugs already on the
> market. This interview was conducted on Nov. 26,
> 2002.
<snipped rest>
I agree with much of what she says, although this is a
little out-of-date WRT Medicare benefits (although how
much of an impact that will make - and for how long,
considering the funding fudging that occurred - is
debatable). There _have_ been some head-to-head drug
effectiveness trials conducted by companies, although
most are done elsewhere.
"The other thing I want to say is, the academic
medical centers are abdicating their responsibility to
teach pharmacology. There is very little teaching that
goes on in medical schools now about drugs, about
their downsides as well as their benefits, about
classes of drugs, about cost-effective prescribing of
drugs. To a large extent, the academic medical
centers, the medical schools, have abdicated this and
left that to the drug companies to do....The
salespeople are wandering the halls of almost every
major hospital in this country, handing out freebies
to the young doctors, telling them all about their new
drugs, which, the evidence shows, the young doctors
pretty quickly respond to and prescribe. And the
medical centers stand back and let that happen."
I can't speak to what's going on now, but when I was a
student and resident, we were indeed taught to look
for drug side effects, and how to read an article
critically. While drug cost was rarely mentioned,
medical benefits and side effects of one versus
another certainly were.
As for formularies, these can be very useful in terms
of cost-benefit *if* there is a reasonable mechanism
to go outside of the approved list.
And to harp again on one of my pet peeves: people have
*got* to take some responsibility for their health WRT
lifestyle choices. With obesity, cardiovascular
disease and alcoholism on both sides of my family, I
haven't abdicated my health to the gods of McDonald's,
Baskin-Robbins and Budweiser...not that it's been easy
when it comes to food, because I *love* eating good
food, and *despise* working out. I _have_ finally
found a lifestyle that incorporates a lot of physical
exercise, allowing me to indulge in dessert most days
a week, and the occasional Big Mac. :)
Note that of course many illnesses occur no matter how
exemplary a lifestyle one leads, and whatever the
genetic dice roll is what the zygote gets -- I do not
in any way discount this, or the effects of
upbringing, or the ravages of serious mental illness
which can lead to neglect of oneself.
Debbi
Had A Brownie Today, In Fact, And It Was Good Maru :D
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