Friday, May 29, 2009

Why is McAllen, Texas the most expensive place in America to get medical care?

Atul Gawande explains why expensive care is often the worst care in The New Yorker.

Monday, May 25, 2009

webcast your brain surgery

The rising popularity of Twittering and webcasting live from the operating room. Hospitals use it as a marketing tool...includes a quote from Jeffrey Kahn.

Saturday, May 23, 2009

"Corinne insisted, I have no moral compass. The most damning illustration has to do with her (now former) job as a pharmaceutical sales rep, where she said she knowingly sold drugs to physicicans that she knew would kill people. 'Selling drugs is a lie. I sold drugs that I knew damn well—I sold Vioxx for Merck before it got taken off the market for killing people. I knew damn well it was dangerous; I went around telling them to write it. There’s a lot of serious lying I’ve done in my life,' she said. That’s okay, Corinne told me, because 'I’m doing a job. For me, in that case, Merck told me to go out and sell drug even though I had hesitation about it. It’s not for me to say.'"

Read more about this drug rep/Survivor-contestant here.

The dangers of new drugs

A Cornell psychiatrist explains how his residents ignore proven drugs in favor of the cool new ones, in the New York Times.

Friday, May 22, 2009


According to a study at the University of Virginia, medical students on a pass-fail grading system perform as well as those on an A through F scale, and they have fewer symptoms of anxiety and depression. Read more here.

Monday, May 18, 2009

Pharma CEO paychecks

Which pharma CEOs are paid the most? The list is topped by Bill Weldon at Johnson and Johnson, who was paid $29.4 million last year. Next in line were the CEOs of Abbott, Wyeth and Bristol-Myers Squibb. Fierce Pharma reports.

Sunday, May 17, 2009

The politics of desperation

"A Virginia family’s campaign for access to an unproven drug highlights the challenges many terminally ill patients face in the search for treatment." Read more in the NY Times.

Saturday, May 16, 2009

Electroboy versus Bristol Myers Squibb

Andy Behrman, author of Electroboy, made $400,000 pitching Abilify for BMS. Now he says he was lying, according to the Wall Street Journal. Read more here.

Thursday, May 14, 2009

NIH says maybe, maybe not

"The National Institutes of Health, after months of pressure, announced last week that it would consider imposing tougher regulations aimed at reducing financial conflicts of interest in scientific research. But it might actually not do anything."

Read more in The Chronicle of Higher Education.

Google wants to know if you're sick

"Google is attempting to find out how much of a role Internet searches play in the self-diagnosis process". Here.

Wednesday, May 13, 2009

Tuesday, May 12, 2009

Slate founder says: ban lawsuits against the device industry

Michael Kinsley warned Congress that "lawsuits would prevent patients from getting access to devices. Identifying himself as a grateful customer of the pharmaceutical industry, he said he had had Parkinsons 15 years. He noted that he was testifying at the request of Medtronic, which approached him last week, though he wasn’t paid by them." The WSJ Health Blog reports.

The future of medicine?

"I am not your typical doctor. I'm easily accessible and mobile," Dr. Jay tells us via his website. That's right: for a yearly enrollment fee, you can IM Dr. Jay about your symptoms anytime. He also makes house calls—or, you know, wherever calls! "We can figure out if I need to come to your work, your home, or meet somewhere else in the city. We can even meet in the park or a coffee shop depending on the problem. Wherever you feel comfortable."

Gawker comments. See Dr. Jay's strange website here.

Monday, May 11, 2009

Saturday, May 09, 2009

Elsevier published at least six fake medical journals

Ben Goldacre reports for the Guardian.

Grassley vs Wagner

An influential U.S. senator has told a federal investigator that a University of Texas System researcher may not have properly disclosed her financial relationship with a drug company.

The inspector general at the U.S. Department of Health and Human Services could launch an inquiry into the scientist, UT child pharmacology researcher Karen Wagner.

The Dallas Morning News reports.

Thursday, May 07, 2009

Legislature approves bill limiting mentally ill patients' participation in drug trials

A bill before Gov. Tim Pawlenty would restrict the ability of clinical drug researchers to enroll mentally ill patients who are under court commitment orders.

The House and Senate both voted unanimously this week in favor of the bill, which was motivated by the suicide of schizophrenic Dan Markingson. Friday marks five years since his death in a group home in West St. Paul.

At the time, Markingson was enrolled in a comparative drug trial at the University of Minnesota — despite objections from his mother that he was coerced into the trial and should be withdrawn.

Read more in the Pioneer Press.

Fire man

Thanks, Maran, for spotting this.

Synthes settles

"The New Jersey attorney general has announced a settlement with a medical device maker accused of failing to disclose financial conflicts of interest among doctors researching its products, and says her office is investigating other similar conflicts in the device industry," says the New York Times. Read more here.

Monday, May 04, 2009

Thought leader repents

Dr. James Stein of the University of Wisconsin, a former industry thought leader, talks about his change of heart in this video.

More About the Mighty Potato

Potatos are hot, hot, hot! And the creator of the "classic American potato," Luther Burbank, is featured not only in the novel we are reading for class, Ruth Ozeki's All Over Creation, but also in a new book reviewed Sunday in the New York Times.

Jane S. Smith has written a biography of Burbank, titled The Garden of Invention: Luther Burbank and the Business of Breeding Plants.

According to the review, Smith writes that the type of russet potato Burbank developed became so popular that McDonald's insisted on its use for the making of its French fries. "Then, in 1995, the Monsanto Corporation would genetically modify the russet Burbank so that the potato could produce its own pesticide to repel the Colorado potato beetle."

And did you know that 2008 was declared the "International Year of the Potato" by the United Nations? Nope, neither did I. That lucky spud.

Sunday, May 03, 2009

Merck published fake journal

The Scientist: NewsBlog:
Merck published fake journal
Posted by Bob Grant
[Entry posted at 30th April 2009 04:27 PM GMT]

Merck paid an undisclosed sum to Elsevier to produce several volumes of a publication that had the look of a peer-reviewed medical journal, but contained only reprinted or summarized articles--most of which presented data favorable to Merck products--that appeared to act solely as marketing tools with no disclosure of company sponsorship.

"I've seen no shortage of creativity emanating from the marketing departments of drug companies," Peter Lurie, deputy director of the public health research group at the consumer advocacy nonprofit Public Citizen, said, after reviewing two issues of the publication obtained by The Scientist. "But even for someone as jaded as me, this is a new wrinkle."

The Australasian Journal of Bone and Joint Medicine, which was published by Exerpta Medica, a division of scientific publishing juggernaut Elsevier, is not indexed in the MEDLINE database, and has no website (not even a defunct one). The Scientist obtained two issues of the journal: Volume 2, Issues 1 and 2, both dated 2003. The issues contained little in the way of advertisements apart from ads for Fosamax, a Merck drug for osteoporosis, and Vioxx. (Click here and here to view PDFs of the two issues.)

The claim that Merck had created a journal out of whole cloth to serve as a marketing tool was first reported by The Australian about three weeks ago. It came to light in the context of a civil suit filed by Graeme Peterson, who suffered a heart attack in 2003 while on Vioxx, against Merck and its Australian subsidiary, Merck, Sharp & Dohme Australia (MSDA).

In testimony provided at the trial last week, which was obtained by The Scientist, George Jelinek, an Australian physician and long-time member of the World Association of Medical Editors, reviewed four issues of the journal that were published from 2003-2004. An "average reader" (presumably a doctor) could easily mistake the publication for a "genuine" peer reviewed medical journal, he said in his testimony. "Only close inspection of the journals, along with knowledge of medical journals and publishing conventions, enabled me to determine that the Journal was not, in fact, a peer reviewed medical journal, but instead a marketing publication for MSD[A]."

He also stated that four of the 21 articles featured in the first issue he reviewed referred to Fosamax. In the second issue, nine of the 29 articles related to Vioxx, and another 12 to Fosamax. All of these articles presented positive conclusions regarding the MSDA drugs. "I can understand why a pharmaceutical company would collect a number of research papers with results favourable to their products and make these available to doctors," Jelinek said at the trial. "This is straightforward marketing."

Jelinek also pointed out several "review" articles that only cited one or two references. He described one of these articles as "simply a summary of an already published article," and noted that they were authored by "B&J Editorial."

"It appears that 'B&J' (presumably Bone and Joint) refers to the Journal, and B&J editorial presumably to the publishers or owners as there is no editor of the journal," Jelinek said in his testimony. "This is a subtle attribution, and many readers may not realise that the paper was written by the owners or publishers of the journal, presuming that is who would write under the heading of 'editorial'."

Lurie, in examining two of the issues for The Scientist, agreed that one particularly strange element of the Australasian Journal of Bone and Joint Medicine is that it contains "review" articles that cite just one or two references. "I've never seen anything quite like this," he said. "Reviews are usually swimming in references." For example, one article on osteoporosis labeled above the title as a "meta-analysis" cites two references -- one itself a meta-analysis. "To the jaundiced eye, [the journal] might be detected for what it is: marketing," he said. "Many doctors would fail to identify that and might be influenced by what they read."

Lurie noted that the Australasian Journal of Bone and Joint Medicine is akin to other publishing strategies employed by drug companies; paying for supplements to existing journals or publishing compilations of original research articles that tend to lack scientific rigor (so-called "throwaways"). "It's kissing cousin to two other tricks that the [drug] companies pull."

In response to several questions about the publication posed by The Scientist, an MSDA spokesperson wrote in an email: "MSDA understood that Elsevier envisaged the complimentary publication would draw on the vast resources of Elsevier, publishers of many leading peer-reviewed journals including Lancet, Bone, Joint Bone Spine and others, to deliver novel and timely full text articles and abstracts to physicians." Many of the articles appearing in the Australasian Journal of Bone and Joint Medicine were in fact reprints or summaries of studies that originally appeared in other Elsevier journals.

A spokesperson for Elsevier, however, told The Scientist, "I wish there was greater disclosure that it was a sponsored journal." Disclosure of Merck's funding of the journal was not mentioned anywhere in the copies of issues obtained by The Scientist.

Elsevier acknowledged that Merck had sponsored the publication, but did not disclose the amount the drug company paid. In a statement emailed to The Scientist, Elsevier said that the company "does not today consider a compilation of reprinted articles a 'Journal'."

"Elsevier acknowledges the concern that the journals in question didn't have the appropriate disclosures," the statement continued. "It is worth noting that project in question was produced 6 years ago and disclosure protocols have evolved since 2003. Elsevier's current disclosure policies meet the rigor and requirements of the current publishing environment."

The Elsevier spokesperson said the company wasn't aware of how many copies of the Australasian Journal of Bone and Joint Medicine were produced or how the publication was distributed in Australia, but noted that "the common practice for sponsored journals is that doctors receive them complimentary." The spokesperson added that Elsevier had no plans to look further into the matter.

One of the members of Australasian Journal of Bone and Joint Medicine's "Honorary Editorial Board," Peter Brooks, a rheumatologist in Australia, said he didn't recall who asked him to serve on the board, but noted that he was on Merck's Asian Pacific and international advisory boards from the mid 1990s until about 2004, as well as the advisory boards of other pharmaceutical companies, including Pfizer and Amgen. "You get involved in a whole bunch of things at this level," Brooks said, adding that he had put his name on "a few advertorials" for pharmaceutical companies about 10 years ago.

As for the Australasian Journal of Bone and Joint Medicine, he said, "If it would have been put to me that [the journal] was just sort of a throwaway, then I would have said 'no'" to serving on its editorial board. He said he was never paid for his role, adding that he "didn't ever get [manuscripts] to review or anything like that," while on the board, because the journal did not accept original manuscripts for review.

"Having looked at one issue, it actually had some marketing studies," Brooks said. "It also had papers that were excerpted from other peer-reviewed journals. I don't think it's fair to say it was totally a marketing journal."

Editor's note (April 30): This story has been updated from a previous version.

Related stories:
  • Elsevier expands biopharma base
    [11th March 2008]
  • Merck's fall from grace
    [May 2006]
  • FDA approves Drug for the Annoyingly Cheerful

    The Onion News Network: FDA approves Drug for the Annoyingly Cheerful

    Friday, May 01, 2009

    Another pharma doc repents

    The 1990s was a heady time for the pharmaceutical industry, which had just embarked on what would become known as the Statin Wars. And James Stein, an up-and-coming heart doctor, was ripe to be hooked as a drug company speaker.

    Stein, now a professor at the University of Wisconsin School of Medicine and Public Health, was a 29-year-old cardiology fellow in Chicago in 1994 when his faculty mentor asked him to fill in for him at a drug company-funded lecture to a large group of doctors.

    It would be his first taste of life as a drug company speaker and consultant.

    Stein got first-class airfare to Dallas. A limousine took him to a luxury hotel for the talk.

    He walked off the stage, and a doctor from the conference handed him an envelope containing a $500 check.

    "I got a pat on the back and he said, 'There's more where that came from, son.' I had no idea what that meant, but I went home and paid off part of my student loans," Stein said in a presentation at UW this month.

    Read more in the Journal Sentinel.