BLOGSCAN - The Over-Selling of Seroquel

<span style="color:#006600;">The anonymous blogger on the Clinical Psychology and Psychiatry blog has been hard at work on the story of how research on Seroquel (quetiapine, by AstraZeneca) was manipulated and oversold. His latest effort is </span><a href="http://clinpsyc.blogspot.com/2009/03/seroquel-haldol-and-full-court-media.html"><span style="color:#006600;">here</span></a><span style="color:#006600;">. Once again, a major theme is how a "key opinion leader," that is, a prominent medical academic lavishly paid as a consultant or speaker, became overly enthusiastic about his employer's product. Unforunately, academic medicine is now rife with well-paid key opinion leaders. I suspect many may have cause in the future to feel sheepish about their former enthusiasms. Meanwhile, beware marketers in academics' clothing.</span>

BLOGSCAN - The Over-Selling of Seroquel

The anonymous blogger on the Clinical Psychology and Psychiatry blog has been hard at work on the story of how research on Seroquel (quetiap...

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Putting a New Schein to the FDA?

When the national discussion seems preoccupied with the bonuses at AIG, the nomination of a new leader of the US Food and Drug Administration did not seem to get the attention it may have deserved. Last week, the president nominated Dr Margaret Hamburg to this position. As <a href="http://www.latimes.com/news/nationworld/nation/la-na-fda-chief12-2009mar12,0,3622976.story">reported by the Los Angeles Times</a>,<br /><br /><blockquote><br />President Obama has decided to nominate former New York City Health Commissioner Margaret Hamburg to head the Food and Drug Administration, turning to a onetime Clinton administration official to help right the beleaguered regulatory agency, a source briefed on the choice said Wednesday.<br /><br />Hamburg, 53, a physician who has worked extensively on bioterrorism issues, is a senior scientist at the Nuclear Threat Initiative, a Washington-based foundation focused on threats from nuclear, biological and chemical weapons.<br /><br />Though less experienced as a regulator, Hamburg has extensive government experience. She served as health commissioner in New York for six years in the 1990s before becoming assistant secretary for planning and evaluation at the Department of Health and Human Services in 1997.<br /></blockquote><br /><br />Tucked away at the end of the LA Times story, and not emphasized in other news articles, was a salient fact:<br /><br /><blockquote><br /><em>She sits on the board of medical supply distributor Henry Schein Inc</em>., but would have to surrender the position if confirmed by the Senate.<br /></blockquote><br /><br />Many now believe the FDA is in crisis, having failed to protect the people from unduly hazardous drugs and devices, and becoming too cozy with drug and device companies, which it may not regard, instead of the population as a whole, as the agencie's clients. Would Dr Hamburg's current position with Henry Schein Inc, however, jeopardize her ability to restore peoples' trust that the agency will put their interests, rather than those of health care corporations first?<br /><br /><a href="http://www.henryschein.com/">Henry Schein Inc </a>is a large distributor of health care supplies, including drugs and devices. For an example of its very extensive catalog, look <a href="http://www.henryschein.com/us-en/medical/Default.aspx?did=medical">here</a>. Henry Schein makes its profits by selling the products that the FDA regulates, particularly drugs and devices. In her role as director of Henry Schein, Dr Hamburg had a legal responsibility to enhance the finances and profits of the company and its stockholders. As we have <a href="http://hcrenewal.blogspot.com/2006/03/new-species-of-conflict-of-interest-in.html">discussed</a> many times previously, a corporate director has a legal obligation to advance the profits and financial fortunes of the corporation he or she serves. As Robert AG Monks put it, corporate directors are supposed to "demonstrate unyielding loyalty to the company's shareholders" [Per Monks RAG, Minow N. <a href="http://www.amazon.com/Corporate-Governance-Robert-G-Monks/dp/1405116986">Corporate Governance</a>, 3rd edition. Malden, MA: Blackwell Publishing, 2004. P.200.]<br /><br />As compensation for that loyalty, corporate directors are usually exceedingly well-paid for the nominal hours they spend in their meetings.So, according to the company's <a href="http://ccbn.10kwizard.com/xml/download.php?repo=tenk&ipage=5585641&format=PDF">2008 proxy statement</a>, Dr Hamburg owned the equivalent of 63,472 shares of stock (current value, at the price of $37.32, <a href="http://www.google.com/finance?hl=en&q=henry%20schein&um=1&ie=UTF-8&sa=N&tab=we">via Google Finance</a>, $ 2,368,775.04). Her total compensation in 2007 for her position as director was $249,151.)<br /><br />Given that Dr Hamburg has spent over five years living with the obligation for unyielding loyalty to the interests of Henry Schein, and has become what many people would consider rich in the process, how easy will it be for her to turn to becoming a strict regulator of the products her former company used to sell? Time will tell. But this is the <a href="http://hcrenewal.blogspot.com/2009/03/meet-new-boss-same-as-old-boss-health.html">second nomination </a>to a major health care post charged with improving the health of all citizens that has gone to someone currently obligated to protect the interests of corporations that now profiting from today's health care milieu. Let us see if this will lead to the change we need in health care.

Putting a New Schein to the FDA?

When the national discussion seems preoccupied with the bonuses at AIG, the nomination of a new leader of the US Food and Drug Administratio...

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Does Pharma Want its Researchers to Believe They Are Next to God?

In "<a href="http://www.nytimes.com/2009/03/20/us/20psych.html?_r=1">Drug Maker Told Studies Would Aid It, Papers Say</a>" (New York Times, Mar. 19, 2009), the Times discusses the case of psychiatrist Dr. Joseph Biederman. Dr. Biederman outlined plans to test Johnson & Johnson’s drugs including risperidone/Risperidal in presentations to company executives and seemed to guarantee positive outcomes for his studies of the drug, raising questions about his research.<br /><br />Biederman has become a key witness in a series of lawsuits filed by state attorneys general claiming that makers of antipsychotic drugs defrauded state Medicaid programs by improperly marketing their medicines. <span style="font-weight: bold;">His work helped fuel a rapid rise in the use of these medicines in children. </span>Biederman earned at least $1.6 million in consulting fees from drug makers from 2000 to 2007 but failed to report all but about $200,000 of this income to university officials.<br /><br />However, if a passage about Dr. Biederman's testimony in court is correct, I believe pharma should consider whether it wants to use someone who believes they are next to God in <span style="font-weight: bold;">any capacity whatsoever.</span><br /><br />There are certain damning statements that, once made by a person, cast a deep shadow over a person's character. I believe this one, if true, may rise to that level:<br /><br /><p></p><blockquote><p><span style="font-size:130%;">In a contentious Feb. 26 deposition between Dr. Biederman and lawyers for the states, he was asked what rank he held at Harvard. “Full professor,” he answered. </span></p><p><span style="font-size:130%;">“What’s after that?” asked a lawyer, Fletch Trammell. </span></p><p><span style="font-size:130%;">“</span><span style="font-weight: bold;font-size:130%;" >God</span><span style="font-size:130%;">,” Dr. Biederman responded.</span></p><p><span style="font-size:130%;">“Did you say God?” Mr. Trammell asked.</span></p><span style="font-size:130%;">“<span style="font-weight: bold;">Yeah</span>,” Dr. Biederman said.</span></blockquote><br />One does not usually joke in deposition.<br /><br />I've been Yale faculty, and would never, ever have made anything even approaching such a comment, least of all in a deposition about drug issues affecting kids. <br /><br />Let alone the the palm-greasing he was afforded, could Dr. Biederman's apparently hyperinflated ego have clouded his judgment and scientific objectivity?<br /><br />In drug R&D, that is inherently an extremely dangerous proposition.<br /><br />Where <span style="font-weight: bold;">children</span> are concerned, <span style="font-style: italic;">catastrophic </span>might be a more apt term.<br /><br />-- SS

Does Pharma Want its Researchers to Believe They Are Next to God?

In " Drug Maker Told Studies Would Aid It, Papers Say " (New York Times, Mar. 19, 2009), the Times discusses the case of psychiatr...

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March is for hoops

As a big college hoops fan, I'm pretty excited that it's finally March. Sadly, my beloved Stanford Cardinal didn't make it to the tourney, but as a proud Arizona native, I still root for my hometown Arizona State Sun Devils. I always go a little crazy -- you might even say <span class="Apple-style-span" style="font-style: italic;">mad</span> -- this time of year. I fill out my bracket, wear a lot of red and gold, and get into arguments with friends of mine from the UofA. I'm a little obsessed.<br /><br />If you're like me, then I have some good news for you. We have several products that can help you follow the tournament.<br /><ul><li>Live scores when you search for your favorite team</li><li>An iGoogle gadget for following the action</li><li>Breaking news on all the tournament excitement on Google News</li><li>Local search to find a spot to watch the game </li></ul>To get you started, we put together <a href="http://www.google.com/landing/collegebasketball09/">some helpful tips</a> about using Google to keep up with the Madness. Best of luck to you and your team! Unless, of course, they're playing ASU. ;-)<br /><br /><span class="byline-author">Posted by Nundu Janakiram, Associate Product Manager</span>

March is for hoops

As a big college hoops fan, I'm pretty excited that it's finally March. Sadly, my beloved Stanford Cardinal didn't make it to th...

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Chrome Experiments are here

When Google Chrome launched last September, it included a powerful JavaScript engine, V8, which was built to make the next generation of web applications perform faster in the browser. In the past few months, we've reached out to more than a dozen developers and designers to experiment with V8 and to find new and fun uses for JavaScript. We worked with <a href="http://www.reas.com/">REAS</a>, <a href="http://www.mrdoob.com/">Mr. Doob</a>, <a href="http://onecm.com/">Ryan Alexander</a>, <a href="http://www.jtnimoy.net/">Josh Nimoy</a>, <a href="http://www.weareinstrument.com/#/team/mark-mahoney">Mark Mahoney</a>, and <a href="http://postspectacular.com/">Toxi</a>, among others.<br /><br />The results of their experimentation have been great, with each project turning the browser window into an interactive application, a game, or even a piece of art. Whether you're a casual web surfer or an advanced JavaScript developer, we think you'll appreciate what they've achieved.<br /><br />Here's a preview of what they have built:<br /><br /><object height="344" width="425"><param name="movie" value="http://www.youtube.com/v/aZo-Uv7TZs8&hl=en&fs=1"><param name="allowFullScreen" value="true"><param name="allowscriptaccess" value="always"><embed src="http://www.youtube.com/v/aZo-Uv7TZs8&hl=en&fs=1" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="425" height="344"></embed></object><br /><br />Take a look for yourself at <a href="http://www.chromeexperiments.com/">Chrome Experiments</a>. Although you don't need Google Chrome to view the site, some of the experiments may run slower, or incorrectly, in older browsers. To download Google Chrome, click <a href="http://www.google.com/chrome?brand=CHMP">here</a>.<br /><br />Naturally, we're looking for more experiments. We will update the site regularly and promote the best projects as Featured Experiments. So, if you have an idea for a web browser experiment, please build it, make it sparkle, and submit it.<br /><br />We'll be highlighting more experiments and holding sessions on Google Chrome at <a href="http://code.google.com/io">Google I/O</a> on May 27 - 28 in San Francisco.<br /><br /><span class="byline-author">Posted by Aaron Koblin, Google Creative Lab</span>

Chrome Experiments are here

When Google Chrome launched last September, it included a powerful JavaScript engine, V8, which was built to make the next generation of web...

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A few not so random thoughts on Healthcare IT

A few thoughts for a Wednesday morning:<br /><br /><ul><li>I had recently written on some (probably) minor issues about <a href="http://hcrenewal.blogspot.com/2009/02/cchit-dissolved-involuntarily-in-april.html">CCHIT</a>, the Certification Commission for Healthcare Information Technology. However, I have more substantive concerns. I would like to know how CCHIT functions differently from a fictional <span style="font-weight: bold;">"Drug Certification Commission."</span> Imagine such a Commission founded by <a href="http://www.phrma.org/">PhRMA</a> and other pharmaceutical industry advocates, partly staffed at high levels by pharmaceutical executives, and "certifying" drugs for consumer purchase simply on the basis of their being manufactured under cGMP guidelines (current good manufacturing processes). Imagine this Commission declaring drugs "certified" without clinical trials, impartial regulatory oversight, postmarketing surveillance and in the face of equivocal studies and outright unfavorable studies showing increased risk of adverse events. How is CCHIT conceptually and substantively different from this fictional drug certification commission?<br /></li></ul><ul><li>I would also like to know how the irrational exuberance over Health IT, vastly accelerated for reasons unclear to me by the "Economic Stimulus Bill", differs from the Madoff scandal. The "Bernard Madoff" version of HIT reality promotes the point of view that even in the face of flimsy and/or <a href="http://hcrenewal.blogspot.com/2009/03/reader-on-why-we-have-busywork.html">contradictory evidence</a>, billions of dollars in investment in today's HIT is guaranteed to reap <span style="font-weight: bold;">massive rewards</span>, <span style="font-weight: bold;">no matter what</span>. Worse than Madoff's scam, those clinicians who don't invest will be penalized. In effect, the government has now taken over Madoff's Acme Anvil EMR Securities, Inc. and is forcing everyone to invest - or else.<br /></li></ul><br />-- SS

A few not so random thoughts on Healthcare IT

A few thoughts for a Wednesday morning: I had recently written on some (probably) minor issues about CCHIT , the Certification Commission fo...

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Spargel

Whenever I get the chance to practice my German with a native speaker, there is invariably a point in the conversation where we come across a word that neither of us can translate into English. At that point, the conversation typically devolves into something like the following:<br /><br />Native speaker: "It's a vegetable."<br /><br />Me: "A tomato?"<br /><br />Native speaker: "No, it's green and sometimes white."<br /><br />Me: "Lettuce?"<br /><br />Native speaker: "No, more like a spear."<br /><br />Me: "Asparagus?"<br /><br />Native speaker: "I think that's right. I'm not sure."<br /><br />These guessing games really interrupt the conversation, and sometimes you're not even quite sure you've figured out the right answer. Recently, I discovered that I can use <a href="http://images.google.com/">Google Image Search</a> as a visual dictionary and cut down on the guesswork. To get to the bottom of what spargel is once and for all, <a href="http://images.google.com/images?hl=en&q=spargel&btnG=Search+Images&gbv=2">I just searched for it</a>.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhK6-xqZ2uc9n8OLzrX30t3ilMwX9MQjlny218KGAJNdoaC6glQ3XheC4H0qjDV4ujBZkCSmBkPKnOFoD-lQQBe4Eq-4_lsGe4uxygjXzcFUQCHgDf4vSpftSN2JiOc6JcE8-hea5LskToE/s1600-h/Spargel.png"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5314564994273362642" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhK6-xqZ2uc9n8OLzrX30t3ilMwX9MQjlny218KGAJNdoaC6glQ3XheC4H0qjDV4ujBZkCSmBkPKnOFoD-lQQBe4Eq-4_lsGe4uxygjXzcFUQCHgDf4vSpftSN2JiOc6JcE8-hea5LskToE/s400/Spargel.png" style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 400px; height: 111px;" /></a>Instantly I realized it's asparagus. No 20 questions, and no guesswork.<br /><br />So the next time you're brushing up on your foreign language skills, remember Google Image Search. It may just save you from eating <a href="http://images.google.com/images?gbv=2&hl=en&q=rosenkohl&btnG=Search+Images">rosenkohl</a>.<br /><br /><span class="byline-author">Posted by Pete Lidwell, Product Manager, Google Zürich</span>

Spargel

Whenever I get the chance to practice my German with a native speaker, there is invariably a point in the conversation where we come across ...

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