quarta-feira, 18 de junho de 2008
Conflito de interesse: o debate continua
Abaixo, reproduzo do Medscape, considerações sobre a tentativa em banir a indústria das atividades de educação médica continuada. Evidentemente, o Medscape tem conflito de interesse no tema. Mas, a argumentação apresentada é simples, pouco sofisticada e contundente.
Let's Get Real About Conflicts of Interest in Medicine
Posted 06/09/2008
John F. Kamp, PhD, JDAuthor Information
Recent finger-pointing on conflicts of interest obscures rather than illuminates the path to better patient care. Bias and conflict of interest are endemic in the human condition. We're all products of our language, concepts, needs, experience, goals, and aspirations.
But, many recent would-be reformers -- piggybacking on the economic and political pressures of the biopharmaceutical and device industries -- have focused almost exclusively on bias created by product marketing and industry funding of organized medicine. Some verge on pontification, proposing or pretending that restrictions on industry participation in research,[1-3] education,[4,5] sampling,[6,7] and marketing[8] would cleanse medical practice and automatically improve patient care. Perhaps the most radical such proposal -- banning most doctor-industry relationships -- comes before the AMA House of Delegates soon.[9] Stay tuned.
Although no one should ignore or deny these possible sources of bias, it's time to consider all important sources of bias in patient care. Doctors, for example, must keep their practices solvent; hospitals must fill beds; and major medical centers must balance the budget while providing research, education, and patient care. No one operates in an economic or moral vacuum.[10]
Meanwhile, a new version of federal legislation, offered by none other than Senator Charles Grassley, suggests a more limited and traditional course.[11] Rather than ban doctor-industry financial relationships, the Grassley bill aims to report them in a single national registry. It would simply illuminate them for the all the world to see-- including patients.
While the Grassley proposal fails to expose all important sources of bias and conflict of interests, it's well worth a closer look by the entire medical community.
I'm John Kamp, Executive Director of the Coalition for Healthcare Communication, and that's my opinion
segunda-feira, 16 de junho de 2008
O ranking das Big Pharmas do bem
The Financial Times noticia que a Big Pharma européia, principalmente a britânica GSK têm produtos dirigidos aos pobres do que os equivalentes americanos e japoneses. A lista completa pode ser vista clicando aqui. Os top five foram GSK (Reino Unido), Novo Nordisk (Dinamarca), Merck (EUA, aqui Merck Sharp & Dhome), Novartis (Suíça) e Sanofi Aventis (França).
GSK outperforms U.S. peers in efforts to make drugs available, affordable to the poor, analysis indicates.
"European pharmaceutical companies -- led by GlaxoSmithKline (GSK) --outperform their U.S. peers in efforts to make medicines available and affordable to the poor, according to an analysis to be released today." U.K.-based "GSK, which is involved in price discounts and researching drugs for use in the developing world, rates highest, while Merck, in third place, is the only U.S. company among the top seven." Notably, "[n]o Japanese businesses "are present and three generic manufacturers, often lauded by non-governmental organizations for their role in making medicines affordable, rank close to the bottom of the top 20." Consultancy firm Innovest's "The Access to Medicines Index,...ranks the companies based on an independent assessment of eight aspects of their activity," and is the "first attempt to quantify the rhetoric of corporate responsibility and allow comparisons between them."
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