Comments

Tom,

Maybe it's a culture thing, but as a guy who grew up in India with no insurance whatsoever, it's really hilarious and a little wierd to see people fighting and suing one another over side effects of essential medicine. In India, you never question a doctor's judgement, and only recently have doctors been included in the Consumer Protection Act. Evenso, not many suits have been filed against doctors or drug companies.

The only effect this will have is that prices of pharmaceuticals will go up - whether healthcare reform takes place or not.

On the other hand, companies might make consumers absolve them of any liability in the case of harmful side-effects, before selling them medicine - which is unacceptable.

A little note: The Netherlands is revamping the entire healthcare system. The total time it took for this entire change was under a year. All aspects of healthcare will be changed - premiums, compulsory healthcare insurance, choice of care, no-claim bonuses.. you name it, they've got it. Now all that remains to be seen is - Is the new system less expensive than the old? I doubt if it will be more effective. What do you think?

Warm regards

Posted by Arun Sadhashivan at November 3, 2005 4:18 PM

thanks you for saying exactly what i think. Message to govt - stop trying to make decisions for us. Educate us about risks but allow us to make our own decisions (and be held accountable for them!).

Posted by Freddie Daniells at November 3, 2005 6:43 PM

I've been using the "other" Cox-2 inhibitor for a month so far.
And I'm still here... at least that's what it seems.

Anyway, I agree... It's damned hard to love a Big Pharmaceutical company. Especially if they say that their antiviral drug is extremely difficult to make... and then a few weeks later they are proven otherwise.

Posted by Gabriel Salcido at November 3, 2005 7:32 PM

I am not keen on drugs because they never take you to the real cause of symptoms, to me they rather are like patches but I support their use in some cases and above all is what Freddie says about allowing people making their own decisions. Having said this what I would like to point out is the excellent image Mr.Peters has got on the video; I don't recall anyone mentioning it in the blog...It is outstanding that he looks better as time goes by (!)and I think it is fair to comment on this aspect - I am also all right complimenting others-. I really enjoyed the video, thanks for it!

Posted by Omara at November 3, 2005 9:29 PM

People die from nut allergies, but we still sell peanuts. Our biological systems are so complex, it would be nearly, if not completely impossible to manufacture a substance that is 100% without risk. Nature can't even do it.

I do agree with Omara, however, that we have formed an unhealthy reliance on medication, especially in recent years. Antibiotics, for example, are practically ineffectual today because we abuse them.

More people die in their bathtubs each year than they do as a result of Vioxx. Should we stop taking baths too? Hopefully not.

Posted by Tom O'Leary at November 4, 2005 8:01 AM

It would be easy to poison yourself in the supermarket spice aisle with nutmeg [for example] - impossible to "regulate" for the lowest common IQ denominator - someone weird always finds a way to abuse themselves [and perhaps others].

The USA pharma challenge is that tort lawyers still [like defeated VP John Edwards] have incredible sway over legislation that tends to reduce free enterprise pharama creativity to lapdog status for super-rich Democratic lawyers and their frivilous lawsuits.

Posted by Sean at November 4, 2005 9:50 AM

I add my own unmitigated agreement that we are over-reliant on drugs, particularly the likes of the promiscuous use of antibiotics ... reducing their usefulness exactly when you need them most. On the other hand, I am now clear, for example, that no amount of exercise or adherence to the right diet will blunt my hypertension to a totally acceptable level; likewise I am not God and do "slip" at times meaning that a statin (Lipitor in my case) is important for keeping my bad cholesterol down. I'm for P &W (Prevention & Wellness), but I'll be damned if I'm not going to take advantage of the tools that have been discovered in the last 50 years or so.

Posted by tom peters at November 4, 2005 10:03 AM

Tom - though you chose your parents well with mom living to almost 95 - I agree though - especially with stem cell remedies of the near future - maybe South Korea well ahead of us - got to take advantage of the biotech - our bodies are on loan only it seems.

Posted by Sean at November 4, 2005 10:27 AM

The greater good argument always has a common sense approach to it whether you're talking about economics, medicine, education, etc.. If we can do something that helps most people and only hurts a small portion of the population then the greater good is served ............ unless you're part of the small portion of the population that is hurt.

I'm all for personal choice and getting the government out of our lives but you can't make an argument only half way. I can't argue for the government to stay completely out of this when the government itself is one of the biggest supporters of the drug companies. They test the drugs, they approve the drugs and God knows they buy (you need only look at our new Avian Flu strategy) a ton of the drugs. So how do we intelligently argue that when they do damage our legal system (and Senators) should stay out?

I agree that a person should be able to make their own informed, educated decision. The problem with this arguement when it comes to the modern Pharma industry is that there is no way for us to get ALL of the NECESSARY information until well after the fact. If we could force Pharma to publish ALL that they have in a reasonably, consumer friendly format great ----- but they don't, and won't. They will however spend billions on advertising, marketing to doctors, financing medical seminars and other types of "educational" opportunities which push our need for them (and of course they're safe!)

It's easy to slam trial lawyers, there's quite a few folks that likely deserve it, however I'm curious as to where we would be if the line of defense that they provide weren't there. If Pharma didn't fear trial lawyers they wouldn't be working so hard to have immunity from prosecution written into all the Health / BioTerror / Immunization bills.

Arguing that trial lawyers and their lawsuits need to be limited to me is somewhat similar to arguing that our free press system should be more tightly constrained - they both are reasonable arguments if you believe that people operate with complete honesty, transparency and our best interest at heart BUT they're both dangerous and naive arguements when you realize they don't.

Every mistake that leads to death or damage caused by a doctor, hospital, procedure, drug has a reason - likely even a compelling one - that explains how it could have happened ~ that does not however, mean it's justified and that they shouldn't be punished.

My 2 cents.....

Posted by Steve at November 4, 2005 10:48 AM

My 2 cents: if Big Pharma wilfully misleads us, punish them. But if problems with a drug emerge that could not have been reasonably foreseen or only apply in a very specific and rare situation, don't. After all, you'll simply push up their costs which they'll recover from Joe Public in their next release.

My issue is with:

a) lawyers who try to kid us that that if Big Pharma hadn't worked out that you'd have side-effects if you took a combination of 4 drugs with a glass of milk and were a white, 37 years old male who had a genetic predisposition to x, that's negligence. And he's a "campaigning lawyer, exposing corporate negligence, profit before health" blah blah.

b) people who think that $75m for having a bad reaction is reasonable compenation.

Going back to the common sense thread above, we do need a sense of proportion about it. Treating every Big Pharma problem as a scandal and wilfull negligence can inure us to the genuinely bad cases.

Posted by Mark JF at November 4, 2005 11:10 AM

Mark JF:

"if Big Pharma wilfully misleads us, punish them." First of all Big Pharma WITHOUT A DOUBT misleads us. Research this stuff beyond the settlements and you will see that there is a clear history in multiple cases of significant efforts to mislead/hide facts/tell partial truths.

If Big Pharma tells us that a drug is safe. If they give us a drug that alters the biochemical makeup of our bodies - without doing or sharing enough research THAT IS BEING NEGLIGENT! They do have a responsibility to insure that their drugs are safe and when they're not to insure that the people taking them who do fall into that unsafe category are made aware of the potential safety risks. The debate I suppose is where that line of "enough" research is to be found.

You state that $75 million is not reasonable compensation - fair enough. What is a reasonable amount then? Should we base it on the value of the person that was killed or injured? Should we base it on the value of the person/company that killed or injured them? What's your value Mark - or even that of a family member or child?

Besides the whole point of punitive damages is TO PUNISH. It is to inflict financial pain for suffering and damage that you've caused. Based on Vioxx sales and Merck 3rd Quarter profits a punitive award of even $75 million (which was not the award) would only equal 3-5%. Mark if you earn for example $100k and you negligently kill someone would you call a punish where you had to pay out only $3,000 - $5,000 fair? or punishing?

The argument to give Big Pharma the benefit of the doubt is one that would be agreed with by most rational people - however, they voided that trust with a lot of people because they have a track record OF NOT being responsible when they knew that there was a risk and damage being done. This wasn't a case where they were dancing in the fields joyously helping the masses when suddenly someone suffered a bad reaction and the Big Pharma rushed to insure the public safety.

A jury found Merck guilty the first time and not guilty the second time. The award the first time wasn't $75 million it will only end up being about $25 million and the bad reaction in that case was death. This on a drug whose annual sales were more than $2.5 Billion and for a company that just posted third quarter profits of $1.42 Billion.

The legal system worked as well as it works in most other situations which is not perfect but pretty good.

Posted by Steve at November 4, 2005 3:40 PM

Horses for courses on this one. I know people who needed pharmaceutical help to give up smoking. I know people who just give up smoking without help. I know people with mental health problems who cannot survive without medication and those with mental health problems who stay alive through talking with a good counselor. There is no absolute answer on this one. Clearly where drugs are used and solve the problem we should celebrate that. My biggest concern is the enormous cost of drugs in healthcare. In the final healthcare organisation I worked for the percentage of total spending each year was about 15% which is amazing. In that organisation it meant over fifteen million pounds each year. There is a huge part of me that believes there is too much reliance on a drug ‘cures’ to non-medical problems. Having said that I personally want the best medication possible of course for any medical problem I have. Living longer is a very desirable option and if it takes drugs to enable that then I am a fully signed up fan. The Two Day “European Competitive Advantage Summit” in Birmingham, England was very good – a shame Tom was unable to make it move it to 'excellent'

Posted by Trevor Gay at November 4, 2005 6:31 PM

Sorry Trevor: "There is no absolute answer on this one" I rather disagree: 1) There is no absolute answer about anything, some folks would continue dreaming about such thing though; 2) With reference to the appropiateness in the use of drugs yes there is an answer, that is: the patient's one.

Also I insist that the health care system is business, think for instance in those cases where the healthcare professionals don't mind at all about a person dying in front of them simply because that person couldn't afford in that moment the specific treatment for him/her. What a tricky business I'd say. We have been trained to rely in organised healthcare the way that it has became for most of us,the persons of this Age, almost like a second religion if not the single one.... And this can be a feasible explanation on why a few persons dying under a drug treatment can make such a scandal, when there are thousands more who die daily and we don't care. Money talks, but of course!

Posted by Omara at November 4, 2005 9:39 PM

My late used Vioxx for arthritis, and really helped her. It became a problem for her when the drug was withdrawn, and I really wondered why there was such paranoia.

Posted by Simon at November 5, 2005 4:03 AM

I admit in front of the World that at times I use vitamins and supplements to play with my mind and body - in moderation - nothing mind blowing mind you - although even Cary Grant took LSD apparently ...

Actually I'm really into it - luckily I need no pharma for now - but am playing with Tribulus, Vit B-12 / E / C / zinc / enzymes, et al - love it - 25 and holding, that is the story I try to stick to ...

Posted by Sean at November 6, 2005 10:11 AM

Please, Tom, try to find a natural remedy if at all possible. I used a pharma remedy for prostitis, prostate infection, a few years ago, and am thankful for that cure.

But in most cases, drink more water, walk more, do yard work, garden, watch comedy films, practice compassion, pray, eat more raw fruit and vegetables.

I never have flu shots, nor do I consider a cold an illness. It's just the body getting rid of toxins and debris.

Search for herbs with curative properties, proven by thousands of years of culture usage, as in China or India.

Hope you resolve your medical issues.

Posted by Steven Streight aka Vaspers the Grate at November 6, 2005 12:48 PM

"Message to govt - stop trying to make decisions for us. Educate us about risks but allow us to make our own decisions (and be held accountable for them!)."

Freddy - Great comment and I am with you. The problem is that people are actually very poor at judging risk around complex situations (actually very poor around fairly simple ones too!!!)

This is especially compounded when the press get involved. We saw this in the UK around the MMR jab. One descredited scientific paper set off a massive panic about the jab. People stopped using it. Consequently the risk of epidemic went up (far higher risk of deaths than the supposed risk by the Jab). Vaccination is one area where actually the risk to an individual by not having the jab is very low because society as a whole is vaccinated. But if a lot of people refuse the jab the risk to society is very high. Do the needs of the many outweigh the needs of the few?

THe issue was that no matter how much info was put in front of the parents their emotions still told them that their children might become autistic because of the jab.

Information has to come from a trusted source. Who is trusted? The press (trusted but not reliable) Gov (possibly) reasonibly reliable but not trusted. The medical/scientific community - give out conflicting research papers every ten minutes! quick viagra

Posted by PaulH at November 7, 2005 7:44 AM

Thanks for that Omara – great comments. I have always held the view that healthcare is totally and only about the needs of patients. Otherwise we may as well pack up and go home now. Yes of course it all has to be affordable and yes of course there will be difficult decisions. There is never enough money in the system but in my experience too much emphasis is placed on the needs of the system rather than the needs of patients and their families. One simple answer that would go a long way to solving that would be to delegate more responsibility and money to staff at the front line in healthcare. We could release millions of pounds in the UK to invest into front line healthcare by simply letting go of the power vested in middle managers. I am now out of the National Health Service after 35 years in the service and I find it easier now to see and say how things really are in the NHS. As I type this many of my former colleagues will be writing reports that no one will read. Meetings will be taking place with no positive outcome and more and more front line staff will be told that their wonderful idea cannot be afforded. The sign I saw on the wall in one NHS office is still valid “If moral does not improve the sackings will continue.” Let me be clear, this is not the fault of the managers themselves – there are some really dedicated managers trying to change things. It is the inability of leaders in healthcare to really shake the tree and rattle the cage.

Posted by Trevor Gay at November 7, 2005 9:58 AM

alternative viagra

Tom,
You were the lucky one. A few years ago i went to an orthopedic surgeon about a shoulder problem I was having. Subsequently he x-rayed my neck, back and shoulder and gave me a steroid shot in the shoulder to reduce the pain and gave me a prescription for Vioxx. Not knowing anything about Vioxx, I trusted his decision. istarted taking Vioxx and immediately started waking up in the middle of the night with my heart racing 90- miles per hour and i don't have heart problems. After 3 days I never took another Vioxx tablet. After a short rehab period, I got on a serious exercise and weight program focused on strengthening my shoulder. As they say, it has made all of the difference since the pain and weakness are gone, even though I know there is still a calcium deposit there. This land of plenty is totally overmedicated and overprescribed. Like the orthopedic surgeon I visited only twice before we had a serious philosophical difference, I don't reward doctors who take short cuts in order to see more patients don't take the time to use pills as a last resort instead of the top of the solution list. I will not use pills unless all other avenues have been exhausted or unless I am in huge pain and there is no other immediate alternative for relief. And yes I do review the little leaflets that the pharmacist includes with the prescription, but if the potential problem such as with Vioxx is not honestly highlighted then how can the average person make a sound medical decision on their own behalf, especially since most doctors don't take enough time to know what they are prescribing.

Steve

Posted by Steve at November 7, 2005 12:14 PM

Paul H:

I don't want to get into a debate about Vaccines here - however, the MMR / Vaccine Safety debate is more complex than you illustrated here. There are far more than one discredited report and the reason that many parents stopped the shots was not based on emotion but facts (many conflicting facts at that).

I find it curious that on the same board and blog where so many people rant about the scary state of our modern medical system - there are so many people who quickly fall in line behind the latest Pharma miracle and that those who disagree are deemed to be making their decision based on "emotions".

My 2 cents...

Posted by Steve B. at November 10, 2005 11:13 PM