Death by Medicine
How Too Much Medicine Can Kill You
During a recent clinic consultation, I saw Mary, in her early 60s, with type 2 diabetes. She was concerned that the muscle pains in her legs may have been a result of the cholesterol-lowering statin drug she was taking. “But I’m scared of stopping it.” She explained how a specialist nurse had told her a clot could break off from her aorta, travel to her brain and cause a massive stroke.I assured her that even in those with established heart disease, who stand to gain most from taking the drug, the risk of death from stopping the medication for two weeks to see if the side-effects would go was close to 1 in 10,000 .
Unfortunately, such misinformation and fear-mongering is common. One of the root causes is undoubtedly driven by the commercial interests of the pharmaceutical industry.
As cardiologist Peter Wilmshurst points out in a talk he gave at the Centre for Evidence-Based Medicine last year, the drug and device industry has an ethical and legal responsibility to produce profit for their shareholders but not to sell patients and doctors the best treatment. But the real scandal, he says, is the failure of regulators and the collusion of sorts between doctors, institutions and medical journals.
According to Peter Gøtzsche, professor of research design and analysis at the University of Copenhagen, prescription drugs are the third most common cause of death after heart disease and cancer. In an analysis published in the BMJ, he estimated that every year psychiatric drugs, including anti–depressants and dementia drugs, are responsible for half-a-million deaths in those aged over 65.
Between 2007 and 2012, the majority of the largest 10 pharmaceutical companies all paid considerable fines for various misdemeanours that included marketing drugs for off-label uses, misrepresentation of research results and hiding data on harms. But as long as these criminal acts generate profit, they will continue unabated.
Medical journals and the media can also be manipulated to serve not only as marketing vehicles for the industry, but also be complicit in silencing those who call for more independent scrutiny of scientific data.
Corporate greed and systematic political failure has brought healthcare to its knees
Earlier this year, the editor of the Lancet, Richard Horton, wrote that possibly half of the published medical literature may simply be untrue and that science had “taken a turn towards darkness”.
It is therefore welcome news that several weeks ago Britain’s chief medical officer, Dame Sally Davies, called for an inquiry into the safety of medicines to restore the public’s trust. But what is disappointing is that she has asked the Academy of Medical Sciences to carry out the review. As one respected senior academic, who did not wish to be named, told me, it was “hardly independent” and it was akin to asking “foxes to guard the hen coop”. And it’s worth noting that the academy has not signed up to the AllTrials campaign started by Ben Goldacre, which calls for all results of all clinical trials to be made available to doctors, researchers and patients.
AdvertisementBut real political will to address these issues has also been lacking. Rather than pursuing his current obsession with new contracts, the health secretary, Jeremy Hunt, would be doing doctors and the British public a far greater service by choosing to attack the manipulations and excesses of vested interests contributing to an inefficient health service.
In July, Sir Bruce Keogh, former cardiac surgeon and medical director of NHS England, said that as many as 10-15% of medical and surgical treatments in the NHS should not have been carried out on patients.
This comes only a month after the Academy of Medical Royal Colleges, the independent organisation representing the UK’s 220,000 doctors, launched a campaign to reduce the harms of too much medicine, stating commercial conflicts of interest, defensive medicine and biased reporting in medical journals as root causes.
One of the academy’s recommendations asks for commissioners to consider different payment incentives for doctors that focus on providing quality care by having sensible conversations with patients about the value of a treatment. Better this than one incentivised by the volume of drug prescriptions or number of operations undertaken.
Professor Chris Ham, chief executive of health thinktank the King’s Fund, says: “Many doctors aspire to excellence in diagnosing disease; far fewer unfortunately aspire to the same standards of excellence in diagnosing what patients want.” And he’s absolutely right.
Three months later, Mary feels like a “new woman” after her muscle pains disappeared within a week of stopping her statins and her quality of life is now much improved, tolerating a lower dose of the drug. She also began following a high-fat Mediterranean diet that was low in sugar and other refined carbs after I told her it would be more effective than any pill we could give her to reduce her risk of heart attack or stroke. She has already lost weight and even her type 2 diabetes is better controlled.
Corporate greed and systematic political failure have brought healthcare to its knees. There are too many misinformed doctors and misinformed patients. It’s time for greater transparency and stronger accountability, so that doctors and nurses can provide the best quality care for the most important person in the consultation room – the patient. As John Adams, the second US president, said: “The preservation of the means of knowledge amongst the lowest ranks is of more importance to the public than all the property of all the rich men in the country.” It’s time to restrain the harms of too much medicine.
Source : The Guardian (Nov. 2015)
100,000 Americans Die Each Year from Prescription Drugs, While Pharma Companies Get Rich
By Daniela Perdomo, AlterNet
Prescription drugs taken as directed kill 100,000 Americans a year. That's one person every five minutes. How did we get here?
How many people do you know who regularly use a prescription medication? If your social group is like most Americans', the answer is most. Sixty-five percent of the country takes a prescription drug these days. In 2005 alone, we spent $250 billion on them.
I recently caught up with Melody Petersen, author of Our Daily Meds, an in-depth look at the pharmaceutical companies that have taken the reins of our faltering health care system by cleverly hawking every kind of drug imaginable. We discussed how this powerful industry has our health in its hands.
Daniela Perdomo: Your book includes some staggering stats. For example, 100,000 Americans die each year from prescription drugs -- that's 270 per day, or, as you put it, more than twice as many who are killed in car accidents each day. Could you elaborate on this? Are these people abusing their prescription drugs or is this a sign of prescription meds gone bad?
Melody Petersen: The study estimating that 100,000 Americans die each year from their prescriptions looked only at deaths from known side effects. That is, those deaths didn't happen because the doctor made a mistake and prescribed the wrong drug, or the pharmacist made a mistake in filling the prescription, or the patient accidentally took too much. Unfortunately, thousands of patients die from such mistakes too, but this study looked only at deaths where our present medical system wouldn't fault anyone. Tens of thousands of people are dying every year from drugs they took just as the doctor directed. This shows you how dangerous medications are.
DP: You write about a growing market for drugs for children. You say we know little about the long-term effects of prescription meds on kids. Let's talk particularly about depression medications and ADHD meds, which seem to be what kids are mostly prescribed.
MP: In recent years, sales of drugs for children have been the industry's fastest growing business. Doctors now prescribe pills to children for all kinds of conditions -- from high cholesterol to anxiety. The market for ADHD drugs has long been a big opportunity for the industry. More recently, the companies have had their sales reps urge doctors to prescribe antidepressants, antipsychotics and other psychiatric meds to children. The result: our kids take more of those medicines than children in other countries. For example, a study last year found that American children take three times more attention deficit medications and antidepressants than children in Europe.
DP: Could you tell me how the prescription med industry is in bed with doctors?
MP: The industry spends hundreds of millions of dollars on physicians every year. In one survey, 9 out of 10 doctors said they had recently taken something of value from the drug industry. And some of those doctors take hundreds of thousands of dollars each year from the industry. The drug companies pay doctors to be their so-called consultants. They also pay them to sit on corporate advisory boards and to give lectures to other doctors. They pay for up to 80 percent of the continuing medical education that doctors need to maintain their licenses. If you ask a doctor if this is a problem, they will more than likely tell you no. But the studies show that even a small gift will sway doctors to write a prescription for a certain drug. The truth is that doctors are no longer independent gatekeepers who keep us safe from drugs we don't need. Far too many of them are financially tied to the industry. They are writing the prescriptions that their financial backers want them to write.
DP: We are the only developed country that doesn't control prescription drug prices. Could you tell me what that means, practically, for consumers?
MP: It means that the drug companies can charge whatever they want to -- even for drugs that don't work very well. One drug costs $400,000 a year. Some cancer drugs now cost $50,000, even though on average, they give the patient just a few weeks extra to live. It's clear that the drugs aren't worth these extreme prices, but the companies are taking advantage of patients who are desperate for a cure. The industry's unlimited hikes in prices have helped make health insurance unaffordable. This is also why wages of American workers have stagnated. When health premiums rise, employers must get the extra money from somewhere, and employee raises are one of the first things to go.
DP: You write about how companies are more interested in developing 'lifestyle drugs for rich Americans' rather than discovering cures for diseases that affect the majority of the world, like malaria. How many cholesterol drugs do we need? Sex drive meds? Hair loss meds?
MP: The answer is that we really don't need many of those kinds of drugs, those lifestyle drugs that don't save or lengthen lives. But the drug companies have discovered there are billions of dollars to be made by selling pills to Americans who worry about getting old, but are otherwise healthy. It's so easy to fall for the marketers' claim that a little pill will enhance our lives and keep us young forever.
DP: Could you tell me about drugs that are developed for one use but used for another. How often does this happen?
MP: It is a common sales tactic in the industry to have sales reps push doctors to prescribe a drug for many uses and patient conditions. The drug companies do this even though it is illegal to promote a drug for anything other than the condition the FDA has approved it for. I detail in my book how a lackluster drug for epilepsy - a drug called Neurontin -- was sold by a company for just about any condition that affects the brain. The company's sales representatives pushed doctors to prescribe Neurontin for children with attention problems, for adults with mania, for just about anyone with restless legs. They did this even though they had no scientific evidence that it helped people with these conditions. This is a very dangerous corporate fraud.
DP: How often are ailments created simply to fit a drug already created?
MP: The industry has proven that it is not beyond creating new diseases when it wants to expand the use of a drug. For example, I wrote in my book about how the company Pharmacia created the disease of overactive bladder to expand sales of a drug for incontinence. We don't know how often this is done because few companies are willing to tell the public how their marketers work behind the scenes.
DP: What do we prescribe drugs for that other countries don't? In other words, what ailments do Americans suffer from that other nations don't?
MP: The drug companies have made Americans believe that almost anything should be treated with a pill. Women can ask their doctors for a drug that will diminish their facial hair. Parents can ask for a stimulant to keep their children calm and focused. Even people who are shy are now told they have a disease that needs to be medicated. This is far less prevalent in other countries because the drug companies don't have as much power elsewhere. The U.S. and New Zealand are the only two developed countries in the world that allow the drug companies to aggressively advertise prescription drugs to consumers.
DP: Why do we rush to prescribe? Have we always been this way or was there a shift at some point?
MP: The prescriptions are driven by the promotional efforts of the industry. Today, the companies start promoting a drug years before it even goes to the FDA for approval. Some drugs have promotional campaigns funded by more than a billion dollars. It was around 1980 when the big drug companies learned that they could make far more profit by focusing their efforts on marketing rather than on the truly hard work of scientific research and finding new drugs.
DP: American life expectancy is low compared to other developed nations. What are they doing right? We're not the only ones with prescription drug companies within our borders.
MP: In America, if you're lucky enough to have health insurance, you can easily get too much medicine, too much health care. Many Americans don't understand that all of health care has risks and that too much of it can actually shorten your life. Is this one of the reasons why we're falling fast in the world rankings on life expectancy? No one knows for sure. But it's obvious that all that money we spend on prescriptions and doctors is not giving us an advantage.
DP: From a consumer/patient standpoint, are certain drug manufacturers better than others?
MP: No. There is not an ethically minded shining star. All the companies operate in a similar way. Fraud is rampant in this industry because there is so much money involved.
DP: How will the health care bill affect prescription drug use and the med industry?
MP: The drug companies and their lobbyists won big under the new health care law. The companies will get millions of new customers. At the same time, Congress agreed with the industry's lobbyists that there should be no limits on how much they can charge for medicines. We needed to make health insurance available to all Americans, but there should have been stronger cost controls and promotional limits in the law. Now, even more people will be at risk of getting dangerous and expensive drugs that they don't need.
DP: What do you make of theories that someday very soon we'll all be on smart drugs. Realistic? Already here?
MP: I recently spoke to a college student who told me he used Adderall, a drug for ADHD, to enhance his studies. He didn't have a prescription for the drug. He got the pills from friends. He knew this was dangerous and illegal, but he did it anyway. People no longer understand that every drug comes with risks. Adderall, for example, comes with a label warning that using it without a prescription can lead to addiction, and in rare cases, death. The marketers have made us believe that we can do just about anything with the help of a pill.
DP: What is the biggest issue relating to prescription drugs that the mainstream media misses?
MP: Overall, the biggest problem is that the news media is not objective when reporting on medicines. Much of the news coverage on prescription drugs exaggerates their potential benefits and glosses over their risks. Many news stories about new drugs don't even mention the side effects. People are getting distorted information on prescription drugs. Many of these news stories are little more than press releases that come straight out of the drug companies' marketing departments.
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MEDICALLY CAUSED DEATH IN AMERICA
By Jon Rappoport
June 28, 2010
An Exclusive Interview With Barbara Starfield
The American health system, like clockwork, causes a mind-boggling number of deaths every year.
The figures have been known for a decade. The story was covered briefly when a landmark study surfaced, and then it sank like a stone.
The truth was inconvenient for many interests. That has not changed. "Medical coverage for all" is a banner that conceals ugly facts.
On July 26, 2000, the US medical community received a titanic shock to the system, when one of its most respected public-health experts, Dr. Barbara Starfield, revealed her findings on healthcare in America. Starfield was, and still is, associated with the Johns Hopkins School of Public Health.
The Starfield study, "Is US health really the best in the world?", published in the Journal of the American Medical Association, came to the following conclusions:
Every year in the US there are:
12,000 deaths from unnecessary surgeries;
7,000 deaths from medication errors in hospitals;
20,000 deaths from other errors in hospitals;
80,000 deaths from infections acquired in hospitals;
106,000 deaths from FDA-approved correctly prescribed medicines.
The total of medically-caused deaths in the US every year is 225,000.
This makes the medical system the third leading cause of death in the US, behind heart disease and cancer.
The Starfield study is the most disturbing revelation about modern healthcare in America ever published. The credentials of its author and the journal in which it appeared are, within the highest medical circles, impeccable.
On the heels of Starfield's astonishing findings, media reporting was extensive, but it soon dwindled. No major newspaper or television network mounted an ongoing "Medicalgate" investigation. Neither the US Department of Justice nor federal health agencies undertook prolonged remedial action.
All in all, those parties who could have taken effective steps to correct this situation preferred to ignore it.
I interviewed Dr. Starfield by email. This is an edited version of the interview.
In the medical research community, have your medically-caused mortality statistics been debated, or have these figures been accepted, albeit with some degree of shame?
The findings have been accepted by those who study them. There has been only one detractor, a former medical school dean, who has received a lot of attention for claiming that the US health system is the best there is and we need more of it. He has a vested interest in medical schools and teaching hospitals (they are his constituency).
Have health agencies of the federal government consulted with you on ways to mitigate the effects of the US medical system?
Are you aware of any systematic efforts, since your 2000 JAMA study was published, to remedy the main categories of medically caused deaths in the US?
No systematic efforts; however, there have been a lot of studies. Most of them indicate higher rates [of death] than I calculated.
Can you offer an opinion about how the FDA can be so mortally wrong about so many drugs?
Yes, it cannot divest itself from vested interests. [There is] a large literature about this, mostly unrecognized by the people because the industry-supported media give it no attention.
Did your 2000 JAMA study sail through peer review, or was there some opposition to publishing it?
It was rejected by the first journal that I sent it to, on the grounds that 'it would not be interesting to readers'!
Would it be correct to say that, when your JAMA study was published in 2000, it caused a momentary stir and was thereafter ignored by the medical community and by pharmaceutical companies?
Are you sure it was a momentary stir? I still get at least one email a day asking for a reprint---ten years later! The problem is that its message is obscured by those that do not want any change in the US health care system.
Since the FDA approves every medical drug given to the American people, and certifies it as safe and effective, how can that agency remain calm about the fact that these medicines are causing 106,000 deaths per year?
Even though there will always be adverse events that cannot be anticipated, the fact is that more and more unsafe drugs are being approved for use. Many people attribute that to the fact that the pharmaceutical industry is (for the past ten years or so) required to pay the FDA for reviews---which puts the FDA into an untenable position of working for the industry it is regulating. There is a large literature on this.
Aren't your 2000 findings a severe indictment of the FDA and its standard practices?
They are an indictment of the US health care industry: insurance companies, specialty and disease-oriented medical academia, the pharmaceutical and device manufacturing industries, all of which contribute heavily to re-election campaigns of members of Congress. The problem is that we do not have a government that is free of influence of vested interests. Alas, [it] is a general problem of our society--which clearly unbalances democracy.
What was your personal reaction when you reached the conclusion that the US medical system was the third leading cause of death in the US?
I had previously done studies on international comparisons and knew that there were serious deficits in the US health care system, most notably in lack of universal coverage and a very poor primary care infrastructure. So I wasn't surprised.
Do the 106,000 deaths from medical drugs only involve drugs prescribed to patients in hospitals, or does this statistic also cover people prescribed drugs who are not in-patients in hospitals?
I tried to include everything in my estimates. Since the commentary was written, many more dangerous drugs have been added to the marketplace.
This interview with Dr. Starfield reveals that, even when an author has unassailable credentials within the medical-research establishment, the findings can result in no changes made to the system.
Yes, many persons and organizations within the medical system contribute to the annual death totals of patients, and media silence and public ignorance are certainly major factors, but the FDA is the assigned gatekeeper, when it comes to the safety of medical drugs. The buck stops there. If those drugs the FDA is certifying as safe are killing, like clockwork, 106,000 people a year, the Agency must be held accountable. The American people must understand that.
As for the other 119,000 people killed every year as a result of hospital treatment, this horror has to be laid at the doors of those institutions. Further, to the degree that hospitals are regulated and financed by state and federal governments, the relevant health agencies assume culpability.
It is astounding, as well, that the US Department of Justice has failed to weigh in on Starfield's findings. If 225,000 medically caused deaths per year is not a crime by the Dept. of Justice's standards, then what is?
To my knowledge, not one person in America has been fired from a job or even censured as result of these medically caused deaths.
The pharmaceutical giants stand back and carve up the populace into "promising markets." They seek new disease labels and new profits from more and more toxic drugs. They do whatever they can--legally or illegally--to influence doctors in their prescribing habits. Some drug studies which cast new medicines in a negative light are buried. FDA panels are filled with doctors who have drug-company ties. Legislators are incessantly lobbied and supported with pharma campaign monies.
Nutrition, the cornerstone of good health, is ignored or devalued by most physicians. The FDA continues to attack nutritional supplements, even though the overall safety record of these nutrients is good, whereas, once again, the medical drugs the FDA certifies as safe are killing 106,000 Americans per year.
Physicians are trained to pay exclusive homage to peer-reviewed published drug studies. These doctors unfailingly ignore the fact that, if medical drugs are killing a million Americans per decade, the studies on which those drugs are based must be fraudulent or, at the very least, massively incompetent. In other words, the whole literature is suspect, unreliable, and impenetrable.
Jon Rappoport has worked as an investigative reporter for 30 years. Nominated for a Pulitzer Prize early in his career, Jon has published articles on medical fraud, politics, alternative health, and sports in LA Weekly, CBS Healthwatch, Spin, Stern, and other magazines and newspapers in the US and Europe.
He is the is author of several books, including The Secret Behind Secret Societies and The Magic Agent (a novel).
Jon is the author of a new course for home schoolers, LOGIC AND ANALYSIS.
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