With any shortage, the possibility of price gouging inevitably arises. The flu vaccine is no exception.
October 2004
All Stories
Policy shift
Dr. Henry Miller, in an editorial, writes that the FDA needs basic policy shifts to prevent another shortage with the flu vaccine.
Prolonging life
There is a debate in Britain on withholding and withdrawing life-prolonging treatment.
The Lancet on Vioxx
The Lancet with an editorial on Vioxx. Some choice words, implicating direct-to-consumer marketing:
. . . in their review paper specifically highlighting the cardiovascular sideeffect profile of COX-2 inhibitors. Concerns were shared by the FDA, who implemented labelling changes in 2002 to reflect the findings from the VIGOR trial.
However, even following these warnings, and in the face of mounting evidence for the cardiovascular side-effects of rofecoxib, ...
CNN news, brought to you by Ambien
Ambien is now sponsoring CNN news segments, as well as having an increased presence on CNN's web site:
Prescription sleep aid Ambien entered into a deal with CNN ad sales to sponsor the "Morning Papers" segment on CNN's NewsNight with Aaron Brown. CNN ad sales COO Greg D'Alba brokered the deal with Sanofi-Synthelabo, a member of global pharmaceutical company Sanofi-Aventis Group.
Under the multi-media partnership, Ambien will also ...
Vioxx debacle: A class effect?
NEJM with two early release articles. One by cardiologist Eric Topol, and the other questioning whether Celebrex and other COX-2's have similar cardiovascular risk.
The repercussions of the flu vaccine shortage
As we have all heard, the big news is the flu vaccine shortage by half. Last year, 87 million got vaccinated. This year the demand was expected to be even higher, but only 54 million of the inactivated vaccine and 2 million of the live FluMist are available. The efficacy data of the flu vaccine is well-established.
With healthy adults, a systematic review showed a significant ...
An upcoming nightmare
Chiron announced that it won't make the flu vaccine this year, because of problems at its plant in Britain. It had planned to supply 48 million of the 100 million doses this year . This is terrible news - more to come.
Update:
The press release from Chiron.
The FDA with their response:
The Centers for Disease Control and Prevention is convening its Advisory Committee on ...
Grand rounds – call for articles
I will be hosting Grand Rounds next week. Submission guidelines can be found here. Please email me your submission with the subject heading "Grand Rounds", by Monday, October 11th at 9pm EST.
If you are interested in hosting future weeks, please contact Nick at Blogborygmi.
Chlamydia screening
It has been recommended that all sexually active women under the age of 25 be screened for Chlamydia. The reason being that most initial infections in women are asymptomatic but may progress to more serious diseases such as pelvic inflammatory disease, ectopic pregnancy, infertility, and chronic pelvic pain.
In the recent issue of the Annals, this strategy has proven to be cost-effective and only emphasizes the ...
Why colon cleansing and colonic irrigation doesn’t work and can be harmful to patients
A reader writes:
It's impossible to perform a Google or Yahoo search using the word "colon", and not get flooded with hits advertising "proprietary" herbal blends guaranteed to cleanse the colon. Is this really necessary? As the ordinary person reads through any of these sites, he is led to believe that most all of us have 10 to 40 lb. of compacted debris in our colons. The "scare literature" continues ...
Paying dearly
Dr. Centor links to a NY Times article asking whether the Vioxx findings are a class effect. He also ends condemning direct-to-consumer advertising:
I would hold Vioxx up as a clear example of the dangers of DCA. DCA tries to spur demand. It did. And now Merck will probably pay. And maybe some patients have paid dearly.
Contrast . . .
. . . between the Bush and Kerry approach to health care are summarized in several newspapers today.
It starts
The first lawsuits are coming against Merck in wake of the Vioxx recall:
Nevels says her 34-year-old daughter, Shelly South, took Vioxx for 21/2 years before dying of a heart attack in November 2002. She claims Merck knew of the risks of Vioxx long before its announcement Thursday.
Also named in the suit is Dr. Waclaw Alex Dymek, the Carrollton physician who prescribed the drug to South. Nevels claims ...
The cost of evolving technology
A recent study has suggested that there has been increasing use of CT angiography in the diagnosis of pulmonary embolism:
A new study, published in the October 2004 American Journal of Roentgenology, shows that during a nine-month period in 1997 –1998, 81 patients underwent CT for suspected pulmonary embolism through the emergency department at University Hospitals of Cleveland. That number increased to 349 during the corresponding nine-month interval in ...
The empire strikes back
Following up the previous piece detailing the Pfizer insider that broke ranks and supported drug reimportation, Pfizer seems to be taking some action:
Pfizer Vice President of Marketing Peter Rost, who has publicly supported the legalization of prescription drug reimportation, on Thursday said that the company has launched an investigation into his political activities . . .
. . . Seven members of Congress on Wednesday wrote to ...
I told you so
Cardiologist Eric Topol with an op-ed in the NY Times, saying good riddance to Vioxx.
Vioxx alternatives: What if you can’t take Celebrex or Bextra?
The common perception that is being trotted out as an alternative to Vioxx is switching to Pfizer's Bextra or Celebrex, the other COX-2 inhibitors out there. However, these medications cannot be taken in those with a sulfa allergy or hypersensitivity. This excludes a large percentage of the population - studies estimate approximately 3.5% have a reaction to a sulfa drug. So, what are your alternatives if you can't ...
The day after
Now that everyone has gotten over the initial news of the Vioxx recall, some of the more interesting analysis emerges.
The San Francisco Chronicle details how understaffed the FDA is:
Miceli said the FDA is woefully understaffed. And its guidelines often lead it to look only at the evidence presented by drug manufacturers, he said -- not at the further data that could have been generated.Forbes goes
Kevin Pho, MD
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Warren Buffett’s prostate cancer choices aren’t right for every man
A version of this column was published on April 24, 2012 in USA Today. There has been a recent uptick of elderly men...
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Many medical decisions require shared decision making
The following column was published on April 1, 2012 in USA Today. I recently saw a middle-age man in my primary care clinic...
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Patients deserve a medical malpractice early offer
The following column was published on March 25, 2012 in the Nashua Telegraph. Medical malpractice historically has been a contentious issue. Doctors...
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Discussing whether tests actually help patients or cause more harm
The following column was published on April 11, 2012 in CNN. When you visit the doctor, chances are you are given a...
Physician
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Being a good doctor is no more an achievement than being a good Mom
At no other time in my medical training was I as confident that, with hard work and dedication, I could master the...
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The malpractice risk of volunteer medical coverage at sporting events
From Outside Online, an article about how physicians are increasingly hesitant to provide volunteer medical coverage at athletic events: "Last year, 13 Americans...
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What does a perfect pediatrics practice look like?
I had a phenomenal day in clinic yesterday. Imperfect for sure but inspiring, connected, and busy. I felt useful and like anybody...
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Tips to improve your patient satisfaction scores
Recently I was asked, “How can I improve my Press Ganey scores?” Presently this question applies mostly to hospitals as CMS is...
Patient
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Health care journalists have tendencies similar to those of doctors
As a patient who was asked to speak at the Association of Health Care Journalists 2012 conference, I felt a bit covert....
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Adaptation can be painful, but it can also be a gift
Nothing will force you to live life on your own terms faster than almost losing it. In 2008, I was on fire....
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Embracing the longing without the outcome
I’m not sure when I stopped missing my husband. I suppose familiarity crept in after 7 years together and I rarely felt...
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Minimize reactance in your health organization
Can you say “reactance”? Don’t feel bad, I wasn’t familiar with the term either until recently. But as you will see, anyone...
Policy
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Repairing the tear in health care’s safety net with social media
The nation’s “safety net” hospitals are designed to ensure that uninsured, lower income and indigent populations receive adequate medical care – a...
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Look to technology to reduce health costs
Technology to lower costs rather than accelerate them. Smart phones to increase physician and other providers’ productivity. Fewer primary care physicians but...
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How to save a trillion dollars in health care
It is both conventional wisdom and factual truth that, unimpeded, American healthcare cost inflation will bankrupt the United States economically, educationally, socially,...
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How the Affordable Care Act combats preventable hospital infections
As the Supreme Court deliberates the Affordable Care Act, Americans should take a closer look at the commonsense reforms embedded in the...
Tech
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EMR liability needs to go further than just the physician
This example of a disaster waiting to happen, in the form of an error-promoting CPOE, is a poster example of why the...
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AMA: Changes are needed in the stage 2 meaningful use EHR proposal
A guest column by the American Medical Association, exclusive to KevinMD.com. Continuing our efforts to move medicine forward while prioritizing patient care and minimizing...
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EMRs require better user-centered design
Healthcare IT News recently asked, “Do doctors have to be typists to get MU incentives?” That question reminded me that given the...
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Electronic records don’t tell us stories that make cognitive sense
One morning recently, I found another physician standing morosely at one of the mobile computer terminals we refer to as “cows”—computers on...
Social Media
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We need to see the potential harm of social media
Prior to 1794, farms across the world could only pick cotton as fast as humanly possible. In the late 18th century, Eli Whitney...
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Why social media may not be worth it for doctors
Social media in healthcare is all the rage these days. You can’t visit even one physician-oriented website without someone breathlessly advising you...
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Transparency defines social media success for doctors
Want to understand social media? Physicians wanting to learn about social media must learn transparency. We must learn transparency on a personal...
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How Twitter was used in a potential mass casualty scenario
It was my first ER shift in charge of the resuscitation area. Needless to say, my adrenaline and nerves were firing like...
