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Tue, 25 Mar 2003 17:00:00 -0500

WC Douglass

Safety patrol?

 

Daily Dose

March 25, 2003

 

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Selfless, benevolent FDA enforces the LETTER of the law...

 

You'll no doubt remember how last month I ranted and raved

about all the slick drug ads on TV nowadays -- and how

they're designed to do nothing more than convince you that

you're sick, then provide you with an easy-to-pop

solution... JUST ASK YOUR DOCTOR!

 

Well, as if on cue, a February article in that often-quoted

paragon of American commercial meritocracy, Consumer

Reports, covers just this subject -- and their findings are

at once vindicating (because after all, I told you so) and

distressing. First off, it turns out that a frighteningly

large percentage of people really DO ask for specific drugs

by name when they go to the doctor...

 

What I didn't count on was how willingly those doctors

prescribed the specific medication their patients requested -

- up to 80% of the time, according to recent surveys. Eighty

percent? Boy, I'll say those direct-to-consumer ads work,

and how!

 

But what really gave me cause for alarm was the fact that

according to the article, 43% of people -- excuse me,

consumers -- labor under the ENTIRELY FALSE notion that the

FDA stringently regulates drug ads, and that

only " completely safe " patent medicines can be advertised.

This is a scary testament to the fact that many (if not

most) Americans believe their government paternalistically

protects them from harmful substances...

 

Nothing could be farther from the truth.

 

The truth is that the typical FDA review of a drug

advertisement is conducted AFTER the ad has already been

released into widespread circulation! Do they know if the

drugs being advertised are safe before we see the ads -- and

maybe even demand the drug from our doctors? No.

 

In fairness to the FDA, though, there is a system of " checks

and balances " in place designed to discourage drug companies

from engaging in any intentional deception. And it's a real

comfort, too: If a drug maker is found to have made

fraudulent or misleading claims in its ads, they face a

stiff penalty...

 

A letter.

 

That's right -- they get a stern talking to! According to

the article, those fierce disciplinarians at the FDA

averaged 100 or more of these letters per year throughout

the 1990s for such violations as:

 

* Minimizing (or omitting) drug risks

* Exaggerated claims of effectiveness

* False claims of superiority over competing drugs

* Suggesting unapproved uses for drugs

* Promoting drugs still in the experimental phase

* Inconsistency of labeling information

* Misleading physicians

 

Interestingly enough, the number of these " penalty " letters

has dwindled in recent years. As of November 2002, only 24

had been dealt out for the year -- maybe they were planning

to hand out 76 more as stocking stuffers?

 

The obvious question is: What happens to drug makers who've

received a letter if they don't change their ads? (Probably

nothing.) But the not-so-obvious question is this: Is the

real purpose of these letters only to shield the FDA in the

event of a scandal?

 

Here's the bottom line: If the FDA were concerned about

protecting you from harmful drugs, they'd thoroughly review

the ads before they ever reach the airwaves and pages. Or

they'd hold drug companies accountable for their deception

in meaningful ways -- like fines in the million-dollar

range...

 

But if they really cared, they'd ban all these ads in the

first place.

 

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Nurse, where's my scalpel?

 

Are you having trouble getting through airport metal

detectors ever since that appendectomy a few years back?

 

If so, you might be carrying around a hemostat or two -- in

your belly!

 

That's right: According to a recent New England Journal of

Medicine report, 1500 patients a year in the U.S. leave the

operating table with some of the hospital's equipment still

INSIDE THEM. What are the most common hiding places for

wayward clamps, sponges, electrodes, retractors and various

and sundry other instruments? The chest, abdomen, hips, and

body cavities like the vagina. Oh, and here's an interesting

tidbit: This kind of thing happens a lot more often to

patients who are overweight!

 

The study further showed that fully two-thirds of these

mistakes occurred even though the surgical equipment was

inventoried before AND AFTER the procedure. This means that

not only can't these doctors operate -- they can't even

count! Complications from these blunders led to internal

bleeding, infection, and sometimes death. Yet in some cases,

patients weren't even aware of their little stowaways until

they were " uncovered " in a later procedure.

 

These findings, from a Harvard-affiliated study (the largest

of its kind ever conducted), should rightly shock you...

 

Even though such mistakes are relatively rare (about 1 in

20,000), they'd be even more of a scarcity if all the

unnecessary surgeries Americans undergo each year were

eliminated. That -- and apparently losing weight -- will

keep us out of harm's way as much as possible.

 

Sometimes being cautious can't hurt,

 

William Campbell Douglass II, MD

 

 

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