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Money and medicine: The story of Avandia

Prescription drug Avandia was once the top-selling diabetes drug in the world — and it still helps more than half a million Americans balance their blood sugar levels. But a Food and Drug Administration panel dealt the drug a blow this week that may have some diabetes sufferers questioning whether they want to use it.

The debate focused on whether Avandia, which is acknowledged to be one of the most effective drugs for treating Type 2 diabetes, comes with dangerous side effects: An increase in a patient’s chance of suffering a stroke or heart attack, and dying from it.

Avandia TimelineIn the end, while a majority of the 33-member panel did agree that Avandia, compared to other diabetes drugs, does increase risk for cardiovascular problems, they didn’t agree that it increases a user’s risk of death. The FDA will decide if and how it will act on the panel’s recommendation soon. Whatever it decides, the drug’s reputation has already been tarnished.

Need to Know’s Jon Meacham sat down with Dr. Jerome Kassirer, former editor-in-chief of the New England Journal of Medicine, to discuss the state of the FDA today in light of the Avandia ruling. Kassirer talked about the conditions that make it possible for drugs such as Fen-phen, Vioxx and now Avandia, the latest drug that may be pulled from the market, to reach consumers.



  • MIke

    I watched the Drug Company interview, the discussion of how the Drug Companies are using doctors for “evaluation and promotion of their drugs”. His comment about the reform bill having transparency of those doctors who “take Money from drug companies” for promoting, lecturing, and receiving “KICKBACKS” from drug companies for prescriptions their patients fill, in other words, Doctors get a check for prescribing drugs of a particular company.
    I am going from Memory, but a couple of years ago I was told by my mother, when she worked for K-Mart that local doctors would show up, to get their check from the drug companies from the prescriptions their patients filled.
    I told her that she was kidding. Well, I googled “Pharmacy Payments to doctors” and came up with a web site in Minnesota that has a law to disclose how much money Doctors receive from drug companies as “Compensation”. The Web site is Minnesota Practitioner Payments:
    I clicked on 2006, 109 PDF files came up, I clicked oni Lilly.pdf and on the third page through 18 pages, the list of doctors that received a “Kickback” from Lilly and one doctor received $293,000 in 2006. Thousands of dollars annually from Lilly and the other 100 or so listed on the site. I did some further research, Minnesota has required disclosure since 1997. There are five states, Vermont comes to mind but Minnesota is the first one to come up when Googled. I looked at articles with the AMA and it seems that 17 other states tried to duplicate the Minnesota law but were Lobbied by the Drug Companies and the Doctors Lobby to kill the disclosure bills so only 5 states exist but it is not common knowledge that Doctors get kickbacks from drug prescriptions their patients fill. The explanation is “obscure” but in reality it is a “Bribe” or “Kickback” incentive for Doctors to prescribe a particular drug company in their practice. I have talked with doctor employees, druggists at Walgreens that “Never heard of the Practictioner payments from Drug Companies.
    Imagine if we had a National Reporting system, this website is Minnesota Only.
    Further research, there are 66,000 drug salesman visting doctors and spending an average of $7800 a year to promote their drugs paid to every doctor.
    The Doctor interviewed on your program is promoting this kind of “transparency”. The state of Minnesota has disclosed the doctor kickbacks since 1997 and no one is aware of it.
    Further research, a drug company in Switzerland charges 400% more for its drug in the USA, to lower the cost to 25% of what it costs in the US to its Swiss citizens with their Universal Health Care.
    I read somewhere 40% of all Americans are on prescribed drugs especially Anxiety drugs, which, with the Doctor Kickbacks, is probably the reason why.
    Like health care reform, the Drug Companies were successful in keeping their stranglehold on the American people in the costs, the “transparency” to be adopted in 2013 is just “fluff”. Disclosing how much Doctors receive in Kickbacks has been going on in Minnesota and has had a minimal impact on how much drugs cost.
    The disclosure is NOT going to stop it, OUTLAWING the Kickbacks, making it illegal for a doctor to receive a Kickback, Immoral, Unethical, and a Conflict of Interest Law from Drug Companies needs to be written. Of course, Doctors, Drug Salesman, and Drug Companies will pour $Billions into Congress to defeat any “Outlawing of Kickbacks” as having 40% of America on prescribed drugs with the “Doctors as drug pushers” is too much to give up.

  • Ayesha

    July 18, 2010

    Dear Alison & Jon,

    Welcome to PBS.

    I am glad your “Need to Know” show follows int he footsteps of Bill Moyer’s Journal and NOW. However, I would request you to follow in their lead and provide a full transcript and not just a video (dumbing down of America). These are the type of topics that Americans need to understand and to have a full conversation on.

    The problem is the higher ups at FDA (not the medical analysts) sees the Pharmaceutical Companies are their “payor” and hence their boss. (Much like the credit agencies saw Big Banks as their boss!) It should be placed in FDA’s mission statement that “we the people” are whom they serve.

    The money issue should be resolved by Big Pharma being required to pay 1% – 5% of their profits to the FDA into a “general fund”, not per drug to be reviewed. This way the payment is separated from the outcome – approve/ disapprove – granted by the FDA, which should ONLY be based on (1) effectiveness of the medication, (2) negative side effects of drug, and (3) is it replacing a similar or equally effective drug. Q.E.D.

    To Mike, thanks for your comments. They are an eye opener as to how Doctors are bilking the system. Obama Care went after the Insurance agencies, as they should have, but not after the equally pernicious practices by Physicians. We live in a market based economy in all other aspects of our lives, save for Physicians. No one dare ask their Physician, how much are you charging? Who determines these costs? Can I shop around for costs?. How?, Since it is such a closely held secret that would shame the secrecy of the “Skull and Bones”.

    I think “we the people” need to REQUIRE Physicians to display their charges, and have patients sign off on them – after explaining what their insurer will pay and what will be the patients’ responsibility post the visit/ procedure OR else they cannot charge the patient after the fact without any pre-knowledge. This shroud of mystery needs to be lifted. The Physicians should be made to feel guilty for charging $5,000, or $20,000 for 5 -20 minutes of their time. Patients should be EMPOWERED to question the cost of their treatments.



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