PharmedOut Newsletter, May 2014
Recent Project News
- PharmedOut's new paper, "Promoting to Everyone, Focusing on No One: The Illogical Promotion of the Influenza Vaccine", was published in World Medical & Health Policy. The article, written by former PharmedOut interns Carly Noel Richards MD and Christine Tran MS, along with Dr. Fugh-Berman, addresses the widespread marketing of the flu vaccine and how it may be more harmful than helpful.
- Our "What Are Your Top 20 Drugs?" survey launched for second and fourth-year Georgetown medical students earlier this month. We look forward to seeing if drug choices differ by level of training, and analyzing the results alongside the original survey.
- On April 6th, Dr. Fugh-Berman was quoted in Paul Thacker's Slate article "How to Handle FDA Rejection" about the misperception that the FDA has not approved Flibanserin (a "female Viagra" drug) due to sexism.
- On April 11th, Dr. Fugh-Berman was quoted in The Boston Herald stating that the campaign to retract a recent JAMA study linking testosterone drugs to heart attacks, stroke and death "smells like industry influence."
- On April 16th, Dr. Fugh-Berman was quoted in this NPR story on a recent study showing that when dermatologists give patients free samples, they end up prescribing medication more than twice as expensive as prescriptions in sample-free offices. "When a doctor gives a sample to a patient, it's a very strong endorsement of a drug," Dr. Fugh-Berman said, and it would look "inconsistent" if they later prescribed a different generic drug.
- PharmedOut recruited physicians and researchers to sign one of several letters to FDA Commissioner Margaret Hamburg, asking the FDA not to approve Roche's Cobas HPV test as an alternative to a Pap smear for cervical cancer screening. The FDA approved the test, and the letters were mentioned in the coverage by the New York Times and AP.
- PharmedOut's Resource of the Month: A full list of PharmedOut's media mentions over the years can be found on our website.
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April's PharmedOut Fodder: Transparency
The topic of transparency came up in two major stories this month: For the first time, CMS released a searchable database on what procedures were covered by Medicare during the 2011 fiscal year, for which physicians, and how much they cost. Among the findings was that two percent of physicians accounted for a quarter of all Medicare payments, and one-quarter of physicians accounted for three-quarters of all payments.
In addition, JAMA published a research paper on how many leaders of academic medical centers also serve on boards of pharmaceutical companies. The answer is that "nearly 40 percent of drug makers worldwide — and nearly every U.S. pharmaceutical manufacturer — had at least one board member who simultaneously served in a leadership position at such centers in 2012." Given that many of these centers have conflict-of-interest policies that prohibit faculty members from accepting drug company gifts, how can they "allow their leaders to serve on the boards of firms that pay them on average over $300,000 per year?", asks The Atlantic.
These news items spawned a large amount of analyses and discussion about conflicts of interest and transparency in healthcare. Proponents say the public needs and deserves to know this information. Especially in the case of Medicare data, clarity on costs may help reduce waste and salvage the program for the future. Opponents — such as some of the called-out physicians — say the payment data lacks necessary context, making it misleading to patients and others.
Combined with the Physician Payments Sunshine Act reports, which were due to HHS this past March 31 and will be made available this fall, perhaps we'll see a rising interest in bringing transparency to the healthcare system. Currently, the vast majority of healthcare consumers do not know the costs of what they are paying for, which some believe is a problem.
While these stories both centered on transparency, one represents a demand for previously confidential data, and the other represents the initiative to amalgamate publicly available information. PharmedOut emphasizes both strategies in tackling issues related to transparency.
The topic of transparency came up in two major stories this month: For the first time, CMS released a searchable database on what procedures were covered by Medicare during the 2011 fiscal year, for which physicians, and how much they cost. Among the findings was that two percent of physicians accounted for a quarter of all Medicare payments, and one-quarter of physicians accounted for three-quarters of all payments.
In addition, JAMA published a research paper on how many leaders of academic medical centers also serve on boards of pharmaceutical companies. The answer is that "nearly 40 percent of drug makers worldwide — and nearly every U.S. pharmaceutical manufacturer — had at least one board member who simultaneously served in a leadership position at such centers in 2012." Given that many of these centers have conflict-of-interest policies that prohibit faculty members from accepting drug company gifts, how can they "allow their leaders to serve on the boards of firms that pay them on average over $300,000 per year?", asks The Atlantic.
These news items spawned a large amount of analyses and discussion about conflicts of interest and transparency in healthcare. Proponents say the public needs and deserves to know this information. Especially in the case of Medicare data, clarity on costs may help reduce waste and salvage the program for the future. Opponents — such as some of the called-out physicians — say the payment data lacks necessary context, making it misleading to patients and others.
Combined with the Physician Payments Sunshine Act reports, which were due to HHS this past March 31 and will be made available this fall, perhaps we'll see a rising interest in bringing transparency to the healthcare system. Currently, the vast majority of healthcare consumers do not know the costs of what they are paying for, which some believe is a problem.
While these stories both centered on transparency, one represents a demand for previously confidential data, and the other represents the initiative to amalgamate publicly available information. PharmedOut emphasizes both strategies in tackling issues related to transparency.
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News Round-Up
(for more, please follow @pharmed_out on Twitter!)
March 27: Health Care Renewal: "Too Good to be True - Sovaldi Kerfuffle Focuses on Price, While Ignoring Limits of Evidence about Effectiveness and Safety" http://hcrenewal.blogspot.com/2014/03/too-good-to-be-true-sovaldi-kerfuffle.html
April 1: Consumer Reports: "Do these 4 drug ads tell the truth?" http://www.consumerreports.org/cro/2014/04/drug-ads-for-cymbalta-crestor-humira-androgel/index.htm
April 1: ProPublica: "Leaders of Teaching Hospitals Have Close Ties to Drug Companies, Study Shows" http://www.propublica.org/article/leaders-of-teaching-hospitals-have-close-ties-to-drug-companies-study-shows
April 2: Financial Times via PharmaGossip: "GlaxoChinaGate contd. - how the reps were trained to bribe" http://pharmagossip.blogspot.com/2014/04/glaxochinagate-contd-how-reps-were.html
April 2: AllTrials.net: "Europe votes for clinical trial transparency" http://www.alltrials.net/2014/europe-votes-for-clinical-trial-transparency/
April 3: FDA: "FDA Commissioner Margaret A. Hamburg Statement on Prescription Opioid Abuse " http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm391590.htm
April 3: Wall Street Journal: "One Thing Drug Companies Won’t Do On Social Media" http://blogs.wsj.com/corporate-intelligence/2014/04/03/one-thing-drug-companies-wont-do-on-social-media/
April 4: Yahoo Finance: "States revolt against powerful new painkiller" http://finance.yahoo.com/news/states-revolt-against-powerful-painkiller-135857280.html
April 7: Pharma Marketing Blog: "Are FDA's Efforts to Improve Adverse Event Reporting Being Hobbled by Pharma?" http://pharmamkting.blogspot.com/2014/04/are-fdas-efforts-to-improve-adverse.html
April 8: National Law Journal: "Huge Punitive Damages Award in Actos Bellwether Trial"
http://www.nationallawjournal.com/id=1202650234795/Huge-Punitive-Damages-Award-in-Actos-Bellwether-Trial
April 9: The Guardian: "What the Tamiflu saga tells us about drug trials and big pharma" http://www.theguardian.com/business/2014/apr/10/tamiflu-saga-drug-trials-big-pharma
April 10: MedPage Today: "PhRMA: Sunshine Not Driving Docs Indoors" http://www.medpagetoday.com/Washington-Watch/Washington-Watch/45207
April 11: Bloomberg: "Eye Doctors Say Medicare Pay List Unfairly Demonizes Them" http://www.bloomberg.com/news/2014-04-11/eye-doctors-say-medicare-pay-list-unfairly-demonizes-them.html
April 13: The New York Times: "Surge in Narcotic Prescriptions for Pregnant Women" http://www.nytimes.com/2014/04/15/science/surge-in-prescriptions-for-opioid-painkillers-for-pregnant-women.html
April 13: BBC: "UK drug company Glaxo 'paid bribes to Polish doctors'" http://www.bbc.com/news/business-26970873
April 14: Reuters: "Medical devices for kids are often only tested on adults" http://in.reuters.com/article/2014/04/14/us-medical-devices-kids-testing-idINBREA3D0U920140414
April 15: Associated Press via ABCNews: "DNA Alternative to Pap Smear Sparks Medical Debate" http://abcnews.go.com/Health/wireStory/dna-alternative-pap-smear-sparks-medical-debate-23331605
April 16: USA Today: "New medical data could allow comparison shopping" http://www.usatoday.com/story/news/nation/2014/04/16/new-cms-data-inspires-entrepreneurs/7735469/
April 16: Los Angeles Times: "Free samples of prescription drugs are costly to patients, study says" http://www.latimes.com/science/sciencenow/la-sci-sn-free-drug-samples-generics-dermatology-20140416,0,1035454.story
April 16: PharmaGossip: "And they try to tell you Big Pharma's Misdeeds Are All in the Past!" http://pharmagossip.blogspot.com/2014/04/and-they-try-to-tell-you-big-pharma.html
April 17: Medical Marketing & Media: "Astellas, DOJ settle for $7.3M" http://www.mmm-online.com/astellas-doj-settle-for-73m/article/343075/
April 23: ProPublica: "MIA In The War On Cancer: Where Are The Low-Cost Treatments?" http://www.propublica.org/article/where-are-the-low-cost-cancer-treatments
April 24: CBSNews: "Tapping into controversial back surgeries" http://www.cbsnews.com/news/tapping-into-controversial-back-surgeries/
April 24: USA Today: "Some top Medicare beneficiaries spend heavily to lobby" http://www.usatoday.com/story/news/nation-now/2014/04/24/drugmakers-lobbying-medicare-payments/8055901/
April 25: wthr.com: "The enemy at home: Veterans addicted and dying from VA pain pills" http://www.wthr.com/story/25336980/2014/04/24/the-enemy-at-home-veterans-addicted-dying-from-va-pain-pills
April 28: Kaiser Health News: "Low T Business Is Booming, Despite Questions About Risks" http://www.kaiserhealthnews.org/Stories/2014/April/28/low-t-testosterone-clinics-safety-costs.aspx
April 29: Boston Business Journal: "Mass. doctors are getting fewer gifts from drug and device companies" http://www.bizjournals.com/boston/blog/bioflash/2014/04/mass-doctors-are-getting-fewer-gifts-from-drug-and.html
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Check These Out!
The National Center for Health Research (previously the National Research Center for Women & Families) will hold their annual Foremothers Award Luncheon in D.C. on May 9th, and are offering a discount for those who mention PharmedOut. This year's event will honor "Health Policy Heroes" Charles Ornstein and Tracy Weber of ProPublica, who have covered many stories related to the Medicare data release, Sunshine Act, and much more. Details and registration instructions are here.
View the Medicare data by state with this interactive map.
Please join Dr. Carl Elliott's call-in campaign for an investigation into the death of Dan Markingson, who committed suicide while participating in a psychiatric study at the University of Minnesota.
"What Evidence is Essential for New Medical Products? Implications for Patients and Health Policy", an event highlighting the public health implications of medical product regulation criteria, will take place June 13th at the American Association for the Advancement of Science. Register for free here.
