The body as machine

Inventor spends Christmas with his perfect woman - a £30,000 custom-made fembot (The Daily Mail)

"Inventor Le Trung spent Christmas Day with the most important woman in his life - his robot Aiko. ... Her touch sensitive body knows the difference between being stroked gently or tickled. ... 'Aiko is always helpful and never complains. She is the perfect woman to have around at Christmas.' "

Celebrity health advice

Are celebrities crossing the line on medical advice? (USA Today)

"Many doctors say they're troubled by stars who cross the line from sharing their stories to championing questionable or even dangerous medical advice. ... Actress Suzanne Somers-- already well-known for her diet books and ThighMaster products -- in October released her 18th book, Knockout, which experts describe as a catalogue of unproven or long-debunked alternative cancer 'cures.' ... [Celebrities] 'can spread misinformation much faster than the average person with a wacky theory. ... Correcting that misinformation -- even with a mountain of evidence -- can be a challenge. ... 'It's much easier to scare people than to unscare them.' "

Last week it looked like Big Pharma had won the latest skirmish over importing low cost drugs from Canada and other countries. But the battle isn't over yet. As FiercePharma told its drug company readers today: "And you thought you could stop worrying about re-importation."

Senator Dorgan's amendment to the health care reform bill went down to defeat on Tuesday, but on Sunday David Axelrod, senior political advisor to President Obama, told CNN that "the president is committed to moving forward" on this issue. "Let me be clear," he said. "The president supports re-importation ... safe re-importation of drugs into this country. ... There's no reason why Americans should pay a premium for the pharmaceuticals that other people in other countries pay less for."

Prescription drugs are much more expensive in the US than they are in other countries. Americans pay 36 percent more than Canadians, on average. We pay 39 percent more than Europeans and 43 percent more than the Japanese. Mevacor, a commonly prescribed statin for lowering cholesterol, costs $200 for 100 pills in the US. In Mexico, the cost is $8-$10. By charging US customers the highest price the market will bear, the US subsidizes the low cost of drugs in other countries.

At least once a year, some brave Senator proposes an amendment that would allow Americans to buy prescription drugs from other countries. Spokesmen for pharmaceutical companies, such as Glaxo and Merck, readily admit that the drugs they manufacture and sell in the US are the same as those they sell outside the US. Whenever the issue of importing drugs comes up, however, they cry: "Imported drugs aren't safe! We have to protect the public!"

When a government is directly involved in health care, the sheer size of its purchasing power allows it to negotiate lower prices for drugs. That's why drugs cost less in Canada over the Internet.

In the US, drug company lobbying is so powerful that it can convince Congress to prohibit the negotiation of discounts (the 2003 Medicare Prescription Drug Act). As if that weren't enough, it's illegal for Americans to order drugs from Canada. (You're allowed to carry a 90-day supply over the border.)

President Obama has, in the past, favored changing legislation that prohibits drug purchases from Canada. (Congress calls this drug reimportation.) John McCain was in favor of change. (It's a popular position when running for election.) Democrats have been advocating this change for years. Between 70 and 80 percent of Americans favor this option.

According to the Center for Responsive Politics, the pharmaceutical industry spent $1.2 million a day on lobbying during the first quarter of this year. Not surprisingly, the biggest spender has been the largest pharmaceutical lobbying group, PhRMA, which has spent $7 million. Pfizer was a close second at $6 million.

Meanwhile, The Washington Post reports that the largest hospitals, medical groups, and insurers have hired more than 350 lobbyists who are either former government staff members or retired members of Congress. Three out of every four major health-care firms have at least one lobbyist on their payroll who's been recruited from inside the government. Nearly half of these come from either key Congressional committees that are currently debating health care legislation or from the staff of key lawmakers, such as Senators Max Baucus and Charles Grassley.

Acetaminophen, whether it's in Tylenol, Arthritis Pain Relief, Nyquil, or Vicodin, is safe as long as you don't take too much. The new maximum dose likely to be recommended by the FDA is 2600 to 3250 milligrams a day. That's ten 325-milligram Tylenols.

Tara Parker-Pope has a question and answer post on the subject in today's NY TImes. One question is: As a precaution, should consumers switch to other types of over-the-counter pain relief?

Source: Gedichten Gedacht

Legally grown opium is used by pharmaceutical companies to make morphine and other pain killers. Fifty percent of that opium is supplied by Australia. According to a BBC News report, a problem has developed with "wallabies entering poppy fields, getting as high as a kite and going around in circles. ... Then they crash." Other animals have also been spotted in the poppy fields "acting unusual."

The story is followed by a number of cute and creative comments. For example:

I've lived in Tasmania for many years. Not only do wallabies congregate in poppy fields, but also on the local golf courses. They do this mainly at night and I can only assume they're playing several rounds of golf while avoiding greens fees. You only need to be really worried when one of the stoned wallabies gets into a golf buggy.

Last week the CEO of Roche Pharmaceuticals had some candid comments on direct-to-consumer advertising:

Direct-to-consumer promotion [of drugs] was the single worst decision for the industry. ... When industry says we're spending all the money on R&D but actually it's spending it on TV advertising to preserve margins, it doesn't get much credibility.

William Burns went on to say the "marginally different and market-it-like-hell model [of prescription drugs] is over."

Who besides the pharmaceutical industry thinks direct-to-consumer DTC advertising is a good idea? Doctors object to patients who self-diagnose and then insist they know just what the doctor should order.

So what happens is they come into the office, and they'll say: 'I need a certain drug.' And a lot of times we'll spend more time either negating the diagnosis that they've made just by the commercial, in addition to explaining why that certain medication is not appropriate for the following reasons.

The public actually sees some advantages to DTC ads. They educate, raise awareness and reduce stigma (think Viagra). But the public also understands that these ads raise prescription drug prices, stimulate unnecessary demand, and do a poor job of explaining the negative side effects.

Personally I think it's one thing for an ad to sweet-talk me into buying a Lexus, but when it comes to my health, someone - the FTC perhaps? - should just say no. DTC ads are only allowed in the US and New Zealand. There's a good reason.

Osteoporosis and the flying nun

Burns' company Roche sells the once-a-month osteoporosis drug Boniva, whose spokeswoman is Sally Fields. For Fields, promoting Boniva is part of her feminist cause:

I want to help change the way women live as they age. We have fought so hard in our lives for things to be better, not to accept the status quo. We surely can't stop now that we are entering this next part of our lives

President-elect Obama has made it clear he wants to change US health policy, and he appears to have widespread public support to do just that. The pharmaceutical industry, on the other hand, likes things just the way they are. We can expect Big Pharma to put up a fight to protect their interests and, in fact, the first shot will be fired this week. But the pharmas need to walk a fine line. Their public relations efforts over the past few years have been an attempt to win public sympathy. Now they need to attack Obama without jeopardizing all that goodwill.

One change in health policy already singled out by Obama is the federal government's ability to negotiate Medicare drug prices. This particular item could cost the drug industry as much as $30 billion. Not surprisingly, PhRMA, the largest pharmaceutical lobbying group, has been preparing for this moment and last week announced a new public relations campaign.

"We're going to do an ad campaign that is designed to make people aware of the importance of preserving your free-market health care system." This from Ken Johnson, a senior VP at PhRMA, quoted in the Washington Times.

In a post titled "Is big pharma preparing to shoot itself in the foot?", David Williams had this to say:

[The PhRMA ad campaign] may try to have the same impact as the famous Harry and Louise ads of 1993 that undermined the planned Hillary Clinton-led reform bill. ... If that's really the aim, someone is misjudging the mood of the public. People aren't looking for "free-market" anything at the moment, especially when what the pharmaceutical industry really means by "free market" is pricing freedom for themselves. ... Here's some friendly advice to the pharmaceutical industry: don't make the mistake of attacking the policies of our new President. Such a move is likely to backfire.

PhRMA polishes its image

PhRMA hasn't been sitting on the sidelines during the election campaign, waiting to see who wins. PhRMA's Johnson also had this to say:

Drugs are expensive and drive up the cost of health care. The problem with drug companies, however, is not simply that individual drugs are expensive. There's a story in the news today about how the Obama victory and a Democratic congress may put downward pressure on drug prices. One industry analyst thinks this won't be a serious problem since drugs have a very high markup: the number of products sold, not their price, drives industry growth. If health coverage expands, drug sales will increase, which is good news for drug companies.

In 1976, the chief executive of Merck told Fortune magazine that he dreamed of marketing drugs the way Wrigley's markets chewing gum: to as large a market as possible. The real problem with drug companies is their attempt to convince as many people as possible that they need drugs. This is disease mongering: expanding markets by convincing healthy people that they're sick. Health has come to mean that feeling fine is an illusion easily shattered by the next news cycle or by the next prescription drug you're encouraged to "ask your doctor about."

When a patient has a disease and a doctor prescribes treatment, the doctor can observe whether or not the patient responds to the treatment. If the treatment doesn't work, it's discontinued. When a healthy patient is at risk for disease and a doctor prescribes treatment, there's no way to be certain the treatment is working. The patient might never have gotten sick. So the treatment continues indefinitely. This wouldn't be a problem if pharmaceuticals were harmless, but all drugs have side effects. The more people you treat with preventive pharmaceuticals, the more people there will be who suffer the adverse effects of treatment.

From Iona Heath: "[D]isease mongering exploits the deepest atavistic fears of suffering and death. ... Human societies are riven by the effects of greed and fear. The rise of preventive health technologies has opened up a new arena of human greed, which responds to an enduring fear. The greed is for ever-greater longevity; the fear is that of dying. The irony and the tragedy is that the greed inflates the fear and poisons the present in the name of a better, or at least a longer, future. Ultimately, the only way of combating disease mongering is to value the manner of our living above the timing of our dying."

Medicalization and disease mongering

I don't have a lot of personal complaints about medicalization. As a woman, I don't worry about erectile dysfunction or male pattern baldness. I haven't had to decide to use Ritalin for a hyperactive child or growth hormones for a son who is shorter than his classmates. In my heart of hearts, I consider myself a social deviant (and am proud of it), but I don't exhibit behavior that brings me to the attention of physicians, psychiatrists, or the law.

Many things that used to be considered a normal part of life - childbirth, menopause, insomnia, sadness, excess weight, aging, death - have been redefined as medical conditions and subjected to diagnosis and treatment. This process is called medicalization: Redefining a non-medical condition as a medical one. Medicalization is a major contributor to the health culture. It broadens the definition of health and encourages us to think of ourselves as in need of medical attention.

The active process of converting a benign condition into a medical disease is called disease mongering. Lynn Payer wrote a whole book on the subject: "[D]isease mongering - trying to convince essentially well people that they are sick, or slightly sick people that they are very ill - is big business. For people to use a diagnostic product or service, they must be convinced that they MAY BE sick. And to market drugs to the widest possible audience, pharmaceutical companies must convince people - or their physicians - that they ARE sick."