Dec

31

I Might Have to Start Buying Pens

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Last night I read article in the New York Times that reported on a voluntary moratorium on branded giveways to physicians by drug companies and their representatives. I found the timing of the article especially curious considering the lengthy piece in the New York Review of Books. The ban goes into effect on 1 January and is voluntary. The reaction is mixed:

“Some skeptics deride the voluntary ban as a superficial measure that does nothing to curb the far larger amounts drug companies spend each year on various other efforts to influence physicians. But proponents welcome it as a step toward ending the barrage of drug brands and logos that surround, and may subliminally influence, doctors and patients. “

What captured my attention was the amount of money involved in distribution of drug samples, pens and notepads.

“Last year, besides giving away nearly $16 billion in free drug samples to doctors, pharmaceutical companies spent more than $6 billion on “detailing” — an industry term for the sales activities of drug representatives including office visits to doctors, meal-time presentations and branded pens and other handouts, according to IMS Health, a health care information company.”

The article also notes that there are conflicting opinions on whether these giveways unduly influence the actions of physicians and that other financial relationships that exist between doctors and drug companies are not impacted by this ban. While the merits of the ban may be debatable, what seems clear to me is that you don’t spend 22 billion dollars on “detailing” if your money isn’t providing a return. The larger issues also remain unaffected.

“The industry code also permits drug makers to pay doctors as consultants “based on fair market value” — which critics say means that companies can continue to pay individual doctors tens of thousands of dollars or more a year. “

I have to admit that I am a little saddened by the ban. Drug company pens were always pretty well made and I’ve been swiping them during doctor visits all my life.

Dec

30

Influence Peddling

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I believe that I am naturally cynical. The glass is half empty of course, but I am more concerned with finding out who has been drinking my water. This inclination toward deep skepticism is magnified many-fold when dealing with bureaucracies, government officials or corporations. Thus, I find myself quite surprised that I was surprised by Marcia Angell’s article in The New York Review of Books.

While I don’t inherently mistrust the medical profession as much as I do a multi-national corporation like a pharmaceutical company, I suppose I could have figured out for myself if I had tried that piles of cash might influence the opinions of medical researchers acting on behalf of a drug company.

“No one knows the total amount provided by drug companies to physicians, but I estimate from the annual reports of the top nine US drug companies that it comes to tens of billions of dollars a year. By such means, the pharmaceutical industry has gained enormous control over how doctors evaluate and use its own products. Its extensive ties to physicians, particularly senior faculty at prestigious medical schools, affect the results of research, the way medicine is practiced, and even the definition of what constitutes a disease.”

There has been growing awareness of the conflict of interest present when research institutions are the beneficiaries of revenue streams, grants and gifts from the manufacturers of the products they are testing. The poisonous nature of these financial relationships do not just corrupt drug testing and research as it turns out. The ties between medical professionals and drug companies distort the primary tool for diagnosing and treating mental illness, the Diagnostic and Statistical Manual of Mental Disorders.

“Given its importance, you might think that the DSM represents the authoritative distillation of a large body of scientific evidence. But Lane, using unpublished records from the archives of the American Psychiatric Association and interviews with the principals, shows that it is instead the product of a complex of academic politics, personal ambition, ideology, and, perhaps most important, the influence of the pharmaceutical industry. What the DSM lacks is evidence. “

Given the near total collapse of the financial system this year and the seemingly endless stream of reporting on inefficient, inept and corrupt management within some of the world’s premier financial institutions, unethical relationships between the medical establishment and the pharmaceutical manufacturers might be considered a given. I may not be as incredulous as I would like to think.

Dec

16

New Reads New Tunes

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For several months I have been accumulated books and cd’s on my wish list. Last week I acted on impulse and ordered several items on the list. My current read list isn’t being read and I have wanted to listen to some unfamiliar music, so that drove me to place the order. I find myself strangely energized by the arrival today of the new media. The shipment included:

The Limits of Power by Andrew J. Bacevich

The Dark Side by Jane Mayer

Allison Moorer – Mocking Bird

Julieta Venegas – Aqui

Maria Rita – Segundo

Tift Merrit – Another Country

Shelby Lynne – Just a Little Lovin’

Melody Gardot – Worrisome Heart

After only four tracks, I am completely enthralled with the Julieta Venegas disc. My habit is to put a disc in the player and listen to five or ten seconds of each song to get a feel for the disc. I do this with each new disc before settling on one play in its entirety. This is pretty much how I decide to buy records when I have the opportunity to listen to samples. But recently I have come up with a new way to buy new music.

I search Amazon for a disc by and artist that I like particularly well and the review the recommendations listed for that feature. I pick one that catches my eye, select it and then review the recommendations for that artist. I repeat this process up to two or three times. Sometimes I listen to samples if they are available, but just as often I don’t. I have used this method several times now and am very pleased with the results. I’m discovering new artists and also expanding my musical awareness and I have yet to buy a single thing that I have disliked.

I was showing a co-worker some of the new selections and he told me that we were able to redeem performance award points for books and music through Amazon. This encouraged me to be a little bolder with my experimentation and within a few minutes I had depleted my points and have another 23 discs coming. Most of the artists are people I have never heard of. I’m quite excited.

Dec

10

Transition

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I am in the process of transferring the blog, so please be patient. Most everything should be moved in 24 – 48 hours.

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