Herb Denenberg Column for week of August 12, 2001. (NF2-#1 Statins). (Two-part series.)
DRUG MANUFACTURERS KEEP FIDDLING WHILE PATIENTS DIE. ANOTHER CASE OF A RECALL THAT CAME TOO LATE AND WARNINGS EVERYONE KNEW WOULD BE IGNORED.
WHY YOU'RE NOT LIKELY TO GET THE TRUTH ON CHOLESTEROL- LOWERING DRUGS THAT PRODUCE $15 BILLION A YEAR FOR DRUG COMPANIES.
A TWO-PART SERIES FOLLOWS:
(Part one of a series). One of the great under-reported conspiracies involves the ability of the pharmaceutical industry to influence and control academic researchers, prescribing physicians, medical journals, pharmacy journals, the Food and Drug Administration, medical reporting and virtually every other aspect of the marketing, distribution, and image-making of prescription drugs. With its immense and growing economic power, the drug industry has been able to have its way in every aspect of the prescription drug marketplace.
This means that the public rarely gets the whole truth about the prescription drugs that it is taking in ever escalating numbers at ever-higher prices. That means drugs will often be mislabeled, misunderstood, misrepresented, misprescribed, and misused. That in turn spells needless death and injury.
Now comes the latest chapter in that long and sad story. After the drug Baycol was linked to 31 deaths in the U.S., and at least 9 abroad, Bayer, the manufacturer of the widely used prescription drug, Baycol, announced a voluntary recall. As with most drug recalls, the bodies stack up and the evidence overflows that the drug should be taken off the market, and only then does the manufacturer act. The generic name of Baycol is cerivastatin. It is known as Lipobay outside of the US. It is used to lower cholesterol. Baycol, and the other drugs in its class (Lescol, Lipitor, Mevacor, Pravachol and Zocor) are called statins.
Because the medical profession and the drug regulators at the FDA are so thoroughly brain-washed by the drug companies, the public never gets the risks of these drugs as well as their benefits. The statins may be great drugs, but those who are to be swallowing them, perhaps for the rest of their lives, should know their risks as well as their benefits. But the great American drug machine headlines the benefits but footnotes or obliterates the risks. This is typical of all aspects of the drug marketplace, and it means that millions of Americans have taken these drugs without getting the full story. Already 13 million Americans take statins, and that number is expected to skyrocket as the new guidelines for lowering cholesterol formulated by the National Heart, Lung, and Blood Institute, are followed.
This criticism is directed at failing to tell patients the truth, and not to say that the statin drugs may not have enormous benefits. But no matter what the benefit of the drug, anyone who takes it should understand its risks as well, and then decide how to balance the benefits and risks.
Take a look at the pronouncements on Baycol, the recalled drug, and you'll understand how the risks and benefits are balanced. You can assume drug companies in their presentations will be long on benefits, and short on risks when explaining a drug. But even prestigious doctors and medical schools adopt those drug company party lines.
Remember that this drug was recalled on August 8, 2001. The first death was reported in January 2000 and reports of other deaths started to roll-in thereafter. Yet the August 2001 edition of the Harvard Health Letter, a publication of the Harvard Medical School, contains an item in response to a question from a reader about the side effects of the statins. The answer from Harvard (written before the recall) says, "Statins appear to be very safe drugs, but no active compound is completely benign." In other words, the advice is that the statins are very safe, but not perfectly safe. This answer did not make sense before the recall, and now appears to be even less sensible.
The Harvard Health Letter then goes on to note: "In 2% or fewer patients, they (statins) cause liver damage, which is usually reversible once patients stop the drug." This would probably provide assurance to most readers, as they would assume even if the drug causes liver damage, it could be cured simply by discontinuing the drug. Nowhere are the consequences of permanent liver damage described in the response. The answer can be found in the package insert: "hepatitis, jaundice, fatty changes in the liver, and, rarely, severe liver damage and failure, cirrhosis, and liver cancer."
Then the Harvard Health Letter describes the kind of muscle damage that has been causing the Baycol-related deaths: "In 1 out of every 2,000 patients - or 0.1% of the time - they can cause muscle damage. Although these risks are small, your doctor should order some blood tests several weeks after you start taking a statin to check for problems." Then there is a cataloging of some of the "fairly minor problems" caused by statins: headaches, diarrhea, and abdominal gas. But again, the assurance is offered, "the fraction of patients affected is small." You have to wonder what the definition of small is. Depending on the dose, as many as 17 percent of those taking statins may get headaches, according to the package insert. Is that small? Up to 6% may experience muscle pain. Is that small? Up to 4% may have stomach pain. Is that small?
The Harvard Medical Letter talks about the drug interactions involving statins. It notes that statins might pose "a danger" (which it nowhere describes) for people taking gemfibrozil and certain other drugs. As to gemfibrozil (which is associated with 12 of the 31 deaths), the Harvard Medical Letter says, "The interaction between statins and gemfibrozil is especially interesting because it increases 'good' HDL cholesterol and is sometimes prescribed when a high LDL cholesterol count has been successfully treated, but the HDL cholesterol level is too low." They make it sound like gemfibrozil has this wonderful side effect, omitting altogether the deadly drug interaction that accounted for many of the Baycol deaths.
What makes the Harvard Medical Letter advice even more unsound is that it talks about 6 different statins, but does nothing to explain the differences in risks between them. Statins were introduced in 1987. Baycol was introduced in January 1998. So good advice should have included the following: Beware of new drugs. Avoid a new drug (less than 5 years old), unless there is some compelling reason to take it. Go with alternatives if they provide the same benefits. So certainly, good advice would have included go with an older drug that has been on the market with a chance to demonstrate its safety over the longer time period.
The Harvard Medical Letter makes another major blunder by omitting the unknown but long-term risks of these drugs. This is especially important, as patients may be taking these drugs for decades and even for life. Yet no one knows what the long-run risks of these drugs are and how safe or dangerous they may be when taken for many years or even many decades.
The Harvard advice is bad on another count as it encouraged the prescribing of Baycol, because of its low price without presenting offsetting risks. It gave the monthly cost of different brands of statins, and Baycol was one of the two lowest price drugs. Zocor is the highest priced at $112.20 a month, while Lescol was the lowest at $41.40. Baycol was second lowest at $45.90. That price array probably encouraged the prescribing of Baycol, to save money, without regard to its increased risk. When Baycol was introduced in 1998, it was probably vigorously pushed by detail men, the branch of the pharmaceutical industry that shower doctors with gifts and drug samples, along with information designed to push them to prescribe. I'll have more about questions on statins and the whole drug delivery system in general in my next column.
(Herb Denenberg is a former Pennsylvania Insurance Commissioner, Public Utility Commission and Professor at the Wharton School. He is now an adjunct professor of insurance and information science and technology at Cabrini College and a senior member of the Institute of Medicine. You can write Herb at POB 7301, St.Davids, PA 19087 or e-mail him at hdenenberg@aol.com. You can also reach him at his web sites: thedenenbergreport.org and denenbergsdump.org).
(Last part of a series). We've seen how Baycol (one of the statin drugs) was recalled in the usual too- little-too-late style of the Food and Drug Administration and the drug companies. In this column, we raise more issue about the recall and the safety of the other statins still on the market and about the state of the drug marketplace.
Baycol is one of six statins that have become a $15 billion a year business because of their ability to lower cholesterol. Their prescribing has been growing, and now 12 million Americans are taking one of the statins. You can be sure when there is a conflict between truth and a $15 billion drug, more will be prescribing the drug than the truth.
Even now, it is assumed by most reporting on Baycol and by FDA pronouncements that the statins, other than Baycol, should pose no concern for those who take them. Yet, the front-page headline of the August 10, 2001 Financial Times (of London) reads: "Europe probes anti-cholesterol drugs." The lead of the story reads: "European regulators have launched an investigation into the safety of one of the fastest-growing groups of drugs on the market (the statins)." The investigation is being coordinated by the drug-safety watchdog of the European Union, the Pharmacovigilance Working Party. They want to make sure that the problems of Baycol that required a recall do not go beyond that drug and involve other statins.
Perhaps the remaining statin that should be the subject of most suspicion is Lipitor. A good rule is to avoid drugs that have been on the market for less than 5 years. Like Baycol, Lipitor has been on the market for less than 5 years, and there's a good chance that all of its dangerous side interactions and side effects may not yet be apparent. The book, Worst Pills, Best Pills, published in 1999, says no one should take Lipitor until 2003. The other four statins (Lescol, Mevacor, Pravachol and Zocor) have been on the market for at least 5 years.
The Harvard item also totally ignores the cancer risk posed by the statins. Studies of mice show that large doses of statins cause cancer. That is no longer laughed off now that it is becoming common knowledge that 85% of the genes of mice are shared with humans.
In sizing up the other statins, remember what we pointed out in our last column: That even prestigious medical schools and other apparently objective sources of information, often do little more than echo the drug industry party line. That last column demonstrated that even the Harvard Medical Letter, from the prestigious Harvard Medical School, often follows the drug industry party line in describing the risks of a drug and fails to fully present the risks as well as the benefits of a drug.
The moral of the story: If one of the great medical schools can't be trusted to give honest advice on drugs, you better do some reading, researching and questioning on your own. After all, the Harvard Medical School, the institution in question, is a medical school that should be the essence of objective, balanced, honest advice. Instead, it gives advice that seems a bit like drug industry propaganda. So you've got to do some digging and questioning on your own. For example, you should check some of the original sources (such as the package insert of the drug) to see what is being left out of what you are being told. See what some of the consumer books on drugs have to say about the drug in question such as Worst Pills, Best Pills and the Essential Guide to Prescription Drugs 2001.
If you can't trust a medical school, you certainly can't trust drug company publications. You have to be especially wary of drug industry brochures and their other publications. I'll give one sample of its advice on the statins from a Parke-Davis flyer entitled "Controlling Cholesterol Together." It says this: "Statins are generally well tolerated. Side effects, if any, are usually mild and temporary. The most common side effects are stomach problems, including indigestion, constipation, and abdominal pain or cramps. Muscle pain or weakness is not frequent, but should be reported to your doctor; if you have a history of liver problems or are pregnant, statins may not be an appropriate medication for you."
I wonder how many of the 31 people who died taking the statin, Baycol, read that eloquent tribute to the drug's safety from Parke-Davis.
There's one other important moral from this story. It is a perfect rerun of the approach to the FDA and the drug industry take when they run into a problem. When the first Baycol death was reported in January 2000, and the deadly interaction between Baycol and gemfibozil was identified, Bayer warned doctors not to prescribe the two drugs together and to start patients on a low dose of Baycol. That would have lessened the chances of the deadly reaction. But the warnings did not change prescribing practices enough to stop the death toll. The drug industry and the FDA have gone through this dance before, and they know in advance it will fail. They typically add warnings, which are not heeded; launch education programs, which fail, and finally end up by recalling the product. Unfortunately, the FDA and the drug companies never learn from experience, or perhaps they want to keep the drug on the market awhile longer to squeeze out more profits.
If good rules of prescribing and taking drugs were followed, many of the deaths would have been prevented. Here are some of them in a nutshell:
1.Whenever possible, it makes sense to start with a lower dose of any drug rather than a higher dose. Many of the problems with Baycol were associated with higher doses.
2. As we've often said in this column, avoid new drugs whenever possible (on the market for less than 5 years).
3. Another standard bit of advice is to avoid a new drug that is simply another version of a drug that is already on the market, a so-called me-too drug. In other words, go with the proven remedies rather than the new ones that are not breakthroughs.
4. One of the most basic rules for the patient is to know about adverse effects of the drugs you are taking. You have to wonder if the victims of the drug were on the alert for signs of muscle pain and possibly muscle damage, which could be fatal. Had they called their doctors immediately, perhaps they would have survived.
5. You also have to wonder whether some of those on Baycol might have been treated by non-drug alternatives to reduce cholesterol such as diet, exercise, and weight reduction. Another important rule is to consider all non-drug alternatives.
6. When it comes to drugs, don't trust and do verify. Don't assume some drug company or doctor necessarily knows best. Ask some questions. Closely question your doctor, and seek advice from your pharmacist. The system is more than slightly out of control, so you have to impose some control yourself.
Thomas Jefferson said, "Information is the currency of democracy." I'd paraphrase that to say, "Information is the currency of medical care." In that arena, we're not getting enough information and much of what we're getting is drug industry propaganda.
(For more information on the Baycol recall, you can call Bayer, its manufacturer, at 1-800-758-9794 or the FDA at 1-888-INFO-FDA.)
(Herb Denenberg is a former Pennsylvania Insurance Commissioner, Public Utility Commission and Professor at the Wharton School. He is now an adjunct professor of insurance and information science and technology at Cabrini College and a senior member of the Institute of Medicine. You can write Herb at POB 7301, St.Davids, PA 19087 or e-mail him at hdenenberg@aol.com. You can also reach him at his web sites: thedenenbergreport.org and denenbergsdump.org).
Herb Denenberg Column for week of August 12, 2001. (NF2-#1 Statins). (Two-part series.)
DRUG MANUFACTURERS KEEP FIDDLING WHILE PATIENTS DIE. ANOTHER CASE OF A RECALL THAT CAME TOO LATE AND WARNINGS EVERYONE KNEW WOULD BE IGNORED.
WHY YOU'RE NOT LIKELY TO GET THE TRUTH ON CHOLESTEROL- LOWERING DRUGS THAT PRODUCE $15 BILLION A YEAR FOR DRUG COMPANIES.
A TWO-PART SERIES FOLLOWS:
(Part one of a series). One of the great under-reported conspiracies involves the ability of the pharmaceutical industry to influence and control academic researchers, prescribing physicians, medical journals, pharmacy journals, the Food and Drug Administration, medical reporting and virtually every other aspect of the marketing, distribution, and image-making of prescription drugs. With its immense and growing economic power, the drug industry has been able to have its way in every aspect of the prescription drug marketplace.
This means that the public rarely gets the whole truth about the prescription drugs that it is taking in ever escalating numbers at ever-higher prices. That means drugs will often be mislabeled, misunderstood, misrepresented, misprescribed, and misused. That in turn spells needless death and injury.
Now comes the latest chapter in that long and sad story. After the drug Baycol was linked to 31 deaths in the U.S., and at least 9 abroad, Bayer, the manufacturer of the widely used prescription drug, Baycol, announced a voluntary recall. As with most drug recalls, the bodies stack up and the evidence overflows that the drug should be taken off the market, and only then does the manufacturer act. The generic name of Baycol is cerivastatin. It is known as Lipobay outside of the US. It is used to lower cholesterol. Baycol, and the other drugs in its class (Lescol, Lipitor, Mevacor, Pravachol and Zocor) are called statins.
Because the medical profession and the drug regulators at the FDA are so thoroughly brain-washed by the drug companies, the public never gets the risks of these drugs as well as their benefits. The statins may be great drugs, but those who are to be swallowing them, perhaps for the rest of their lives, should know their risks as well as their benefits. But the great American drug machine headlines the benefits but footnotes or obliterates the risks. This is typical of all aspects of the drug marketplace, and it means that millions of Americans have taken these drugs without getting the full story. Already 13 million Americans take statins, and that number is expected to skyrocket as the new guidelines for lowering cholesterol formulated by the National Heart, Lung, and Blood Institute, are followed.
This criticism is directed at failing to tell patients the truth, and not to say that the statin drugs may not have enormous benefits. But no matter what the benefit of the drug, anyone who takes it should understand its risks as well, and then decide how to balance the benefits and risks.
Take a look at the pronouncements on Baycol, the recalled drug, and you'll understand how the risks and benefits are balanced. You can assume drug companies in their presentations will be long on benefits, and short on risks when explaining a drug. But even prestigious doctors and medical schools adopt those drug company party lines.
Remember that this drug was recalled on August 8, 2001. The first death was reported in January 2000 and reports of other deaths started to roll-in thereafter. Yet the August 2001 edition of the Harvard Health Letter, a publication of the Harvard Medical School, contains an item in response to a question from a reader about the side effects of the statins. The answer from Harvard (written before the recall) says, "Statins appear to be very safe drugs, but no active compound is completely benign." In other words, the advice is that the statins are very safe, but not perfectly safe. This answer did not make sense before the recall, and now appears to be even less sensible.
The Harvard Health Letter then goes on to note: "In 2% or fewer patients, they (statins) cause liver damage, which is usually reversible once patients stop the drug." This would probably provide assurance to most readers, as they would assume even if the drug causes liver damage, it could be cured simply by discontinuing the drug. Nowhere are the consequences of permanent liver damage described in the response. The answer can be found in the package insert: "hepatitis, jaundice, fatty changes in the liver, and, rarely, severe liver damage and failure, cirrhosis, and liver cancer."
Then the Harvard Health Letter describes the kind of muscle damage that has been causing the Baycol-related deaths: "In 1 out of every 2,000 patients - or 0.1% of the time - they can cause muscle damage. Although these risks are small, your doctor should order some blood tests several weeks after you start taking a statin to check for problems." Then there is a cataloging of some of the "fairly minor problems" caused by statins: headaches, diarrhea, and abdominal gas. But again, the assurance is offered, "the fraction of patients affected is small." You have to wonder what the definition of small is. Depending on the dose, as many as 17 percent of those taking statins may get headaches, according to the package insert. Is that small? Up to 6% may experience muscle pain. Is that small? Up to 4% may have stomach pain. Is that small?
The Harvard Medical Letter talks about the drug interactions involving statins. It notes that statins might pose "a danger" (which it nowhere describes) for people taking gemfibrozil and certain other drugs. As to gemfibrozil (which is associated with 12 of the 31 deaths), the Harvard Medical Letter says, "The interaction between statins and gemfibrozil is especially interesting because it increases 'good' HDL cholesterol and is sometimes prescribed when a high LDL cholesterol count has been successfully treated, but the HDL cholesterol level is too low." They make it sound like gemfibrozil has this wonderful side effect, omitting altogether the deadly drug interaction that accounted for many of the Baycol deaths.
What makes the Harvard Medical Letter advice even more unsound is that it talks about 6 different statins, but does nothing to explain the differences in risks between them. Statins were introduced in 1987. Baycol was introduced in January 1998. So good advice should have included the following: Beware of new drugs. Avoid a new drug (less than 5 years old), unless there is some compelling reason to take it. Go with alternatives if they provide the same benefits. So certainly, good advice would have included go with an older drug that has been on the market with a chance to demonstrate its safety over the longer time period.
The Harvard Medical Letter makes another major blunder by omitting the unknown but long-term risks of these drugs. This is especially important, as patients may be taking these drugs for decades and even for life. Yet no one knows what the long-run risks of these drugs are and how safe or dangerous they may be when taken for many years or even many decades.
The Harvard advice is bad on another count as it encouraged the prescribing of Baycol, because of its low price without presenting offsetting risks. It gave the monthly cost of different brands of statins, and Baycol was one of the two lowest price drugs. Zocor is the highest priced at $112.20 a month, while Lescol was the lowest at $41.40. Baycol was second lowest at $45.90. That price array probably encouraged the prescribing of Baycol, to save money, without regard to its increased risk. When Baycol was introduced in 1998, it was probably vigorously pushed by detail men, the branch of the pharmaceutical industry that shower doctors with gifts and drug samples, along with information designed to push them to prescribe. I'll have more about questions on statins and the whole drug delivery system in general in my next column.
(Herb Denenberg is a former Pennsylvania Insurance Commissioner, Public Utility Commission and Professor at the Wharton School. He is now an adjunct professor of insurance and information science and technology at Cabrini College and a senior member of the Institute of Medicine. You can write Herb at POB 7301, St.Davids, PA 19087 or e-mail him at hdenenberg@aol.com. You can also reach him at his web sites: thedenenbergreport.org and denenbergsdump.org).
(Last part of a series). We've seen how Baycol (one of the statin drugs) was recalled in the usual too- little-too-late style of the Food and Drug Administration and the drug companies. In this column, we raise more issue about the recall and the safety of the other statins still on the market and about the state of the drug marketplace.
Baycol is one of six statins that have become a $15 billion a year business because of their ability to lower cholesterol. Their prescribing has been growing, and now 12 million Americans are taking one of the statins. You can be sure when there is a conflict between truth and a $15 billion drug, more will be prescribing the drug than the truth.
Even now, it is assumed by most reporting on Baycol and by FDA pronouncements that the statins, other than Baycol, should pose no concern for those who take them. Yet, the front-page headline of the August 10, 2001 Financial Times (of London) reads: "Europe probes anti-cholesterol drugs." The lead of the story reads: "European regulators have launched an investigation into the safety of one of the fastest-growing groups of drugs on the market (the statins)." The investigation is being coordinated by the drug-safety watchdog of the European Union, the Pharmacovigilance Working Party. They want to make sure that the problems of Baycol that required a recall do not go beyond that drug and involve other statins.
Perhaps the remaining statin that should be the subject of most suspicion is Lipitor. A good rule is to avoid drugs that have been on the market for less than 5 years. Like Baycol, Lipitor has been on the market for less than 5 years, and there's a good chance that all of its dangerous side interactions and side effects may not yet be apparent. The book, Worst Pills, Best Pills, published in 1999, says no one should take Lipitor until 2003. The other four statins (Lescol, Mevacor, Pravachol and Zocor) have been on the market for at least 5 years.
The Harvard item also totally ignores the cancer risk posed by the statins. Studies of mice show that large doses of statins cause cancer. That is no longer laughed off now that it is becoming common knowledge that 85% of the genes of mice are shared with humans.
In sizing up the other statins, remember what we pointed out in our last column: That even prestigious medical schools and other apparently objective sources of information, often do little more than echo the drug industry party line. That last column demonstrated that even the Harvard Medical Letter, from the prestigious Harvard Medical School, often follows the drug industry party line in describing the risks of a drug and fails to fully present the risks as well as the benefits of a drug.
The moral of the story: If one of the great medical schools can't be trusted to give honest advice on drugs, you better do some reading, researching and questioning on your own. After all, the Harvard Medical School, the institution in question, is a medical school that should be the essence of objective, balanced, honest advice. Instead, it gives advice that seems a bit like drug industry propaganda. So you've got to do some digging and questioning on your own. For example, you should check some of the original sources (such as the package insert of the drug) to see what is being left out of what you are being told. See what some of the consumer books on drugs have to say about the drug in question such as Worst Pills, Best Pills and the Essential Guide to Prescription Drugs 2001.
If you can't trust a medical school, you certainly can't trust drug company publications. You have to be especially wary of drug industry brochures and their other publications. I'll give one sample of its advice on the statins from a Parke-Davis flyer entitled "Controlling Cholesterol Together." It says this: "Statins are generally well tolerated. Side effects, if any, are usually mild and temporary. The most common side effects are stomach problems, including indigestion, constipation, and abdominal pain or cramps. Muscle pain or weakness is not frequent, but should be reported to your doctor; if you have a history of liver problems or are pregnant, statins may not be an appropriate medication for you."
I wonder how many of the 31 people who died taking the statin, Baycol, read that eloquent tribute to the drug's safety from Parke-Davis.
There's one other important moral from this story. It is a perfect rerun of the approach to the FDA and the drug industry take when they run into a problem. When the first Baycol death was reported in January 2000, and the deadly interaction between Baycol and gemfibozil was identified, Bayer warned doctors not to prescribe the two drugs together and to start patients on a low dose of Baycol. That would have lessened the chances of the deadly reaction. But the warnings did not change prescribing practices enough to stop the death toll. The drug industry and the FDA have gone through this dance before, and they know in advance it will fail. They typically add warnings, which are not heeded; launch education programs, which fail, and finally end up by recalling the product. Unfortunately, the FDA and the drug companies never learn from experience, or perhaps they want to keep the drug on the market awhile longer to squeeze out more profits.
If good rules of prescribing and taking drugs were followed, many of the deaths would have been prevented. Here are some of them in a nutshell:
1.Whenever possible, it makes sense to start with a lower dose of any drug rather than a higher dose. Many of the problems with Baycol were associated with higher doses.
2. As we've often said in this column, avoid new drugs whenever possible (on the market for less than 5 years).
3. Another standard bit of advice is to avoid a new drug that is simply another version of a drug that is already on the market, a so-called me-too drug. In other words, go with the proven remedies rather than the new ones that are not breakthroughs.
4. One of the most basic rules for the patient is to know about adverse effects of the drugs you are taking. You have to wonder if the victims of the drug were on the alert for signs of muscle pain and possibly muscle damage, which could be fatal. Had they called their doctors immediately, perhaps they would have survived.
5. You also have to wonder whether some of those on Baycol might have been treated by non-drug alternatives to reduce cholesterol such as diet, exercise, and weight reduction. Another important rule is to consider all non-drug alternatives.
6. When it comes to drugs, don't trust and do verify. Don't assume some drug company or doctor necessarily knows best. Ask some questions. Closely question your doctor, and seek advice from your pharmacist. The system is more than slightly out of control, so you have to impose some control yourself.
Thomas Jefferson said, "Information is the currency of democracy." I'd paraphrase that to say, "Information is the currency of medical care." In that arena, we're not getting enough information and much of what we're getting is drug industry propaganda.
(For more information on the Baycol recall, you can call Bayer, its manufacturer, at 1-800-758-9794 or the FDA at 1-888-INFO-FDA.)
(Herb Denenberg is a former Pennsylvania Insurance Commissioner, Public Utility Commission and Professor at the Wharton School. He is now an adjunct professor of insurance and information science and technology at Cabrini College and a senior member of the Institute of Medicine. You can write Herb at POB 7301, St.Davids, PA 19087 or e-mail him at hdenenberg@aol.com. You can also reach him at his web sites: thedenenbergreport.org and denenbergsdump.org).
Louis J Sheehan
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