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Tue, 2 Sep 2003 14:40:56 -0500

WC Douglass

Prescribable cause

 

Daily Dose

 

September 2, 2003

 

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Who's regulating the regulators? (Part two)

 

In the last " Dose, " I exposed the loosening FDA regulation of

drug marketing - and how the government isn't in a hurry to

mend its ways, since it's pulling in a hefty chunk of

pharmaceutical-industry change. But going easy on drug

marketing regulations also creates a " Pandora's box " of

potential misuse (and mis-prescription) of these drugs.

Here's what I mean:

 

In order for a drug to be approved by the FDA, it must be

designed, formulated, and proven effective for a SPECIFIC

CONDITION - or at least a narrow range of related conditions.

Broadening the spectrum of maladies a drug is intended to

treat would make the approval process slower, more

cumbersome, and even less likely. However, sales of a drug

radically increase as its " prescribability " widens.

 

Let's imagine a company designs Elixra-B - a drug designed to

treat foot fungus. If it can prove itself effective for this

specific ailment, FDA approval is relatively simple, fast,

and cheap to attain. But what if Elixra-B is also suitable

for treating baldness, shingles, eczema, and genital herpes?

Proving all of this with trials and scientific studies prior

to FDA approval would be enormously expensive and time

consuming.

 

However, if the FDA blithely allows a slick TV ad picturing

smiling, happy people euphorically applying Elixra-B to their

scalp, skin, and you-know-where (as well their feet), the

message is clearly sent to the general public that Elixra-B

is for more than just foot fungus - all you need to do is ASK

YOUR DERMATOLOGIST.

 

Meanwhile, every skin doctor in the country just attended an

all-expense-paid conference in sunny Las Vegas sponsored by

Cheatham & Steele Pharmaceuticals, the makers of Elixra-B. At

this conference, the most renowned dermatologist in the world

gives an " unbiased " and " educational " all-day seminar about

how Elixra-B cures baldness, eczema, shingles, and herpes as

well as foot fungus.

 

Voila - prescriptions of Elixra-B go through the roof. And

because these sales are for " unauthorized uses, " Cheatham &

Steele completely dodges the liability bullet.

 

As scary as it sounds, this kind of indirect, back-door

marketing is exactly how the drug biz makes a lot of its

money. In fact, in one high-profile case (reported in the New

York Times), a drug company spokesperson admitted that 75

percent of one drug's sales were for unauthorized uses.

 

Bottom line: Without stringent and conscientious regulation,

advertisements mislead the public - and doctors mislead each

other - about a drug's applicability. And drug makers reap

the greatest number of sales for the least possible

accountability, expense, and approval hassles from the FDA.

 

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Modern medicine's " repair rates " leave us stranded...

 

I hate to give kudos to the rag, but every once in a while,

the government's (and the medical establishment's) official

apologist newspaper, The Washington Post, runs a good article

on mainstream medicine and its foibles.

 

Earlier this summer, the Post published an article that

equated conventional medical care with the auto repair

business. The basic gist of the piece is that if auto repairs

failed at the same rate as conventional medical procedures

and recommendations, we would hardly be able to drive

anywhere, according to the Institute for Healthcare

Improvement.

 

That's right: That guy down at the corner garage who took

three appointments to fix your leaking radiator might well be

more competent than the doctor who handles your next ER

visit...

 

This finding really stuck with me - especially as I read some

of the article's other conclusions, which included survey

results showing that Americans:

 

* Have nearly a 50 percent chance of receiving sub-optimal

care in any given hospital or doctor's office

* Endure a huge variance in quality of care based on their

specific condition

* Risk " overtreatment " for many common conditions - like

migraines

* Receive recommended medication practices only 69 percent of

the time

* Get adequate counseling and teaching only 18 percent of the

time

 

And these aren't the only evidences of glaring

inconsistencies rampant in modern conventional medicine, the

article reveals.

 

But none of this should surprise you. If you've been a Daily

Dose or Real Health reader for any length of time at all, you

already know that going to the hospital or doctor's office is

all too often one of the most dangerous things you can do.

 

Always driving the truth,

 

William Campbell Douglass II, MD

 

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