Panaceia or Hygeia

immunize yourself against the pandemic of lifestyle diseases

Posts Tagged ‘AstraZeneca’

Drug Dealers Fund Doctors’ Education

Posted by Colin Rose on September 10, 2009

Here is a classic example of Big Pharma controlling what doctors get to hear during “continuing medical education”. Big Pharma pays big money to have their logos appear below that of McGill, a presumed institute of higher learning that is tacitly approving of their drugs and the methods they use to promote them.

There is always the meaningless disclaimer about how the grants are “unrestricted”. Just try inviting a speaker who is at all critical of Big Pharma and see how fast the grant disappears.

How much does the McGill Faculty of Medicine receive? How much of the money goes into undergraduate education? Is the money also influencing what gets taught to medical students?

Write to the Dean of the Faculty of Medicine, Richard Levin,  and try to get his answers. Lots of luck.

McGill-Refresher-Course-Drugs

Posted in cme, continuing medical education, drug marketing, professionalism | Tagged: , , , , , , , , , , , | Leave a Comment »

AstraZeneca pays medical students

Posted by Colin Rose on April 13, 2009

So it has finally come to this. It is not enough that drug dealers fund medical school faculties, now they are paying medical students. Anyone who thinks this donation to a bursary fund by one of the most aggressive drug marketers is not going to give them a lot of influence over drug policy in New Brunswick is very naive. Insidiously, the entire medical profession is becoming a marketing branch of drug dealers.

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Bursary program launched for med students

Cindy Wilson/Telegraph-Journal

Published Friday April 3rd, 2009

newbrunswick-az-photo

SAINT JOHN – The first donation Thursday to a new trust fund will allow two medical students to receive four years of free education at the Saint John medical school.

Mark Jones, president and CEO of AstraZeneca, said he hopes his company’s $500,000 donation will help kick-start the New Brunswick Medical Education Trust.

The aim is to raise enough money to pay for the education of 10 students per year. In return, the students will have to promise to stay and work in the province.

The New Brunswick Medical Education Trust was established Thursday afternoon when AstraZeneca Canada Inc., a pharmaceutical company, donated the first $500,000 toward the bursary program.

“The hardest donation to get is the first one,” said Mark Jones, president and CEO of AstraZeneca.

“Once you have somebody, it’s easier to bring others in. We just hope this donation will help kick-start this program.”

Dr. Donald Craig, chairman of the Medical Staff Organization of Zone 2, Regional Health Authority B, said the $500,000 was the first step in raising $15 million for a sustainable bursary program.

Craig said the money will be invested and the return on investment will pay the tuition for 10 medical students each year to study in the province

“We will pay the tuition for four years of medical school. We will probably find them summer work. If they are married, we will try to find their spouses jobs and in return we are asking for a service contract,” Craig said.

Craig said it has not been determined how long the bursary students will be required to live and work in the province.

He said the return on investment for the $500,000 donation received Thursday will pay for the tuition for two medical students who will study in New Brunswick when the medical program opens in September 2010.

Craig said business, governments and citizens will be asked to contribute to the trust and eventually enough money will be raised to fund 10 students per year.

“I hope the donation encourages other pharmaceutical companies. I hope it encourages communities in the province and governments provincially and federally, big industry, big business. We are going to be looking at all those aspects for help,” Craig said.

The trust was established by the Saint John Regional Hospital Foundation and the Medical Staff Organization as a way to attract and retain doctors in the province.

On Thursday, Jones presented the cheque to the trust at an event held at the Regional Hospital.

When he was approached about the project, he said, the story of the challenges New Brunswick has faced in setting up the medical school and recruiting doctors was compelling and he wanted to be part of the effort toward change.

Health Minister Mike Murphy was on hand for the announcement and said there will be more announcements to come.

Murphy said Nova Scotia receives $150 million in research each year while New Brunswick gets $9 million for clinical trials. He said, in time, he believes the province can “outstrip and out rival Nova Scotia.”

“You will hear from the government and myself in several weeks with some exciting news about an initiative the government wants to put together,” Murphy said. “There is a necessity to have an infrastructure base and to have researchers here in Saint John, because as we know those who are going to teach in medicine will want to teach, practise and research. We are working very hard on that.”

Posted in drugs, ethics, professionalism, statins | Tagged: | Leave a Comment »

OBSTAT-Doctors being paid to push drug study

Posted by Colin Rose on April 3, 2009

“Dr. LeLorier reports having served as a paid speaker or consultant for the following manufacturers of statins: Merck Frosst Canada, Pfizer Canada, AstraZeneca, and Bristol-Myers Squibb.” Why would anyone take any advice on statins from him?


Doctors being paid to push drug study
BY TOM BLACKWELL
National Post
03 Apr 2009

Quebec doctors are being offered $100 for every new patient they put on cholesterollowering statin drugs as part of a major, federally subsidized study that is raising questions about the influence of the pharmaceutical industry on health…read more…

Posted in cardiology, drug marketing, drugs, ethics, professionalism, statins | Tagged: , , | Leave a Comment »

Taliban’s super success: opium

Posted by Colin Rose on November 28, 2008

If it weren’t for heroin addiction the Taliban would not exist and we would not be fighting a war in Afghanistan. Until we conquer the problem of addiction in our society there will always be criminals, terrorists and drug companies preying on the misery of addicts. Another example: instead of dealing with junk food addiction we would rather spend $many billions on drugs to treat its symptoms. The recent report of the JUPITER trial, funded by AstraZeneca and really an infomercial for Crestor, is a good example. No attempt was made to treat the addiction of the mostly overweight or obese subjects in trial. Only a drug was tested to treat the metabolic manifestations of the addiction, like “dyslipidemia” and CRP. Consequently many of the subjects became diabetic.


Taliban’s super success: opium
KIRK KRAEUTLER NEW YORK TIMES
The Gazette
28 Nov 2008

UNITED NATIONS  Afghanistan has produced so much opium in recent years that the Taliban are cutting back poppy cultivation and stockpiling raw opium to support prices and preserve a major source of financing for the insurgency, says the head of the…read more…

Posted in addiction, diabetes, Type 2, drugs, junk food, obesity, statins | Tagged: , , , , , , , , | Leave a Comment »

JUPITER is a gas giant

Posted by Colin Rose on November 21, 2008

An excellent article by André Picard in today’s Globe and Mail, the only story on JUPITER I have seen in the lay press that reveals the massive fraud behind the reporting of this “study”.

JUPITER is aptly named. It’s gigantic. Probably the largest, most expensive drug trial in history. When one looks below the surface of the publication in the NEJM, the results are about as exciting as the Jovian composition. A lot of gas. I would conservatively estimate that this “study” cost at least $500 million. But if you are AstraZeneca and stand to sell $many billions worth of Crestor because of this paper that’s small change. And junk food addicts, who comprise most of the subjects of JUPITER have one more excuse, however deceptive, to continue their self-destructive habits.

Here is my opinion posted in the NEJM blog on the paper.

nyt-jupiter-unethical

A more detailed analysis of the marketing driven deception and lack of professionalism in the paper by Sandy Szwarc.

Another perspective by John McDougall similar to mine on the big lie behind the claim that many “healthy” people need Crestor..

When all of these criticisms are considered it turns out that JUPITER is nothing more than a thinly disguised  infomercial for Crestor and should never have been published in a presumably high quality journal like the NEJM. But in being able to make this paper freely available on the web (and not wait 6 months like other papers) the NEJM must have received a large payment from AstraZeneca.

Non-blinded statin trials like JUPITER, have the potential for bias in subjective outcomes like the decision to do an angioplasty or coronary bypass, outcomes that constitute the vast majority of the combined endpoint. Also, it is quite likely that when the JUPITER subjects knew that their blood LDL was low because they were taking Crestor they had less incentive to change self-destructive lifestyles. That is probably why the group treated with Crestor had significantly more diabetes. In light of the JUPITER trial the Therapeutics Initiatives group at the University of British Columbia has updated their recommendations for use of statins in primary prevention, which would include people like those entered into the JUPITER trial, and concluded that “statins do not have a proven net health benefit in primary prevention populations and thus when used in that setting do not represent good use of scarce health care resources.

See a slide show on JUPITER and “dyslipidemia”.

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Lead “investigators” of JUPITER

Paul M Ridker, M.D., Eleanor Danielson, M.I.A., Francisco A.H. Fonseca, M.D., Jacques Genest, M.D., Antonio M. Gotto, Jr., M.D., John J.P. Kastelein, M.D., Wolfgang Koenig, M.D., Peter Libby, M.D., Alberto J. Lorenzatti, M.D., Jean G. MacFadyen, B.A., Børge G. Nordestgaard, M.D., James Shepherd, M.D., James T. Willerson, M.D., Robert J. Glynn, Sc.D., for the JUPITER Study Group

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Dominican Republic

What typical JUPITER subjects would look like. These are "apparently healthy" people? Is it not unethical to prescribe drugs to these people to "treat" the symptoms of their self-destructive lifestyles?

Nowhere in the JUPITER paper will you see it mentioned that CRP can be markedly reduced with cost-free lifestyle change alone, no statins, as shown in this paper in the Journal of Applied Physiology in 2006, results of which are summarized below. The subjects in the JAP paper were just the same as in the JUPITER study, obese people, many with metabolic syndrome but the authors did not call them “apparently healthy”. They had nothing to sell.

jap-diet-crp

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When it comes to statins, don’t believe the hype

November 20, 2008
The Globe and Mail
André Picard”Cholesterol drug causes risk of heart attack to plummet” – Fox News.

“Cholesterol-fighting drugs show wider benefit” – The New York Times.

“Cholesterol drug cuts heart risk in healthy patients” – The Wall Street Journal.

The New York Times article summarized the exciting news in a front-page story saying that “millions more people could benefit from taking the cholesterol-lowering drugs known as statins.”

That’s big medical/business news, because statins are already the bestselling drugs in the world, with sales in excess of $20-billion (U.S.).

Quoting some of the world’s top heart researchers, media reports touted the importance of a blood test for C-reactive protein. That’s because those benefiting from statins had high levels of CRP (a marker for inflammation) rather than high levels of LDL cholesterol, which is usually the criterion for statin prescription.

The news stories were based on research published last week in the prestigious New England Journal of Medicine and presented, with much fanfare, at the annual convention of the American Heart Association.

Like much reporting on medical research (and drug research in particular), however, there is more (or, more accurately, less) to these stories than meets the eye.

The principal finding in this study was that participants who took a statin pill recorded a 50-per-cent reduction in the risk of heart attack, stroke, surgery and death compared with those who took a placebo (a sugar pill).

Who wouldn’t be wowed by those numbers? Who wouldn’t want that miracle drug?

But the benefits are relative risk reductions.

When you look at the raw data in the study, they reveal that 0.9 per cent of statin users had cardiovascular problems. By comparison, 1.8 per cent of those taking a placebo had heart problems.

There were 17,802 participants in the study, yet there were only 83 cardiac events among statin users, compared with 157 in the placebo group. That’s 50 per cent fewer.

Are those really “dramatic” findings? Do statins really make heart attack risk “plummet”?

According to a cautionary editorial in the New England Journal of Medicine (which received virtually no mention in news reports), 120 people in this study needed to be treated with a statin for two years to see a benefit in one person.

That’s a lot of people taking a pricey drug ($3 Canadian a day) for no benefit – not to mention that there are risks.

While researchers (and journalists who report on studies) love to highlight benefits of drugs, they too often gloss over risks.

Like all drugs, statins have side effects. The drug used in the study, rosuvastatin (brand name Crestor), has been associated with muscle deterioration and kidney problems.

In the study, those taking statins had a higher risk of developing Type 2 diabetes – 3 per cent compared with 2.4 per cent of those taking a placebo. That’s a 25 per cent higher relative risk among people with very little heart disease to begin with.

As noted earlier, researchers (and news stories) suggested that, based on the findings, the number of patients taking statins could and should expand dramatically.

But is that really what the research tells us, even in its most optimistic interpretation?

The study involved exclusively men older than 50 and women older than 60 who did not have high cholesterol or histories of heart disease or inflammatory illness. All the people in the study needed to have low cholesterol and high CRP.

Initially, researchers recruited 90,000 people in those age groups, but more than 80 per cent of them were deemed ineligible. This is a very select population.

To say, by extrapolation, that these “dramatic” (read: modest) benefits apply to the general population is erroneous.

Similarly, while it is true that about half of all heart attacks and strokes occur in people whose cholesterol is not considered high, does that mean everyone should get a blood test to measure levels of C-reactive protein? Hardly.

Yes, there is more heart disease among people with high levels of CRP, but the jury is still out on what this means.

Some scientists believe that because CRP – secreted in response to inflammation – is present in plaque, it increases the risk that the plaque will burst, leading to blood clots that cause heart attacks. But other researchers think that CRP levels are, at best, a telltale sign of heart disease, a bit like grey hairs are a sign of aging – not its cause.

The CRP test is expensive at almost $50. And it’s worth noting that one of the principal authors of the new research holds the patent on the test and makes money every time it is used.

When you cut through all the hype and the self-interest, what we know is this: Statins reduce levels of [LDL] cholesterol. This is beneficial to people who have had a heart attack or other serious heart problems.

But for otherwise healthy people, high CRP levels or not, the potential benefits of taking statins are marginal, and the risks are not insignificant.

Hardly the stuff of dramatic newspaper headlines.

Posted in atherosclerosis, cardiology, cholesterol, coronary artery disease, death, diabetes, diabetes, Type 2, drugs, junk food, obesity, professionalism, statins, waist circumference | Tagged: , , , , , , , , , , , , , , , , , , | 2 Comments »

Statins added to WHO list of “essential” drugs

Posted by Colin Rose on May 10, 2007

Well, it finally happened. The statin peddlers convinced WHO to add statins to the list of essential drugs.

But look at who was behind the initiative, Dr Gotto

Dr. Gotto receives many thousands of dollars from statin peddlers.

Here is a disclosure statement from a recent publication

“Antonio M. Gotto, Jr., MD, DPhil, serves as a consultant for
AstraZeneca, Bristol-Myers Squibb, Johnson & Johnson-Merck, Kos
Pharmaceuticals, Kowa, Merck & Co., Inc., Merck-Schering Plough,
Novartis, Pfizer Inc, and Reliant Pharmaceuticals.”

Surely this should have been mentioned in the Cornell press release.

Personally, I refuse to take any advice from anyone who receives even one cent from a drug dealer.

I completely agree with Dr Kishore’s statement:

“Increasingly, ‘Western’ high-fat diets, tobacco use and urbanization have
helped make heart disease a bigger killer than ‘The Big Three’—HIV/AIDS,
tuberculosis and malaria—combined.”

Indeed, high risk individuals have high risk lifestyles.

But the FIRST thing to do is change the diet and eliminate tobacco BEFORE labeling statins essential drugs. To do otherwise will reduce any incentive to improve lifestyle and make the obesity and diabetes pandemic even worse.

Do you think that the “developing” world is going to be happy with generic simvastatin? Not likely. They are going to start demanding patented Crestor and Vytorin, just like the rich Americans.

Cubans take no statins but live longer than Americans? If statins are not essential in Cuba, why should they be in Africa?
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Weill Cornell Medical College Students Help Change Global Health Policy

NEW YORK (May 21, 2007) – In a move to improve global public health, Weill
Cornell Medical College students have helped place a lifesaving heart
disease drug onto the World Health Organization’s (WHO) list of essential
medicines. This list is a guideline for developing countries to choose which
high-priority drugs should be supplied to their citizens inexpensively.

Students from Weill Cornell’s chapter of Universities Allied for Essential
Medicines (UAEM) answered the charge of Dr. David Skorton, President of
Cornell University, and Dr. Antonio M. Gotto Jr., dean of Weill Cornell
Medical College, to “seek new strategies for Cornell to advance public
health” across the globe.

“I am extremely proud that the students at Weill Cornell Medical College
have had such an admirable influence on global health policy,” says Dr.
Skorton, who is also a professor of internal medicine and pediatrics. “Such
actions by our students show the promise of their future leadership.”

“Adding this medicine to the list of essential medicines represents an
exceptional achievement by our students,” says Dr. Gotto, an internationally
renowned expert in heart disease prevention, who served as the senior
advisor for the project. “Because of the students’ success, over 150
national governments that work with WHO will be encouraged to recognize
heart disease as a serious health concern deserving of great medical
attention.”

UAEM comprises a national group of students whose goal is to determine how
universities can help ensure that biomedical products, including medicines,
are made more accessible in poor countries and further the amount of
research conducted on neglected diseases affecting the poor.

“For years, it was thought that heart disease was a concern of affluent
countries. But, today, nearly 80 percent of all deaths due to heart disease
occur in the developing world,” says Sandeep Kishore, an MD-PhD student at
Weill Cornell Medical College who helped spearhead the initiative with UAEM.
“Increasingly, ‘Western’ high-fat diets, tobacco use and urbanization have
helped make heart disease a bigger killer than ‘The Big Three’—HIV/AIDS,
tuberculosis and malaria—combined.”

Kishore and Ben Herbstman, UAEM members, petitioned WHO that simvastatin
(Zocor)—originally manufactured by Merck—be added to the list. Simvastatin
was selected based on its worldwide availability, cost-effectiveness and the
interest of generic firms in producing it. Such statin medicines have been
shown to lower low-density lipoprotein cholesterol (LDL) levels, commonly
known as “bad cholesterol,” by 25-30 percent in individuals at high-risk for
heart disease.

Last month, the students from UAEM — with the assistance of medical
librarians from Weill Cornell’s Samuel J. Wood Library & C.V. Starr
Biomedical Information Center — were successful in their efforts to get a
generic version of Zocor included on the list of essential medicines. Now,
the United Nations and other philanthropic foundations can donate large
numbers of the statin drug to the national pharmaceutical inventories of
developing countries.

Furthermore, generic versions of the medicine will be sold at a fraction of
their original price tag. The drug will cost as little as $40 per year per
person—10 cents a day—down from nearly $1,200 a couple of years ago.

The announcement comes on the heels of Cornell University’s new Africa
Initiative, a university-wide movement to promote sub-Saharan African
development and health.
The Weill Cornell chapter of UAEM has hosted an ongoing series of global
health events. On June 15, the former CEO of Merck, Inc., Dr. Roy Vagelos,
will present a lecture titled “Corporations Can and Should Do Social Good”
in a seminar exploring new academic-pharmaceutical alliances to increase
access to medicines worldwide.
Weill Cornell Medical College

Weill Cornell Medical College—located in New York City—is committed to
excellence in research, teaching, patient care and the advancement of the
art and science of medicine. Weill Cornell, which is a principal academic
affiliate of NewYork-Presbyterian Hospital, offers an innovative curriculum
that integrates the teaching of basic and clinical sciences, problem-based
learning, office-based preceptorships, and primary care and doctoring
courses. Physicians and scientists of Weill Cornell Medical College are
engaged in cutting-edge research in such areas as stem cells, genetics and
gene therapy, geriatrics, neuroscience, structural biology, cardiovascular
medicine, AIDS, obesity, cancer and psychiatry—and continue to delve ever
deeper into the molecular basis of disease in an effort to unlock the
mysteries behind the human body and the malfunctions that result in serious
medical disorders. Weill Cornell Medical College is the birthplace of many
medical advances—from the development of the Pap test for cervical cancer to
the synthesis of penicillin, the first successful embryo-biopsy pregnancy
and birth in the U.S., and most recently, the world’s first clinical trial
for gene therapy for Parkinson’s disease. Weill Cornell’s Physician
Organization includes 650 clinical faculty, who provide the highest quality
of care to their patients. For more information, visit http://www.med.cornell.edu.

Contact:
Andrew Klein
(212) 821-0560
ank2017@med.cornell.edu

Sandeep Kishore
(917) 733-1973
sunny.kishore@gmail.com

# # #


Sandeep P. Kishore, M.Sc.
Medical Scientist Training Program (MSTP) Fellow
Weill Cornell / The Rockefeller University / Sloan-Kettering Cancer
Institute
Tri-Institutional MD-PhD Program
420 East 70th St, Suite 10M
New York, New York, USA 10021
email: sunny.kishore@gmail.com
tel: (917) 733 -1973
_______________________________

Posted in atherosclerosis, coronary artery disease, diet, professionalism, statins | Tagged: , , , , , , , , , , , , | Leave a Comment »

Get With The Guidelines – Do as the drug salesmen say

Posted by Colin Rose on May 4, 2007

Here is a classic example of drug dealers influencing the prescribing habits of doctors. If you read this GWTG-CAD carefully you will find a litany of insinuations WITHOUT PROOF. The data presented here are only observational. There is no control group. What were the lipids of the population that didn’t have a heart attack? The main insinuation is that the only cause of atherosclerosis is “dyslipidemia” and if the whole population of the world achieved “ideal” lipid levels by taking enough statins to lower their LDL to less than 70 mg/DL and somehow managed to also get their HDL higher than 60 mg/DL, there would be no heart attacks. There is NO PROOF for this hypothesis. 21% of the heart attack patients were on statins before their heart attack but still had one!

Now, if you want to know how such stupidity gets into print and gets the backing of the AHA, just look at the disclosures which are in small print at the bottom left. Enough said.

Posted in cholesterol, coronary artery disease, drugs, professionalism, statins | Tagged: , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a Comment »

COURAGE demolishes the myth of the “widow maker” and the “time bomb” but does not use optimal medical therapy

Posted by Colin Rose on March 26, 2007

For 30 years since the development of a balloon-tipped catheter to dilate coronary arteries, now known as PCI (percutaneous coronary intervention), it has been revealed truth from “experts”, most of whom paid their mortgages by doing PCI’s, that all significant coronary narrowings should be dilated to prevent a heart attack. In spite of overwhelming evidence that heart attacks are caused by rupture or early, unstable, non-obstructive plaques, most cardiologists still believe that heart attacks (sudden complete blockage of a coronary artery) occur at the site of the largest plaques. Patients are shown angiograms and told they have a “widow maker” or are “sitting on a time bomb”. I refused to do angioplasties until there was some proof for this superficial but very lucrative theory. Again, it turns out I was right. Even in patients with major narrowings and symptoms, PCI does not prolong life or prevent heart attacks. Chronic symptoms were slightly more improved in the PCI group but most medically-treated patients had symptom improvement just with pills.

 

Legal Addictions

The COURAGE type subject

All cardiologists give lip service to the necessity for lifestyle change as the ultimate cure for atherosclerosis, but in this study there was no attempt at lifestyle change. Most patients were overweight or obese, gained weight over the five year study. 20% smoked and did not stop. While the authors claim to using “optimal” medical therapy, they did not even try significantly changing lifestyle, the obvious cause of the patients’ atherosclerosis. No doubt even better results that could have been obtained with just lifestyle change, without pills or PCI, as Dean Ornish showed many years ago.

If you want an explanation for why, except for a feeble attempt to raise HDL by exercise, NO attempt was made to change lifestyle meaningfully before using statins or PCI you need look no further than the source of funding and the disclosure statements of the authors. Those who recieve substantial income from drug dealers are not keen on proving that cost-free lifestyle change alone will do the same or better than expensive drugs.

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Now, why has it taken 30 years to finally prove the futility of PCI in patients with stable or stabilized coronary disease? Unlike new drugs, there are no rules and no government agency mandating that surgical procedures have to undergo clinical trials before being done on the general population. Any surgeon can develop some operation that seems superfically rational and he and his colleagues can do many thousands of those operations, costing millions or billions of dollars and risking many lives until someone gets around to actually testing it to see if the outcome is really as advertised.

Doctors profess to want to practice “evidence-based medicine” but when change negatively affects bank accounts habits change very slowly if at all. Angioplasty in stable CAD can always be rationalized by the classic, “my patient is different than those in the controlled trial”. We can predict that angioplasties in patients with stable CAD will not decline significantly until most of those trained in the procedure have retired. The system could save a lot of money by giving each of them $one million and a house in Mexico to retire to.

Posted in angioplasty, atherosclerosis, coronary artery disease, diet, drugs, professionalism, statins | Tagged: , , , , , , , , , , , , , , , , , , , , , , , , , , , , | 1 Comment »