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The Wall Street Journal Health Blog today posted a couple of articles (here and here) on the costs and the effectiveness of preventative medicine in the US and Germany.  The articles outline that despite their high costs, preventative medicine programs do not actually help to prevent any disease such as colon or breast cancer.  In fact the article on Germany, based on research by the German magazine Der Spiegel, claims that the only people who benefit from the screenings are the doctors who are paid fees to perform the test.  For example, there are no randomized trials (the gold standard for medicine) demonstrating benefits for patients who under go regular colonoscopies.  In the US researchers looked at a prevention program performed with 200, 000 Medicare participants.  They found that it didn’t improve patient’s health and it didn’t result in fewer doctor and hospital visits and therefore less cost. 

For anyone who came to our dinner event last March these articles shouldn’t come as a suprise.  Preventative medicine is a misnomer.  It doesn’t actually prevent anything.  You could have a colonoscopy every single day for a year, but doing so would not lower your chances of getting colon cancer.  Preventative medicine is really early detection and screening.  It simply tells you if you already have the problem (this is an important role but it clouds the issue in peoples minds).  True preventative medicine is all about the lifestyle choices you make.  Each one of us has the keys to determine if we develop or don’t develop any of these chronic diseases such as heart disease and cancer.  We should be (and do in our office) advocating lifestyle intervention; that is the key to making America (and Germany) healthy, and in the process saving billions of dollars, not costly screening tests.

MSNBC just posted an article on the upcoming FDA decision to approve new pyschiatric drugs for children.

For this discussion I’m going to leave aside the questions of 1.) whether these drugs are safe and effective (many groups are questioning whether enough studies have been done to determine the long term effects of the drugs), and 2.) do children need to be taking them or is there a better way to help them?

Just like efforts to promote Lipitor for children, we are again seeing drug manufactures attempting to push medicine designed for adults onto younger and younger children.  This time it is a drug that many studies show has no greater effectiveness, or less side effects, then current drugs on the market.  What is the motivation behind this push then?  Well these older drugs were first developed in the 1950s, meaning that they can be bought as generic.  The cost for them is around $100/month.  The newer drugs cannot be bought as generic, they sell for between $300/month and $500/month.  These drugs had combined sales of $14.6 billion last year.  With approval for use in children that number could conceivably double.  My question is what motive beyond money could there be to approve new drugs (that haven’t been long term tested, even beyond 6 weeks) for children, and promote there use over older, known drugs when there is basically no difference in effectiveness between the two?

If these new drugs are approved by the FDA, there are two groups of people I feel sorry for.  The first, of course, is the children who take it, especially if these drugs turn out like so many others who are not properly tested (or are and those test results are buried), and have dangerous long term effects that we don’t know about now.

The second group is the doctors who perscribe these drugs.  In many cases all the information that doctors receive about a drug, its effectiveness, side effects, etc.  are from the manufactures themselves.  Most doctors, especially general practitioners, simply do not have the time to do due diligence and study every single drug they prescribe.  There are too many.  They are forced to rely many times on marketing materials they receive from drug reps, whose job it is to convince the doctors to prescribe their medication, in the case of these psychiatric drugs cost 2-3 times more but show little to no increased effectiveness.  For a more indepth view of the lengths that drug reps go to sell their products check out this article from ABC News.  It interviews a former rep for Eli Lily who sold Zypraxa, one of the drugs we’re discussing here.  He describes the lengths he went to sell doctors on drugs.  In another article a chiropractor from Michigan posts a blog describing his interaction with some pharmaceutical reps.

In the end we all pay the price if these drugs are approved.  The children who take them unknowingly face the unknown consequences of long term use of these drugs.  We, the public, have to pick up the tab on the increased cost of using these medications over the ones currently prescribed.

Update:  The panel voted to OK the psychiatric drugs just a couple hours ago.  The FDA doesn’t have to take the recommendation, but does anyone think that they won’t?  Again, there is too much money riding on it for them not to.  Don’t forget, many of these same folks who determine supposedly impartially determine what drugs get approved eventually leave the FDA to work at the drug companies themselves in high paying positions.  They definitely don’t want to endanger that golden parachute.

In a completely related note, the Wall Street Journal reports another research psychiatrist has been accused of not disclosing the fact that he receives money from the drug company, GlaxoSmithKline, which make the drug Paxil.  He was researching on a NIH grant the effects of Paxil on pregnant women.  /sarcasm| I’m sure that GSK was paying him out of the goodness of their heart and expecting nothing in return in regards to his research, even though it could be worth billions to them if her returns the “correct” outcome. /sarcasm\

Natural Health June 2009

The June 09 issue of Natural Health Magazine has a short article describing chiropractic care.  None of it will be new info for our patients, but it is a good introductory article and while it does focus on back pain it does make mention that chiropractic care is about more than just it.

Align your spine: chiropractic care helps relieve back pain but it can also ease fatigue, headaches, and indigestion

7 Health Secrets - Your Genes Don’t Control Your Destiny

This is the first clip in our 7 Health Secrets podcast series, available on ITunes - simply search for McKinley Chiropractic!

Dr. McKinley discuss epigenetics and the fact that your genetic code doesn’t determine your life.

Enjoy!