Conflicts of Interest

June 28, 2019

‘Grass-roots’ vaccination foes funded by wealthy few

With children in tow and emotions cranked to the max, parents from coast to coast have protested officials’ efforts to protect the public’s health by requiring children to be immunized against contagious and infectious diseases that can cause great harm. A cornerstone of the vaccination resistance has been its proponents push to portray themselves as a grass-roots movement of independent individuals fighting medical overreach by the state.

But the Washington Post, as part of its coverage of the nation’s most severe outbreak of measles in three decades (more than 1,000 cases with just half the year over), reported that Bernard Selz, a philanthropic Manhattan hedge fund manager, and his wife, Lisa, have given more than $3 million to groups that oppose vaccination. This has allowed individuals associated with the groups to organize vaccination opponents, giving them leaders to coalesce around and an out-sized voice in public controversies over kids and shots.

Selz money has gone to Andrew Wakefield, a British doctor who brought professional disgrace on himself and who had his medical license in his home country stripped over falsehoods he spread through a since-retracted article in a medical journal purporting to link vaccine shots to autism — a claim not only unsupported but debunked repeatedly by rigorous, published, follow-on research.

June 23, 2019

Opioid crisis? ‘Not my fault,’ say surgeons and drug maker’s heir

by Patrick A. Malone

As the nation’s opioid and drug overdose crisis deepens, it can be hard to watch as the “Not My Fault” crowd clucks about its blamelessness in pushing potent painkillers that have played a part in killing more Americans in 2016 and 2017 alone than lost their lives in the Vietnam War.

The latest NMF protagonists include:

David Sackler, the outrage-fueling scion of the family that owns Purdue Pharmaceutical, the maker of OxyContin. That drug — and the relentless and inaccurate sales and marketing push that the Sackler family put behind it — helped to foster a calamitous wave of prescription painkiller abuse and addiction, deep media investigations and court cases have shown. OxyContin, in turn, assisted in opening the door to lethal abuses and overdoses of even stronger legal and illicit drugs, including the painkiller fentanyl and street heroin.

June 21, 2019

Pleas for ‘wellness’ moderation: Foods aren’t dirty, bad, or a cause for shame

by Patrick A. Malone

Moderation matters in all things, though its proponents often seem to get shoved aside by more extreme views. Now there is welcome new push-back against wellness hype by those who instead want science- and evidence-based approaches to health and nutrition to prevail.

In separate and unrelated expressions of their points of view, novelist Jessica Knoll (in a New York Times Op-Ed) and dietitian and nutritionist Ellie Krieger (in a Washington Post column) both take after the way that a certain chic crowd tries to get Americans — women especially — to adopt what they say is wrong thinking about food and eating.

Krieger (shown, above left) calls it cringe-worthy that individuals focusing on diet and nutrition reflexively now apply loaded, moralistic terms to food like good, bad, dirty, and unclean. She describes the problem she and others in the field have with this:

June 16, 2019

For Insys, infamy in two opioid crisis firsts: convicted founder and bankruptcy

by Patrick A. Malone

Insys Therapeutics, a drug maker that peddled powerful and addictive painkillers in sordid ways, entered yet another phase of its penalties for its criminal conduct: The firm in quick fashion agreed first to pay $225 million to resolve federal bribery charges, then promptly sought bankruptcy protection.

Federal prosecutors, who earlier had won criminal racketeering convictions against the firm’s CEO and other Insys executives, emphasized that the Big Pharma firm hasn’t declared itself insolvent in its bankruptcy action and will pay up for damages caused by Susbsys, its chief product.

Subsys is a liquid containing the super potent painkiller fentanyl. It is administered as a drop under the tongue and was supposed to benefit cancer patients with grueling pain. Instead, Insys CEO John Kapoor “used speaker’s fees and lap dances to lure doctors into prescribing Subsys for far more patients than the drug was approved for and cheated insurers into covering prescriptions for the costly medication,” the Washington Post reported. Kapoor and other Insys execs await sentencing after their federal felony convictions.

May 23, 2019

Generic drugs ensnared in price-fixing and shoddy manufacturing claims

by Patrick A. Malone

With Big Pharma pressing the limits in promoting and pricing prescription medications, patients and their advocates long have hoped that generic drugs might be difference-makers on costs and practices. Those positive wishes, however, may be dying out by the day.

The attorneys general of dozens of states have sued major generic makers including Teva, Pfizer, Novartis and Mylan, accusing them of conspiring to inflate generic drug prices by as much as 1,000%, the New York Times and other media organizations reported.

The makers’ price-fixing affected more than 100 generics, including “lamivudine-zidovudine, which treats H.I.V.; budesonide, an asthma medication; fenofibrate, which treats high cholesterol; amphetamine-dextroamphetamine for A.D.H.D.; oral antibiotics; blood thinners; cancer drugs; contraceptives; and antidepressants,” the New York Times said.

May 8, 2019

Big Pharma executives convicted of criminal racketeering with opioid sales

by Patrick A. Malone

Even as more felony charges may follow in drug epidemic, sleep med warning suggests pill popping stays too popular

Five top executives at a major drug maker have been convicted of criminal racketeering for their aggressive and deceptive marketing of a fentanyl spray in a case that prosecutors long have said may warn corporate leaders about their culpability in the nation’s opioid painkiller crisis.

Federal jurors deliberated for 15 days before finding guilty John Kapoor, founder and CEO of drug maker Insys (shown at right). Jurors also convicted Richard M. Simon, former Insys national director of sales; Sunrise Lee and Joseph A. Rowan, both former regional sales directors; and Michael J. Gurry, former vice president of managed markets. As the New York Times described the case against them:

April 3, 2019

$1 billion+ may seem like a lot of money. It still can’t resolve many questions.

by Patrick A. Malone

Although lawsuits can result in needed financial support and welcome recognition of harms suffered by patients seeking medical services, the civil justice system has its limits. They showed in cases in the news in which disputing parties agreed to more than $1 billion in resolutions that left issues unanswered.

What to make of the:

$270-million that Purdue Pharmaceutical will pay to end its part of a fight with Oklahoma over the opioids crisis that has killed hundreds of thousands of Americans

March 25, 2019

Electronic records mess threatens patient safety, investigation finds

by Patrick A. Malone

Tempting though it may be to dismiss doctors’ howls about electronic health records—maybe they’re Luddites or they’re just another group of high-paid workers beefing about their job tools—the persistent and significant nightmare of the complicated computer systems has been this: Do they harm patient care?

The answer now may be: Yes, billions of taxpayer and private dollars spent on EHRs may be reducing patient safety.

That’s the finding of the independent, nonpartisan Kaiser Health News Service, based on its extensive investigation in partnership with Fortune Magazine. The two media operations reported that:

March 22, 2019

Health care has its share of gaming by the deep-pocketed and powerful

by Patrick A. Malone

The rich and powerful may seem to run amok as the nation lurches through its latest gilded age. But sometimes:

They get reined in by public shaming, as seems to be occurring with a developing scandal over insider deals in the University of Maryland Medical System (UMMS).
It takes prosecutors to check abuses, as is occurring with the college admissions mess and notably how it harms students with genuine need for learning accommodations.

March 17, 2019

A lesson on vaping from sugary drinks of yore: Crack down on Big Tobacco

by Patrick A. Malone

Those who are senior enough to remember the allures of sweet drinks like Tang, Hawaiian Punch, and Kool-Aid also may need to be sage enough to share a deep, evidence-based distrust and disapproval for the nefarious actions of Big Sugar and Big Tobacco. Those suspicions may need to be renewed in regulators’ crackdowns on vaping, its flavorings, and flavored tobacco cigarettes.

Yes, the federal Food and Drug Administration now has formally detailed its plan to curb the soaring youthful purchases and uses of e-cigarettes for vaping, telling merchants that they soon will be required to keep these goods, including flavored liquids that the devices catalyze, in separate walled off areas of stores and away from those age 18 and younger. This will affect not only big retailers like Walgreens and Wal-Marts but also gas stations and convenience stores.

Online vendors soon will be required to have mechanisms, so proof of age becomes part of cyber buys of e-cigarettes and their associated products.