Ethics & Guidelines for Prescribing Drugs

     "The Journal Sentinel/MedPage Today examined 20 clinical practice guidelines for conditions treated by the 25 top-selling drugs in the U.S.
     These drugs sit in the medicine cabinets of millions of Americans -- Nexium (esomeprazole magnesium) for acid reflux, Lipitor (atorvastatin) for high cholesterol, Cymbalta (duloxetine) for depression, and OxyContin (oxycodone) for pain. Their collective sales topped $94 billion in 2011, accounting for 30% of drug revenue in the U.S.
An analysis of the guideline panels, which involved 293 doctors, found:

• Nine guidelines were written by panels where more than 80% of doctors had financial ties to drug companies.
• Four panels did not require members to disclose any conflicts of interest.
• Of the 16 guideline committees that required disclosure, two-thirds of the panel members had ties to drug companies.

     Some guidelines written by conflicted panels recommend drugs that have not been scientifically proven to safely treat conditions, leading to inappropriate or over prescribing, specifically guidelines for anemia, chronic pain, and asthma."

http://www.medpagetoday.com/PrimaryCare/GeneralPrimaryCare/36522?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&xid=NL_DHE_2012-12-19&eun=g259408d0r&userid=259408&email=novaquest@eastlink.ca&mu_id=5254360

     "The publication of an editorial questioning the benefits of high dose epoetin was canceled by the marketing branch of a journal after being accepted by the editorial branch highlighting concerns of conflict of interest in publishing.^[22]
     In 2011, author Kathleen Sharp published a book, Whistleblower’s story,^[23] alleging drug maker Johnson & Johnson encouraged doctors to prescribe epoetin in high doses, particularly for cancer patients, because this would increase sales by hundreds of millions of dollars. Former sales representatives Mark Duxbury and Dean McClennan, claim that the bulk of their business selling epoetin to hospitals and clinics was Medicare fraud, totaling $3 billion.^[24] In a lawsuit, Duxbury alleged his employer wrongfully terminated him in 1998. He lived in Gig Harbor, Washington. He was born on March 23, 1960 and died on Tuesday, October 13, 2009, at age 49, while his case was still in litigation."
http://en.wikipedia.org/wiki/Epoetin_alfa 

     My Dad was pressured by his physician into taking epoetin (~1999) for anemia. Because his physician was so insistent, in spite of the fact that it cost $1,000. out-of-pocket, he complied. There was no benefit (for my Dad), and he died of heart failure.

Dalhousie University's Caduceus Project, conceived & directed by Miro Davis