Wednesday, July 8, 2009

Medicine's not-so-silent killer: Drugs gone bad

Bad reactions to drugs cause the death, hospitalization or serious injury of more than 2 million people in the United States each year, including more than 100,000 fatalities, according to Public Citizen.

Adverse drug reactions are one of the leading causes of death in the country. The odds of suffering an adverse drug reaction don't just impact senior citizens -- almost half of the FDA reports of deaths and 61 percent of hospitalizations from adverse drug reactions were in people younger than 60.

According to Dr. Robert Steinbrook, who wrote an article on doctor/industry ties in the New England Journal of Medicine, it is very common for doctors to have financial ties to a company that makes drugs or devices.

"Most physicians in the United States have financial relationships with industry, ranging from the acceptance of meals to the receipt of large sums of money for consulting, speaking, or conducting research," he wrote.

Harvard Medical School plans to strengthen its conflict-of-interest rules for doctors and researchers, after an investigation into several of its faculty members. It will join Stanford University, the University of Pennsylvania, the University of California at Los Angeles and at San Francisco, and the University of Massachusetts in adopting stricter policies.

Last year, the American Medical Student Association gave Harvard an "F" on its conflict-of-interest policy because it fails to address whether companies can provide gifts for doctors and researchers. A review of its policy began after a US Senator from Iowa accused three Mass General psychiatrists of not fully disclosing payments they received from drug companies for consulting and other activities. The doctors believe they complied with the rules, but Harvard Medical School and Mass General are conducting their own investigations.

Recently, the Vermont legislature passed a law requiring drug and device makers to publicly disclose all money given to physicians, naming names and listing dollar amounts. The law, which took effect July 1, is considered one of the most vigorous state efforts to regulate the marketing of medicine. It also bans nearly all industry gifts and meals to doctors, nurses and medical staff. Makers of medical devices and drugs spend almost $3 million on marketing to health care professionals in Vermont, according to the state's attorney general.

Minnesota already requires drug companies to report payments to doctors and new regulations in Massachusetts limit gifts and call for disclosure of any payment or gift of $50 or more. However, Vermont's law goes a step farther, banning all free meals. The law also closes a loophole in pervious regulations that allowed companies to keep specific expenses private by claiming them as trade secrets.

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