Dapper dolphins dealing crack to children

And they think it’s just one big joke.

Abortion in Queensland – is it what you think?

If you criminalise abortion, what do you expect will happen?

(The Australian) TEGAN Simone Leach was 19, pregnant and “scared” when her boyfriend’s sister arrived in Cairns last Christmas Day with a consignment of contraband tablets and doctor’s instructions written in Ukrainian.

What transpired after Ms Leach allegedly terminated her pregnancy with the abortion pill RU486 and the Queensland police got involved, has unleashed a legal and political storm of the like not seen before in this country.

Ms Leach will face court next month charged with the crime of procuring her own miscarriage, in what is believed to be the first case of its kind to be brought under Queensland’s century-old abortion laws.

If convicted, she faces up to seven years’ jail.

The young man in her life, Sergie Brennan, 21, faces up to 14 years’ imprisonment for attempting to procure an abortion and three years’ jail on a further charge of supplying the means to procure an abortion. [more]

As expected there is quite a lot of anger coming from liberal left sector – with the launch of the Pro-choice Action Collective in Queensland. They have a facebook group and a website. But is this the right case to be defending?

The wallabies are wasted

You’ve probably all heard it by now. Tasmanian wallabies are getting wasted in poppy fields and creating crop circles.

I was gonna blog this way back in last week. But then I had a farewell from work, a farewell from friends, social lounge, someone else’s farewell, clean, pack, uniquest, and then today I had to scramble to unpack and scan identifying documents in the vain hope of proving that I can afford to pay for potential accomodation (I can… I hope).

But man… those wallabies… that is awesome.

I wonder if that means there may be a grant out there on doing some studies on marsupials and drugs/addiction?

Image credit: mrmanc on flickr (CC by attribution & share-alike)

Insight into Australian medical marketing

Insight on SBS ran a televised forum on medical marketing practices in Australia about a month ago, but I’ve only just caught up and watched it – it’s still available online. The forum involved proponents from within the industry, key watchdog figures, specialists, general practitioners, medical students and a few patients/consumers.

The key thing everyone seems to want is transparency – including the pharmaceutical industry, if only to appease public concerns.

Unregulated pharmaceutical advertising looks like this

It was good to see a discussion that focused well on the situation here in Australia (i.e. no direct-to-consumer advertising, subsidised universal healthcare, and a strict marketing code of conduct by an industry body enforced by an independent review panel). The best points I feel were made by the professor who pointed out that there is no problem with transparency, but why are we singling out the medical profession and pharmaceutical industry? Why are we not as concerned about the links the industry has to politicians, or pharmacists*, or the influence created by sponsorship of mining, agricultural, tourism and other industries on their respective providers?

No industry is as regulated and scrutinised as our medicines industry. Yet, it continues to be criticised as not doing enough. Sure, the system is by no means perfect, breaches occur – but they are pulled up on breaches, punished, and those breaches are publicised (and as the Pfizer representative said, that hurts their public  image much more than any fine). I would not like to silence the critics, as that is the only way we can improve this system. They made good points that I’ve already blogged about recently drug samples don’t help, and brand name reminders (no matter their value) influence doctors.

Some concerns though seem a bit silly. What is wrong with bringing doctors from overseas to talk about medical advances? And just as odd, what is wrong with a mere 3% of doctors being sponsored to go overseas to learn about medical advances? Do they think Australia should develop it’s medical knowledge in isolation from our neighbours and field leaders in the US and Europe?

And some were just based on pure inability to comprehend how industry works, or anti-industry sentiment. I’m sure one person brought up the low cost of medicine manufacturing per pill compared to per pill costs to the consumer (because that is the only cost the industry faces ever?).

Some things I would have liked to have seen discussed more (or at all):

• Spokespersons from either medical education or advertising companies – the people who actually produce the marketing materials?
• Education in university medical courses – are medical students in Australia trained to deal with industry?
• Training given to industry representatives regarding the code of practice – why do breaches still occur if everyone knows the rules?
• Those industry marketers not participating in the MA, who watches them?
• More scrutiny on those outside of the industry – pharmacists, consumer products, CAM and others who make spurious health claims  and marketing incentives outside of regulatory bodies?
• The ghost writing issue (this was probably avoided due to the legalities surrounding the Merck/Elsevier case, or SBS just didn’t know about it)

*The “chemists” the crusie ship guy were on about, were more than likely street-pharmacists, or even pharmacy assistants, regarding sales of alternative medicines, vitamins and/or consumer medicines – absolutely nothing to do with prescription medicines. I wonder if they’ll do a similar special with the Pharmacy Guild?

Free drugs: Just say no?

“Everybody likes something free.” I don’t think anyone is going to disagree with Chimonas and Kassirer there.

Drugs are expensive. And even if in a country like Australia, universal insurance may mean that vital medicines are cheap for the end-consumer, somewhere someone has pay the full price (i.e. the government).

Because drugs are so expensive, many drug companies – particularly when releasing a new product, will offer “free samples”. Now these aren’t quite like a give-away taste-test counter like at the local deli – the drugs still need to be prescribed by the doctor to a sick patient – but the principle is the same. You try it, and if it works, hopefully you’ll buy the real deal.

Sounds great! Hospitals get free medicines. Doctors learn about new treatments. Patient receives expensive treatment cheaply. And Pharma makes a friend. Everyone is a winner! What’s not to love?

Well… turns out it’s not quite the rosy picture we’d pictured. PLoS Medicine carries an investigative essay on the ramifications of free drug samples on the health care system.

Summarised points below:

Drug-fuelled psycho-textbooks unleashed in hospitals

Thus reads the tabloid headlines.

Okay. Okay. Not quite.

Wall Street Journal blog actually states:

The Boston Globe got wind of the study, which found that among 20 authors of the guidelines for treatment of depression, dipolar disorder and schizophrenia, 18 had at least one financial tie to a drug maker, and 12 had ties in at least three categories, such as consulting, research grants, speaking fees or stock ownership.

It still sounds like an expose on the sinister Big Pharma Conspiracy.

Is this really worrying? Is it even surprising?

More than medicine

Hot on the heels of discussions about Pharma and digital media – GSK has recently launched a corporate blog More Than Medicine. They aren’t the first Big Pharma to do so, Johnson & Johnson is also present in the blogosphere with JNJ BTW.

The idea behind the blogs is to create a more comfortable dialogue between these large overarching organisations and the end-product consumers (i.e. you and me).

J&J: “Everyone else is talking about our company, so why can’t we?”

GSK: “Our goal is to encourage an open, productive discussion about a range of topics .. that doesn’t sound like it’s written in ‘legalese’.”

Already GSK has been called out for having pseudonymous bloggers – but while it might somewhat detract from their claim to broad openness, it’s hardly a rare thing amongst bloggers (ummm… does yours truly qualify?*) Relationships don’t have to be built up on a first name basis.

Already the two blogs have very different styles, and showcase positive ways in which Pharma can successfully harness this new media.

Do you feel special?

Via Biology in Science Fiction.

Look closer

Nikon has the results from its 2008 “Small World” Photomicrography competition.

People’s choice Chicken Embryo does simply amaze.

But I’m going to pick on these two pictures. They are very interesting, and also hard to guess. Can you work out what they are?

Study: Stabbing ≈ relief?

I really want more information before I make judgement on this news release:

“Acupuncture beats drug to hot flashes: study”

But I already have a few flags.

The best outline of the study was at the hospital’s own press release (I could find no peer reviewed published data*, anyone care to point to it).

“Seventy of the 140 patients enrolled in the two-year study will be randomly assigned to receive acupuncture for 12 weeks. The other half will receive Effexor over the same time period. Data will be collected at quarterly intervals in the first year. Researchers will test the effectiveness of acupuncture for reducing hot flashes and if it has fewer side effects than Effexor.” – Henry Ford Health n.d

ZZ: Please note Reuters places the final included patients figure at 47 patients, but still has them split 50:50. Lots of drop outs and exclusions*, or did they just shortfall their expected enrolment.

Now the design almost seems well and good. Patients were selected for meeting criteria, such as having 14 or more flashes per day etc. But while patients are being randomly assigned, it’s not exactly blind* is it? You can’t really hide who your giving medicine too and who you are jabbing acupuncture needles into.

Additionally, where are the controls? There is no placebo* on either treatment. A good study would at least have a third group receiving a placebo version of Effexor. An excellent study would also use placebo acupuncture or at least a placebo CAM (complimentary or alternitive medicine – or “woo”). A mindblowingly overfunded mega-study would have groups receiving both treatments, and combinations of conventional and CAM treatments and conventional and CAM placebos.

Were the patients denied any other treatments while on this study? or after the treatment period, (acupuncture was given 12 weeks out of the 104)? Sometimes clinical studies comparing a new drug’s efficacy allow standard drugs to be used as well. Otherwise you are denying a patient ethical treatment. Sometimes that “standard drugs” used in addition to the treatments on trial may even be the drugs you drawing comparisons with. Perhaps the acupuncture group was taking Effexor or other drugs*. And perhaps in lower doses, explaining their lower levels of side-effects.

So, what exactly is Effexor?  Well it’s the proprietery name for venlafaxine (Wyeth must be so happy about this free press). It’s an antidepressant, not an anti-hot flash medication. Now, while not its intended use, there is evidence that low doses of venlafaxine and other antidepressentscan effect relief during hot flashes , but it is not the standard treatment as the news reports are suggesting*. Mayoclinic‘s page on hot flashes explains that hormones (oestrogen, progesterone) are what is recommended.

Don’t miss the flip-flop after the break.

Natural non-high relief

via Science Daily

A new drug hopes to exploit cannaboid receptors without getting you high.

By targetting cannaboid receptors found outside the brain, UK researchers hope that CB2 agonists will not only be capable of being a non-high inducing medicinal herb, but even be an alternative to other risky pain-relieving drugs like morphine.

Non-opioid drugs are gaining a bit of press lately. Last month, there was Xenome’s new drug derived from cone shell venom.