President-elect Barack Obama should take note – health reform is about the little things just as much as it is sweeping changes to the system.

Information gathered from a batch of more than 8,500 meetings held around the country in December will be compiled and used to help design the healthcare proposal that has been in the news as of late. Obama’s transition team plans to post some of the material at change.gov.

One particular meeting took place late December 2008, between newly appointed secretary of health and human services, the former Senate Majority Leader Tom Daschle, and more than two dozen seniors During this meeting, seniors told Daschle that they placed more importance on certain things such as waiting times to see their doctor, the increasing cost of prescription drugs, and the narrow range of Medicare coverage for certain medical procedures, equipment, and treatments.

An Example for Health Care Reform: Alzheimer’s

One woman at the meeting cited her family’s history of Alzheimer’s disease for her hope that the new administration will put heavy emphasis on medical research. A man said that helping people live healthier lives should receive more emphasis than it currently does – not only to improve health, but also to reduce medical costs for individuals and the nation as a whole. Another man says he wants medical providers to show more concern for the people they treat than whether or not those people will pay their medical bills.

Daschle says that lawmakers are more likely to get behind a new health care system if voters provide enough incentive pressure. And it seems that the transition team is listening: The Obama administration is encouraging seniors to submit their own stories about health care – and any other issues they think need to be addressed.

The team should also take one final note: The current effort to gather information about the health care system has been compared to the 2005-2006 attempt by the Citizens Health Care Working Group. More than 6,500 people participated in meetings across America, and a further 14,000 participated in online surveys. The Congress-sponsored group eventually recommended guaranteed health coverage for certain doctor’s visits, and some ways to protect people from high health care costs – but none of its recommendations were acted upon.

Let’s hope that this new round of meetings prompts some real change.

photo credit: woodleywonderworks

Fibromyalgia is a devastating disease that causes chronic pain and other symptoms for those who are affected – but it’s a disease with no known cause and no standard treatment. Many people haven’t even heard of the condition, but if that’s the case it’s not because the drug industry isn’t trying hard enough.

Drug Companies’ Hundreds of Millions Help Raise Awareness of Fibromyalgia

Last year, drug industry giants Pfizer and Eli Lilly spent hundreds of millions of dollars in advertising to “raise awareness” of fibromyalgia. The companies donated more than six million dollars to non-profit organizations for educational campaigns and medical conferences, too.

That’s more than the companies donated for Alzheimer’s, and diabetes. And only donations made for cancer, depression, and AIDS were higher than the donations made to further the cause of fibromyalgia.

Why all this trouble for a disease nobody’s heard of, that some doctors don’t even believe exists? Simple. Pfizer and Eli Lilly are using their money and influence to “raise awareness” and get doctors prescribing fibromyalgia drugs for people with the disease.

Is Fibromyalgia Real? Why the Sudden Drug Company Interest?

Fibromyalgia is a real disease, especially to those people who are affected by it. But there’s no standard treatment – just a couple of drugs more commonly used to treat other conditions which improve symptoms for some people with fibromyalgia.

Pfizer markets a drug called Lyrica, which originally received FDA approval for the treatment of epileptic seizers. Eli Lilly’s drug, Cymbalta, was originally approved for depression. Both have now been FDA-approved to treat fibromyalgia symptoms and will probably soon be appearing on the formulary lists of prescription drug plans, if they haven’t already.

Sales of the Fibromyalgia Prescriptions since Big-pharma’s Campaign

Since the companies began marketing “awareness” for fibromyalgia, sales increased from $395 million to $702 million for Lyrica, and from $442 million to $721 million for Cymbalta, between 2007 and 2008. Each company spent just over $125 million in advertising its drugs in the first nine months of 2008.

Now this might not necessarily be a bad thing. After all, people with this chronic, painful condition are getting treatment that they need.

The problem, however, is that the underlying purpose for Eli Lilly and Pfizer is simply selling drugs, and some healthcare professionals are concerned that undue influence from the pharmaceutical industry will pressure doctors into diagnosing fibromyalgia more often, even if it might not be appropriate.

In addition, some doctors believe that fibromyalgia, while a real condition, isn’t necessarily physical – that there may also be a psychological or neurological component in the development of the disease. If that’s the case, the drugs that Pfizer and Eli Lilly are pushing may not be the best solution for people with fibromyalgia.

photo credit: ccox888

Off-label prescribing—the practice of prescribing medication for a condition for which it is not indicated or approved—is very common in America, particularly in the treatment of psychiatric disorders. In 2001, an estimated 21% of prescriptions for the 160 of the most commonly-used drugs were off-label.  And 75% of those off-label prescriptions were written for conditions for which there is absolutely no scientific evidence to prove they work!

The law doesn’t prevent this practice, although it does prevent pharmaceutical companies from promoting off-label prescribing. Often, there’s no real harm in off-labeling, but equally so, there’s even more often no scientific proof that those off-label drugs are doing you any good. The only evidence is what’s called anecdotal – evidence that has been noted by doctors, but there has been no scientific study carried out to provide hard proof.

Doctors and law-makers know it’s a problem, but they say it’s such an extensive issue that they just don’t know how to even begin solving it. This December, however, that might be about to change, as a group of physicians will publish a paper in scientific journal Pharmacotherapy, about ways in which solutions to the off-labeling problem might be approached.

The researchers who studied the issue have identified a list of fourteen medications that are often prescribed for off-label uses. Many of the drugs on the list are antidepressants and anti-psychotics – drugs used to treat psychological problems. Six of the drugs on the list are used to treat bipolar disorder. All three of these represent categories of illness where both physicians and their patients are eager to try new solutions and off-label prescriptions.

Often, this can provide an effective means of treatment for people with psychological disorders – but the problem is, these drugs haven’t been FDA tested and approved for the uses to which they are put. That means a serious risk of unintended and unanticipated side effects, which in turn can endanger the life and safety of the patient.

An additional problem is that drug companies are reluctant to put their products through the testing required for off-label uses, not only due to the expense, but also because testing might prove the existence of undesirable side effects that might make the drugs less popular for off-label use.

The solution? The researchers and physicians who have studied the off-label issue have proposed that an extensive round of testing and surveying be conducted on the fourteen drugs identified as being most commonly used for off-label purposes. They also say that patients should be proactive and ask their doctors for more information about the medications they are prescribed.

photo credit: ragesoss

Prescription medications are expensive, and many doctors seem to become “prescription-happy.” These doctors’ first response to a patient complaint is usually to prescribe something new if something doesn’t work the first time. Even if you’re just taking one or two medications, you could be paying more than you need if you are taking brand name drugs, instead of generics.

According to a recent study, led by Dr. Aaron Kesselheim of Brigham and Women’s Hospital and Harvard Medical School in Boston, this is particularly true when it comes to medications prescribed for the treatment of heart and cardiovascular conditions. According to the researchers, there is no evidence to suggest that brand name drugs work any better than their generic counterparts.

The Brand Name vs. Generic Debate

What exactly are generic drugs? They’re drugs on which the patent has expired. When a pharmaceutical company develops a new drug, they hold the exclusive patent on that drug for a certain number of years. After that time, the exclusive rights are lost, meaning that other companies can manufacture the drug under a different name. These are termed generic drugs, because they are no longer associated with the brand name company which originally developed them.

The new generic drug might have a different shape and color, or may have different fillers or binders added to the active ingredients. In most cases, however, there is no difference at all in how well the generic drug works in comparison to its brand name counterpart. Big-name pharmaceutical companies have gone to extensive lengths to try and prove that generic drugs are inferior, but the results of the new study suggest that’s just not true.

So what’s the difference between brand name drugs and generic drugs? Just one thing – the cost. The cost per pill of a brand name medication might be a few dollars, but for a generic drug prescribed for the same purpose, the cost might be only a few cents. While 66% of drugs prescribed in America are generic, they account for less than 15% of the money spent on all prescription drugs.

This doesn’t mean, however, that you should rush to your doctor and demand that they prescribe only generic drugs for you. It’s always most important that you receive the medications your doctor feels will work best for you – whether brand name or generic. Although, of course, if you’re taking an expensive brand name medication, there’s no reason why you can’t ask your doctor if there is a cheaper generic alternative that might work just as well.

What the research really shows is that if you’re taking medication for a heart or cardiovascular condition, you can feel secure whether it’s brand name or generic. You don’t have to worry that your treatment is inferior just because you’re taking an inexpensive generic medication.

photo credit: ragesoss