Tuesday, May 22, 2007

Who Is Deciding What Your Doctor Prescribes?

Originally posted  to Get the Facts & Get Involved at 5/22/2007 05:41:00 PM

" The American Medical Association, a larger and far more established group, makes millions of dollars each year by helping data-mining companies
link prescribing data to individual physicians.  It does so by licensing access to the AMA Physician Masterfile, a database containing names, birth dates,
educational background, specialties and addresses for more than 800,000 doctors. "
Doctors may be bound by oath to protect your privacy but drug company salespeople are not.  Ask your doctor if he has chosen to opt-out of the AMA patient prescription data sharing.   Don't let the pharmaceutical and insurance companies decide the quality of your healthcare.    plk
Doctors, Legislators Resist Drugmakers' Prying Eyes 
Washington Post Staff Writer

Seattle pediatrician Rupin Thakkar's first inkling that the pharmaceutical industry was peering over his shoulder and into his prescription pad came in a letter from a drug representative about the generic drops Thakkar prescribes to treat infectious pinkeye.

In the letter, the salesperson wrote that Thakkar was causing his patients to miss more days of school than they would if he put them on Vigamox, a more expensive brand-name medicine made by Alcon Laboratories.

"My initial thought was 'How does she know what I'm prescribing?'  I just feel strongly that medical encounters need to be private."

Many doctors object to drugmakers' common practice of contracting with data-mining companies to track exactly which medicines physicians prescribe and in what quantities -- information marketers and salespeople use to fine-tune their efforts.

The industry defends the practice as a way of better educating physicians about new drugs.

Now the issue is bubbling up in the political arena.

Last year, New Hampshire became the first state to try to curtail the practice, but a federal district judge three weeks ago ruled the law unconstitutional.

This year, more than a dozen states have considered similar legislation, according to the National Conference of State Legislatures.  They include Arizona, Illinois, Kansas, Maine, Massachusetts, New York, Nevada, Rhode Island, Texas, Vermont and Washington, although the results so far have been limited.  Bills are stalled in some states, and in others, such as Maryland and West Virginia, they did not pass at the committee level.

The concerns are not merely about privacy.  Proponents say using such detailed data for drug marketing serves mainly to influence physicians to prescribe more expensive medicines, not necessarily to provide the best treatment.

"We don't like the practice, and we want it to stop," said Jean Silver-Isenstadt, executive director of the National Physicians Alliance, a two-year-old group with 10,000 members, most of them young doctors in training.  "We think it's a contaminant to the doctor-patient relationship, and it's driving up costs."

The American Medical Association, a larger and far more established group, makes millions of dollars each year by helping data-mining companies link prescribing data to individual physicians.
It does so by licensing access to the AMA Physician Masterfile, a database containing names, birth dates, educational background, specialties and addresses for more than 800,000 doctors.
After complaints from some members, the AMA last year began allowing doctors to "opt out" and shield their individual prescribing information from salespeople, although drug companies can still get it. So far, 7,476 doctors have opted out, AMA officials said.  Some critics, however, contend that the AMA's opt-out is not well publicized or tough enough, noting that doctors must renew it every three years.

The New Hampshire court's ruling has raised new doubts about how effective legislative efforts to curb the use of prescribing data will be, but the state attorney general has promised to appeal.
And state Rep. Cindy Rosenwald (D), the law's chief sponsor, vowed not to give up the fight.

"In this case, commercial interests took precedence over the interests of the private citizens of New Hampshire," Rosenwald said.  "This is like letting a drug rep into an exam room and having them eavesdrop on a private conversation between a physician and a patient."

The April 30 ruling by U.S. District Judge Paul Barbadoro, nominated to the federal bench in 1992 by President George H. W. Bush, called the state's pioneering law an unconstitutional restriction on commercial speech.
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From the Archives

Do You Really Need All Of Those Drugs?

Originally posted by Pamela to Pam's Coffee Conversation at 8/22/2006


Before you read the following article I want to caution anyone currently taking prescribed medication not to stop taking their medicine without consulting their physician or seeking an alternative opinion.


Now with that said,  have you noticed that virtually everyone you know is taking some form of prescription medication.?     Do we really need all of these drugs?  You might be taking one drug that has side effects so you take another drug to treat the side effects of the first drug,  then a third drug to treat the side effects of the second and so on, and so on and so on ......   plk



Drug Ads Sell a Problem, Not a Solution 

by Jonathan Rowe



POINT REYES STATION, CALIF. -- It is an old saying in the advertising trade that you sell the problem, not the solution. That helps explain why the media today are awash with images of disease. Erectile dysfunction, depression, stress, attention deficit disorder, on and on - you can't escape them and the sense of looming peril that they conjure up.


Politicians sell terror and fear; pharmaceutical companies sell disease. Every state and stage of existence has become a pathology in need of pharmaceutical "intervention," and life itself is a petri dish of biochemical deficiency and need. Shyness is now "social anxiety disorder." A twitchy tendency has become "restless leg syndrome." Three decades ago the head of Merck dreamed aloud of the day when the definition of disease would be so broad that his company could "sell to everyone," like chewing gum.


That day is rapidly approaching, if it's not already here. "We're increasingly turning normal people into patients," said Dr. Lisa M. Schwartz of the Dartmouth Medical School. "The ordinary experiences of life become a diagnosis, which makes healthy people feel like they're sick."


In one sense, the ads have been successful. The Kaiser Family Foundation found that every dollar drug companies spend on ads brings more than four dollars in additional sales. But for most others, the result has been soaring medical insurance costs, toxic side effects, and new tensions between doctors and patients, who increasingly badger doctors for the drugs they've seen on TV.


One study found that 30 percent of Americans have made these demands. A Minnesota doctor complained recently that patients now push him for sleep medications "when maybe they just need to go to bed on a more regular basis."


But perhaps the worst part is that prescription drug ads have immersed us all in a pervasive drug culture that seems to have no boundaries. We are being reduced to helpless "consumers" who have no capacity to deal with challenges other than by taking a pill. Last month Tim Pawlenty, the Republican governor of Minnesota, called for a moratorium on prescription drug ads. It's about time.


For most of the past half century, there were tight restrictions on the general advertising of prescription drugs. These require doctors' guidance for a reason; so why should Madison Avenue get involved? But under heavy pressure from the drug and advertising industries, the government backed down in the late 1990s, and that started the tsunami.


Spending on drug ads for the general public more than tripled between 1996 and 2001. It is now some $4 billion a year, which is more than twice what McDonald's spends on ads. In 1994, the typical American had seven prescriptions a year, which is no small number. By 2004, that was up to 12 a year. Homebuilders are touting medicine cabinets that are "triple-wide."


The industry says this is all about "educating" the consumer. But an ad executive was more candid when he said - boasted, really - that the goal is to "drive patients to their doctors." Reuters Business Insight, a publication for investors, explained that the future of the industry depends on its ability to "create new disease markets." "The coming years," it said, "will bear greater witness to the corporate-sponsored creation of disease."


The Kaiser study found that drug ads increase sales for entire categories of drugs, not just the one in question. The ads really are selling the disease more than a cure.


Advertising is just one way the industry has sought to accomplish this goal. It also funds patient advocacy groups such as Children With Attention Deficit Disorder (CHADD), and doctors who push for expanded definitions of disease, among a host of other things. (When the definition of ADD expanded in the 1980s, the number of kids tagged with this problem increased by 50 percent.)


But advertising is the most pervasive and aggressive way of selling sickness. It also is the hardest to justify. Medicine is supposed to be about science, not huckstering; about healing people, not persuading more of them that they are sick. There are far better ways to inform the public about health issues than to spend billions of dollars a year pushing pills.


This is why more than 200 medical school professors recently called for an end to prescription drug ads, and why close to 40 health and seniors groups have joined them. Even the American Medical Association, many members of which have close ties to the pharmaceutical industry, has urged restrictions. Washington should listen to these doctors. As Governor Pawlenty put it, we need to put "the decisionmaking back where it should be - on an informed basis between the patient and the doctor."


Jonathan Rowe is issues director at Commercial Alert and a fellow at the Tomales Bay Institute. He is a former Monitor staff writer.



© Copyright 2006 Christian Science Monitor




Thinking about getting off the prescription drug merry-go round?  Check out these resources:






Holistic Ireland  




Dr. Weil.com     


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Originally posted to Pam's Coffee Conversation at 5/3/2005 
Steve posts a very important question in his Modulator post. The pharmaceutical industry is steadily growing with the introduction of drugs to treat our ever expanding list of ailments while it seems that very little is being invested in preventing the ailments in the first place.

In fact, based on television marketing it seems like a good portion of our society is depressed or has high cholesteral, asthma, allergies or ADD. And at least half the male population must suffer from ED as a side effect of the other drugs that they're taking. There's a drug to treat the illness and a drug to treat the side effect of that drug and so forth and so on. It seems like a new disease is identified every year and a new drug released within the next six months. Very few of the new drugs are curative. Most are maintenance meds that the individual will take for the rest of their life.

Conversely, while the pharmaceutical industry is booming rain forests are disappearing along with the ozone layer and the polar icecaps. And, islands of garbage are developing in our oceans. Compared to the pharmaceutical industry very little is invested in cleaning our polluted environment and reducing the stress factors that contribute to many illnesses. Sadly, it seems that there is no economic incentive to change this equation. There is only the moral imperative to do what is right and try to save the human race. plk

Pharmaceutical Industry Question

Even though its growth rate has declined from the hot 18% of 2001 to 10% the pharaceutical industry still had a pretty darn good year in 2004:

In 2004 the U.S. pharmaceutical industry reached the quarter trillion dollar mark for the first time, with $251 billion in product salesI suspect the industry would prefer the 18% growth rate but there are some pressures holding them back:

According to NDCHealth, four factors have contributed to the overall pharmaceutical market growth decline: generic erosion; safety issues and product withdrawals; increased consumer switching to over-the- counter (OTC) medications and a lack of new blockbuster drugs.On the other hand market penetration for some drugs appears significant:

-Among all patients receiving a drug in 2004, 10% were on Pfizer's Zithromax® and 5% were on Pfizer's Lipitor®.Here is the question: Is it in the interest of the $251 billion pharmaceutical industry to have a healthier or a sicker customer base?

Based on your answer and given this data:

Overall, drug companies spent $78.1 million on lobbying in 2001, bringing the total lobbying bill for 1997-2001 to $403,071,467. (See Table 2) The companies employed 623 different individual lobbyists in 2001 – or more than one lobbyist for every member of Congress.what was the industry trying to accomplish and what types of programs would they support? Do you think Pfizer would rather have more or fewer people taking statins and Lipitor® in particular?


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