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Author Topic: US Hates NICE
Cytania
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In this case the UK's National Institute Of Clinical Excellence. This bureau makes drug purchasing decisions on behalf of all British hospitals and doctors. It's a gatekeeper, if a drug can't prove it's worth it doesn't get in. However the Whitehouse wants an open market and isn't afraid to put pressure on Tony Blair's government. Should you be interfering in another country's medical economy on the behalf of pharma-corps?

http://society.guardian.co.uk/health/story/0,,1947280,00.html

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Daruma28
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When the much maligned and demonized pharma corps that are responsible for the research and development of the vast majority of the world's greatest life saving and life changing pharmaceuticals, all based on the incentives provided by free market profits -- and another country seeks to reduce or eliminate the incentives that gave the impetus to develop and manufacture those pharmaceuticals in the first place, than I say, hell yes.
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RickyB
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You're thinking with your hard-on again, Daruma ( [Big Grin] ). Not that you don't have a certain point, but you don't go telling other people what to do just like that.
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philnotfil
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No. We should force other people to buy our products? They shouldn't be allowed to decide what is best for them?
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Adam Masterman
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Even from you this kind of thinking is appalling, Daruma. Forcing another nation to alter its public health policies to boost corporate profit? Why not just make citizens of Brittain serfs on the Pfizer plantation? This kind of unthinking obedience to Smithian free-marketism is ridiculous. Case in point:

My shrink was telling me about how insurance companies work in his industry. First of all, practitioners need to sign a waiver in order to be part of an HMO's doctors list. In other words, to have access to the vast majority of the patient pool, one must release HMO's, in advance, of any liability surrounding the mental health care they pay for. If that were all, it would merely be sleazy, but it isn't. The HMO then makes the determination as to how much treatment a patient needs. My doctor gave the example of a patient of his who had both suicidal and homocidal ideation. This patient had detailed plans to kill others and himself, but wasn't (currently) acting on them. My doctor said that if he were to treat the patient as minimally as requested by the HMO, it would be almost criminal negligence. If the patient ever did act on his plans, there would WITHOUT QUESTION be legal liability relative to his shoddy treatment. Because the HMO would have been cleared in advance, that would leave him,the doctor, as the sole target of that liability. So in addition to the guilt of losing a patient, he would also face civil penalties which would almost certainly ruin him financially, all because medical decisions are being made by corporations.

So what he and apparently many mental health professionals do is provide the additional necessary treatment for free. Its a huge cost, and drives many from the profession or to different areas, but the alternative is obviously unacceptible.

I'm not saying that we need a fully socialist system, but to pretend that there is no inherent conflict between free market capitalism and patient's rights is absurd. These kinds of conflict pop up all the time, and if we don't address them then we will end up with the absolute cheapest health care our HMO can dig up.

Brits have a right to collectively higher public servants to screen pharmaceuticals for them. Its an ideal situation really, because said officials don't have a vested interest either way relative to specific drugs. They are free to make decisions based on what is in the best interest of potential patients. Pharma corps, on the other hand, will make decisions based on the bottom line, period. Its an important difference to understand.

Adam

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The Drake
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It is not forcing another country to change health policy, but economic policy.

We pressure countries all the time to open their markets. Now, if the UK oversight was for safety - that's one thing. But this is economics.

Doesn't the UK trust its doctors to make rational decisions?

Mr. Blair, tear down that wall!

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Adam Masterman
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quote:
posted November 14, 2006 09:12 AM                      
------------------------------------------------------------------------
It is not forcing another country to change health policy, but economic policy.
We pressure countries all the time to open their markets. Now, if the UK oversight was for safety - that's one thing. But this is economics.

Hardly. Regulaiting price increases availability. The NIH is making decisions to maximize the amount of medication that it can provide to those in need. That has a direct impact on public health, and it trumps Pfizer's right to boost its bottom line.

One of the things the U.S. is asking for is for Brittian to allow direct to patient advertising. Anyone here want to argue that this is in the patient's best interests, as oppossed to the drug company's?

Adam

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kenmeer livermaile
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USA: Either change your methods of defining the marketability of the drugs we want to sell to you or else...

UK: Or else what?

USA: Or else we won't sell to you.

UK: OK. Don't sell to us.

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Colin JM0397
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There are two arguments getting intermingled here that need separated.

I'm no fan of big Pharm, but it is a love-hate thing. Yes, of course, they have developed all sorts of stuff that has saved lives and helped folks lead better lives. However, there a many, many valid complaints about the ethics of their ad campaigns, FDA approval manipulation, and the usefulness of many drugs to begin with...

For example, how many people know that the average antidepressant has about the same efficacy as a placebo?

That aside, this is a simple market controls vs. free market debate. Replace drugs with widgets.

The UK has the government reviewing widget efficacy and price to determine if Joe Limey can have the opportunity to have a new widget.

The US wants the UK government to remove themselves and the price controls and let the consumers and docs drive widget demand and price.

Regulating prices does not increase availability. Lets look at the US fuel crisis in the 70's. Those were price controls at work. You mess with the price, you mess with the natural supply and demand.

A quick scan of the article looks to me to be a simple request to open up the markets to competition without unnatural controls like price fixing

I for one do grow tired of the demonization of profit as a driving motive for a business. While the drive for profit with no ethics is a problem and should be dealt with accordingly, deriding a business/person/corporation for trying to make a profit in and of itself is just asinine and naive to the workings of the world. Profit drives business, period. Doing good and making a positive impact on the world drive some business motivation, but you can't do good for the world if you put yourself out of business.

On a side note, when did it get to be such a sin for a company to make a profit? Would you prefer they go out of business and stop making the next round of drugs that might help you?

Besides, just think of how cool it'll be when our UK friends can have Tony Blair hawking viagra like Bob Dole did? And all those the fun little side effect warnings at the end of commercials "warning, use of this product may cause anal leakage, heart explosions, brain deflating, your hair to fall out, your manhood to shrivel up and fall off, and horrible foot odor."

Now, how well the public is actually informed over these drugs is another story altogether... But lets not confuse hatred for big pharm with a simple free market vs. market controls discussion.

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kenmeer livermaile
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When America legalizes marijuana for medicinal use, I'll look benignly on us telling the UK to let pur pharmcos advertise on the BBC.
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LetterRip
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Daruma,

quote:
When the much maligned and demonized pharma corps that are responsible for the research and development of the vast majority of the world's greatest life saving and life changing pharmaceuticals
You seem to have confused pharmaceutical corporations with the government sponsored research done by universities [Smile] Pharmaceuticals primarily fund 'me too' drugs, which are of marginal benefit (and argueably of negative benefit) to society.

jm,

quote:
The US wants the UK government to remove themselves and the price controls and let the consumers and docs drive widget demand and price.

Regulating prices does not increase availability. Lets look at the US fuel crisis in the 70's. Those were price controls at work. You mess with the price, you mess with the natural supply and demand.

A quick scan of the article looks to me to be a simple request to open up the markets to competition without unnatural controls like price fixing

It has been shown that advertising (especially to patients but also to doctors) drives prices and drug adoption. Including for drugs that are clinically worse than already adopted and cheaper drugs. They are in essence protecting consumers from being scammed.

quote:
I for one do grow tired of the demonization of profit as a driving motive for a business.
Which isn't what is happening.

quote:
But lets not confuse hatred for big pharm with a simple free market vs. market controls discussion.
Somehow I suspect you would object to Britian disallowing patents on drugs because patents are anti free market.

LetterRip

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Pete at Home
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Cytania, are you saying that Great Britain doesn't use its international clout with other nations to promote its exports?

You're right to resent it, but acting like this is something only the US does walks the fine line between hypocrisy and naivete.

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The Drake
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quote:
Pharmaceuticals primarily fund 'me too' drugs, which are of marginal benefit (and argueably of negative benefit) to society.
Don't these "me too" drugs drive down the cost of that class of medication?
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RickyB
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Actually, from reading the article, it would seem that in this case, patient organizations are also against some of the NICE restrictions.

Still, it looks awful for the US govt. to pressure another country on behalf of the pharma corps. On the other hand, sometimes that becomes necessary. I'll refrain from passing judgement on this subject.

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Colin JM0397
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LR, now you're just being silly. I am many things but an anarchist is not one of them. There are certainly valid uses for government oversight and control.

You don't need a market study in any field to show advertising works.

I look at it this way:

Governments are run by people making decisions based on their personal biases. Sometimes they even make those decisions for nefarious reasons or, thinking themselves to be smarter than the rest of us, they make stupid decisions because they think they know better.

The market has no thinking apparatus so therefore has no biases, and doesn't act benevolently or malevolently, it just is.

Socialists abhor the idea of letting a non-thinking entity drive society, and I abhor the idea of over-thinking do-gooders with an agenda driving society.

Of course, there’s big catch here:
The free market can’t operate properly without an honest-to-God free flow of information that allows the people to make informed decisions. IMO, the government should stop with the market controls and focus on ensuring all the information needed to make intelligent, informed decisions is out there. Given proper information, I trust people to drive the market in an intelligent direction that benefits the vast majority of us.

Of course, I also see the possible problem here – the government I don’t trust to make unbiased decisions I would task to ensure an unbiased flow of information. However, guaranteeing the information is not the same as controlling what information is available.

I am of the opinion if there was a free flow of information, a lot of the big Pharm companies would quickly go out of business, and rightfully so.

For example, a recent study from Italy talks about MD’s prescribing fish oil for heart attack survivors. It also shows the fish oil has a better success rate than the latest and greatest from Big Pharm – the statins, IIRC, as well as NO side effects.
If that made the evening news and the headlines on some major newspapers, what would the effect be?

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The Drake
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The US has been pressuring Japan over rice for years. Should we be upset about that also?

I don't particularly care about whether it is a medical product or not.

No subsidies + No tariffs + No price caps = More jobs

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LetterRip
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The Drake,

from what I've read only generics (ie once the medication is off patent) have that impact.

LetterRip

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LetterRip
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Interesting study by the CBO,

quote:
CBO examined the list prices of breakthrough and me-too drugs over time for five therapeutic classes.(22) In four of the five, the list price of the breakthrough product continued to increase in real terms--that is, by more than just the effects of inflation--after the entry of one or more me-too products.(23) In only one case (that of fluoroquinolone anti-infectives) did the breakthrough drug lower its list price in real terms after the first me-too drug entered the market.

A study by John Lu and William Comanor also found that the average list price of brand-name drugs continues to rise faster than inflation after the introduction of a me-too competitor.(24) For 13 drugs that received an A rating from the FDA (as most innovative), the average inflation-adjusted list price after eight years on the market was 7 percent above the launch price. For 48 B-rated drugs (slightly less innovative), the inflation-adjusted list price was 32 percent higher, on average, eight years after launch.

That same study also found that although prices continued to increase, the rate of increase was slower for those drugs that had more brand-name competitors on the market. The introductory price also tended to be lower when more similar brand-name drugs were already on the market. Those findings suggest that the rate of price increase is slowed by competition between brand-name drugs.

http://www.cbo.gov/showdoc.cfm?index=655&sequence=4

Don't have time to finish reading it right now... will comment more later.

Also see this article on competition with generics..

http://www.fda.gov/CDER/ogd/generic_competition.htm#P3_356

LetterRip

[ November 14, 2006, 01:29 PM: Message edited by: LetterRip ]

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The Drake
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That's bizarre. Thanks for the hard data, LR.
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kenmeer livermaile
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"Those findings suggest that the rate of price increase is slowed by competition between brand-name drugs."

Wow. Competition produces price-leveling. WHo'da thunk?

I gotta question: why are our government officials spending their time and our money on our nickel to tell other governments how to run their business affairs? It's a strange twist between the ideas of regulation/deregulation.

In other words: why can't our goddamed pharmcos hire their own friggin' British lobbyists to bribe British officials? Must we have our own corrupt officials gop overseas and corrupt their officials?

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Daruma28
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"On a side note, when did it get to be such a sin for a company to make a profit? Would you prefer they go out of business and stop making the next round of drugs that might help you?"

That is my main point here.

And LR - are you trying to say that it is the Government that is responsible for funding all of the advances in pharmaceutical R&D?

bah. You give the Government too much credit.

Just on a personal note: Glaxo Smith Kline developed and manufactured a drug that saved my own life. I hope they make as much profit as they ethically can.

Profits and the profit motive are GREAT.

No amount of self-rigteous socialist guilt tripping is going to get me to change my mind about that.

I am surprised that you Adam, would find that attitude surprising, coming from me. I've never expressed any contradiction to that point of view the entire time I've been here.

I love pharma companies, and I could give a rats ass about their advertising practices, because last I checked, anyone that makes a life altering decision based on a 30 second commercial AND NO OTHER CONSIDERATION deserves exactly what they get.

Finally, I make a pretty damn good living since more than a few of the "Big bad Pharmaceutical Companies" are my companies clients.

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LetterRip
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Daruma,

quote:
And LR - are you trying to say that it is the Government that is responsible for funding all of the advances in pharmaceutical R&D?
No that isn't what I'm saying. What appears to be the case is that publicly funded research runs around 85-90% for the 'breakthrough' discoveries.

quote:

No amount of self-rigteous socialist guilt tripping is going to get me to change my mind about that.

I don't think anyone was trying to do so - pointing out that it is the 'socialist' public funding that creates the break through research isn't 'guilt tripping' just observation.

quote:

I love pharma companies, and I could give a rats ass about their advertising practices, because last I checked, anyone that makes a life altering decision based on a 30 second commercial AND NO OTHER CONSIDERATION deserves exactly what they get.

Since insurance and government pays significant portions of most pharmaceutical purchases, such advertising results in both unnecessary growth in insurance premiums and unnecessary growth in taxation related to health.

The government has a direct interest in preventing unnecessary growth in pharmaceutical costs.

Thus what motive should the government have in allowing advertising and sales of additional pharmaceuticals which offer no additional benefit to its populace and causes increased costs.

LetterRip

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kenmeer livermaile
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I like profit. Motive is essential to purposeful living.

I look at all mainstream socioeconomic models and judge them over how well they do over the long haul.

The profoyt motive must, I think, be present in any viable economy. Greed, ambition, insecurity must be addressed for an economy to succeed. The p[rofit motive works with all three.

How the benefits to society accrue over time, especially, how they adapt to changing (usually by dwindling) resource bases, is what most interests me.

Hey, Daruma: what did Glaxo SMith Kline save you from? With a name like GSK, it hasd beeter be good.

Antibiotics have saved at least half of us to live to 40 years of age, and saved 80-90% of us who've made it to 60.

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The Drake
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"Thus what motive should the government have in allowing advertising and sales of additional pharmaceuticals which offer no additional benefit to its populace and causes increased costs."

Why should government be in the job of deciding what commercials should air? Might as well say Burger King and McDonalds shouldn't be able to advertise their unhealthy food. Keep treading down that road, and I don't think you'll like where it leads.

Presumably, doctors are not prescribing drugs for their patients based on whim or being bamboozled by the drug commercials. As long as that oversight is in place, the only purpose the commercials serv e is to build awareness for a new option.

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kenmeer livermaile
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"As long as that oversight is in place, the only purpose the commercials serve is to build awareness for a new option."

How neatly stated. You should work in PR. [Wink]

"Why should government be in the job of deciding what commercials should air? Might as well say Burger King and McDonalds shouldn't be able to advertise their unhealthy food. Keep treading down that road, and I don't think you'll like where it leads."

Pharm commercials for prescription drugs have only been legal in the states since 1996. We have been steadily climbing UP, not sliding down, that slippery slope. (Money defies gravity.)

Innarestin' data:

<begin>
"David Kessler didn’t mince words. “Your companies likely will face lawsuits eventually about the claims they make for their products in television commercials,” the former Food and Drug Administration commissioner told a group of pharmaceutical executives. “One day in a courtroom, I assure you, one of you is going to have your DTC ads played.”

Prescient speech
It wasn’t just hard-hitting; it was prescient: Mr. Kessler’s speech came in 1998, a year after the FDA’s momentous decision to relax the guidelines regarding direct-to-consumer TV ads from drug companies.

Since that time, DTC drug advertising has emerged from a dawdling $12 million business to a $4.1 billion ad category spanning some 70 advertised drugs. As predicted, it’s also become a lightning rod for political and public criticism, subject to charges that it encourages consumers to pressure doctors for drugs they don’t need; that it glamorizes drugs that have later been found to have dangerous side effects; and, in the case of erectile-disfunction drugs, that it uses promotes medicinal drugs for recreational uses.

‘Got away from us’
“In some ways, DTC got away from us,” said Dr. Kessler, now dean of the School of Medicine and vice chancellor of medical affairs at the University of California-San Francisco.

It was in 1996 that the unmistakable sound of Cole Porter came singing through TV sets across the country, ushering in a decade of what has been a watershed for the advertising and pharmaceutical industries.

“Blue skies, shining on me, Nothing but blue skies do I see.”

Groundbreaking Claritin spot
The spot, from Schering-Plough for allergy medication Claritin, never mentioned what the product treated, advising viewers instead that “Clear days and nights are here” and to “see your doctor”—a phrase that would become a veritable tagline for pharmaceutical ads.

While 2006 marks the 10-year anniversary of the Claritin ad, it was actually 24 years ago that the FDA unwittingly opened the door to DTC. Speaking at the American Advertising Federation conference and addressing the Pharmaceutical Advertising Council, then-FDA Commissioner Arthur Hull Hayes Jr. summarized the state of drug advertising, saying it “may be on the brink of the exponential-growth phase of direct-to-consumer promotion of prescription products.”

Drug companies jumped on the phrase “exponential growth” and took it to mean the FDA, however tacitly, supported DTC.

‘Opening a closed door’
“It was viewed by the industry as FDA opening a closed door,” said Kenneth R. Feather, a former associate FDA commissioner.

A year later, in 1983, Boots Pharmaceuticals aired the first direct-to-consumer TV ad when it promoted its prescription ibuprofen medication, Rufen. The company also ran newspaper ads at the same time. That was in May; by September, the FDA asked the industry for a voluntary moratorium on drug advertisements. (Ibuprofen actually went over the counter a year later.)

In 1984, Upjohn sponsored a major conference on DTC advertising in Washington, D.C., where it made no bones about expressing its opposition to the practice. But less than five years later, Upjohn was touting the merits of DTC after its hair-restoration medication, Rogaine, was approved by the FDA and needed to be marketed.

Things were relatively quiet until 1996, when the Claritin ad appeared and all but forced the FDA to make a decision. Before that, the FDA’s guidelines for consumer advertising of prescription medications were the same as its guidelines for professional advertising, which called for full disclosure of risk and benefit information-easy to put in small type in a newspaper or magazine ad, but time-consuming to convey in a TV spot. That’s why, when Schering-Plough aired the Claritin ad, it did not say what the product was for.

Landmark FDA decision
The FDA issued its landmark decision in 1997, relaxing the earlier guidelines for TV commercials. Instead of including the “brief summary” that took up a full page in magazine ads and would take too long to explain in a TV spot, pharmaceutical companies could direct viewers to a magazine ad, an 800 number or a website.

DTC exploded almost immediately. Spending shot from $12 million in 1989 to $1.17 billion in 1998.

But the explosion, in retrospect, came too quickly. “I was at JWT in 1997 doing global business development, and all of a sudden we had pharma companies calling on us, including this company called Parke-Davis and something called Lipitor,” recalled Brian Heffernan, now the chief marketing officer for GWS, a health-care-ad agency in Columbus, Ohio. “We had no capability or knowledge at the time of what was happening.”
<end>

Funny. I've seen Claritin ads and Viagra adas and -- quelle moment! -- Bob DOle pretending to do another ad for Viagra in an ad that suddenly revealed itself to be a Pepsi commercial wielding ancient memories of its '60s 'Come Alive!' series of commercials. I also saw an ad for Lipitor, which I've taken for at least two years now.

But it was my doctor who suggested I go on Lipitor, and he gave me the basic skinny on it. (Not enough, in my opinion, but doctors rarely communicate well in my experience anyweay.)

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The Drake
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quote:
pressure doctors for drugs they don’t need
You mean, like how doctors prescribed unadvertised antibiotics in such large quantities that they wrecked their efficacy, just to get the guy with the flu to go home?

quote:
But it was my doctor who suggested I go on Lipitor, and he gave me the basic skinny on it. (Not enough, in my opinion, but doctors rarely communicate well in my experience anyweay.)
And how did he/she hear about it? [Wink]

Frankly, I wouldn't know a darn thing about Lipitor, except for the commercials. Is that a bad thing?

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RickyB
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You know what your problem is, Daruma? That you're motivated more by what you're against than what you're for.
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Cytania
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Hi, sorry for the gap, my mother had a bit of a turn yesterday... NICE is analagous to the FDA. So to a degree the Whitehouse is asking the UK not to second guess them. NICE has annoyed the pharmacorps by putting question marks over drugs prescribed widely in the US, often ones withdrawn later. NICE isn't a price fixer but it does refuse on the basis that a drug is expensive, has multiple side-effects and fractional percentage improvements. Doctor's still make choices but NICE screens out drugs they shouldn't waste time, money and patient hopes over.
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kenmeer livermaile
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When America's FDA starts making sense on drugs like marijuana, and when we no longer lump alcohol, tobacco, and firearms under one bureau (as if it were still 1870 and we were busy bribing Injuns with backy, wacky-water, and rifles), then I'll not smirk with indulgent impunity at our attempts to deregulate the drug policies of foreign nations.

Then I'll smirk with restraint. )

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Dagonee
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quote:
Even from you this kind of thinking is appalling, Daruma. Forcing another nation to alter its public health policies to boost corporate profit? Why not just make citizens of Brittain serfs on the Pfizer plantation? This kind of unthinking obedience to Smithian free-marketism is ridiculous.
Forcing? What is this forcing you speak of?
Frankly, I find the willingness of so many people to discuss this issue as "forcing" to be appalling. The opening post couched this as "interference" and it seems almost everyone bought into this formulation of the issue without really questioning it.

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kenmeer livermaile
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Force is an application of energy. Inteference, pressure, coercion: all require force. When said force puts its target in a sufficient bind, we then say the victim has been 'forced'. But it is the application of energy, be it evangeical enthusiasm or Bismarkian realpolitik, force is force.
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Dagonee
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So what's up with all you people forcing the U.S. to not lobby Britain? Force is force, right?

More to the point, the specific force being applied was likened to serfdom - a state enforced by the the threat of physical punishment or death to those who attempted to leave it. Further, it was described as not allowing people "to decide what is best for them."

Play the clever word games as you are wont, it doesn't invalidate my point. The discussion on this issue was skewed from the beginning by few people questioning the underlying characterization of the events.

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The Drake
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Stop forcing us to adopt your definition of force, KL. [Big Grin]
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kenmeer livermaile
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I surrender. In so doing, I not only pay my share of freight charge for Drake's Big Green Smiley but also sidestep dagonee's side-stepping of the fact that he intruded a usage of meaning of terms without establishing a definitin thereof. Or should I call it "playing clever word games"?

As to the original topic of debate, I note that while American pharmacological research is probably the global leader in finding new remedies and treatments, the American medical delivery system is fairly poor in comparison to others, especially when weighed against financial outlay.

We create amazing medical prowess, but our means of getting it to people is not as good as our ability to invent fine medicine.

This line of reasoning leads to a simple distinction so obvious it tends to be ignored: pharmco research does not necessarily share anything with pharmco advertising or lobbying. Biomolecular research PhDs are very different animals from MBA types, capisch?

Britian might be wise indeed to gladly invest in purchasing our mediciens but declining to adopt our peculiar brand of aggressive marketing.

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Everard
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"So what's up with all you people forcing the U.S. to not lobby Britain? Force is force, right?"

Some force is more powerful then other force.

And some types of force are rightly applied, and some goals that require the use of force are justified, if the type of force is rightly applied.

Lobbying for a nation to stop protecting the health of its citizens in a way that nation deams necessary, in order to maximize the profits of corporate interests, is in many of our opinions an unjustified use of force, while asking that our government to stop behaving in immoral behaviors is a very justified use of force.

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Dagonee
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quote:
Lobbying for a nation to stop protecting the health of its citizens
Yet another characterization that begs the ultimate question. Clearly the U.S. doesn't think this would harm the health of its citizens. So actually they're lobbying for a nation to allow medicines that we have found, after extensive testing, to be good for the health of our citizens.

Further, it's still not a use of force by any meaningful definition of the term.

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Everard
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Except that after extensive teting, these medicines have NOT beenfound to be good for the health of our citizens. They'v ebeen found to do nothing.

But, you know, you could have figured out what I was REALLY saying if you'd finished reading the sentence you quoted part of. Taking me out of context doesn't bolster your argument.

ANd yes, its a use of force by most meaningful definitions of the word.

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The Drake
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The US has lodged 84 complaints with the WTO (17 invoving the EC). That's one form of using force. None of these involve prescription drugs. Is "mentioning it in a speech" considered force?

No one has yet mentioned the flipside of NICE.

quote:
Draft National Institute for health and Clinical Excellence (NICE) guidance concludes Tarceva would not be a good use of NHS resources.

The drug is used to treat non-small cell lung cancer.

Cancer charities expressed disappointment, saying thousands of patients could benefit from the drug.

"Non-small cell lung cancer is very difficult to treat, and Tarceva is one of the few significant advances against the condition to emerge over the last decade.

"While not a cure, the drug can significantly extend the lives of patients with this form of lung cancer.

...

"It would be incomprehensible for such a drug to be available to patients in Edinburgh but not Newcastle.

Mike Unger, of the Roy Castle Lung Cancer Foundation, said patients had been recommended the drug by their GPs, but were unable to get it.

...

Andrew Dillon, NICE chief executive, said neither had been shown to be more effective than other commonly used, cheaper alternatives.

He said: "Our initial assessment of the evidence shows that neither of these drugs represents a good use of scarce NHS resources."

Mr Dillon said the appraisal committee had asked Roche, the makers of Tarceva, for further information about the drug.

Tarceva, known technically as erlotinib, is one of a new generation of so-called biological therapies.

It stops cancer cells growing by blocking the action of a growth factor to which the cells are especially sensitive.

Do you want a Government, or your Doctor, to decide if a therapy is "worth it"?

quote:
Linda Gordon, 47, who is suffering from lung cancer, has been forced to fund an initial dose of Tarceva herself as she has been refused funding by Bromley Primary Care Trust.

Her consultant oncologist has described her as "absolutely the ideal patient to be treated with this agent".

Ms Gordon said: "It's unbelievable that NHS resources can be given as the reason to deny me the drugs that my doctor thinks I should have.

"Before taking Tarceva I was breathless and couldn't even have a normal conversation or eat without coughing continuously.

"The effects were so bad that I would choke on my food, that doesn't happen at all now.

"My quality of life has improved so much and that is not only good for me but also less stressful for my relatives."

She sounds pretty happy that NICE is protecting her health as a citizen, doesn't she?
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Cytania
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Drake you've fallen for an extremely biased take on Tarceva. There are several other small-cell cancer drugs and they are substantially cheaper. Tarceva is no more effective at treating cancer.

There will always be patient groups who campaign for a drug regardless of the medical arguments, I can't explain why.

"Do you want a Government, or your Doctor, to decide if a therapy is "worth it"?"

Drake, we all need to trust our Doctor to pick the right drug for whatever ails us. It's a matter of specialism. NICE is not the government and the panels that make decisions on drugs are composed of Doctors, specialists in their fields. Their decisions are evidence based.

Even a Doctor would refer themselves to a colleague if they had an ailment that was out of their field of expertise. We have to trust professionals, self-medication is a highly dangerous road. Your argument is bogus Drake.

[ November 16, 2006, 10:39 AM: Message edited by: Cytania ]

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Dagonee
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quote:
Except that after extensive teting, these medicines have NOT beenfound to be good for the health of our citizens. They'v ebeen found to do nothing.

But, you know, you could have figured out what I was REALLY saying if you'd finished reading the sentence you quoted part of. Taking me out of context doesn't bolster your argument.

I didn't take you out of context. Again, you've simply put forth your characterization of what we are doing as a means to support your conclusion that what we are doing is bad.

Again, the initial post that called Daruma's thinking "apalling" likened it to serfdom.

No one has bothered to support the contention that this is somehow forcing people to take medicine so that our companies can make profit. It's simply been assumed as a starting point from the beginning of the thread, and used to support some pretty strong language condemning those who don't agree.

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