You Mean Our Corporate Overlords Don't Really Care About Us?
Inverse Benefits Due to Drug Marketing Undermine Patient Safety and Public Health, Study Finds.
ScienceDaily (Jan. 13, 2011) — Drugs that pharmaceutical companies market most aggressively to physicians and patients tend to offer less benefit and more harm to most patients -- a phenomenon described as the "inverse benefit law" in a paper from the University of Texas Medical Branch at Galveston.
Published online on Jan. 13 in the American Journal of Public Health, the article explores recent withdrawals of blockbuster drugs due to safety concerns and finds a clear pattern of physician-focused marketing tactics that ultimately exposed patients to a worsening benefit-to-harm ratio. Potential patient safety and public health implications include unnecessary exposure to adverse side effects, high medical costs and competition for scarce resources.
"This is not a random occurrence, but rather a repeating, planned scenario in which drugs, discovered with good science for a specific set of patients, are marketed to a larger population as necessary, beneficial and safer than other alternatives," said co-author Dr. Howard Brody, a professor and director of the Institute for the Medical Humanities at UTMB Health. "Marketers are just doing their jobs. However, the reality is that for most new drugs, safety and efficacy are scientifically proven for only a small subset of patients. It's time for physicians to take a stand and not prescribe them so readily."
The inverse benefit law, coined by the authors and inspired by Hart's inverse care law (1), is manifested in marketing techniques commonly deployed to extend a drug's use beyond the proper evidence base. Brody and co-author Donald W. Light, a professor at the University of Medicine and Dentistry of New Jersey, identify these strategies and illustrate the "law" with recent examples:
Guidelines that reduce diagnostic thresholds and rely on surrogate endpoints -- as seen in the steady lowering of blood glucose levels at which diabetes should be diagnosed to support glitazone drugs. Or relying on statins to lower cholesterol versus having a proven impact on the hard endpoint of decreasing heart disease incidence.
Exaggerated safety and efficacy claims -- as many as 140,000 cases of serious coronary disease in the U.S. might have been caused by rofecoxib, a COX-2 inhibitor, that was broadly marketed as safer and more effective than standard nonsteroidal anti-inflammatory drugs.
"Disease mongering" -- Osteopenia, once considered a non-disease state in patients who had not lost enough bone density to be diagnosed with osteoporosis, has now turned into a disease itself, in hopes of convincing physicians and patients that biphosphonate drug treatment will prevent their "disease" from progressing.
Encouraging unapproved uses -- three of five prescriptions for antipsychotics are for off-label use, even though 75 percent of those prescriptions lack evidence of benefits but expose patients to harm. Recent examples include gabapentin and olanzapine.
"While we looked only at marketing directed toward physicians, direct-to-consumer advertising plays a critical role in driving demand for a drug by patients who fall outside the group that might truly need it, and pressuring physicians to prescribe it more readily," said Brody. "European countries are now debating whether to join the U.S. and New Zealand in allowing DTC advertising and we hope that our work could help inform that discussion."
Brody and Light recommend a series of remedial actions, including: restrict writing usage guidelines to groups free of commercial conflicts of interest; independently fund and design trials focused on safety and efficacy; and create a neutral agency (e.g., a branch of the National Institutes for Health) to conduct drug trials, including comparative effectiveness research to improve evidence-based prescribing.
The authors point to recent efforts such as the National Physicians Alliance's Unbranded Doctor Campaign and The Physician Payment Sunshine Act as positive steps toward a safe marketplace where physicians and patients access valuable, effective drugs.
"There is an unintended, but direct conflict between pharmaceutical marketing and public health," said Brody. "Physicians should approach commercial marketing by pharmaceutical companies with a critical eye. Future reform polices should look to reduce, minimize and limit these practices. Patients can also play an important role by being more skeptical of drug ads … and remember, the most important directive in them is to 'talk to your doctor'."
(1) Hart JT. The Inverse care law. Lancet. 1971;1 (7696); 405-412.
They apparently just want the money. I'm shocked!
No. 2 Bank Overcharged Troops On Mortgages
NBC News exclusive: JPMorgan Chase also improperly foreclosed on homes.
The overcharges may never have come to light but for Rowles, 31, and his wife, Julia.
"It's been a nightmare. It's been my living nightmare," Julia Rowles said of her experience with Chase, in an interview with NBC News in Beaufort, S.C.
The saga began in 2006 when Rowles went on active duty. Under the SCRA, he could get his mortgage interest rate, which was adjustable and rising, lowered to 6 percent.
But Chase took a few months to lower Rowles' rate, overcharging the family, Rowles says, by as much as $900 a month. In the fall of 2006, Chase finally began charging Rowles the correct 6 percent rate. For the next year or so, everything went relatively smoothly.
Then, two years ago, the Rowles family says, Chase began hitting them with collection calls that escalated to sometimes three a day, claiming they owed as much as $15,000.
"Saturday, Sundays, middle of the night. It did not matter if it was a holiday," Julia said. "Collection calls at 3 in the morning. He would state, "I'm in California. I'm stationed here in Miramar. It's 3 in the morning. What are you doing calling me?" "Well, sir, this is an attempt to collect a debt."
She said they threatened to take the house and report the family to a credit agency, even though the Rowles family didn't owe the bank anything and never missed a payment.
No - we don't need no stinkin regulations on banks; or any other corporations. They are the lifeblood of the country. They outsource jobs...I mean create them. They only focus on profit...I mean good business practices. When they make a mistake...nah, they almost never do that! Don't they do what is good for themselves AND the customer? Sure, but only when they have to.
They will not do the right thing unless they are forced - don't want to lower profits, dont'cha know.
And You Thought I Was Exaggerating The Threat Of Fascism
Big Media Gets Bigger as FCC and Justice Department Approve Comcast/NBC Merger
As brutal ironies go, it will be tough to beat this one.
On the same day that President Obama launched a drive to identify what he referred to as "excessive" regulation of business, the Federal Communications Commission and the Department of Justice—both of which are defined by his appointments—effectively abandoned more than a century of antitrust principles and approved one of the biggest corporate mergers in American history.
Instead of regulating the telecommunications industry, the FCC's vote to approve Comcast's proposed acquisition of a majority stake in NBC Universal—creating a conglomerate that will be the largest cable provider, the largest Internet provider and one of the largest producers of content in the United States—represents the ultimate surrender to the demands of corporate America.
"Once we allow companies to become this powerful, the FCC does not regulate them," says Vermont Senator Bernie Sanders. "They regulate the FCC," says the senator.
No reasonable regulator would debate Sanders's point—or the threat to democracy posed when traditional protections against media monopoly are abandoned.
Unfortunately, there was only one reasonable regulator on the FCC, Commissioner Michael Copps.
Copps, a stalwart defender of media diversity and the public interest, cast a lonely vote against the Comcast/NBCU merger.
"Comcast's acquisition of NBC Universal is a transaction like no other that has come before this Commission—ever," argued Copps, the one Democrat on the commission who was not appointed by Obama. "It reaches into virtually every corner of our media and digital landscapes and will affect every citizen in the land. It is new media as well as old; it is news and information as well as sports and entertainment; it is distribution as well as content. And it confers too much power in one company's hands."
FCC chair Julius Genachowski, an Obama appointee, backed the merger, as did the other Democrat appointed by the president, Mignon Clyburn. They joined the two Republican members of the commission on the pro-merger side of a 4-1 vote.
By any measure, it was the wrong vote—as was the Justice Department's dismissal of antitrust concerns raised by the deal.
Copps says: "The Comcast-NBCU joint venture opens the door to the cable-ization of the open Internet. The potential for walled gardens, tollbooths, content prioritization, access fees to reach end-users and a stake in the heart of independent content production is now very real."
Parallel objections came from the savviest observers of media issues on Capitol Hill.
"Big media just got a lot bigger," declared Congressman Maurice Hinchey, the New York Democrat who chairs the congressional Future of Media Caucus. "The FCC's decision to allow Comcast to acquire NBC Universal will burden the American people with more media consolidation, fewer independent sources of information and higher cable bills. I have no doubt that today's decision will lead to more mega media mergers in the near future. That is certainly not in the public interest."
Senator Al Franken, D-Minnesota, was equally adamant, "The FCC's action today is a tremendous disappointment. The commission is supposed to protect the public interest, not corporate interests. But what we see today is an effort by the FCC to appease the very companies it's charged with regulating," said Franken. "With approval of this merger, the FCC has given a single media conglomerate unprecedented control over the flow of information in America. This will ultimately mean higher cable and Internet bills, fewer independent voices in the media and less freedom of choice for all American consumers."
Franken vows to fight "any further media consolidation of this kind."
Unfortunately, while Franken and others fight that battle, President Obama will be busy battling a fantasy: the illusion that business is excessively regulated. If Tuesday's decisions by the FCC and the Justice Department confirm anything, it is that business has little to fear from regulators.
Anyone Here Still Think That The Healthcare Insurance Companies Don't Need Regulation
Insurance Company Drops Cancer Patient, Veteran, Because He Accidentally Underpaid By Two Cents
One of the worst abuses of the private health insurance industry is the practice of denying claims to pay for necessary care or revoking the coverage of policyholders for frivolous reasons. A Vietnam veteran from Thornton, Colorado, is the latest victim of this practice.
Vietnam vet Ronald Flanagan has been battling cancer for more than two years. Two weeks ago, Flanagan was getting prepped for a bone biopsy at the local Exempla Rock Creek Medical Center. But at the last minute, his wife called the hospital and told them to stop the procedure because she had just received notice that they no longer have insurance. The reason why? The couple had accidentally underpaid their insurer by two pennies and it decided to drop them from their plan:
Two pennies. That’s the difference between a potentially life-saving surgery, and a dropped insurance plan. Those two cents could cost Vietnam veteran Ronald Flanagan everything. “Everybody we talk to is very surprised that two cents is enough to do this,” said Flanagan.
It was an innocent enough mistake, according to Ron’s wife, Frances Flanagan. “If I only had just hit the nine instead of the seven,” Frances said. When she was paying their monthly health insurance premium online in November, Frances swapped a 7 for a 9, leaving their $328.69 payment two cents short.
In a statement provided to a local news station, the couple’s insurer, Ceridian Cobra Services, explained, “Since the payment was not full, it fit into the definition in the regulations of an ‘insufficient payment’ … Ceridian understands nothing is more importantthan one’s health.” Local station ABC 7 interviewed the Flanagans about their plight. “I felt that it was all my fault,” said Mrs. Flanagan, who made the accounting error, choking back tears. Watch it:
The recently passed health care law — which congressional Republicans are unanimously trying to repeal — includes a whole host of protections that would rein in the ability for health insurers to drop patients for frivolous reasons like this. If Republicans are successful, these protections would disappear.
However, in the long run, it’s worth noting that one of the best ways to prevent the situation that the Flanagans are in is to offer them access to a public, not-for-profit system like Medicare, which has a higher approval rating than private insurance, runs more efficiently than any private insurer, and that most Americans want to be able to join.
Here's a post from the forum after this article by Den Hickey
Next time you talk to a Libertarian who thinks all we need is to get government out of the way of business... ask them how they feel about insurance companies looking for ways to cancel the policies of cancer patients, which is effectively a death sentence since they can't get coverage with anyone else for their "pre-existing condition".
Read Deadly Spin by Wendell Potter to learn more about the companies that repukes protect.
AT&T Sued for Fraudulent Data Usage Billing
Anne Landman on February 1, 2011
A class-action lawsuit filed against AT&T alleges the company routinely overstates web-server data traffic on its monthly bills by 7 to 14 percent, most notably for IPhone users. Plaintiffs allege that AT&T "bills for phantom data traffic when there is no actual data use initiated by the customer." Independent consultants report that they bought a new IPhone and disabled every possible source of data connectivity they could possibly find on it, yet within ten days their account had logged 2,292 KB of data usage on the phone. The suit says, "This is like the rigged gas pump charging you when you never even pulled your car into the station." Plaintiffs allege breach of contract, unjust enrichment, fraudulent and unfair business practices. AT&T intends to defend itself vigorously against the suit, and that "Transparent and accurate billing is a top priority" for the company.
This can't be true, can it? Corporations would never do this to a "customer", would they?
Just to make more money? Holy crap!
Holy Crap! You Mean This Story We've Been Told Isn't True Either?
Report: Wal-Mart actually kills jobs, creates taxpayer burdens
NEW YORK - Wal-Mart's lengthy struggle to open in New York City has hit fresh problems -- a controversial report that said America's biggest discounter does not just sell cheap, it makes neighborhoods poorer. The report concludes that Wal-Mart, the biggest U.S. private employer, kills jobs rather than creates them, drives down wages and is [...]