Tuesday 25th July, 2006

 

Dr.David E Bratt MD

 
 
 
 
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Vitamins and other drugs

A series of four articles in this week’s British Medical Journal, almost all in a row, one after the other, made for interesting reading.

The first was “Roche defends buying lavish meals for doctors at Sydney’s restaurants.”

The Swiss drug giant Roche, with global annual sales last year of more than US$28 billion, has been accused of breaching the pharmaceutical industry’s code of conduct in Australia, by providing lavish meals to doctors at several of Australia’s leading restaurants.

Sales of its anti-cancer drugs have apparently increased by a staggering 42 per cent between 2004 and 2005. The group of doctors had been attending a Roche-sponsored scientific symposium on haematology-oncology treatments.

The industry’s code of conduct in Australia states that “for educational meetings directly organised by, and the responsibility of, companies, all hospitality must be simple and modest.”

Roche spent more than US$49,000 on one meal for almost 300 people at the exclusive Guillaume at Bennelong restaurant, in the Sydney Opera House, in July 2005. The restaurant, one of Australia’s best, has a menu featuring dishes like sterling caviar, basil infused tuna, kingfish sashimi, and the best of Australian and French wines.

At least two other dinners at other exclusive restaurants were held. At one dinner, partners were present, which is another no-no according to the code.

Roche claims to be attempting to retrieve payment for those partner meals, but has so far been unsuccessful. The doctors involved are now engaged in divorce proceedings.

An ethicist and haematologist (specialist in blood diseases) from the University of Sydney, Dr Ian Kerridge, said that lavish wining and dining is still common practice for doctors who prescribe expensive cancer drugs. He says that such events are designed to build trust with doctors and ultimately make them “less rigorously critical” of industry-sponsored studies.

The second article is headed “More evidence suggests that PSA testing leads to over diagnosis of prostate cancer.” Seems that the PSA test, widely used by some doctors to diagnose cancer of the prostate, is a bit, to put it mildly, oversensitive. In other words, it can diagnose cancer where there is none.

In the study done at Cambridge University in England, up to 40-64 per cent of the PSA-detected cases were estimated to be over-diagnosed.

PSA testing was undoubtedly detecting cancers that would not reveal themselves in the lifetime of the individual, said Dr Muir Gray, director of the National Screening Committee.

Why test then? Ask the company that sells the test to doctors. And ask the doctors themselves. Were they taken to dinner?

The third article, “Vitamins promoter goes on trial for fraud,” is about an alternative medicine doctor blamed for the death of a nine-year-old boy with bone cancer. He has gone on trial for fraud in Germany after he convinced the boy’s parents to use a “miracle cure” rich in vitamins and to reject conventional medical treatments.

In early 2004, the parents of Dominik Feld ended the boy’s course of chemotherapy and refused to allow hospital doctors to amputate his infected leg in an effort to save him, switching to Dr Rath’s vitamin treatment instead. He died soon after.

In the face of all the eagerness to take vitamins, next came an obscene report from the United Nations that “more than 300 million children in poor nations are chronically malnourished.”

The condition can lead to tragic irreversible mental stunting and lower IQs, and it can impair capacity to learn, a report by the World Food Programme says. Really?

According to UN expert bodies, about 135.5 million underweight preschool children have mental damage, and about 32 per cent are moderately or severely stunted and may never achieve their full mental capacity.

Each year almost six million children under five years “die of factors linked directly to undernutrition,” the report says, adding that hunger causes widespread physical and mental damage in the children who survive.

Does this make you wonder about some of the “big boys” and “big girls” in T&T?

Interestingly, data compiled show that despite the robust economic growth in 1995-2003, India had 55.3 million malnourished children under five years of age—the world’s largest number of cases.

In the same period, Pakistan had 8.7 million, Ethiopia 5.8 million, Indonesia 3.9 million, the Congo 3.1 million, Sudan 1.9 million, Uganda 1.2 million, Brazil 950,000 and Mexico 836,000.

“Hungry children become damaged adults with limited opportunities and capacities, who end up having hungry children of their own,” says the UN.

The solution seems simple. Take them all to dinner and give them vitamins.

 

 

 

 

 

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