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Beware Hidden Drug Company Agenda

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By DAVID LUBIN

Published: September 20, 2007

The Tribune, on Aug. 27, published an 'other view' written by Peter Pitts, entitled 'One Size Medicine Does Not Fit All.' What Pitts said just wasn't right, at least as far as I was concerned. In essence, he was condemning those who believe in the concept of 'evidence-based medicine.' I believe in it.

You look at treatments and outcomes and decide, by the evidence, what seems to work and what doesn't. For instance, we know that most sore throats are caused by viruses, so those who receive antibiotics probably won't get better with them because antibiotics are not effective against viruses. That's the evidence. Sure, some get better, but they probably would eventually anyway.

Most doctors agree, but for some reason, to appease patients or parents of children with earaches (which also have been shown to get better without antibiotics), they continue to prescribe antibiotics inappropriately. And thus physicians have contributed to the emergence of bacteria that are resistant to the routine antibiotics we use.

Although Pitts might feel that Zithromax is worth the cost, it's not a very useful antibiotic, even when indicated for a bacterial infection, because of the resistance developing to it. And the newer, more expensive antibiotics are just as worthless in treating viruses as the older, cheaper ones.

He then compares what legislators are trying to do to a one-size-fits-all, top-down solution to improve health care. A bill would authorize $3 billion for new research 'on the comparative effectiveness of health care services to inform health care providers.' I see studies all the time that one drug is more effective than another, and if there is a connection between efficacy and cost, I'd like to know, and so would my patients who might have to pay $250 for a newer drug rather than $10 for an older generic medication.
Pharmaceutical companies are mixing and matching what is already available, mainly because patents are running out, thus bringing generics to the forefront. So they put together two meds and charge more money for it, and invariably tell physicians that the two together are always more effective than if both are taken individually. I know, it's hard to believe, isn't it?

Did I mention that CMPI, of which Pitts is the president, is a project of the Pacific Research Institute for Public Policy? Formed in 1979, it promotes 'the principles of individual freedom and personal responsibility. The Institute believes these principles are best encouraged through policies that emphasize a free economy, private initiative and limited government.'

Two corporations listed as being involved with PRI include Pfizer, maker of the pricey drugs Lipitor, Viagra and the new tobacco-kicking Chantix, which sells for more than $100 for a month's worth. Also listed as a corporation with involvement on the PRI Web site is PhRMA, the Pharmaceutical Research and Manufacturers of America. PhRMA, in turn, represents about 50 pharmaceutical companies and is one of the largest and most influential lobbying groups in Washington.

David Lubin is a Tampa physician.

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