Map of life expectancy at birth from Global Education Project.

Friday, March 30, 2007

These guys are relentless

Y'all know how much I love those Europeans for being a beacon unto the world when it comes to health care policy, including the ban on Direct to Consumer drug advertising and the UK's wise and delightsome National Institute for Clinical and Health Excellence, that produces evidence based guidelines for cost effective treatment. Yes, those are prosperous, democratic capitalist countries with civil liberties and markets and comfortable middle classes and all that good stuff yet somehow they manage to do it without letting drug companies run the health care show. What would the Cato Institute say?

Anyhow, the drug companies aren't giving up without a fight. Hannah Brown in the new BMJ tells us how they are trying to undermine the EU ban on DTC advertising, and Clare Dyer tells us how Pfizer is trying to overturn NICE's guidelines for use of the (largely useless) drug Aricept for dementia. (Sorry, the second one is subscription only but you can read the first couple of paragraphs.)

As Brown explains, the drug companies aren't asking the EU parliament to let them advertise, exactly, but just to let them fund "informational resources" for consumers. They claim that otherwise, people won't have access to reliable information, and that the ban harms the "competitiveness" of the European drug industry. Both claims are obviously nonsensical on their face: there are plenty of reliable informational resources for consumers about drugs, and there is certainly no reason to think that information sponsored by drug manufacturers is somehow going to be less biased than what is already out there. As drug company critics point out, it's pretty much impossible to clearly delineate where "information" ends and "advertising" begins, when the vendor is providing the information. If there's a concern about people getting info from unreliable sources, all the EU needs to do is put its stamp of approval on high quality info. And the European drug industry doesn't somehow become more competitive when all drug companies can shill equally in Europe.

As for Aricept, it's a perfect example of why we need a NICE here in the U.S. It has been shown that it can briefly slow the progress of Alzheimer's disease. Then, after a few months, it stops working. So, NICE has approved it for moderate AD, but not for early or late stages, which is perfectly sensible. Use it when it can do the most good, and don't waste money on it when it won't do anything. But Pfizer wants to be able to sell it to people for years on end, as it does in the U.S., even though the evidence shows that is pointless.

So, we'll see if the superior wisdom of our friends across the ocean holds up. Whether the Greatest Country in History ever discovers common sense remains to be seen.

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