From the monthly archives:

September 2004

Poor colon cancer screening rates

September 30, 2004

Colon cancer screening rates are still low:

Overall, 58 percent of men and 51 percent of women [aged 50 to 74 years -ed] in the study reported ever having undergone endoscopy, but only 35 percent reported being tested in the five years before 1997. Just 42 percent of men and 31 percent of women reported endoscopy [...]

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Vioxx FAQ

September 30, 2004

A nice summary of frequently asked questions to the Vioxx recall from WebMD, including more information on the trial:

What evidence supports the withdrawal?
Merck’s decision to withdraw Vioxx from the market is based on new data from a trial called the APPROVe trial. In the APPROVe trial, Vioxx was compared with placebo (sugar pill). The purpose [...]

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Pfizer responds

September 30, 2004

Pfizer stands by its drug in response to the Vioxx recall, calling Celebrex is an “appropriate treatment alternative,” to Vioxx. Too soon to say whether this is a class effect, but certainly Celebrex and Bextra will be closely watched.

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Vioxx fallout: Lawsuit boon?

September 30, 2004

James Cramer with a view from TheStreet.com - Merck Will Be Tort Bar’s Next Target:

Is Merck going to be a trust for those who took Vioxx? That’s what you are betting if you sell this stock down $12. You are betting that the tort bar, which has almost finished destroying tobacco and asbestos, just found [...]

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Vioxx fallout

September 30, 2004

Now that Vioxx has been pulled from the market, what to do? My office has certainly been deluged with calls. From what I can gather, the study leading to the recall showed an increased risk of heart attack and other CV complications 18 months after patients took 25mg of Vioxx. Here are some [...]

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Merck withdraws Vioxx

September 30, 2004

Following up this previously written piece, today Merck pulls Vioxx from the market. Huge news - and what does the future hold for other COX-2’s, like Celebrex and Bextra?
Update:
Here is a link to the study leading to the withdrawal. Some key points:
1) There was an over 3-fold risk of acute MI and [...]

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Debate on malpractice

September 29, 2004

There is an interesting debate going on at Medrants between Dr. Centor and a lawyer. The topic of defensive medicine came up:

Many physicians do order unnecessary tests. This phenomenon occurs most often in emergency rooms, but also occurs in office practice.
When does this occur? I do not have hard data (again db asks for [...]

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Insomnia

September 29, 2004

Medpundit comments on the recent study touting cognitive behavior over medications for insomnia. She writes:

Now, how do I get my patients to believe it? In my experience, people just want “something to help me sleep.” I have a hand-out I give patients that describes the steps to improve sleep, which is basically an exercise [...]

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Increasing revenue

September 29, 2004

Pharmacies are thinking about charging for consultations:

Pharmacists like White have long been called on by customers to do more than just fill prescriptions. But drugstores, from giants like Rite Aid to smaller regional chains, are looking to expand their counseling programs and boost revenue - a trend that could be bolstered by the prescription-drug benefit [...]

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Malpractice affecting the people

September 28, 2004

Think the malpractice crisis isn’t affecting the public? Think again:

The IssuesPA/Pew Poll has found that a remarkable 26 percent of Pennsylvanians polled “said rising malpractice insurance costs have forced their family to change doctors in the past year”, and that state residents polled also favored a constitutional cap on pain and suffering damages by [...]

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Neurologists debate . . .

September 28, 2004

. . . the growing trend of cosmetic neurology. One scenario:

“For instance, if pilots perform better in emergencies when they take donepezil (a drug typically used to treat dementia), should they be expected or required by their employer to take this medication?” Chatterjee said. “We need an explicit notion of what it means to [...]

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Arms race

September 28, 2004

Massachusetts has the same number of MRIs as all of Canada, and there are no signs of slowing down:

Not surprising, the number of patients having MRIs is soaring, too; 487,700 scans in 2002, up more than 80 percent in four years, according to the most recent data from IMV Medical Information Division, an Illinois market-research [...]

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No surprise . . .

September 28, 2004

. . . that half of the Viagra pills sold on the internet are fake.

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Grand rounds

September 28, 2004

Today marks the debut of Grand Rounds, a weekly summary of the best from the medical blogs. Blogborygmi is hosting this week’s edition. Visit and spread the word!

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Empowerment

September 27, 2004

This article suggests that the price-comparison tool on the Medicare web site will have Medicare beneficiaries questioning their doctors about their prescriptions:

The discovery that a competing brand-name drug or generic substitute is significantly less costly will likely convince some beneficiaries to ask their physicians about the appropriateness of a switch, Health and Human Services Secretary [...]

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