Hospitalizations from prescription drugs increase 98% in 5 years!

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Below is an article on prescription abuse and misuse in the U.S.  The numbers are startling.  If we want to begin to cut health care costs we need to reign in the pharmaceutical industry and their aggressive marketing.  See my comments at the end of the article.

NY Times Article

By ABBY GOODNOUGH

Published: January 5, 2011

The number of emergency room visits resulting from misuse or abuse of prescription drugs has nearly doubled over the last five years, according to new federal data, even as the number of visits because of illicit drugs like cocaine and heroin has barely changed.

The Substance Abuse and Mental Health Services Administration found there were about 1.2 million visits to emergency rooms involving pharmaceutical drugs in 2009, compared with 627,000 in 2004. The agency did not include visits due to adverse reactions to drugs taken as prescribed.

Emergency room visits resulting from prescription drugs have exceeded those related to illicit drugs for three consecutive years, said R. Gil Kerlikowske, President Obama’s top drug policy adviser.

“I would say that when you see a 98 percent increase,” Mr. Kerlikowske said, “and you think about the cost involved in lives and families, not to mention dollars, it’s pretty startling.”

In 2010, the Substance Abuse and Mental Health Services Administration reported that the number of people seeking treatment for addiction to painkillers jumped 400 percent from 1998 to 2008. And in a growing number of states, deaths from prescription drugs now exceed those from motor vehicle accidents, with opiate painkillers like Vicodin, Percocet and OxyContin playing a leading role.

In September, the Drug Enforcement Administration organized the first national prescription drug take-back program, and thousands of people dropped off old or unused drugs at designated locations around the country. While the effort captured but a tiny fraction of the addictive drugs in the nation’s medicine cabinets, law enforcement officials said it helped people understand how deadly such drugs can be. Another collection day is being planned for April, Mr. Kerlikowske said.

“The most important thing that actually seems to be gaining a lot of traction,” he said, “is the recognition that the prescription drugs sitting in your medicine cabinet can be dangerous. That’s huge.”

Dr. Court’s Comments

In a time when health care costs are through the roof and insurance premiums continue to rise this story explains a lot.

Since 2004 the number of emergency room visits has almost doubled because of complications from pharmaceutical agents that were misused or abused.  This does not take into account the number of people who are hospitalized because of adverse reactions or complications from taking their medications as prescribed.

There is a major war going on against illicit drugs like cocaine and heroin and rightfully so.  But according to this research hospitalizations for prescription drugs exceed those of the illegal drugs.  Why are we not fighting back against this problem?

In my opinion, the aggressive marketing of pharmaceutical drugs is partly to blame.  Just watch the nightly news.  You will see ad after ad for drugs. This leads people to believe that these drugs are basically harmless because of the happy and joyous people you see living their wonderful lives on these drugs.  It desensitizes people to their dangerous side effects.

Don’t believe me?  How much attention do you think the average American pays to the list of side effects that each company is required to state in their commercials?  The level of attention is directly related to how many times to you hear something.  The more you hear it, the less you pay attention to it.  And you hear it all the time!  You can’t get away from it on television.

Prescription drugs have their place, but that place should be as a last resort.  If all other methods have failed, perhaps  a drug will work. Tell me if this sounds familiar:

“If diet and exercise alone are not enough to control your cholesterol, adding Lipitor may help.”

You know what the problem with that statement is?  Diet and exercise are never given a chance.  The first thing that happens when someone is diagnosed with high cholesterol is a prescription is written.  No advice about diet or exercise is given.  Over prescribing has become a habit in the medical community and because of this, we pay the price.

If we want to reduce the number of hospitalizations from prescription drugs we need to reduce the number of prescriptions that are written in this country by using safe and effective alternatives and we need to stop the aggressive marketing of pharmaceutical agents to the general public.

Confessions of a Pharmaceutical Sales Rep

The above video was brought to our attention from a patient of ours who happens to be a medical doctor.  The woman in the video is a former pharmaceutical sales person and speaks about the amazing ways in which Big Pharma tricks doctors into believing what they are prescribing has no downside.

Big business is big business no matter what the company is selling.  Just because the pharmaceutical industry makes drugs that are supposedly good for us (their words, not mine) does not mean they aren’t in it to make as much money as they can possibly make.  The problem is that these drugs are dangerous and Big Pharma tries at every turn to mislead the public and medical professionals to minimize the potential dangers of drugs.  Did you know that 106,000 people per year die from the negative effects of properly prescribed drugs? That number is almost as high as the number of people who die from stroke each year.

I recently read an article about the cholesterol lowering class of drugs called statin medications.  It was a sort of tongue and check article that touched on this subject.  It was written by a chiropractor who works in a hospital.  He has frequent interaction with medical doctors because of this and is privy to the conversations that most people don’t get to hear.  In his article he said that he’s overheard some physicians saying that everyone should be on statin medications because of their “health benefits” and almost nonexistent side effect profile.  He went as far to propose, sarcastically of course, that we should just start putting statins in our water as a measure of public health.  After all we already put fluoride in the water.  Why not add a little statin in there too!?  The problem is that statins have little health benefit and have a very large side effect profile.

Big Pharma is trying to spin these types of ideas day and night.  Anything to increase profits and crush the competition.  At some level, people who work for these corporate giants want to help people and cure diseases.  The problem is that the people in charge care about one thing – money and power.  Power begets money and money begets power.  Once those two things are in the fold, you can forget about honesty in terms of research, marketing and maybe worst of all, political policy.  While they don’t directly control legislation, their 2500+ lobbyists do a great job making sure their interests are well taken care of.

There needs to be a change in the way Big Pharma is regulated.  If we do not, health care prices will continue to increase and America will continue to be one of the unhealthiest nations in the world.

Pills, pills, pills…

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Welcome back!  We’ve been away for a while from the blog with the Labor Day holiday but we’re back with startling new information about the amount of prescription drugs Americans take.

In my opinion, prescription medicines are the most overly used consumer product available in this country.  Many times they are used for conditions that are incredibly responsive to dietary changes, exercise and supplement programs.  Examples of these conditions includes type II diabetes, high cholesterol, depression and asthma.  These also happen to be some of the biggest money makers for the drug companies.

New research points out just how drugged we are as a society.  Over the last 10 years, the percentage of Americans who took at least one prescription drug in the past month increased from 44% to 48%, says a federal government study.  That’s right.  Almost half of the people in the United States reported taking at least one prescription drug in the last month.  Half! That means that almost 150 million people used a pharmaceutical product to deal with a health condition.

Use of two or more drugs increased from 25% to 31%, and the use of five or more drugs increased from 6% to 11%, according to the analysis of data from the National Health and Nutrition Examination Survey (NHANES).

The numbers for people over 60 are even more frightening.  The study found that 90% of adults 60 years old or older used at least one prescription drug in the last month. More than 76% used two or more prescription drugs and 37% used five or more.

One in five children used at least one prescription drug in the last month as well.

These numbers are astounding. Big Pharma would have you believe they are helping people be healthy by having them take their drugs.  The truth is, however, someone is not truly healthy unless they aren’t taking any drugs.  These drugs are toxic and have serious side effects.  While some drugs are necessary and allow people to live longer lives, the vast majority are over prescribed and unnecessary.

Not surprisingly, spending for prescription medications has sky rocketed.  Since 1999, spending has more than doubled.    In 2008, spending in the US for medications topped $234.1 billion.  Access to health insurance increased the risk (yes, risk) of taking a prescription medication.  While I think it’s noble to try and get everyone fair access to health insurance, it is not going to make us healthier.  It will only guarantee that more people take more medication.

These numbers are disturbing but the trend is going to continue as long as people continue to insist that drugs are the only way to treat disease and people continue to disregard their responsibility for their health.

The research is clear.  One of the largest problems with our health care system is the cost.  The research is also clear that one of the largest contributors to that cost is the dangerous side effects and interactions from drugs that were taken as prescribed.  If half of all Americans are taking prescription medication from one month to the next and medications that are taken properly significantly increase health costs in this country, shouldn’t we be trying to get Americans off prescription medication?

In order to make health care more affordable we need to get people to be healthier.  That includes getting them to exercise, watch their diet and take supplements that have shown to be effective with very low (if any) side effect.  It does not include getting more people on more drugs.  To me this is not a hard concept.  The research reflects what I am saying.  It just needs to be implemented.

Fast Food Chains To Offer Statins With Their Meals?

Below is a blog post from cnn.com.  It simply amazes me that a peer reviewed journal would suggest that fast food companies offer statins with their meals to offset their horrible health effects.  See my comments at the end of the article.

CNN Blog Post

A new report in the American Journal of Cardiology suggests that fast food restaurants should offer statins – a popular class of cholesterol-lowering medications – alongside their unhealthy food.

“We propose that the fast food industry is well placed to offer advice and supplements to counteract the cardiovascular harm arising from the foods they purvey,” the report said. “These companies already have an infrastructure for providing a variety of condiments… A generic statin could be added to the panoply of items in the self-service tray at little additional cost.”

The study – which likened taking a statin before eating to putting on a bike helmet before biking – was based on analyses of other scientific studies, and concluded that taking the drugs could offset the risk of eating fast food just enough to render the food harmless.

“Most of the primary prevention statin regimes we examined, with the exception of pravastatin, had the strength to counteract the increase in risk caused by an unhealthy diet; or eating an additional 36 g[rams] of total fat or 2.8 g[rams] of trans fat per day – approximately equivalent to a Quarter Pounder with cheese and a small milkshake,” the British researchers said in the study.

But Dr. Ralph Sacco, president of the American Heart Association, says that not only isn’t the solution that simple, it could be dangerous.

“There are other things regarding obesity that are important that a statin won’t neutralize, such as diabetes and high blood pressure,” Sacco said. “Even though we agree statins have a lot of good evidence in reducing cardiovascular and stroke risk, there are certain risks with any medications.”

The risks are relatively infrequent but include liver damage, muscle cramps and long-term muscle damage.

The British researchers concluded that the risks of eating fast food are much greater.

“Statins have been shown to be safe even at high doses,” the report says. “The documented safety record of statins is substantially better than that of fast foods, which carry not only direct cardiovascular risks, but other risks due to obesity.”

But regardless of whether the benefits do in fact outweigh the risks,  Sacco says there are far better ways to reduce the negative effects of obesity.

“If you can control it with diet and exercise, that would be our preference rather than having to take a medicine.”

Dr. Court’s Comments

This is perhaps the most ridiculous recommendation I have ever seen from a mainstream medical publication.  They are suggesting that fast food chains offer cholesterol lower medications, called statins, with their meals to offset the negative health effects they have on human physiology. This is the pinnacle of not taking responsibility for one’s health.  Why take responsibility if you can take a pill to supposedly offset the detriments to your health from eating the most unhealthy foods in the world?

Statin medications are not as safe as Big Pharma would like you to believe. Statins are HMG-CoA reductase inhibitors, that is, they act by blocking the enzyme in your liver that is responsible for making cholesterol (HMG-CoA reductase). The fact that statin drugs cause side effects is well established—there are now 900 studies proving their adverse effects, which run the gamut from muscle problems to increased cancer risk.

For starters, reported side effects include:

• Muscle problems, polyneuropathy (nerve damage in the hands and feet), and rhabdomyolysis (a serious degenerative muscle tissue condition)
• Anemia
• Acidosis
• Sexual dysfunction
• Immune depression
• Pancreas or liver dysfunction, including a potential increase in liver enzymes
• Cataracts

These side effects hardly seem harmless and to give them as an option with your value meal from McDonald’s is outrageous.  It is a great marketing ploy by the pharmaceutical industry to get as many American’s on statins as possible.  Think about it.  Wouldn’t this kind of strategy significantly increase sales of statin drugs?  Of course it would.  And where do we start and stop giving them to people.  Does a 3 year old eating a happy meal get a statin to go with it?  What about people who are already taking statins?  Do they just take extra because you really never can get to much medication can you?  The slope is a slippery one and I cannot believe this has even been suggested.

I was happy to see the president of the American Heart Association take the other side of this story.  He mentions that statins do nothing to offset the other health complications of fast food like diabetes and high blood pressure.  This is true.  You can’t take a statin to avoid diabetes.  What he doesn’t mention is the fact that those kinds of food – food high in refined sugar – are notorious for raising inflammation in the body.  When you raise inflammation you raise the risk of heart disease, stroke, cancer and osteoporosis to name just a few.  You can’t control inflammation by taking a statin.  Some new research does suggest that statins lower one of the inflammatory enzymes called CRP.  But that’s just one.  There are others that are still detrimental to one’s health.

This kind of a recommendation is dangerous.  Period.  It is also irresponsible for the American Journal of Cardiology to publish such information.  It plants a dangerous seed.  This kind of a recommendation encourages people to continue to make poor decisions regarding their diets.  It gives them an excuse to continue to destroy their health under the pretense that they are offsetting their bad decisions with a pill.  Instead, we should be encouraging people to make healthier choices regarding their diet and lifestyle.

Swine Flu Pandemic? How Big Pharma used its power to scare the world

Remember the swine flu?  Last year it was all you heard about on the news.  Each evening we were shown statistics that gave us an up-to-the second tally of deaths linked to H1N1.  “Experts” were encouraging everyone to get the vaccinated against this serious threat.  Local clinics were swamped with terrified people demanding the vaccine for their entire family.  All of this was because the World Health Organization (WHO) declared that the swine flu was a world wide pandemic.

Now the British Medical Journal (BMJ) has published an article accusing the World Health Organization of conflicts of interest with regard to H1N1.  The authors accused the organization of exaggerating the severity of the virus, and of taking advice from experts with ties to vaccine- and antiviral-producing pharmaceutical companies.

Almost exactly one year ago Dr Margaret Chan, the director general of the World Health Organization announced to the world that there was pandemic in full effect.  She told us that she had consulted with leading scientists, doctors and virologists to make her decision.

The WHO offers advice to governments for situations just as these.  If there is a major pandemic they advise governments on how to handle it.  Following the WHO’s advice, governments bought billions of dollars worth of vaccines, oseltamivir (Tamiflu) and zanamivir (Relenza).  And according to the BMJ, the vast majority of it is sitting unused.

The First Sign that Something was Up

For some reason, the WHO changed the definition of ‘pandemic.’  In response to the chicken flu outbreak in 1997 in Hong Kong, the WHO began to organize a pandemic preparedness plan.

The WHO’s first influenza pandemic preparedness plan was stark in the scale of the risk the world faced in 1999: “It is impossible to anticipate when a pandemic might occur. Should a true influenza pandemic virus again appear that behaved as in 1918, even taking into account the advances in medicine since then, unparalleled tolls of illness and death would be expected.” (From the BMJ)

The WHO is rightfully concerned about a flu pandemic of that scale.  An estimated 50 million people, about 3% of the world’s population (1.6 billion in 1918), died of the disease. A total of 500 million, or 1/3 were infected.  How could the WHO compare the swine flu last year to the 1918 flu?  They aren’t even close.

The WHO has been accused of removing the words “enormous numbers of deaths and illness” from the definition of pandemic.  I guess if you remove those words the 1918 influenza pandemic and the swine flu “pandemic” of 2009 could be categorized together.

Maybe, just maybe, this is the problem

The initial preparedness program was written entirely by people who stood to gain from frightening the world into stockpiling antiviral drugs (namely Tamiflu and Relenza).  Roche, is the manufacturer of Tamiflu, and GlaxoSmithKline, manufacturers Relenza.  Both companies had employees on the committees advising Dr. Chan on whether or not to issue a pandemic warning.  On the initial preparedness program it said:

“R Snacken, J Wood, L R Haaheim, A P Kendal, G J Ligthart, and D Lavanchy prepared this document for the World Health Organization (WHO), in collaboration with the European Scientific Working Group on Influenza (ESWI).” What this document does not disclose is that ESWI is funded entirely by Roche and other influenza drug manufacturers. Nor does it disclose that René Snacken and Daniel Lavanchy were participating in Roche sponsored events the previous year, according to marketing material seen by the BMJ/The Bureau. (From the BMJ).

Why are these antiviral drugs considered so important in a pandemic?  Because vaccines are likely to take months to be available in the numbers required for a true pandemic of the scale that hit in 1918.  These antivirals could be life saving if a truly virulent strain of flu emerged.  They would also be a windfall of revenue for the pharmaceutical companies making them.

Of course, there are many natural remedies that boost immunity very effectively, but they are not marketed because they don’t have the big money of Roche or GlaxoSmithKline behind them.  That’s for another blog though.

The WHO says it checked into the backgrounds of the people it relied on to make its guidelines which called for countries to stockpile antiviral drugs.  It says it investigated the financial ties of these scientists to the pharmaceutical industry.  But, according to the BMJ they are refusing to release the information they gathered in their investigations.  This lack of transparency is concerning.

Because of these recommendations that the WHO put forward, mostly established by scientists with significant ties to Big Pharma, Roche and GlaxoSmithKline made $12 billion on antiviral drugs with the lion’s share going to Roche and Tamiflu ($10 billion).

And all this for drugs that should have never been approved for use in the US! An FDA advisory committee originally recommended that Relenza not be approved because it had safety concerns and showed very little benefit over placebo in US trials.  The FDA did not adhere to the advice of its committee (it is not required to) and approved it because “they would feel better if there was something on the market in case of a pandemic,” and  “it wasn’t a scientific decision.”  This is according to Dr. Michael Elashoff who was a former employee of the FDA, and was the statistician working on the Relenza account.  This fact, according to Dr. Elashoff paved the way for Tamiflu’s approval later that same year.

Dr. Chan wants the WHO’s work on H1N1 examined.  She asked for an independent review of how the WHO handled H1N1 in January.  Hopefully this will produce some results, but I doubt it.

Traditional medicine is filled with conflicts on interest from Big Pharma.  This is just another example.  The swine flu was not a major pandemic and according to the WHO “the overwhelming majority of patients experienced mild symptoms and made a rapid and full recovery, even without medical treatment.”  If that was the case, and I believe it was, why did they instruct countries to stockpile billions of dollars worth of pharmaceuticals?  I think the answer is clear.  Big Pharma was able to strategically place scientists on influential panels to sell drugs.

During the swine flu “pandemic” I recommended that patients take a little extra vitamin C, D, and A, get plenty of rest and eat as healthy as possible.  Those recommendations are far safer than running out and vaccinating yourself or prophylactically taking Tamiflu, both of which have serious side effects.  Remember, a conservative approach is almost always the best way to tackle a problem.

Heartburn Meds Increase Bone Fracture Risk

A new warning from the FDA states that drugs called proton pump inhibitors increase the risk of wrist, spine and hip fractures.  These proton pump inhibitors are used to treat heart burn.  They prevent your stomach from producing the acid required to properly digest food.

Drugs cited by the FDA are Nexium, Dexilant, Prevacid, Prilosec, Zegerid, Protonix and Aciphex.  The FDA warns that use of these drugs for more than just one year or at high doses is enough to increase the risk of fracture.  The increased risk of fracture was seen in people 50 years old or older.

“A staggering 113.4 million prescriptions for proton pump inhibitors are filled each year, making this class of drugs, at $13.9 billion in sales, the third highest seller in the United States,” writes Mitchell H. Katz, M.D., of the San Francisco Department of Public Health in an editorial in Archives of Internal Medicine, May 10, 2010. He notes that while proton pump inhibitors are helpful in treating selected medical conditions, the huge numbers prescribed indicate that many–53-69%–are prescribed inappropriately.

This is a very dangerous situation.  Not only do huge numbers of people take these drugs, the vast majority are taking them unnecessarily or for conditions that do not respond to proton pump inhibitors!  This is particularly troublesome in light of the information from a study concluded last fall:

Treatment with the anti-heartburn drugs known as proton pump inhibitors (PPIs) for eight weeks induces acid-related symptoms like heartburn, acid regurgitation and dyspepsia once treatment is withdrawn in healthy individuals, according to a new study. More than 40 percent of healthy volunteers, who had never been bothered by heartburn, acid regurgitation or dyspepsia, developed such symptoms in the weeks after cessation of PPIs.

If these drugs are being prescribed for people incorrectly or for people who don’t need them, there is a very real chance a physician could create the very problem he is supposedly treating.  In people who do not have peptic disease “rebound hypersecretion” occurs.  To explain, within two weeks of stopping the PPI your stomach begins to actually over produce acid.  This is all induced by taking a pill that is supposed to reduce acid production.

The researchers in the above study concluded:

“If rebound acid hypersecretion induces acid-related symptoms, this might lead to PPI dependency. Our results justify the speculation that PPI dependency could be one of the explanations for the rapidly and continuously increasing use of PPIs.”

An extremely convenient way to get people hooked on your product don’t you think?  I wouldn’t put it passed the pharmaceutical industry to design a product that would cause total and lifetime dependency on it.

Unfortunately, these drugs are treated by most physicians as if they are harmless.  They are intended to be used for no more than 14 days at a time.  However, I have many patients that come to me who have been on them for years. When they voice their concerns to their physicians they are reassured that what they are doing is safe and not to worry about the long term effects of these drugs.  It’s outrageous.

What Really Causes Heartburn?

The problem with PPIs is that they reduce stomach acid when the problem for most people who experience reflux is not over production of acid at all.  It’s actually under production of stomach acid!  This lack of stomach acid leads to improper digestion of food which can be irritating to the stomach.  It also allows a very specific bacteria to grow called H. pylori.  This bacteria is responsible for producing ulcers and possibly increasing the symptoms you are trying to prevent.  There are actually over 16,000 articles supporting the fact that suppressing stomach acid does not treat the problem.

Natural Ways to Treat Your Heartburn

The first and potentially most important way is to lose weight. People who are overweight are much more likely to suffer from heartburn.  Often times losing weight solves the problem without any other interventions.

Try a little sodium bicarbonate. Sodium bicarbonate, or baking soda, is a great way to relieve the symptoms.  One half to one teaspoon of baking soda mixed with water and swallowed often relieves the symptoms immediately.

Find out if you have a hiatal hernia. A hiatal hernia is when the stomach begins to slip up passed the diaphragm.  When this happens is allows stomach acid to reach the esophagus causing irritation.  There are simple manual maneuvers that can reduce this hernia without surgery.  It is very effective if applied correctly.

Change your diet! If you want heartburn, eat lots of processed food and sugar.  By eliminating these things from your diet you can significantly improve your symptoms.

Eliminate any food triggers you have identified. Occasionally foods will trigger symptoms like this.  If this is the case there is no need to take a PPI.  Simply eliminate these foods from your diet and you’ve solved your problem.

The increased risk of fracture is serious.  Often times a hip fracture is fatal in the elderly.  Keeping your body healthy from multiple aspects is important for reducing your risk of heartburn and dependency on PPIs.  If you follow the steps outlined above you should be able to significantly reduce your symptoms in a very short period of time.

A (small) step in the right direction

No more letting industry help pay for developing medical guidelines. Restrictions on consulting deals. And no more pens with drug company names or other swag at conferences.

These are part of a new ethics code that dozens of leading medical groups announced Wednesday, aimed at limiting the influence that drug and device makers have over patient care.

It’s the most sweeping move ever taken by the Council of Medical Specialty Societies to curb conflict of interest — a growing concern as private industry bankrolls a greater share of medical research.

The council includes 32 medical societies with 650,000 members, from neurologists and obstetricians to family doctors and pediatricians. They include the American College of Physicians, the American College of Cardiology and the American Society of Clinical Oncology, the largest group of cancer specialists in the world.

“We take very seriously the trust that is placed in us by physicians and patients to be authoritative, independent voices in cancer care,” ASCO’s chief, Dr. Allen Lichter, said in a statement. He led the panel that developed the code.

One of its most controversial rules: requiring top leaders of any medical society and top editors of its journals to have no consulting deals or financial ties to industry.

“When a physician stands up to represent medicine and his or her specialty, there shouldn’t be any confusion as to who they’re speaking for,” said Dr. Norman Kahn, the council’s chief executive and a former rural medicine doctor from California.

The code requires groups to:

• Publicly post any industry support the group receives, such as money for continuing education sessions.
• Decline industry funding for developing medical practice guidelines, such as who should get a drug, a test or treatment. Require that most members of a guidelines panel be free of financial ties to industry.
• Disclose any financial ties that leaders and board members have with companies.
• Ban company or product names and logos from pens, bags and other giveaways at conferences.

Fourteen groups in the council, including ASCO and the College of Physicians, have already adopted the code. Most of the rest plan to by the end of the year.

Last year, leading medical journals agreed to use a uniform conflict-of-interest disclosure form for researchers publishing in their journals. The new ethics code the council is adopting should make financial ties more transparent to patients and breed professionalism and trust in doctors, Kahn said.

Via: USA Today and the Associated Press.  See Full Article

Dr. Court’s Comments

I certainly think this is a step in the right direction.  Pharmaceutical companies control medicine completely now.  They control the treatments, the research, the education and worst of all, your options.  Their reach is as far as you can possibly imagine.

Treatments that are natural, effective and inexspensive get passed over because Big Pharma wants it that way. They make sure to “educate” (indoctrinate is more like it) as many doctors as possible that any natural remedy is quackery.

Medical guidelines are written by doctors with significant ties to Big Pharma and the insurance companies reimburse treatments based on these guidelines.  Let’s use an example to illustrate:

You enter your doctor’s office and he is holding your recent blood test in his hand.  He tells you that your cholesterol is high and you need to start Lipitor right away.  You ask you doctor if there are any other treatment options, but because your doctor has just been to a conference sponsored by Pfizer (the maker of Lipitor) he tells you that there are no better options for you.  He is telling you this because he just learned that “the research” (done by Pfizer) says Lipitor is the most effective treatment for high cholesterol and that it’s the only medication studied that shows it reduces heart attack and stroke risk.  He was also told that diet and exercise only reduce cholesterol by 10%-15% so you shouldn’t bother because you need to lower it more than that.  All these “facts” he is quoting you are from research Pfizer has conducted on its own product.  And if this weren’t enough, your insurance company will pay the most for Lipitor because the guidelines written for cholesterol management were written by a team of 10 physicians, 4 of which had financial ties to Pfizer.

What he didn’t learn at his conference is that things like diet and exercise are very effective tools for reducing cholesterol when applied correctly.  Low carbohydrate is the way to go on that one.  He also did not mention that things like red yeast rice, niacin and plant sterols are very effective ways to reduce cholesterol without resorting to a poisonous chemical like Lipitor.  These things were not mentioned at his conference because alternatives would hurt overall sales.  By the way, your insurance company will reimburse you exactly $0 for anything that isn’t a drug because they don’t have billions of pharmaceutical dollars behind them.  They also won’t pay for you to go to the gym and actually get healthy.

Hopefully these new guidelines will have an effect, but because they are not federal acts I doubt they will have any real impact.  Your best bet is to be your own advocate.  If you don’t want to take a drug, find out from a nutritionally trained physician what you can do.  If you’re concerned about the effectiveness the fix is simple – do objective testing like blood work to see if what you are doing is working.  I think you’ll be surprised to find out just how effective these natural alternatives are.

Pfizer creates fake company to take rap in criminal case….and gets away with it!

Below is a story from CNN that is a must read.  It shows everything that is wrong with the pharmaceutical industry.

CNN Article

Imagine being charged with a crime, but an imaginary friend takes the rap for you.

That is essentially what happened when Pfizer, the world’s largest pharmaceutical company, was caught illegally marketing Bextra, a painkiller that was taken off the market in 2005 because of safety concerns.

When the criminal case was announced last fall, federal officials touted their prosecution as a model for tough, effective enforcement. “It sends a clear message” to the pharmaceutical industry, said Kevin Perkins, assistant director of the FBI’s Criminal Investigative Division.

But beyond the fanfare, a CNN Special Investigation found another story, one that officials downplayed when they declared victory. It’s a story about the power major pharmaceutical companies have even when they break the laws intended to protect patients.

Big plans for Bextra

The story begins in 2001, when Bextra was about to hit the market. The drug was part of a revolutionary class of painkillers known as Cox-2 inhibitors that were supposed to be safer than generic drugs, but at 20 times the price of ibuprofen.

Pfizer and its marketing partner, Pharmacia, planned to sell Bextra as a treatment for acute pain, the kind you have after surgery.

But in November 2001, the U.S. Food and Drug Administration said Bextra was not safe for patients at high risk of heart attacks and strokes.

The FDA approved Bextra only for arthritis and menstrual cramps. It rejected the drug in higher doses for acute, surgical pain.

Promoting drugs for unapproved uses can put patients at risk by circumventing the FDA’s judgment over which products are safe and effective. For that reason, “off-label” promotion is against the law.

But with billions of dollars of profits at stake, marketing and sales managers across the country nonetheless targeted anesthesiologists, foot surgeons, orthopedic surgeons and oral surgeons. “Anyone that use[d] a scalpel for a living,” one district manager advised in a document prosecutors would later cite.

A manager in Florida e-mailed his sales reps a scripted sales pitch that claimed — falsely — that the FDA had given Bextra “a clean bill of health” all the way up to a 40 mg dose, which is twice what the FDA actually said was safe.

Doctors as pitchmen

Internal company documents show that Pfizer and Pharmacia (which Pfizer later bought) used a multimillion-dollar medical education budget to pay hundreds of doctors as speakers and consultants to tout Bextra.

Pfizer said in court that “the company’s intent was pure”: to foster a legal exchange of scientific information among doctors.

But an internal marketing plan called for training physicians “to serve as public relations spokespeople.”

According to Lewis Morris, chief counsel to the inspector general at the U.S. Department of Health and Human Services, “They pushed the envelope so far past any reasonable interpretation of the law that it’s simply outrageous.”

Pfizer’s chief compliance officer, Doug Lanker, said that “in a large sales force, successful sales techniques spread quickly,” but that top Pfizer executives were not aware of the “significant mis-promotion issue with Bextra” until federal prosecutors began to show them the evidence.

By April 2005, when Bextra was taken off the market, more than half of its $1.7 billion in profits had come from prescriptions written for uses the FDA had rejected.

Too big to nail

But when it came to prosecuting Pfizer for its fraudulent marketing, the pharmaceutical giant had a trump card: Just as the giant banks on Wall Street were deemed too big to fail, Pfizer was considered too big to nail.

Why? Because any company convicted of a major health care fraud is automatically excluded from Medicare and Medicaid. Convicting Pfizer on Bextra would prevent the company from billing federal health programs for any of its products. It would be a corporate death sentence.

Prosecutors said that excluding Pfizer would most likely lead to Pfizer’s collapse, with collateral consequences: disrupting the flow of Pfizer products to Medicare and Medicaid recipients, causing the loss of jobs including those of Pfizer employees who were not involved in the fraud, and causing significant losses for Pfizer shareholders.

“We have to ask whether by excluding the company [from Medicare and Medicaid], are we harming our patients,” said Lewis Morris of the Department of Health and Human Services.

So Pfizer and the feds cut a deal. Instead of charging Pfizer with a crime, prosecutors would charge a Pfizer subsidiary, Pharmacia & Upjohn Co. Inc.

The CNN Special Investigation found that the subsidiary is nothing more than a shell company whose only function is to plead guilty.

According to court documents, Pfizer Inc. owns (a) Pharmacia Corp., which owns (b) Pharmacia & Upjohn LLC, which owns (c) Pharmacia & Upjohn Co. LLC, which in turn owns (d) Pharmacia & Upjohn Co. Inc. It is the great-great-grandson of the parent company.

Public records show that the subsidiary was incorporated in Delaware on March 27, 2007, the same day Pfizer lawyers and federal prosecutors agreed that the company would plead guilty in a kickback case against a company Pfizer had acquired a few years earlier.

As a result, Pharmacia & Upjohn Co. Inc., the subsidiary, was excluded from Medicare without ever having sold so much as a single pill. And Pfizer was free to sell its products to federally funded health programs.

Two years later, with Bextra, the shell company once again pleaded guilty. It was, in effect, Pfizer’s imaginary friend stepping up to take the rap.

“It is true that if a company is created to take a criminal plea, but it’s just a shell, the impact of an exclusion is minimal or nonexistent,” Morris said.

Prosecutors say there was no viable alternative.

“If we prosecute Pfizer, they get excluded,” said Mike Loucks, the federal prosecutor who oversaw the investigation. “A lot of the people who work for the company who haven’t engaged in criminal activity would get hurt.”

Did the punishment fit the crime? Pfizer says yes.

It paid nearly $1.2 billion in a criminal fine for Bextra, the largest fine the federal government has ever collected.

It paid a billion dollars more to settle a batch of civil suits — although it denied wrongdoing — on allegations that it illegally promoted 12 other drugs.

In all, Pfizer lost the equivalent of three months’ profit.

It maintained its ability to do business with the federal government.

Pfizer says it takes responsibility for the illegal promotion of Bextra. “I can tell you, unequivocally, that Pfizer perceived the Bextra matter as an incredibly serious one,” said Doug Lankler, Pfizer’s chief compliance officer.

To prevent it from happening again, Pfizer has set up what it calls “leading-edge” systems to spot signs of illegal promotion by closely monitoring sales reps and tracking prescription sales.

It’s not entirely voluntary. Pfizer had to sign a corporate integrity agreement with the Department of Health and Human Services. For the next five years, it requires Pfizer to disclose future payments to doctors and top executives to sign off personally that the company is obeying the law.

Pfizer says the company has learned its lesson.

But after years of overseeing similar cases against other major drug companies, even Loucks, isn’t sure $2 billion in penalties is a deterrent when the profits from illegal promotion can be so large.

“I worry that the money is so great,” he said, that dealing with the Department of Justice may be “just of a cost of doing business.”

Dr. Court’s Comments

This case sets a dangerous precedent.  It tells large pharmaceutical companies that they can get away with just about anything because the federal government is powerless to stop them.

When a company is criminally responsible for something they should have to pay the price.  While Pfizer makes many drugs that are life savers for many people, the vast majority of them are oversold and over hyped for reasons that are well illustrated above.

All too often drugs are pushed for their ‘off label’ use.  This means they are pushed by the pharmaceutical companies to be used for things they are not approved for.  Very frequently people are prescribed anti-depressants for anxiety or take an antihistamine to sleep better.  While they may work for these purposes, they are not intended or tested to be safe for those purposes.

I always ask my patients why they are taking a certain prescription even it is seems straight forward because I can never be too sure.

This is also why health care is so expensive.  Needless drugs drive up the cost for all of us.  In my opinion off label prescribing should be illegal and safer more conservative options should always be considered.

Large companies like Pfizer do not have the best track record when it comes to being ethical.  Big money leads to small minds when in terms of ethics and morality.  Billions and billions of dollars tends to cloud the mind apparently.

Until tight regulation of the pharmaceutical industry is achieved, these cases will continue to surface.  The bank collapse that occurred in the recent recession showed us that the financial industry needed tighter regulation.  I believe that, unfortunately, something terrible will have to happen before Big Pharma has someone watching over it.

Big Pharma Calling all Healthy People!

I recently came across an article in the NY Times entitled “Risks Seen in Cholesterol Drug Use in Healthy People.”  To me this seems like an obvious statement.  However, the FDA has recently approved the drug Crestor, a cholesterol lowering statin, for use in people with normal cholesterol levels.

Statin demand continues to grow from ever expanding approvals and aggressive public marketing

AstraZeneca, the company who makes Crestor, has been hard at work trying to expand their market for this drug.  It is the hallmark of the pharmaceutical industry.  There are only so many sick people.  What do you do when all of them are taking your drug?  Expand to the healthy people.

This makes absolutely no sense at all.  Putting healthy people on a drug for a supposed risk reduction should be criminal.  There is no way that they risk does not outweigh the benefit.  For example, recently published evidence indicates that statins could raise a person’s risk of developing Type 2 diabetes by 9 percent!  By taking a statin you increase your risk of developing a disease that will create the problems you are trying to avoid in the first place.

The reason the FDA has approved this move you ask?  Supposedly Crestor lowers inflammatory markers in the body.  The inflammatory marker they are referring to is something called c-reactive protein or CRP.  CRP has been linked to cardiovascular disease.  The higher your CRP, the higher your risk for heart attack and stroke.  It’s a pretty simple association.  There is debate about whether it is a causal relationship, but from the research I have read, the lower your CRP the better off you are.

You might ask then what problem do I have with a drug that lowers an obvious risk factor for heart disease?  My problem is that lowering CRP does not require a statin medication.  I routinely measure CRP in my patients.  Many people come back high in CRP and we put them on an anti-inflammatory diet, on anti-inflammatory supplements and recheck their blood work in 8-12 weeks.  I have yet to fail to reduce anyone’s CRP.  It isn’t rocket science.  It is simple diet, exercise and supplementation.  When people improve their overall health and lose weight, other health factors improve.  The side effects from statins can be serious.  That weighs heavy on the risk side of that all important risk:benefit ratio.  The side effects to improving your diet, exercising and taking select anti-inflammatory supplements are virtually nil.

Under the new FDA approved guidelines an estimated 6.5 million people in this country who have no cholesterol problems and no sign of heart problems will be deemed candidates for statins. That is in addition to the 80 million who already meet the current cholesterol-based guidelines — about half of whom now take statins.

What a spectacular way to increase revenue.  Just imagine you own and business and there is a segment of the population who has no reason to use your product.  What if you could create a reason for them to use your product?  It would be like owning a dress shop and convincing men that they need to wear dresses because it will increase virility.

Look at it this way; a 30 day supply costs between $60-$100 for Crestor.  We’ll use an average of $80 to compute our numbers.  (And I believe this to be a low estimate of cost as a number of sources put the cost of Crestor at $3.50 per pill for 30 tablets.)  With this new approval there are 6.5 million potential new customers.  At $80 per month that is potentially $520 million in extra sales per month or $6.24 billion per year!

Now, AstraZeneca knows that not all 6.5 million people who qualify for the drug will take it, but what if they just got an extra 100,000 people on it per year?  That’s still $96 million in extra sales.  No small amount.

The new Crestor guidelines continue a steady expansion of the number of people considered candidates for statins over the last decade. The recommendations and guidelines have been expanded by various advisory panels — many of whose members have also done paid consulting work for the drug industry.

Another of those panels is now preparing statin guidelines due next year, which are expected to further expand the number of candidates for the drugs.  Just what we need.  More people on statins.  There are more effective ways to lower cholesterol.  Drugs are not the answer.

The clinical trial on which the F.D.A. approved the new Crestor use was a global study of nearly 18,000 people. It looked only at patients who had low cholesterol and an elevated level of inflammation in the body as measured by the aforementioned CRP.

The study concluded that it reduced heart attack and stroke by similar numbers.  The rate of heart attacks, for example, was 0.37 percent, or 68 patients out of 8,901 who took a sugar pill. Among the Crestor patients it was 0.17 percent, or 31 patients. That 55 percent relative difference between the two groups translates to only 0.2 percentage points in absolute terms — or 2 people out of 1,000.

Stated differently, 500 people would need to take Crestor for a year to prevent 1 heart attack, most of which are survivable.

What if those people, instead of being given a drug, were taught how to eat properly, exercised and took some proven anti-inflammatory supplements?  I believe we would see a much larger reduction in heart attack and stroke not only because their health would improve, but because of the other benefits of eating right and exercising.  Unfortunately, I do not have a randomized, placebo controlled study to point to because these things are not studied. Funds are not allocated to unpatentable products and exercise regimes.

At a time when we are trying to reduce health costs in this country, spending $638,000 to reduce the risk of one heart attack or stroke doesn’t make sense.  Not when there are other ways that are less expensive and likely more effective.  The pharmaceutical industry will never stop trying to expand its market.  We have to be educated to know that there are safer, more natural ways to improve health.

Drugs shown to have no benefit (and some risks) for diabetics

The results of a new study in diabetics has shown that adding drugs to drive blood pressure and blood-fats lower than current targets did not prevent heart problems, and in some cases caused harmful side effects.  This study was launched 10 years ago by the federal government to see if lowering blood sugar, blood fats or blood pressure would reduce heart attacks and strokes in diabetics.  The results showed that the drugs had no effect on reducing incidence of heart attack or stroke and for some caused serious side effects.

The results were called ‘disappointing’ but from my perspective this couldn’t be better news.  Had this study had positive outcomes it would have given another reason why every diabetic should be on more drugs to ‘protect their hearts.’

The studies were presented Sunday at an American College of Cardiology conference and published on the Internet by the New England Journal of Medicine.

They involved people with Type 2 diabetes — the most common form and the one rising because of the obesity epidemic. Diabetics have more than double the risk of dying of heart attacks or strokes than people without the disease.

The first piece of the study — about blood sugar — was stopped two years ago, when researchers saw more instead of less risk with that approach.

For the blood-fat study, researchers led by Columbia University’s Dr. Henry Ginsburg recruited more than 5,500 diabetics who also had another health risk, such as high blood pressure or cholesterol.

All were given a statin — cholesterol-lowering pills sold as Lipitor and Zocor.  Half also were given Abbott Laboratories’ blockbuster drug, TriCor; the rest got dummy pills. TriCor is a fibrate, a drug that lowers blood fats called trigylcerides while boosting “good” cholesterol.

Nearly five years later, the groups had similar rates of heart attacks and strokes.

The blood-pressure part of the study was led by Dr. William Cushman, preventive medicine chief at Veterans Affairs Medical Center in Memphis, Tennessee. About 4,700 diabetics were treated with various medicines to keep their systolic blood pressure — the top number — either below 140 or below 120.

The intense treatment did not reduce the number of heart attacks, although it prevented more strokes, a less common problem. Side effects were greater with the intense treatment.  (Excerpt from usatoday.com)

The question raised in the article I read was ‘what should diabetics do then?’  First of all, they ask this question like medication is the only answer for these people.  Many millions of people have type II diabetes or are on their way to having it.  The first thing that should be done is avoid the disease in the first place.  Type II diabetes is not a disease in the classic sense.  It is no more a disease than obesity is a disease.  It can be avoided with a healthy lifestyle.  Proper nutrition should be a class in school just like science or math.  The fact that children learn more about the planet Mars than they do about how to truly eat nutritiously is ridiculous. I am not suggesting the sciences are not important, but I bet most kids couldn’t tell you the difference between a carbohydrate, a fat and a protein other than ‘fat is bad for you’ (which is wrong anyway).  True nutrition in which carbohydrates are emphasized less and healthy fats are emphasized more would go along way to reducing the health care crisis in this country.  The low fat paradigm will not work because it is inconsistent with human physiology.

I am not so naive to think that if children were educated from a young age about health and nutrition that we could prevent every case of type II diabetes.  With that said ‘what do diabetics do then?’  They change their lifestyles immediately upon diagnosis. It’s as simple as that.  I have many patients who have been diagnosed with type II diabetes and we routinely improve their outcomes with diet and supplementation.  The solution is simple; change the diet to a low carbohydrate diet, increase exercise and support them with supplementation designed to increase insulin sensitivity.  The trick is not to lower blood sugar intensely (as this study’s goal was) it is to change their hormonal picture.  While on our program blood sugar levels do decrease because of the diet but the real change is insulin regulation.

In the article I read the answer to the question ‘what do diabetics do?’ was answered by what most would consider a prominent physician.  He said:

Focus on healthy diets and lifestyles, and take tried-and-true medicines that doctors recommend now to control health risks, said several experts, including Dr. Clyde Yancy, a Baylor University cardiologist and president of the American Heart Association.

I agree totally with the first part of the statement although I am sure the “diet” he is referring to is of the low fat variety which will not work for diabetics.  Diabetes is a disease (an I use ‘disease’ lightly) of carbohydrate metabolism.  Eating a low fat diet forces one to eat more carbohydrates.  Where is the logic in that!?

The second part of the statement is completely and totally ridiculous.  He tells us we should use “tried-and-true medicines that doctors recommend now to control health risks.”  The medications used in this study are the very drugs that almost every medical physician in this country would call “tried and true ways” to reduce cardiovascular disease.  Find me a medical physician who has any answer besides medication Lipitor or Zocor for lowering cholesterol and I’ll be surprised.  They did not make mention of the specific drugs they used to lower blood sugar or blood pressure but I am sure they are the common ones I see everyday in practice.  A statement like the one from Dr. Yancy simply doesn’t make sense in the context of what was studied.

Type II diabetes is a disease almost exclusively brought on by years of dietary indiscretions.  The fix is not drugs and this study shows that.  The fix is diet and lifestyle modification in which people significantly reduce carbohydrate consumption and begin to exercise.  Doing this improves health outcomes and has no side effect to worry about.  Depending on chemicals to do the job for you won’t work.