generic internist

Pharmaceutical Dollar Rationing by Results

So, if I go out to dinner and the experience is less than satisfactory, I should get a rebate or not be charged?

....and that risk should be shared by different providers??

.....and if I can't decide whether it was satisfactory, I could come back for my money one month or years later???

Schering Plough, Merck: Potential Cancer Concerns

Too much information, released prematurely and mishandled by the media and many experts. Reminds me of the Avandia story, still awaiting data.

I guess we could conclude that Vytorin reduces the most common lung cancer death, prevents breast cancer death, yet increases cancer in general (stomach, skin and prostate) so that you are more likely dead within 3 years of taking a cholesterol lowering drug.

I don't think we have ever encountered a drug in the history of medicine that can kill a patient with cancers in multiple systems within three years. Why should Zetia do this? We don't even have a proposed mechanism, even though we are doing more cancer than cardiovascular clinical trials. I don't expect the NIH though, to start running trials for cancer prevention using drugs that increase cholesterol absorption.

The Seas trial was randomized for cardiovascular risk factors.....I doubt that it was randomized for cancer risk factors such as familial cancer tendency or prior personal history of cancer (other than identifiable active cancer which would exclude one from most clinical trials).

It seems irresponsible for the NEJM to advocate the science, but then selectively discard it, if associated with the pharmaceutical industry Many of our patients will only hear the false cry of cancer, and discontinue therapy inappropiately.

Pfizer: Silly Counterfeiting Statistics, Bloomberg Edition

a disturbing position to take, Felix. In a medical system that has no tolerance for adverse outcome, you propose we overestimate the risk for drug counterfeiting. You may be correct, but the imported heparin substrate killed 88 individuals, that we know of. This should be a wake up call. We need to maintain our highest standards, which the rest of the world can try to emulate.

Rose colored glasses will not serve us well, if we open the door to a potential new form of bioterrorism.

Merck and Schering-Plough Make the Bad News About Vytorin Even Worse

19% of the ENHANCE group who were statin naive showed no benefit either, nor did a subgroup with greater plaque burden, at study entry. This bodes poorly for the Improve -it outcome study and the fate of zetia.