New England Journal of Medicine recently published a paper looking at “A Decade of Direct-to-Consumer Advertising of Prescription Drugs”, where the study authors looked at pharma company spending on DTC advertising and physician promotion in the past 10 years (1996-2006). The authors also looked at the FDA regulation of drug advertising during this time. While drug companies’ promotional spending went from $11.4 billion (1996) to $29.9 billion (2005) where DTC ad expenditures grew by 330%, this made up “only” 14% of the almost $30 billion in drug companies’ promotional spend.
On the other hand, FDA’s warning letters fell from 142 in 1997 to 21 in 2006. The authors speculate this could either be due to drug companies becoming better behaved and playing by the rules, or due to the FDA being too short-staffed to follow up on all violative behaviors. I’m skeptical whether this reduction in FDA warning letters is mostly due to staff shortage at the FDA given how steep this drop was (142 to 21 per year); while I’d like to think that drug companies are finally being “scared straight” by the various scandals and class action lawsuits in the recent years, I’m also not so much of a pollyanna to believe that no violative behaviors are being produced. Still, it looks like DTC is here to stay, as much as many doctors loathe it with a passion of a thousand suns. Continue reading
This week the American Heart Association and the American College of Cardiology have published updated treatment guidelines for heart attacks (or, as the journal article titled it, “Update of the Clinical Competence Statement on Cardiac Interventional Procedures”). The entire update is currently available in full from the Journal of the American College of Cardiology (JACC) via this link (technical). According to Reuters Health, which reported on this update, the guidelines focus on identifying patients at risk early and the right treatment. In patients with “low risk”, medication therapy is recommended, and tests of cardiac functions are suggested. In patients with “high risk” intervention including angioplasty is recommended.
I’ve been tracking the various developments and commentaries on the controversy surrounding diabetes drug Avandia (rosiglitazone, manufactured by GlaxoSmithKline). For those of you interested in background information and commentaries relating to the use of Avandia and increased risk for heart disease, as well as the affordability of chronic medications like diabetes drugs, I’ve compiled a short reading list including abstracts to the original research articles to help you get started. Please read my conflict of interest disclosure at the end of this article. Continue reading
In 1999, Louis Constan, MD wrote an article called, “Doctor, Tell Me About This New Drug” within the humor category of The Journal of Family Practice. It’s now almost 7 years later, and many of what Dr. Constan highlighted have become reality. I will share one of my personal favorites to start:
Magazines have so many drug ads in them that they should stop charging us for subscription fees.
I understand the need for advertising. Money from ads help publications stay afloat. Even virtual information resources like this one costs something, so I’m not going to criticize magazines for displaying ads. On the other hand, the sheer amount of ads that some of these magazines have is becoming ridiculous – not only in professional (medical or industry) magazines – but in consumer magazines.
When I was a professional road warrior (translation: consultant), I’d haul along my piled-up reading materials. I would use the “down-time” (translation: waiting for my plane to arrive) I had to catch up on reading. One day, while I was waiting at the airport terminal and going through pages and pages of drug ads, I had a revelation: I would rip out all the ads and leave what I wanted to read in the magazine. That way, I could get through my reading materials, uninterrupted by intercalating pages of ads. Continue reading
Recently, journalists picked up on a poster session on the effect of ginger on ovarian cancer cells at the 97th American Association for Cancer Research Annual Meeting (AACR) in Washington, DC (April 1-5, 2006). Forbes called it, “Ginger an Ovarian Cancer Killer.” The poster authors’ school, University of Michigan also sent out a press release subtitled, “Cell studies show promise for ginger as potential ovarian cancer treatment.”
This illustrates my concern of how a piece of scientific “evidence” is so preliminary, yet generates a level of sensation that is far from warranted.
I also object to U. of Michigan’s use of the word “promise” in the press release. I’d have preferred the entire subtitle replaced with the disclaimer, “Study done in petri dish – not even animals or human – please do not gorge on ginger.”
A definition of “promise” speaks to expectation of something that is likely to happen. This study is too early to speak of any promises. Continue reading