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Outrage Checklist

Outraged? Check.
Furious? Check.
All riled up? Check.

In other words, 2007 has been yet another year filled with drug company connivery, regulatory nightmares, and plenty of underhanded scheming.

Here, then, is my annual review of the most heinous of these outrages. Please fasten your seatbelts, take a deep breath, and we'll go for a wild ride through the darkest caverns of the medical mainstream.

Follow the money

The year of living outrageously got off to a big start in early February when Texas Governor Rick Perry issued an order mandating that all Texas girls entering sixth grade receive a shot of Gardasil, the vaccine that protects against certain strains of the human papillomavirus (HPV), which can cause cervical cancer. Mandating a vaccine to prevent a sexually transmitted virus that's easily detected and treated when women have annual gynecological exams is bad enough. The frosting on the cake: Turns out Gov. Perry has some links to Merck (the maker of Gardasil), not the least of which includes a $6,000 contribution Merck's political action committee made to the governor's re-election campaign.

You can read all about it in the e-Alert "Texas Two Step." http://www.hsibaltimore.com/ealerts/ea200702/ea20070208a.html

About six months later, the British Medical Journal reported that the FDA's Vaccine Adverse Event Reporting System (VAERS) had received reports of three deaths and more than 1,600 other adverse reactions linked to Gardasil over the past year.

"Bells Should be Ringing"
http://www.hsibaltimore.com/ealerts/ea200708/ea20070822a.html

Failure to comply

Texas wasn't the only state interested in forcing vaccines on school children. On a blustery Saturday morning in November, hundreds of parents lined up outside a Maryland courthouse - ordered there by the state's attorney to explain why they had not had their children vaccinated. They also had the option of bringing their children along so the kids could receive multiple vaccinations on the spot, even though this might have posed a health risk for some children. And again, money was at the root of the state action. According to the Association of American Physicians and Surgeons (AAPS), a substantial amount of state funding for the school district would have been lost if students and their parents failed to comply with the ordered vaccines.

"The Usual Suspects"
http://www.hsibaltimore.com/ealerts/ea200711/ea20071127a.html

And again…the money

In the e-Alert "Get Up and Go" (3/27/07), I examined a stunning revelation from the FDA that there is no evidence that Procrit (and other erythropoiesis-stimulating drugs which are used to treat anemia) reduces fatigue, increases energy, or improves quality of life for cancer patients undergoing chemotherapy or radiation. But it gets much worse: The companies that make these drugs actually pay generous sums to doctors who administer the intravenous medications in their clinics. Not only is this completely legal, but it also encourages the use of higher doses, which may increase the risk of heart attack and stroke.

"Words Fail"
http://www.hsibaltimore.com/ealerts/ea200705/ea20070523a.html

Still risky after all these years

In 2003 we first told you about a link between the diabetes drug Avandia and an increased risk of congestive heart failure (see the e-Alert "Sweet Heart" 10/16/03). Three and a half years later, the New England Journal of Medicine made headlines with a study that illustrates just how expansive this danger really is. But here's what the headlines didn't mention: Increased risk of heart attack is just part of Avandia's risk profile.

"Catching Up"
http://www.hsibaltimore.com/ealerts/ea200705/ea20070529a.html

See als "David Graham and the Deathly Hallows" http://www.hsibaltimore.com/ealerts/ea200708/ea20070806a.html

$90 million loophole

When a best selling drug's patent runs out and generic versions of the drug become available, the lower prices benefit everyone except drug companies. Earlier this year, the FTC reported that the drug company Schering-Plough paid a total of $90 million to drug manufacturers to persuade them to delay production of a generic version of a Schering- Plough blood pressure medication. This scheme is known as "pay to delay," and while it has a fishy smell, a loophole makes it completely legal.

"Working Every Angle"
http://www.hsibaltimore.com/ealerts/ea200703/ea20070320a.html

The bad and the good

One day in the summer of 2003, an insurance broker walked into a hair salon in Southern California and convinced 51-year-old Patsy Bates - a hairdresser and the owner of the salon - that she could save some money if she switched her insurance carrier to one of California's largest health insurers. This wasn't a scam - when the broker left her shop Patsy had valid health insurance coverage - but what happened next was reprehensible. If you've ever had a problem with a health insurance claim, you'll probably find yourself rooting enthusiastically for Patsy, who fought back and caught a break. Now it appears she's on the verge of a very satisfying triumph.

"Working Without a Net"
http://www.hsibaltimore.com/ealerts/ea200711/ea20071128a.html

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