quinta-feira, 15 de fevereiro de 2007

Projeto no Congresso americano para barrar "discriminação genética".

O Congresso americano avança para impedir que testes genéticos sejam utilizados por empregadores e por empresas de seguro. Se aprovado será um exemplo bom para os demais países. Ao que consta, há locais com teste para doenças como a coréia de Huntington.
Abaixo, trecho de reportagem do The Wall Street Journal.
Genetic-Discrimination BanNears Congressional Approval By JANE ZHANGFebruary 15, 2007; Page A11 WASHINGTON -- A bill barring discrimination by employers and insurers based on genetic information is moving swiftly through Congress, drawing praise from privacy advocates and objections from business groups that the measure is too broad. The legislation would be the first federal law prohibiting health insurers from denying coverage or charging higher premiums based solely on genetic information. It also would forbid employers from using the information to make hiring, firing and other job-placement decisions.

terça-feira, 13 de fevereiro de 2007

J&J e Ethicon do Brasil: quero certidão negativa do Brasil.

A Johnson & Johnson declarou nos Estados Unidos que um de seus executivos prevaricou em países não identificados com produtos da Ethicon. Como a Ethicon atua em quase todos os hospitais do país, gostaria muito de ver uma declaração negativa oriunda da matriz isentando os executivos brasileiros da empresa. A ANVISA precisa agir de imediato, afinal estamos todos sob suspeita: órgão regulador, a filial brasileira, gestores públicos e privados e dirigentes hospitalares. Abaixo, artigo de The Wall Street Journal sobre o tema.
J&J Reports Improper Payments Drug Firm Tells RegulatorsOf Expenditures Overseas;A Senior Executive Resigns By AVERY JOHNSON, KARA SCANNELL and JON KAMPFebruary 13, Johnson & Johnson said it alerted federal officials to improper overseas payments and that one of its senior executives is resigning over the probe. The New Brunswick, N.J., health-care conglomerate voluntarily told the Department of Justice and the Securities and Exchange Commission that it believes its subsidiaries made improper payments in two countries regarding the sale of medical devices. Michael J. Dormer, world-wide chairman for Medical Devices & Diagnostics, stepped down as a result of the revelations. Mr. Dormer had been in charge of several medical-device divisions, including Ethicon, Ethicon Endo-Surgery and DePuy. The company didn't name the countries involved. A J&J spokesman declined to comment beyond the press release, which said that Mr. Dormer told the company in a letter that he has "ultimate responsibility by virtue of my position" for the subsidiaries involved in the disclosure. The J&J spokesman said Mr. Dormer was not available. An SEC spokesman declined to comment. Get alerts for breaking news -- such as Fed moves, major world events and big mergers -- delivered straight to your desktop. Alerts will appear in a small window on your screen, much like an instant-messaging window. The disclosures are a bitter pill for a company that prides itself on its clean corporate image. It was not immediately clear whether the probe extended beyond the countries, which J&J described as "small" markets, or what specific allegations or subsidiaries it involves. But J&J said that the payments in question may fall within the jurisdiction of the federal Foreign Corrupt Practices Act, which prohibit improper payments to foreign officials in order to win or keep business. The Justice Department and SEC have stepped up their pursuit of foreign-bribery cases in recent years, including a record $28.5 million collection against Titan Corp. in 2005. Titan pleaded guilty to settle allegations involving improper payments to Titan's agent in Benin, Africa, some of which were passed on to the re-election campaign of the country's then-president, according to government papers. The government alleged that Titan paid the money in an effort to win higher fees for a telecommunications project. Other companies have reached settlements, which generally involve deferred-prosecution agreements with federal prosecutors where the company or its subsidiary agrees to settle the allegation instead of facing an indictment. In a deferred-prosecution agreement, an indictment is usually filed but is dismissed if the company adheres to the terms of its settlement. As part of a joint settlement, most companies also agree to have a corporate monitor in place to inspect internal controls and book-and-record keeping. The SEC and Justice Department have several open joint investigations. Johnson & Johnson has a huge medical-devices business, with products ranging from replacement hips and knees to blood glucose meters and drug-coated heart devices. The company's Medical Devices & Diagnostics division registered $20.28 billion in sales last year, about 38% of total corporate sales. Device sales were split about evenly between the U.S. and international markets.

segunda-feira, 12 de fevereiro de 2007

Pague seu almoço, doutor!

The New York Times divulga o Projeto Prescrição destinado a acabar com os famosos almoços de divulgação onde a indústria farmacêutica divulga seus produtos. Nos EUA com comida chinesa, aqui com sanduíches de quinta categoria. Yale, Penn U e Stanford já proibiram essa prática. Aqui, o Hospital Universitário da USP há mais de dois anos decidiu encerrar a festa e, pagar ele mesmo lanche de reuniões científicas com produtos de melhor qualidade. Ganham todos, dos pacientes aos acionistas da Big Pharma e, principalmente a academia. Aliás, pagar o próprio almoço é um exercício de autonomia. Perdem os marqueteiros, sales rep e, padarias de qualidade discutível. A Universidade e a Big Pharma necessitam colaborar, mas em pesquisas científicas e de incorporação tecnológica. Lanche ruim, caneta, bloco de notas e canecas definitivamente não agregam valor ao produto acadêmico. Porém, pior do que uma caneta que dura dois dias e uma baguete insossa com patê de fígado é a prática de autoria disfarçada de artigos científicos de pesquisas da própria indústria.
Doctors and Drug Makers: A Move to End Cozy Ties By STEPHANIE SAUL Published: February 12, 2007 More Hippocrates, less Hunan hot sauce. Free lunches for doctors are under attack yet again. Free lunch deliveries to medical offices, along with those ubiquitous drug company logo pens, have come to symbolize the extensive financial ties between doctors and the drug industry. And there is evidence they influence which drugs are prescribed. But pressure is building against the widely reported gifts and other potential conflicts, an effort that took hold last year when a group of influential doctors condemned financial arrangements between doctors and drug companies in The Journal of the American Medical Association. Tomorrow, a new push is scheduled to be announced by Community Catalyst, a health care consumer advocacy group based in Boston, and the Institute on Medicine as a Profession, a research group at Columbia University. With a $6 million grant from the Pew Charitable Trusts, the organizations plan a national campaign calling for restrictions on the interactions between doctors and drug companies, and urging doctors to base their prescription writing more on medical evidence than on marketing. “If you’ve been in the waiting room when these Chinese lunches are taken into the back office, it may raise the question whether the decisions are based on the best scientific evidence about medication or whether or not those Sichuan shrimp have something to do with the prescribing patterns,” said Jim O’Hara, the managing director of policy initiatives at Pew. The pharmaceutical industry spends $12 billion a year marketing to doctors, and much of that money is in the form of free samples delivered to doctors’ offices, often accompanied by lunch for the entire staff. When the University of Michigan health systems banned such lunches in 2005, they calculated that the lunches had been worth $2.5 million a year. The free drugs are samples of the newest and most expensive branded products. The drug industry hopes that by starting patients with free samples, they will remain on the more expensive medication rather than using a cheaper generic. And there is evidence that doctors who have relationships with the pharmaceutical industry prescribe more of the expensive drugs. The new initiative, called the Prescription Project, is an outgrowth of an article published in January 2006 in The Journal of the American Medical Association in which a coalition of scholars and doctors proposed that academic medical centers across the country take the lead in restricting interactions between doctors and the health care industry. Several medical centers, including those at Yale, the University of Pennsylvania and Stanford, have announced such restrictions. The Prescription Project aims to spread those restrictions to other academic medical centers, doctors’ organizations and third-party payers. Some medical school deans are reluctant to impose such restrictions, fearing that they will lose research money, according to David J. Rothman, an author of last year’s journal paper who is also president of the Institute on Medicine as a Profession. “They say, ‘If we did this, we would lose a third of our faculty. They’ll go to places with less stringent requirements; if we did this, we’ll tick off the drug companies and there’ll be payback,’ ” said Professor Rothman. One of the group’s plans is to document the impact of changes at Yale, the University of Pennsylvania and Stanford. “Did the drug companies stop giving Penn research money?” he said. “I don’t for a minute believe that is going to happen.” The organization’s goal is not to prohibit research grants or consultancies, but to limit gifts, travel fees, speakers’ bureaus and ghostwriting while at the same time encouraging prescriptions based on a medical evidence. “Gifts bring with them the felt need to reciprocate,” said Professor Rothman, who teaches social medicine at Columbia. “We’re not saying you’re being bribed,” he added. “We’re saying you’re being gifted. Some of it could be raw monetary hustling. But some of it is this psychological — ‘Well, they just sent me out to Las Vegas, their drug is as good as anybody else’s, why not just say thank you.’ ”

NEJM arma um terreno minado: vários estudos sobre stent coronariano

The New England Journal of Medicine adiantou a sua edição de 13 de março apresentando seis artigos sobre a discussão sobre o melhor tipo de stent coronariano. O editorial escrito pelo próprio editor Jeffrey Drazen é um primor de tucanagem científica. Mas, parabéns a ele por ter apresentado tantos pontos de vista e, nos deixado confuso. Afinal, ciência é dissenso e, quem gosta de consenso que vá para a igreja ou viver em Cuba, Líbia, e quetais.
A revista armou um terreno minado com mais de um artigo analisando o mesmo banco de dados. Talvez, no feriado de carnaval consiga andar na ponta do pé e, tentar desarmar as armadilhas que cada autor colocou nos textos.
Já discuti bastante esse tema anteriormente. Amanhã, publicarei o impacto na mídia. Vamos ver o que acontecerá com as ações dos dois principais fabricantes do stent farmacológico: a J&J e a Boston Scientific.
Por ser assinante e, com o cookie,não consigo identificar se os artigos estão liberados para acesso livre em http://www.nejm.org

Imperdível: Revista Pesquisa Médica

Encontra-se no número 1, a revista Pesquisa Médica editada pela Segmentofarma e dirigido por Sílvia Campolin, jornalista sênior de ciência e saúde. Imperdível a edição impressa e, também o site http://www.revistapesquisamedica.com.br
A linguagem é concisa e precisa. Algo raro que somente jornalistas tarimbados são capazes.

domingo, 11 de fevereiro de 2007

A indústria dos protetores solares agradecem ao IUV.

A Folha de S.Paulo (11/02/06) informa que publicará diariamente o índice de radiação ultra-violeta (IUV) na secção de metereologia, tal como ocorre na maioria dos jornais do mundo. Tudo bem, teremos uma informação a mais para nos preocupar, junto com o fantasioso "risco-país".
Esse IUV irá estimular ainda mais a indústria da proteção da luz solar como os fabricantes de protetores de luz solar.
Pobre astro-rei! Fundamental para a vida no Planeta, agora é acusado de causar doenças. A relação entre irradiação solar e câncer de pele (não-melanoma) de letalidade baixa é decorrente do tempo de exposição e, não da intensidade. Ou seja, o problema é muito maior para o trabalhador do campo e da cidade expostos todos os dias do que para crianças e jovens mimados que se lambuzam de protetores solares em breves períodos do ano. Lembro que os "protetores não protegem" do melanoma, um câncer com letalidade alta.