U.S. Drug Companies Running the Show at Massachusetts General

[lesbiaphrodite]

A recent article indicates that big drug companies like AstraZeneca and Johnson & Johnson are funding doctors and research hospitals who agree to push their high-powered antipsychotic drugs on kids. See article:

http://www.nytimes.com/2008/11/25/health/25psych.html?ref=us

 

[Guest]

U.S. Drug Companies Running the Show at Massachusetts General

A recent article indicates that big drug companies like AstraZeneca and Johnson & Johnson are funding doctors and research hospitals who agree to push their high-powered antipsychotic drugs on kids. See article:

http://www.nytimes.com/2008/11/25/health/25psych.html?ref=us

No, the article doesn't show that. It shows that one drug company (Johnson & Johnson) provided funding for one research center at the request/insistence of one psychiatrist, and that the research center is apparently on the grounds of Massachusetts General. The article doesn't make clear whether the research center is actually a part of the hospital organization.

AstraZeneca is mentioned only in connection with a lawsuit alleging harm to patients due to use of one of its products.

If the allegations stated in the article are proven to be true, both J & J and Dr. Biederman have a great deal to answer for, and hopefully they will.

It may be that this sort of thing is widespread throughout the pharmaceutical industry, but it's flat wrong to draw that conclusion from this article.

 

[JAMESBJOHNSON]

This isnt new.

Psychotropic drugs for kids were unknown 40 years ago. Readin ritin, and rithmetic were taught to the tune of a hickory stick.

Newspapers furnish a reliable baseline for childhood pathology in the past. Viloent children were reported in the papers, but the reported incidents were rare. I dont recall knowing one disturbed child through 12 years of public school.
Special Education was for kids with physical disabilities like blindness or polio.

By 1988 every school had classes for emotionally handicapped and severely emotionally disturbed kids. I blame disability checks given to parents and schools.

 

[lesbiaphrodite]

U.S. Drug Companies Running the Show at Massachusetts General



No, the article doesn't show that. It shows that one drug company (Johnson & Johnson) provided funding for one research center at the request/insistence of one psychiatrist, and that the research center is apparently on the grounds of Massachusetts General. The article doesn't make clear whether the research center is actually a part of the hospital organization.

AstraZeneca is mentioned only in connection with a lawsuit alleging harm to patients due to use of one of its products.

If the allegations stated in the article are proven to be true, both J & J and Dr. Biederman have a great deal to answer for, and hopefully they will.

It may be that this sort of thing is widespread throughout the pharmaceutical industry, but it's flat wrong to draw that conclusion from this article.

Actually, this isn't the first article to discuss this problem and I didn't draw these conclusions solely on the basis of it. The atypical antipsychotics in question have been shown to cause massive problems like diabetes and other metabolic disorders in patients who take them.

Mass. General and this psychiatrist aren't the only folks doing this sort of thing. Do the research and you'll see that my conclusions are not off the mark, and this ain't the only article on the subject.

 

[lesbiaphrodite]

Drug companies run the psychiatric profession. And the drugs they are pushing are often harmful. For your reading pleasure:

http://www.antipsychiatry.org/mosher.loren.1.htm

http://www.psychsearch.net/lawsuits.html

http://www.coreynahman.com/atypical-antipsychotic-lawsuits.html

 

[Guest]

Actually, this isn't the first article to discuss this problem and I didn't draw these conclusions solely on the basis of it. The atypical antipsychotics in question have been shown to cause massive problems like diabetes and other metabolic disorders in patients who take them.

Mass. General and this psychiatrist aren't the only folks doing this sort of thing. Do the research and you'll see that my conclusions are not off the mark, and this ain't the only article on the subject.

Didn't say that your conclusions were off the mark--just that they couldn't be drawn from the single article you referenced. By the way, one of the sites you later referenced (http://www.antipsychiatry.org/) hasn't been updated for three years. Just thought I'd let you know.

I agree that both phenothiazines and atypical antipsychotics can have severe side effects. In my 20 years of clinical practice, I've seen plenty of examples. However, many other medications--from drugs designed to reduce insulin resistance to anti-coagulants to cancer treatments--can also have severe, even fatal, side effects.

The question, to my mind, is whether the significant side effects uncovered during the clinical trials are appropriately analyzed and reported to the FDA, and then communicated effectively and honestly to the prescribing physician. It's then a matter of clinical judgement as to whether the physician believes that the benefits of the drug outweigh the potential risks.

If the drug companies are not accurately reporting the data, or the reps are encouraging physicians to use the drug off-label, these are certainly unethical and likely illegal actions.

The AMA recognizes the potential for undue influence on the part of pharma companies. Here's what they've determined for their members:

http://www.ama-assn.org/ama/pub/category/4001.html

Also, the pharmaceutical industry itself has evolved a set of guidelines (PhARMA) to avoid exactly these kinds of situations. You can read them here. Granted, the industry evolved these guidelines in large part to try to avoid additional regulation on a state-by-state basis, but (if followed) they represent a significant step forward. Certainly, there will always be bad apples who are in it just for the money, whether management or sales.

I'm not an apologist for the pharmaceutical industry, believe me. What we have now is no means a perfect system, but overall it seems better than it used to be. A large part of the existing problem appears to be the FDA not performing its mandated oversight and regulatory functions with regard to new drug approval. Whether that's due to conflict of interest or understaffing, I don't know.

 

[trysail]

It is a fact that the best drug is no drug. As noted by Gnome, ALL drugs have side-effects. Individual genetics determine individual drug metabolism, efficacy and tolerance. Genomic medicine remains the Holy Grail of drug development.

All drug usage and development absolutely requires a medical cost-benefit calculus and acceptance of a certain unavoidable risk.

In economic terms, it is estimated that it costs somewhere on the order of a total of two billion dollars ( $2,000,000,000 ) to develop a new drug ( from laboratory to clinical trials through FDA approval ). The odds that a novel compound will be approved for clinical trials are estimated at 1 out of 600. The odds that a compound approved for clinical testing will ultimately demonstrate safety and efficacy ( and thus FDA approval ) are 1 out of 20. The research and development costs for the average new drug are eight hundred million dollars ( $800,000,000 ).

Taken as a whole, the pharmaceutical industry's drug development effort is a colossally expensive and very risky proposition that has demonstrably yielded enormous social benefits.

I have a hard time swallowing the idea that a significant number of physicians connected with Mass General have breached their ethical responsibilities and an even harder time believing "U.S. Drug Companies Running the Show at Massachusetts General."

 

[JAMESBJOHNSON]

Both of you are wrong.

The problem is insurance wont pay for conduct problems and situational stressors. AND parents & schools insist that boys be sedated. So the wise MD writes a script, labels the problem something she can bill for, and the school gets another special ed student.

The whole goddamn thing is criminal malpractice and conspiracy to defraud.

 

[Guest]

Both of you are wrong.

The problem is insurance wont pay for conduct problems and situational stressors. AND parents & schools insist that boys be sedated. So the wise MD writes a script, labels the problem something she can bill for, and the school gets another special ed student.

The whole goddamn thing is criminal malpractice and conspiracy to defraud.

News flash--insurance frequently, if not routinely, pays for outpatient treatment of conduct disorder, oppositional defiant disorder, and adjustment disorders. Not infrequently, depending on the policy, it will pay for residential or inpatient treatment. Trust me--I've treated enough of them.

Putting a child diagnosed with any of those three conditions, but nothing else, on an atypical antipsychotic is, in my opinion, indefensible and malpractice.

With the exception of adjustment disorders, treatment is a fairly lengthy process; there are no magic bullets. What would you have the school do, James, for the 6-12 months or longer that the kid continues to act out, disrupting class and threatening other students and faculty? Would you prefer he or she be institutionalized as a guest of the state? Just wondering.

 

[JAMESBJOHNSON]

GNOME

Ditto, here. When I treated kiddies at out hospital (1988-1994) insurance didnt pay for conduct disorders. I know this because they all sent their own people over to interview the kids and authorize inpatient. In most cases the insurance evaluator refused to pay for treatment and refused to invalidate the commitment order, so we were stuck with the kids and got no money for it.

Right after I was hired I was told IF WE CANT BILL FOR IT, THEY DONT HAVE THE DIAGNOSIS.

 

[Guest]

GNOME

Ditto, here. When I treated kiddies at out hospital (1988-1994) insurance didnt pay for conduct disorders. I know this because they all sent their own people over to interview the kids and authorize inpatient. In most cases the insurance evaluator refused to pay for treatment and refused to invalidate the commitment order, so we were stuck with the kids and got no money for it.

Right after I was hired I was told IF WE CANT BILL FOR IT, THEY DONT HAVE THE DIAGNOSIS.

I got out of the business in 1999; conduct disorder was fairly commonplace by then. As long as we could demonstrate that the kid met the diagnostic criteria, no problem with insurance.