Take a ride on the love train

Saturday Night Live says: Come on, old people, get on board right here.

Pressure rising

"Three pharmaceutical companies donated $700,000 to a medical society that used most of the money on a series of dinner lectures last year to brief doctors on the latest news about high blood pressure." Read more in the New York Times.

Oprah pimps cosmetic medicine

See "The Oprah Treatment" in The New York Times.

Script-tracking backlash

The AMA makes $40 million a year peddling information about doctors to pharma without their consent. In the face of legislation to prohibit the practice, the AMA now says that it will allow doctors to opt out. Only the procedure for opting out doesn't really mean doctors can opt out. See "Doctors Object to Gathering of Drug Data" in The New York Times.

Pre-diagnosis drugs for Schizophrenia

Mixed Result in Treating Schizophrenia Pre-Diagnosis

"In recent years, psychiatric researchers have been experimenting with a bold and controversial treatment strategy: they are prescribing drugs to young people at risk for schizophrenia who have not yet developed the full-blown disorder."

"Daily doses of the antipsychotic drug Zyprexa, from Eli Lilly, blunted symptoms in many patients and lowered their risk of experiencing a psychotic episode in the first year of treatment, the study found. But the drug also caused significant weight gain, and so many participants dropped out of the study that investigators could not draw firm conclusions about drug benefits, if any.

The long-awaited study, which was financed by Eli Lilly and the National Institute of Mental Health, raised more questions than it answered, experts said."

Outsourcing guinea pigs

According to the BBC:

"India's outsourced call centres are well known, but not its outsourced patients. By 2010, some estimate there will be two million patients in India on clinical trials. An entire industry has sprung up, specialising in recruiting patients and managing experiments. And a BBC investigation into the conduct of these trials has found that some patients are unaware they are being experimented on at all. "

See "Drug trials outsourced to India," and a trailer for the BBC documentary.

The monkeys read Nietzsche

See Dance Monkeys Dance

Wheelchair Unbound

Harriet McBryde Johnson, a disabled lawyer from South Carolina, visits the Holocaust Museum.

"Then I see the wheelchair. It's similar to other prewar wheelchairs I've seen, but there's something unusual about the frame. Is this a tilting mechanism? A fancy suspension system? Looks like fine German engineering. I like vintage wheelchairs. An obsolete Everest & Jennings drive belt hangs in my office as a bit of nostalgia, like an old wagon wheel in a barbecue shack. I have an urge to jostle the chair, to see what that frame does. The sign mentions a German institution. So, no single owner. But even in institutions, people manage to bond with chairs. A state-owned chair may be occupied by the same person every day, parked beside that person's bed at night."

See "Wheelchair Unbound" in The New York Times Magazine.

Amy Laura Hall at the U

This Friday, April 21: Duke theologian Amy Laura Hall will give a talk titled "Human Mistakes and Mishaps: Disability, Children, and Atavism During the Center of Progress. It will be in 2-122 Molecular & Cellular Biology Building (MCB).

Grading health journalism

Gary Schwitzer has launched Health News and Review, which gives grades to health stories in the media based on accuracy, balance and completeness. It is modeled on Media Doctor, an Australian project that inspired a similar website in Canada.

Side Effects at the U

Side Effects, an independent fiction film about a drug rep, directed by Kathleen Slatter-Moschkau (a former rep for Johnson and Johnson) will be shown in Moos Tower 2-620 on Monday, April 17, at 5 pm. Kathleen Slattery-Moschkau will be here to answer questions after the film.

More symptoms to ADHD coming your way...

"Overly Wired? There's a Word for It"
"The frenzy of our wired world, he argues, is giving nearly all of us the symptoms of attention deficit disorder. To conquer the enemy, he says, we first need to name it."
So he has come up with the following suggestions, among others:

¶Screensucking, which he defines as "wasting time engaging with any screen — for instance, computer, video game, television, BlackBerry." He goes on to use his new word in a sentence: "I was supposed to write that article, but instead I spent the whole afternoon screensucking." That concept hits particularly close to home.

¶EMV, or E-Mail Voice. This, Dr. Hallowell writes, is "the unearthly tone a person's voice takes on when he is reading e-mail while talking to you on the telephone." Researchers at M.I.T., he tells us, have developed a program that can electronically measure how engaged people are in a conversation, giving scientific certainty to your suspicion that you are not being listened to.

And more!

Merck loses another one

Delivering a sharp blow to Merck, a New Jersey jury found Wednesday that the company had not properly warned patients of the dangers of its drug Vioxx and had caused a heart attack suffered by John McDarby in 2004. The jury awarded Mr. McDarby, who had taken Vioxx for four years, $3 million in compensatory damages and Irma, his wife, an additional $1.5 million. Read about it here.

Another drug trial accident....

Another drug trial accident: a healthy volunteer had to go to the hospital because a reaction to the drug makes his face "look like elephant man"...

Four out of five doctors surveyed

Cosmedicine™": endorsed by Johns Hopkins Medicine. (Seriously.)

"Our business relationship with KAA is an opportunity to apply our expertise to an industry that we believe can benefit from our research and clinical experiences and a company that has expressed a commitment to representing its products' capabilities based on quantifiable study."

"We look forward to exploring with KAA other ways we can bring value to their company and, perhaps, to the skin health marketplace generally."

"Johns Hopkins Medicine faculty members receive standard fees for consulting with KAA on both their service business and Cosmedicine™. Johns Hopkins Medicine receives fees from KAA, holds stock in the company, and has a voting seat on KAA's board."

Problems with Body World...

"An exhibit of real human corpses is the most popular show ever at San Francisco's Masonic Center. But problems uncovered by the ABC7 I-Team threaten to shut down the exhibit. The most obvious problem is the corpses are leaking...."

This little piggy went to market

Cloned pork, coming to a restaurant near you.

Life coaching goes mainstream

Life coaches are in the style section of this Sunday's New York Times:

"But behind the scenes life coaches are also finding plenty of work in the entertainment business. As their ranks swell nationwide — the International Coach Federation says its membership has doubled to 9,500 personal and business coaches since 2001, 56 percent of them in the United States — a growing roster is specializing in celebrities and Hollywood. "

"Although the federation does not keep track of coach specialties, coaches who devote themselves to the entertainment business — many of them former actors, television network executives, film producers or scriptwriters who sell their services as insiders — say they have seen more acceptance and a doubling and even tripling of demand for their services in the last three or four years."

Watching Coolhunters in action

Here are two PBS- Frontline shows that parallel the class discussion on Wednesday.

"The Merchants of Cool" is all about marketing strategies for teenagers with a section
 where they show cool hunters hitting the streets looking for people and other pretty
 sneaky marketing strategies,which are especially worrisome because they target younger
and younger kids. There's also another Frontline 90 minute documentary, "The Persuaders"
which is all about how we're so overwhelmed by traditional advertisements that marketers
 have to come up with more creative strategies...there's this one guy in it who
is especially interesting (and creepy) because he makes millions selling his ad strategies
 to big companies, but his way of extracting what customers are looking for is this strange
pseudoscience/hypnosis practice which he does on focus groups.

Provigil rejected for ADHD

An FDA advisory panel has recommended rejecting Cephalon's application to market Sparlon, a clone of its narcolepsy drug Provigil, for ADHD in children. "The advisory committee voted 12-to-1 against recommending Sparlon's approval, citing its concerns about Stevens-Johnson syndrome, a rare and vicious blistering of the skin that can be caused by certain drugs."

Doctor slipped a twenty

Doyle Redland reporting, from The Onion Radio News.

Put me in, life coach

The Daily Show, on life coaches.

Drug czar

"Donald Rumsfeld has made a killing out of bird flu. The US Defence Secretary has made more than $5m (£2.9m) in capital gains from selling shares in the biotechnology firm that discovered and developed Tamiflu, the drug being bought in massive amounts by Governments to treat a possible human pandemic of the disease." Read more...

British guinea pig update

More on the Parexel study from The Times of London: "Experts knew that drugs similar to the one that nearly killed six men at a London hospital last week could have had dangerous side effects. Trials last year in America of a similar “monoclonal antibody” caused severe toxic reactions in patients. But the UK study went ahead after the regulatory authority failed to consult outside specialists who would have warned against proceeding." The full story is here.

Provigil by another name

Cephalon wants the FDA to approve its narcolepsy drug modafanil (also known as Provigil) for ADHD. Why? Because the patent has expired; they have paid generic manufacturers not to make it; and approval for pediatric use will give Cephalon six more months of exclusivity. Merrill Goozner of the Center for Science in the Public Interest blogs the story in "Pawns in Their Game."

Psychotropic love affair

"When it comes to psychotropics, we are all men easily swept off our feet, composing bad love poems, willing to wine and dine at sky-high prices, only to break off our engagement with a stamp and a pout once we see our bride-to-be without her makeup." Lauren Slater writes about America's love affair with psychoactive drugs in the New York Times.

The Bitter Pill Awards

Per our conversation on DTCA several weeks ago, I thought we might all get a laugh out of the Bitter Pill Awards. Here, you can nominate your pick for most heinous DTC drug campaign whether it air on TV, radio, Internet, or even in print advertising. Also, check out the winners from last year. My favorite is the Viagra ad described here:

"Pfizer ran ads for Viagra in 2004 that featured the drug's blue "V" logo as devilish horns behind a man's head, with statements like "Remember that guy who used to be called `Wild Thing?' The guy who wanted to spend the entire honeymoon indoors? Remember the one who couldn't resist a little mischief? Yeah, that guy. He's back." The ads were suggestive enough that the FDA issued one of its rare enforcement letters, asking Pfizer to stop running the ads."

Guinea pigs to the world

Half of all clinical trials are being conducted in countries like India, China, and Brazil, writes Jennifer Kahn in Wired. The consulting firm McKinsey predicts that the market in India for outsourced trials will hit $1.5 billion by 2010. See "A Nation of Guinea Pigs."

Lunesta v Sonata v Ambien

Alan Cassels weighs in on The Sleeping Pill Wars.

All you have to do is dream

Mark your calendars: only one month to go until National Sleep Awareness Week. This means a week of non-stop news stories about sleep-deprived Americans, and tons of press for sleeping pills and other sleep products, courtesy of the industry-supported National Sleep Foundation. You can prepare yourself by reading the Forbes cover story, "The Sleep Racket," or listening to the On Point public radio show, "To Sleep Via Pill."

We are all ADHD now

75,000 Americans show signs of addiction to stimulant drugs such as Ritalin and Adderall, says a new study in the journal Drug and Alcohol Dependence, and over 1.6 million have misused the the drugs. Students are using stimulants to boost their academic performances. But the study itself was funded by Eli Lilly, the manufacturer of Strattera, a non-stimulant alternative. The full story appears in The Washington Post.

Have a look as well at Joshua Foer's 2005 article in Slate.com, "The Adderall Me: My Romance with ADHD Meds." Larry Diller writes about marketing stimulants in his 2001 Salon.com article, "An end run to marketing victory." The WBUR radio show On Point ran a program last week on ADHD drugs, especially the recommendation of an FDA advisory panel that stimulants be tagged with a "black box" warning.

CMAJ editors sacked

The Canadian Medical Association (CMA) has fired John Hoey and Anne Marie Todkill, the editors of its flagship journal, the Canadian Medical Association Journal (CMAJ), after a controversial article on Plan B. The CMA is getting hammered by critics for interfering with the editorial policy of the journal.

Hallmark MD

The American Medical Association has decided to launch an ad campaign for itself. It is running TV ads on shows like The O'Reilly Factor and Project Runway; in print, it is distributing thank-you cards for patients to send to their doctors. "Your doctor is always there for you. Helping you to feel your best. Now is your chance to return the favor with a specially designed card from the AMA."

Corporations, universities: same thing

The chancellor of the University of California-San Diego, Marye Anne Fox, received at least $339,260 in cash and stocks in the past year from corporate consulting and advisory board positions. Her links include a medical device manufacturer and a contract research organization. Fox says that “All things involved in managing and directing and envisioning for corporate entities are virtually the same things you have to do for universities."

FDA staff objects, FDA approves anyway

Scientists at the FDA unanimously recommended rejecting the application of Cyberonics Inc. to sell its surgically implanted vagus nerve stimulator as a treatment for depression. The only clinical trial failed to show effectiveness. But Dr. Daniel G. Schultz, director of the FDA's Center for Devices and Radiological Health, decided to approve it anyway. Why, asks The New York Times?

Abbott is suspended

Abbott Laboratories has been nailed for entertaining doctors at dog races and lap dancing clubs. (PharmaGossipp has an interesting take on the story as well.)

The Strib plumps a weight loss pill

The story in Wednesday's Star Tribune on a new, as yet unapproved diet drug from Sanofi Aventis reads as if it came from a press release, complete with enthusiastic endorsement by Sanofi's paid doctor-shills.

Alan Cassels to speak at the U

Thursday, Feb. 16 2006
12:15 PM to 01:15 PM

Student Committee on Bioethics Lecture Series

Disease Mongering 101: The Marketer's Guide to Selling Sickness
Alan Cassels

Moos Health Sciences Tower - 2-650
University of Minnesota

Alan Cassels is a drug policy researcher in Victoria, BC, Canada. He led a team of researchers which produced Canada’s first evaluation of the quality of media reporting of prescription drugs. He recently co-authored the book Selling Sickness: How The World's Biggest Pharmaceutical Companies Are Turning Us All Into Patients (Nation Books, 2005).

After reading the Conrad essay on medicalization, I looked for the paxil self-test he mentions online and took it: http://www.paxilcr.com/Social_Anxiety_Disorder_Test.jsp

Very amusing...As I expected, it told me "Your score in not typical of a person suffering from SAD," but then went on to say " We strongly encourage you to make an appointment with a qualified healthcare professional to discuss your symptoms." What symptoms??

Plus, you can see why so many people think they have SAD when according to the self-test, avoiding talking to people you don't know or finding it distressing to swear in public count as symptoms.

Embryos R Us

Fertility is not a miracle; it's a market. Or so says Harvard Business School professor Debora Spar in her new book, The Baby Business: How Money, Science, and Politics Drive the Commerce of Conception (Harvard Business School Press, 2006.) Spar is interviewed by Lynn Harris in Salon.com, and (by podcast) on "The Leonard Lopate Show."

A black box for the stimulants?

An FDA advisory panel has recommended that stimulants such as Ritalin, Adderall and Concerta carry a black box warning because of their dangerous effects on the heart.

Writing for dollars

While the country works itself into a frenzy over the $2 billion a year that lobbyists spend to influence politicians, it fails to notice that the drug industry spends nearly 10 times that much to influence doctors. Or so writes former NEJM editor Jerome Kassirer in The Boston Globe.

Are you PharmFree?

The American Medical Student Association is the only mainstream American medical group to take a principled stand against gifts from the drug industry. When they demonstrated at Pfizer headquarters on PharmFree Day, Pfizer called the police.

Are you PharmFree?

The American Medical Student Association is the only mainstream American medical group to take a principled stand against gifts from the drug industry. When they demonstrated at Pfizer headquarters on PharmFree Day, Pfizer called the police.

Bribing doctors is bad, etc etc

So says The New York Times.

And what about Groundhog Day?

"What are you giving thanks for?" asked the Viagra ads at Thanksgiving. "What are you doing New Year's Eve?" they asked at year's end. Keep an eye out as Valentine's day approaches.

Stopdrugads.org

Commercial Alert, an Oregon nonprofit, is sponsoring a campaign to stop direct-to-consumer advertising of prescription drugs. The U.S. and New Zealand are the only industrialized countries in which such advertising is allowed.

"Silicone is a time bomb"

Bumps like capers bulging from your lips, ridges like worms below your eye sockets, rice grains running along your forehead, and a walnut-size bump between your eyebrows: doesn't The New York Times make cosmetic surgery sound good?

More kickbacks, please

Same story, different drugmaker: this time it is Novo Nordisk, a Danish company, that is accused of paying doctors, PAs and pharmacists to switch patients to their drug.

Saw a story about the "virtual human ken doll" on CNN yesterday, very disturbing because he recognizes that he has body dysmorphic disorder yet the plastic surgeons are still willing to continue on him...

http://et.tv.yahoo.com/celebrities/etsid2910170012291/

-Emily

Rhetoric Parlor Series: Antidepressant Advertising.

The first entry in this semester's Rhetoric Parlor Series will be this Friday at 4:15 in Magrath Library Room 8. Cristina Hanganu-Bresch will present from her dissertation in progress on the way pharmaceuticals are promoted to physicians. The official title of the talk is "The Visual Semiotic of Depression: Two decadesof antidepressant advertising in the American Journal of Psychiatry."

Here's a quick primer on semiotics. Hope to see you there.

--Paul

Next week....

Next meeting with health journalism students, Feb 1, Murphy Hall Room 100, 1o:30-1:00.

Read:

Trudy Lieberman's "Bitter Pill" in Columbia Journalism Review

The Seattle Times' "Suddenly Sick" series

HRT on the ABC

The Australian Broadcasting Corporation's radio show, The Health Report, has produced a useful program on the selling of hormone replacement therapy for menopause, available by podcast.

Blowing the whistle on Medtronic

Qui tam litigation has come to Minnesota. According to The New York Times, a whistleblower lawsuit alleges that medical device maker Medtronic paid a Wisconsin surgeon in Wisconsin $400,000 a year to work just eight days, and that doctors who visited the Memphis office were taken to strip clubs while the expenses were disguised as trips to the ballet.

A nose for a deal

Pakistani Britons are traveling to their homeland to get discount cosmetic surgery, says The Independent. "Nose jobs, tummy tucks, liposuction and breast enlargements are the favoured treatments for many who feel 'pressure to have Western features' but who want to pay only a fraction of what they would be charged in Britain."

Is advertising obsolete?

At times the speakers at the Word-of-Mouth Marketing conference in Orlando could have been mistaken for revival preachers, writes Julie Bosman in The New York Times. "Among Friday's offerings were sessions titled 'Turning Customers Into Evangelists,' 'Word of Mouth in Faith-Based Markets' and 'How to Create Brand Converts." (Not to mention "Bring Brands Back from the Dead.")

Detox Mansion

James Frey is taking a beating from journalists for making up long passages of his bestselling detox memoir, A Million Little Pieces (which was set in a Minnesota recovery facility for the rich and famous), but apparently his fellow patients were taking him to task long before the journalists were.

Obesity Inc.

The genius of American capitalism is the way it generates so much revenue both from making thin people fat, and from promising to make fat people thin. The Obesity Industry constitutes about 3% of the American economy, according to Michael Rosenwald in The Washington Post, including $133.7 billion annually for fast-food restaurants, $1.8 billion for diet books and $124.7 billion for medical treatments related to obesity. (Not to mention cottage industries such as Goliath Casket, which has, according to its web site, has been "serving the needs of the Oversized Casket Community for 20 years.") Meanwhile, investors are betting heavily on a new wave of diet drugs due on the market soon, including Sanofi-Aventis SA's Acomplia, while Wyeth is still paying out vast amounts in legal settlements to patients injured by its diet drug combination Fen-Phen.

Dead can dance

Everyone loves museums and galleries, and when you think about it, is there any more relaxing way to spend an afternoon than a peaceful stroll through a gallery of stylishly displayed human corpses? The Medical Humanities and Ethics Program at Northwestern University has dedicated the first issue of its newsletter, The Atrium, to the ethical debates surroung the display (and dissection) of human bodies -- bottled fetuses, anomalous body parts, and the plasticized corpses on display at Bodyworlds. It's called "Bringing Out the Dead."

Exquisite corpse

Sure, folks may be lining up to see human bodies on display at Gunther von Hagens' Bodyworlds exhibit, but you have not really seen dead bodies on display until you have seen an exhibit by the The Minnesota Association of Rogue Taxidermists (MART). MART is an organization "dedicated to the showmanship of animal oddities, natural adaptation and mutation." Their exhibits include artificial chimeras, mutant chickens, vampire mermaids, flying monkeys and a variety of road kill. Best of all: it's for sale. If you go to the on-line shop you can buy "Frogs Eating Human Toes." MART says, "Want your frog vomiting gore? We can do that. Prefer something more innocent? How about a frog sucking on a toe like a pacifier? We can do that too! Frogs eating toes....buy one for your mom!"

Black box warning?

GlaxoSmithKline wants to market an over-the-counter version of its diet pill Xenical. The good news: an FDA reviewer says it is a safe and effective weight loss agent. The bad news: side-effects include "involuntary leakage of undigested fat."

The Sheffield University scandal

Stay tuned for updates on the saga of Aubrey Blumsohn, the Sheffield University medical school professor who was suspended after he raised questions about a shady $250,000 research contract between the university and Procter & Gamble Pharmaceuticals. Jennifer Washburn detailed the story in Slate last month. Last week the university official at the center of Blumsohn's allegations, Richard Eastall, resigned from his NHS post. More on this story as it develops...

Health care for everyone?

The Boston Review has published a forum on American health care reform, with excellent contributions by Jill Quadagno, John Geyman and Barbara Starfield, but the most provocative essay in the forum may be the one authored by Victor Fuchs and Ezekiel Emanuel, titled "Getting Covered." Fuchs and Emanuel argue that the most politically realistic plan for getting adequate health care for all Americans is not a single payer system, but a system of universal health care vouchers. They argue that a voucher system will be easier to reconcile with the American individualism that has doomed all previous efforts at universal coverage. Fuch and Emanuel write, "We can each push our favorite plan and have universal health care fail yet again. Or we can compromise and get all Americans covered."

Clone Psychology

What would it be like to grow up as a clone? Like being an identical twin? Like being a stepchild? Like being the ghost of a dead sibling, whose genetic constitution you share? The Australian Broadcasting Corporation radio show "All in the Mind" explored this question on January 14 with ethicist Julian Savulescu, reproductive biologist Alan Trounson and psychiatrist Stephen Levick. (The show is also available by podcast and mp3 download.)

Who's afraid of human enhancement?

Reason magazine has published an edited transcript of a symposium on enhancement technologies, titled "Who's Afraid of Human Enhancement?" featuring Ron Bailey, a writer for Reason and author of Liberation Biology, Eric Cohen, the editor of The New Atlantis; and Joel Garreau, a reporter for The Washington Post and author of Radical Evolution. (It is also available on mp3 at the site.)

A Reason symposium is not the place for leftists who are worried about bioenhancement -- Bailey envisions an idyllic family picnic in 2010 where a 150 year-old great-great-great-grandma plays touch football with her 30-year-old great-great-grandson, while even Cohen, a bioenhancement skeptic, says "I’m enough of a free market person to believe that if something works in wealthy societies, eventually most people are going to be able to afford it" -- but if you are looking for a lively, literate introduction to the ethical issues surrounding enhancement technologies, this debate will get you started.

That Sam-I-Am, that Sam-I-Am, I do not like that Sam-I-Am

Green Eggs and Ham. Your standard torture-and-kidnap story, or a tribute to American salesmanship and open-mindedness? The Wall Street Journal weighs in.

How much for his hair and fingernail clippings?

William Shatner has sold his kidney stone to an on-line casino in order to raise money for a housing charity. The casino paid $25,000 for the stone and will add it to a collection that includes a half-eaten cheese sandwich bearing the image of the Virgin Mary.

Guinea Pig Zero at the U

Robert Helms, activist, professional research subject and editor of the legendary zine Guinea Pig Zero, will be speaking at the University of Minnesota. Here are the details.

Lecture

Guinea Pig Zero:
Notes from a Professional Research Subject

Robert Helms
Founding editor of Guinea Pig Zero: A Journal for Human Research Subjects
Thursday Jan 26 2006
12:15PM-1:15PM
Moos Tower 2-650
University of Minnesota

Publishers Weekly says:

In 1996, freelance lab rat and activist Robert Helms, under the nom de plume Guinea Pig Zero, began to publish a zine with the same name. In Guinea Pig Zero: An Anthology of the Journal for Human Research Subjects, he gathers together a few dozen contributions (many of which he penned) exploring "this dark little corner of modern science from the subject's own viewpoint." From Donno's tale of going bonkers in a sleep-deprivation study, to Beth Lavoie's discussion of the various poisons to which soldiers in the Gulf War were exposed, to Helms's history of a 1935 test subject strike, these are strange and frightening stories that may make our trust in the medical establishment seem naive.

A Weblog on Medical Consumerism.

Check back weekly for links relevant to our classroom studies.