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The Promises And Pitfalls Of Evidence-Based Medicine

The Promises And Pitfalls Of Evidence-Based Medicine | Disease mongering | Scoop.it

Evidence-based medicine (EBM) aims to address the persistent problem of clinical practice variation with the help of various tools, including standardized practice guidelines. While advocates welcome the stronger scientific foundation of such guidelines, critics fear that they will lead to “cookbook medicine.”

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Disease mongering
Overdiagnosis of disease: a modern epidemic sickness.
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MSD minaccia azioni legali per far cessare le critiche ad un suo prodotto. Pillole.org

La MSD ha minacciato azioni legali contro l'epidemiologo clinico Alberto Donzelli, per indurlo a cessare di esprimere critiche nei confronti dell'uso di un prodotto dell'azienda. 

Assume connotati internazionali la controversia tra la Merck Sharp & Dohme e il Dottor Alberto Donzelli, responsabile appropriatezza clinica della ASL di Milano. Il BMJ ha pubblicato un articolo che riassume la vicenda.

La filiale italiana della compagnia farmaceutica Merck Sharp & Dohme (MSD) ha stoppato un medico di primo piano nella gestione della salute pubblica intimandogli di cessare di indirizzare ai Medici di Medicina Generale testi medici critici nei confronti dell'uso di uno dei farmaci della società. 

Nei testi, Alberto Donzelli, il capo della formazione, appropriatezza e medicina basata sulle evidenze presso l'azienda di sanità pubblica di Milano (ASL Milano), aveva analizzato le prove pubblicate sul farmaco ezetimibe scoraggiandone l'uso in aggiunta alle statine. 

Una lettera a "cessare e desistere" è stata inviata in febbraio dal direttore medico di MSD, Patrizia Nardini, ed è stata recapitata dal direttore degli affari legali della società. Hanno accusato Donzelli di colpa grave e di una violazione dell'etica medica e minacciato di far causa a lui e a Milano Sanità per una cifra di € 1,3 milioni (1 milione di sterline; $ 1.78m). La lettera era indirizzata a Donzelli, con copia inviata al direttore generale della ASL di Milano e al presidente dell'Ordine dei Medici di Milano Roberto Carlo Rossi.  aggiornamento, ricerca, supporto, promozione del ruolo dei medici.
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New York’s Ban on Big Sodas Is Rejected by Final Court - NYT - #diseasemongering

New York’s Ban on Big Sodas Is Rejected by Final Court - NYT - #diseasemongering | Disease mongering | Scoop.it
The State Court of Appeals declined to reinstate New York City’s limits on sales of jumbo sugary drinks, exhausting the city’s legal options.
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Financial relationships between the pharmaceutical industry and physicians have come under increased scrutiny. Less attention has been paid to relationships between industry and the leadership of a...

Financial relationships between the pharmaceutical industry and physicians have come under increased scrutiny. Less attention has been paid to relationships between industry and the leadership of a... | Disease mongering | Scoop.it

Financial relationships between the pharmaceutical industry and physicians have come under increased scrutiny. Less attention has been paid to relationships between industry and the leadership of academic medical centers (AMCs), who wield considerable influence over research, clinical, and educational missions.

When AMC leaders serve on pharmaceutical company boards, they hold a fiduciary responsibility to shareholders to promote the financial success of the company, which may conflict or compete with institutional oversight responsibilities and individual clinical and research practices.1 The potential conflict between responsibilities of individuals who hold leadership roles in both industry and academia deserves exploration.

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Medicina: la libertà di cura è libertà di farsi truffare? - Il Fatto Quotidiano

Medicina: la libertà di cura è libertà di farsi truffare? - Il Fatto Quotidiano | Disease mongering | Scoop.it
La libertà di cura è un fondamento di una società civile. Libertà di come curare la propria salute significa che ogni individuo deve essere libero di accet
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Le mercantilisme menace les communautés de pati...

Le mercantilisme menace les communautés de pati... | Disease mongering | Scoop.it

Tribune. Un groupe de responsables d’associations de malades s’inquiète du détournement mercantile de réseaux conçus à l’origine comme des outils de démocratie sanitaire.


Via Guillaume de DURAT, LA BLOUSE BLANCHE
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Glaxo to Stop Paying Doctors for Drug Promotion | Health Impact News

Glaxo to Stop Paying Doctors for Drug Promotion | Health Impact News | Disease mongering | Scoop.it
Drug giant GlaxoSmithKline has announced it will no longer pay health care professionals to promote its products or the diseases they treat to “audiences who can prescribe or influence prescribing.” Glaxo also plans to stop compensating its sales...

Via Lionel Reichardt / le Pharmageek
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MSD Italy is criticised for threatening legal action over prescription advice to GPs

The Italian branch of the drug company Merck Sharp and Dohme (MSD) has stopped a leading public health doctor and administrator from circulating texts to GPs advising them about the use of one of the company’s drugs.

In the texts, Alberto Donzelli—the head of education, appropriateness, and evidence based medicine at the public health authority of Milan (Milan Healthcare)—had analysed the published evidence on the cholesterol lowering drug ezetimibe and discouraged its prescription in addition to statins.

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Confessions of an Rx Drug Pusher [Kindle]

Confessions of an Rx Drug Pusher [Kindle] | Disease mongering | Scoop.it
This is the story of Gwen Olsen. Once a very successful pharmaceutical sales rep., now her mission is to stop the over-medication of our children. Gwen is th...
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Researcher who falsified HIV results pleads not guilty in US court

A researcher who spiked rabbit blood with human antibodies to make it appear that an experimental HIV vaccine worked has pleaded not guilty to fraud in a US federal court, despite previously admitting his acts in a resignation letter to his university.

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SELLING SICKNESS TO THE WORRIED WELL: #Disease Mongering

SELLING SICKNESS TO THE WORRIED WELL:   #Disease Mongering | Disease mongering | Scoop.it
Watch Ch. 4, the Marketing of Madness. Find out how common life situations have been turned into psychiatric diseases so that drug companies and psychiatrists can gross over $150,000 a minute selling lies.
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Cancro, chi è povero muore

Cancro, chi è povero muore | Disease mongering | Scoop.it
Per la prima volta in Italia due farmaci oncologici sono in vendita solo a pagamento: chi vuole curarsi deve pagare più di mille euro a settimana. Si viola la Costituzione, ma il governo fa finta di niente
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Les associations de patients financées par les labos : quels risques ? : Allodocteurs.fr

Les associations de patients financées par les labos : quels risques ? : Allodocteurs.fr | Disease mongering | Scoop.it
Toutes les maladies ou presque ont leur association de patients. En France, il en existe environ 14.000. Certaines d'entre elles entretiennent des relations embarrassantes avec les firmes pharmaceutiques.
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Is Coca-Cola’s antiobesity scheme the real thing?

Is Coca-Cola’s antiobesity scheme the real thing? | Disease mongering | Scoop.it

The soft drinks manufacturer Coca-Cola is offering to halt the scourge of obesity in its tracks. The Coca-Cola Zero ParkLives scheme—launched last year as a pilot in Birmingham—offers running, cycling, rounders, tai chi, and bushcraft.

The scheme, which Coca-Cola describes as “ground breaking,” is now to be extended to 50 parks in three English cities. It will cost the company £20m between now and 2020,1 and the aim is further expansion. Coca-Cola introduced the scheme because it wants “to play a more productive role in finding solutions to obesity.”2

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Dabigatran: how the drug company withheld important analyses

Dabigatran: how the drug company withheld important analyses | Disease mongering | Scoop.it

In an investigation by The BMJ Deborah Cohen finds that recommendations for use of new generation oral anticoagulants may be flawed because regulators did not see evidence showing that monitoring drug plasma levels could improve safety

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HIV Drug Companies Staged "Bidding War" Over Kickbacks to Doctors, Suit Says

HIV Drug Companies Staged "Bidding War" Over Kickbacks to Doctors, Suit Says | Disease mongering | Scoop.it
The complaint suggests corrupt practices at one company can create instant incentives that force competing companies to respond, engulfing an entire category.
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Top 10 downloaded iPhone health app can cause significant patient harm - iMedicalApps

Top 10 downloaded iPhone health app can cause significant patient harm - iMedicalApps | Disease mongering | Scoop.it
How a popular iPhone health app is being used by patients incorrectly to monitor blood pressure

I was going through the Apple App Store’s Health & Fitness category last week, when I noticed an interesting health app that had made it into the top 10 “Paid” and “Top Grossing” sections.1  The app’s name is: “Instant Blood Pressure — Monitor Blood Pressure Using Only Your iPhone”.

The following screen shots show the initial description you get of the app in iTunes or your iPhone.

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HARMFUL MEDICAL OVERUSE - Italy’s “Doing more does not mean doing better campaig

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Patient digitalisé ou manipulé? - Editorial - Focus - InVivo

Patient digitalisé ou manipulé? - Editorial - Focus - InVivo | Disease mongering | Scoop.it

Via Lionel Reichardt / le Pharmageek, LA BLOUSE BLANCHE
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Ces médecins qui tissent des liens avec les laboratoires pharmaceutiques sont-ils influençables…Et influencés ?

Ces médecins qui tissent des liens avec les laboratoires pharmaceutiques sont-ils influençables…Et influencés ? | Disease mongering | Scoop.it

Ces médecins qui tissent des liens avec les laboratoires pharmaceutiques sont-ils influençables…Et influencés ?

Lorsqu’on les interroge sur leurs multiples liens et conflits d’intérêts avec les grands labos et les scandales sanitaires dus à certains médicaments, ces leaders d’opinion se vexent, et deviennent même agressifs pour certains. Ils s’estiment totalement indépendants et persuadés de n’être en rien influençables...


Via Michel Delon, Lionel Reichardt / le Pharmageek
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Michel Delon's curator insight, October 19, 2013 12:51 PM
Quels avantages ou bénéfices récoltent ces leaders d’opinion pour répandre de fausses informations ?
sylvie Royant-Parola's comment, October 20, 2013 7:26 AM
Cet article est une caricature... Que de telles situations aient existé, surement, mais depuis plus de 10 ans elles sont l'exception. Les labos nous ont aidé sur 3 plans, le financement de participation à des congrès, et je peux vous assurer que ce ne sont pas des vacances, même si on peut utiliser une après midi pour découvrir la ville où on est. Grâce à ces congrès et aux invitations par les labos il y a eu de vrais échanges au sein de la communauté des chercheurs ou des cliniciens, avec souvent à la clé des coopérations de recherche ou de réseaux qui sont nés. Le deuxième volet du financement touche les dons aux associations qui ont permis ce que la rigidité des instituions ne permet pas : la mise en route de protocoles, le tenue de registre, l’achat de matériel, le financement d’un poste de chargé de mission pendant quelques mois… Enfin le troisième volet touche la formation, pour payer le déplacement des intervenants (qui interviennent le plus souvent bénévolement), les salles de réunions, et plus globalement la logistique. Pour quelques abus, on suspecte et embête toute une profession Il ne faut pas oublier que l’exercice médical, surtout en libéral, est très solitaire. Or nous avons besoin d’échanger entre nous, de faire du lien à la fois pour maintenir nos connaissances mais aussi pour notre moral. Les labos ont joué ce rôle. Attention de ne pas tout démolir. Un médecin triste est un médecin dangereux !
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Corruption: medicine’s dirty open secret | BMJ

Corruption: medicine’s dirty open secret | BMJ | Disease mongering | Scoop.it
NotesCite this as: BMJ 2014;348:g4184 ("Healthcare is a high risk sector for corruption. Best estimates are that between 10% and 25% of global spend on...

Via Family Doctor, Lionel Reichardt / le Pharmageek
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#pilloleamare: cosa stiamo imparando? | dottprof.com

#pilloleamare: cosa stiamo imparando? | dottprof.com | Disease mongering | Scoop.it
Alberto Donzelli è una persona perbene che da anni cura - per il servizio di educazione all'appropriatezza e medicina basata sulle evidenze della ASL di Milano
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Lo strano caso del dottor Donzelli e del Signor MSD | Partecipasalute.it

Lo strano caso del dottor Donzelli e del Signor MSD | Partecipasalute.it | Disease mongering | Scoop.it


Pillole è una rivista di informazione curata dal Servizio educazione alla Appropriatezza ed EBM (medicina basata sulle prove) della ASL di Milano. In seguito ad un articolo su un farmaco ha ricevuto da una azienda farmaceutica una richiesta di risarcimento danni.

I referenti delle riviste ISDB (*) hanno sottoscritto una lettera di sostegno all’attività di questa rivista nel pubblicare informazioni basate sulle prove, spingendo altresì ad un confronto costruttivo sui dati e non alla sterile querelle legale. Vi invitiamo a leggere la lettera, a sostenerla e farla girare. http://www.slideshare.net/sfwebm/lo-strano-caso-del-dr-donzelli-finale-2...

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The FDA is Cracking Down on Big Pharma Social Media

The FDA is Cracking Down on Big Pharma Social Media | Disease mongering | Scoop.it

The FDA sent one company a warning letter for Facebook "likes"

 

The FDA often sends warning letters to companies for violating FDA regulation on how their products are marketed. For instance, if a company is advertising its product as a treatment for an ailment its not approved for, they’re going to hear from the FDA. 

 

So is the case with a recent FDA warning letter to Zarbee’s Naturals, which the FDA scolded for not only claiming to treat conditions like coughs (supplements cannot make these claims, otherwise they would drugs and regulated as such), but for the company’s Facebook “likes” and tweets.

 

Of course, some pharmaceutical companies find the FDA guidance overbearing. “If the FDA is going to require the same type of fine print that you see in a magazine ad to be in a tweet, then the FDA is essentially taking that tool away from patients who may want to hear from companies as well as healthcare professionals,” Jeffrey K. Francer, vice president and senior counsel with Pharmaceutical Research and Manufacturers of America told the publication GEN in an interview. “I assume that the FDA believes that its own tweets are truthful and not misleading. If they believe that, then why couldn’t a company use Twitter in the same way that the FDA is using Twitter?” Francer thinks the guidelines interfere with the First Amendment.


Via Pharma Guy, Dimitra Kontochristou
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Pharma Guy's curator insight, July 13, 5:22 AM


PhRMA calling in the big guns to fight FDA's SM GLs - the First Amendment!

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Patient Opinion Leaders as the New Healthcare Influencers

Patient Opinion Leaders as the New Healthcare Influencers | Disease mongering | Scoop.it

While the notion of online influence, with accompanying tools such as Klout, may be a new concept within the digital world, finding those individuals that hold most sway with their peers was already critical in every business sector way before the internet sprang to life.


Via Plus91, Stéphanie Chevrel, Renaloo, Giovanna Marsico
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Has industry co-opted patient engagement?

Has industry co-opted patient engagement? | Disease mongering | Scoop.it
 Patients Like Me, a popular, for-profit, online patient community. Patients Like Me makes its money by selling health data gathered from its patient member profiles 
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Andrea Robotti's curator insight, July 3, 7:43 AM

Una delle principali ripercussioni markettare della promettente frontiera degli user-generated contents potrebbe esser proprio la possibilità che le piattaforme dove i pazienti si recano per condividere le proprie esperienze, raccolgano i loro profili al momento dell'iscrizione e li possano rivendere a terze parti.

Alcune domande al riguardo mi vengono fuori spontaneamente:


La riteniamo un'eventualità eticamente ammissibile?


Quanto reale è il rischi che nascano delle realtà con finalità esclusivamente speculative? 


Come è possibile difendersi? 


Potrebbe essere quella del social login una alternativa percorribile per spingere questi siti web a fornire le giuste garanzie in termini di privacy e proprietà esclusiva dei dati?

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Vaccinazioni in calo del 25%: la vittoria della disinformazione - Wired

Vaccinazioni in calo del 25%: la vittoria della disinformazione - Wired | Disease mongering | Scoop.it
L'allarme del Siti a cui fa eco anche il ministro Lorenzin: "L’assenza di alcune malattie è come la libertà, ti accorgi di quanto sia importante solo dopo averla persa”
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