Gotta love this guy! Dr. Milton Packer writes a column on MedPageToday … and he is just a cool clinical investigator and outspoken honest voice about health care issues.
He is an internationally recognized clinical investigator who has made many seminal contributions to the field of heart failure, both in understanding its mechanisms and defining its rational management. Dr. Packer’s work has spanned nearly 40 years and has been strongly supported by numerous investigator-initiated grants from the NIH and from industry. His research established the cornerstone of the current modern treatments for heart failure, for which he was the recipient of the Lewis Katz lifetime achievement award in cardiovascular research. Dr. Packer is also widely recognized for his outstanding leadership abilities, having led the Division of Circulatory Physiology at Columbia University for 12 years, which he built into the nation’s most outstanding research group devoted to heart failure. He has been the principal investigator of more than 15 large international multicenter trials. He is currently the Distinguished Scholor in Cardiovascular Science at Baylor University Medical Center.
In his recent article called It’s Official! Curing Patients Is Bad for Business, Milton Packer describes the end result of profit-dominated drug development, from MedPageToday, 18 April, 2018.
Pharmaceutical companies are developing new drugs in only two therapeutic areas these days — cancer and rare diseases. Why? These are the only therapeutic areas where exorbitant pricing is tolerated by payers.
How exorbitant are we talking about? Most new drugs for cancer and rare diseases are being priced above $400,000 a year per patient. Some drugs are being priced at $1 million per treatment. And prices continue to soar.
Who loses from this pricing practice? You might think the patients with cancer or with rare diseases are most likely to suffer. But that isn’t true.
To cover these exorbitant costs for even a small number of people, payers slash their expenditures in other therapeutic areas, and these cuts affect millions of people. For example, instead of agreeing to pay for the best treatment for diabetes for $1,500, payers approve the use of a second-rate treatment for $75. Physicians are not good at challenging payers, so most patients will get the second-rate treatment.
So the patients who lose the most are typically those who do not have cancer or rare diseases. Actually, nearly everyone else loses when a company prices a novel drug at extreme levels.
In another piece on Big Pharma and their BIG support of patient advocacy groups, Patient Advocacy Groups Take In Millions From Drugmakers. Is There A Payback? by Emily Kopp of InsulinNation.com, 9 April 2018.
Pharmaceutical companies gave at least $116 million to patient advocacy groups in a single year, reveals a new database logging 12,000 donations from large publicly traded drugmakers to such organizations.
Even as these patient groups grow in number and political influence, their funding and their relationships to drugmakers are little understood. Unlike payments to doctors and lobbying expenses, companies do not have to report payments to the groups.
The database, called “Pre$cription for Power,” shows that donations to patient advocacy groups tallied for 2015 — the most recent full year in which documents required by the Internal Revenue Service were available — dwarfed the total amount the companies spent on federal lobbying. The 14 companies that contributed $116 million to patient advocacy groups reported only about $63 million in lobbying activities that same year.
In another piece by Milton Packer, When You Talk to Patients, Do You Look at Them or at a Computer?, Dr. Packer wonders whether some physicians are healers or replicants, published on MedPageToday, 25 April 2018.
PLEASE LET ME KNOW IF YOU HAVE HAD SIMILAR EXPERIENCES! I know i have, more than I even can acknowledge or feel good about!
I recently saw a prominent physician for a medical problem. She was highly regarded in her field, and it took a while to get an appointment. I really wanted to hear her opinion of my illness. At my appointed time, I was led to an exam room, and shortly thereafter, she entered, introduced herself and promptly sat before a computer screen. While staring constantly at the screen, she went rapidly through a series of questions, which constituted her superficial effort to take a history of my illness.
We talked for about 5 minutes. And I noticed that — during this entire time — she never made eye contact with me. I really tried to engage her in the particular details of my complaints, but I didn’t succeed.
I asked: “Are you going to examine me?” As she continued to hammer at the computer keyboard, she responded: No need to do that. After the 13th minute, she finally looked at me again — to say goodbye. Total eye contact during the entire medical appointment was less than 60 seconds.
A lot transpired during those 60 seconds of eye contact. She looked in my direction, but she was actually looking past me. In contrast, I made sure to look into her eyes, and was saddened by what I saw. There was no emotion, no connection, no empathy. She was going through the motions, and doing it as fast as she possibly could. Most important of all (to her), she documented that she did everything right.