Wednesday, January 9, 2008

Pharmaceuticals

I watched a show on PBS last night about medicating children. Kim had to tell me to stop yelling at the TV. I am kind of passionate about the overuse of medications in our society. "Medicate to conform to the norm" should be the motto. . .for someone.

My work world is quite heavily involved with pharmaceuticals and the intellectual property fields. I have met Nobel Prize laureates that are more concerned with finding answers to our biology to help those with disease and could really care less about making a bazillion dollars on their discoveries and I have also met petty scientists that scream that they have found the cure to every cancer and deserve to have the Nobel Prize and a company that make a bazillion dollars. I also work with lawyers. I prefer to work with the scientists.

Anyway, I am amazed at the trust we put in our doctors. We make an appointment because we have a concern about our health. We spend 10 minutes with the doctor and he suggests that a certain pharmaceutical should correct our symptoms. "OK, you are the expert I'll take it". Would you give a contract to someone that wants to build your house after a ten minute discussion? No, you would take at least a day to think about it, speak to other builders, maybe do a little research? Why would you not do this for your health? Treat your symptoms? How about treating the cause? How about asking another doctor? Would something NON pharmaceutical help? Maybe exercise or a change in diet? We defer to doctors way too easily. Being a doctor is a job! Some doctors are good. Some, not so much. Why would I trust this doctor, I have no clue about, to make a decision for me or my family member. Hello, that is MY responsibility. Doctors are there to help us make those decisions. I learned alot about being an advocate for health care from my wife. She was so not shy about questioning doctors when they suggested treatments or antibiotics for my daughters. It turns out that many doctors prescribe pharmaceuticals because their "customers" expect them to.

I am certainly not taking a position that Doctors are not our friends. Over the last year I have had the opportunity to meet many many doctors at UVA Medical Center and am impressed with their commitment to quality.

It amazes me that many people are on many drugs to treat the symptoms of some disease or condition and on other drugs to combat the side effects of the drugs that treat the symptoms and none of them actually treat the disease state itself.

We live in a society were we are led to believe that a pill should be all we need when in fact more discretion in our life styles might prevent many of the conditions that call for these pills.

Now, I should be clear that I am not anti pharmaceutical. Not by a long shot. I praise God for the benefits of a pharmaceutical that stopped infantile spasms in a young boy this year. Without a successful treatment for this disease, [more]brain damage, lack of mental and physical development or death were possible until the disease ran its course. The untreated course can be 5 or more years. The first line treatment of the few treatments for infantile spasms (a horrible convulsive seizure disease that is accompanied by a brainwave anomaly that results in a child, that to someone not seeing/knowing the child within, that seems to be a shell) is ATHGAR GEL, a steroid (adrenocorticotropic horomone). The good news is that the treatment with ATHGAR GEL worked. It entailed daily injections over a 4 month period. When the treatment started it was quite expensive. $1800 a vial. A vial lasted 5 days at the peak of the treatment. By the time the peak of treatment was at hand, however, the drug was approved as an orphan drug. The price increased. "We increased the price to make the drug more available" the customer service representative from the manufacturer told me. Oh, by the way, the price increased to over $26,000 a vial. No I did not make a typo. The daily injection cost $5,000. Over the course of treatment, over $250,000 worth of medication was used. There was a time when my refrigerator was worth over $100,000 stocked. I thank them for making the drug. The Japanese make a synthetic version that costs a fraction of a fraction of the FDA approved "natural version". It appears to me, upon a review of the literature, to work just as well. The FDA has not approved that version for use in the USA. There is another drug available in Canada that also costs a fraction of a fraction, but it too is not FDA approved for use in The USA.
I could go on, and probably will in the future.

Take home message: Ask questions, take responsibility, and be thankful.

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