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CDC over-hyping Tamiflu, pharma buying doctors’ attention, and improving the social determinants of health

February 12, 2015

In order to bring you more of the news you want to read, RightCare Weekly summarizes and interprets three important articles and provides headlines linking to the many other articles and editorials you’ll find interesting. As always, RightCare Weekly presents articles related to moving our healthcare system toward the right care for all patients.

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Features:

  • Tamiflu is a widely-hyped antiviral drug used to treat the flu. Countries across the world have stockpiled the drug, for use in case of a serious flu pandemic, but it’s still unclear just how effective the drug is in terms of relieving symptoms or reducing the risk of serious complications. A new paper in the Lancet has rekindled that debate. The new trial claims that Tamiflu not only reduced symptoms for patients, but also it reduced hospitalizations – a finding that’s out of line with the most credible prior analysis. And as with previous studies, the analysis is subject to substantial biases: Tamiflu manufacturer Roche funded the initial trials and provided the data, and the study was funded by MUGAS, which Ryan Radecki, MD, points out looks like a “puppet foundation fraught with conflict-of-interest.” Two of the four authors have financial conflicts of interest with the drug’s manufacturer or patentholder. The lack of clear evidence that Tamiflu works hasn’t stopped the CDC from promoting Tamiflu. CDC Director Tom Frieden, MD, has been hyping the benefits of Tamiflu in the media, including the questionable claim that it reduces hospitalizations and mortality. Jeanne Lenzer reports in The BMJ that the CDC receives substantial funding from the pharmaceutical industry, including $174,800 from Roche to “support qualitative research into influenza prevention and treatment messaging.” Even at the CDC, it looks like money talks.

 

Question: Should the nation’s premier public health agency take money from the pharmaceutical industry?

  • Health continues to be too focused on the biomedical and not enough on other determinants of health, says America Bracho, MD, executive director of Latino Health Access, and a keynote speaker at next month’s Lown Institute annual meeting in San Diego. Many unhealthy lifestyles are linked to socio-economic determinants like poor nutrition and lack of physical activity, and in Bracho’s view addressing some of these drivers of ill-health can prevent illnesses from taking hold in the first place. “Some people blame the sick for not eating more fruits and vegetables to stay healthy… but they cost more and you need more money to buy them. So there are circumstances in one’s life that do not allow people to make the right choices,” she said in a recently posted commentary. Lown Institute Vice President David Martin, echoes the same in a Boston Business Journal op-ed last week. “The tragedy of our current system, despite all our reforms, is that it still revolves around treating patients after they have become sick and does little to address the systemic causes of illness and disease, he said.

 

  • Last Week Tonight with John Oliver took on the scandal of pharmaceutical company advertising. Viewers are introduced to a wide range of shady pharmaceutical industry practices, including direct-to-consumer advertising, using under-informed, but attractive drug reps to push medications, free lunches and drug samples, and paying physician “thought leaders” to promote drugs for off-label uses. The vast sums companies spend on marketing make it seem like “Drug companies are a bit like high-school boyfriends: They’re much more concerned with getting inside you than being effective once they’re in there.”  Fortunately, more and more data on pharmaceutical company payments to doctors is being released. The segment closes with a smart suggestion for patients: “Pharmaceutical money: Ask your doctor if his taking it is right for you.”

 

Announcement:

Interested in improving residency education and helping young physicians learn to provide right care? Submit your abstracts to ICRE, the International Conference on Residency Education. Submissions are due March 6th. Find out more here.

 

Headlines:

 

Patient-centered care

 

End-of-life care

 

Quality improvement

 

Healthcare reporting

 

Social determinants of health

 

Public health

 

Choosing Wisely

 

Insurance system

 

Payment system

 

Patient safety

 

Anti-vaccine movement

 

Data privacy

 

Nursing homes

 

Personalized medicine

 

RightCare Weekly is made possible through the generous support of the Robert Wood Johnson Foundation

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