Medical Herbalism

boardswalker

SomeDose wrote: »

Now, what about all the other thousands of approved drugs that have been used safely and succesfully? What does that say to you about the current system? That it works in the vast majority of cases...or that it's all coincidence?

The idea that its only a few drugs that were bad is not supported by the evidence.

What I have learned over the last few weeks researching this area is that pharmaceuticals are significantly more dangerous than herbal or alternative medicines. I have also learned that the people who ask for evidence then ignore any evidence that does not support their paradigm.

A report of the Australian Governement on CAM states “In 2002, approximately 94 per cent of ADR reports received by the ADRU related to prescription medicines, and three per cent each to over-the-counter (OTC) and complementary medicines. The small number of reports received by the ADRU of suspected adverse reactions to complementary medicines is considered to be, in part, due to the fact that complementary medicines are, by and large, low risk products and have a low propensity for adverse effects.”

A 2006 report into fatal adverse drug reactions in the US hospitals states that Based on the literature from 1964-1996, overall incidence of ADRs in hospitalized patients was 6.7% (range 1.2-24.1%), and of fatal ADRs 0.32% (0.1-0.85%). These aggregate figures translate to 2,216,000 hospitalized patients/year who experience a serious ADR and 106,000/year who die from an ADR. Fatal ADRs rank fourth to sixth in leading causes of death. As sobering as these figures appear, ADRs also are one of the more frequent causes of hospitalization (3.7-6.5% of patients).

That estimate of 100.000 deaths per annum from ADRS in the USA seems to have become widely accepted in the literature.

In 2005, Jean-Pierre Garnier, Chief Executive Officer, GlaxoSmithKline said “If anyone thought drugs were without side-effects, hopefully that’s over. All drugs have side-effects. We are having to spend hundreds of millions of dollars on lawyers.”

Meanwhile his colleague Allen Rose, admitted that doctors treating patients routinely applied the trial-and-error approach which says that if one drug does not work there is always another one. "I think everybody has it in their experience that multiple drugs have been used for their headache or multiple drugs have been used for their backache or whatever.”

While I admire your concern for the safety of the patient, I cannot understand your fixation with herbal medicine. All the evidence suggests that your efforts in keeping the patient safe should be directed much closer to home.

The Expert Committee of the Australian Government said it best “Complementary medicines are, by and large, low risk products and have a low propensity for adverse effects.”

SomeDose

See, now the focus of your argument has changed. You've presented some evidence here about ADRs for conventional drugs, and how they're responsible for hospital admissions, mortality etc etc. Now I've no reason to doubt your figures above since they seem to broadly agree with current stats. But anyone involved in conventional medicine is already well aware of the risks of ADRs, and we've already stated that virtually every drug has some degree of risk attached to it!

The key tenet to pharmacological therapy is to balance the benefits of a drug against its adverse effects (potential or actual). So, to use an extreme example, a noradrenaline infusion is never appropriate for the old dear who's just fainted on the rehab ward, but it's wholly justified for the guy in septic shock on ITU in order to keep him alive (the benefit), even though he may lose his fingers because of it (the risk).

You need to be aware that ADRs in general bear no relation to a drug being licensed and declared acceptably safe for use. Now, you've provided us with incidence rates of ADRs in hospitalised patients and mortality rates etc, but these are essentially meaningless in the context of your earlier arguments (i.e. that the licensing and regulatory processes allow "unsafe" drugs to enter the market). It would be much more relevant to the debate if you could provide incidence rates of ADRs for individual drugs. I suspect you'll struggle to find any, because to my knowledge this data does not exist beyond vague estimates such as "less than 1 in 10,000", "common", "very rare" etc etc.

I'll give you an example from my own experience: Not too long ago I had to make a report to the MHRA on a fatal adverse reaction to an anaesthetic drug (suxamethonium, in case you're interested). My report (available here) is one of 20 fatal immune system reports for that drug (and 60 fatalities overall)...so on that basis would you think that drug is unsafe? Well, I'd say yes if we knew it was used in only 100 patients and hence carried a 20% incidence of fatal anaphylaxis. But since we know that sux has been used in probably millions of patients, this translates to a very low (theoretical) incidence so we can conclude it has an acceptable safety profile for its purpose.

boardswalker wrote: »

The idea that its only a few drugs that were bad is not supported by the evidence.

The evidence? Sorry, but you're going to have to produce a hell of a lot more than just Vioxx, SSRIs and random quotes to convince us that the current licensing and regulatory process has systematically been proven to be unsatisfactory.

boardswalker wrote: »

While I admire your concern for the safety of the patient, I cannot understand your fixation with herbal medicine. All the evidence suggests that your efforts in keeping the patient safe should be directed much closer to home.

Err, but that's precisely what I and others do! We research. We look at the studies. We weigh up the evidence, risks and benefits. We make an informed decision. We report. We learn from errors and mistakes. We improve and inform future practice. What do CAM practitioners do?

boardswalker wrote: »

The Expert Committee of the Australian Government said it best “Complementary medicines are, by and large, low risk products and have a low propensity for adverse effects.”

Be that as it may, CAM products may indeed be safe....which is absolutely irrelevant if they have no proven therapeutic effect.

boardswalker

The focus of my argument has not changed at all. The OP was repeatedly asked for studies/evidence that supported the therapeutic use of herbal medicine. So, in order to be included, you have to have studies. What I am showing is that conventional medicine is very selective about studies and eidence. Where there are studies that show pharmacueutical treatments to be dangerous, the conventional medical system simply ignores them.

It's clear that many individuals who are educated in the conventional medicine system cannot be objective about pharmaceuticals. You cannot even engage in a discussion on the safety of drugs. (the good guys who raise concerns get shafted/intimidated etc)

An early poster stated that " a very important aspect of modern medicine is preventative medicine". In the light of all of the side-effects/the ADRs/Trial-and-error it's very hard for me to believe that prevention is given enough importance.

You want evidence that will satisfy the criteria of conventional medicine. yet these criteria are accepted as being biased towards the products of the pharmaceuticial companies.

Pharmaceuticals companies heavily influence education and continuing professional eductional. (That important point was ignored). Unless you are prepared to go outside that you will not find the evidence you want.

I have asked for evidence that herbal medicine has had any vioxx type disasters - no response.

I pointed out the influence of pharmaceutical companies on education/licensing - no response.

I asked what where physicians can get independent evidence to help make prescribing decisions - no response.

I asked about the bias in the drugs trials processes - its accepted that the system is not perfect. In fact it's far from perfect, it's seriously flawed.

According to research presented at the 2008 annual meeting of the American Sociological Association (ASA), by Donald Light, a professor of comparative health policy at the University of Medicine and Dentistry of New Jersey, rather than using current approved drugs as benchmarks of efficacy, the existing testing system evaluates the effectiveness of new drugs based on their effects compared to placebos. Systematic reviews indicate that one in seven new drugs is superior to existing drugs, but two in every seven new drugs result in side effects serious enough for action by the U.S. Food and Drug Administration (FDA), including black box warnings, adverse reaction warnings, or even withdrawal of the drug.

Based on this system, Light asserts that new drugs are twice as likely to harm patients as to provide them with benefits superior to existing drugs.

SomeDose wrote: »

We research. We look at the studies. We weigh up the evidence, risks and benefits. We make an informed decision. We report. We learn from errors and mistakes. We improve and inform future practice. What do CAM practitioners do?

What independent evidence are you looking at? (I bet that's another question that no-one will answer). All the evidence that I find says that the conventional research/studies/evidence gets it wrong. 100,000 deaths a year is a lot of evidence. All the time, I have trying to explain that your decisions cannot be fully informed.

Read this
"Drug companies are not publishing all the trial data that they submit to the FDA, and those trials that are published are more likely to show positive results.

Rising et al. compared all the New Drug Applications (NDAs) (the vehicle for initiating a new clinical trial) given to the FDA in 2001 and 2002 to subsequent published literature. They found that only about 3/4 of the trials were later published in journals, and those that were published were 5 times as likely to show favorable results for the drug being tested by the drug company as those that were not"

Where can you find the unpublished trials. Without them, how can you make valid evaluations.

When I quote scientific studies that don't suit your case, you write that's just a quote. If drug-company provides a study to show what they want, you call that evidence. Lets be clear about that. Your evidence is simply very selective - and selective is not reliable.

Publishing bias is a real issue whether you are talking about academia or industry. The difference here is that we are dealing with bias that can seriously injure, and can even kill, thousands of patients -- hence we need more aggressive policies to eliminate the bias.

Right now, the supposed evidence and testers are not independent.

Until you accept there are problems and that there is bias, you won't take any action to change.

I asked it before who guards the guards.

samson09

Do we seriously think that the pharmaceutical companies have our best interests at heart at all times?

Bayer, the third largest pharmaceutical company in the world certainly doesnt.

See: Bayer:Rat Of The Week
http://www.youtube.com/watch?v=spnEaO3yumk

2Scoops

samson09 wrote: »

Do we seriously think that the pharmaceutical companies have our best interests at heart at all times?[/URL]

Do herbalism companies?

samson09

2Scoops wrote: »

Do herbalism companies?

Have "herbalism companies" ever knowningly distributed medicne contaminated with the Aids virus?

2Scoops

samson09 wrote: »

Have "herbalism companies" ever knowningly distributed medicne contaminated with the Aids virus?

This is fun. Have "pharmaceutical companies" ever knowingly distributed non-medicine contaminated with lead?

Dr Galen

while I agree that something dodgey looks to have been going on with the whole Bayer Factor 8 stuff it's worth noting that

a) it was a Bayer subsidiary that did this
b) it happened over 20 years ago. Regulations and many other things have changed a lot since then

samson09

Mystik Monkey wrote: »

while I agree that something dodgey looks to have been going on with the whole Bayer Factor 8 stuff it's worth noting that

a) it was a Bayer subsidiary that did this
b) it happened over 20 years ago. Regulations and many other things have changed a lot since then

True and true, just highlighting what companies such as Bayer are capable of.

More recent examples of the dodgy nature of the pharmaceutical companies include:


Wyeth Pharmaceuticals hired ghostwriters to produce at least 40 articles in medical journals supporting the use of hormone-replacement drugs by menopausal women, according to files unsealed as part of lawsuits over the products

http://www.philly.com/inquirer/health_science/daily/20090806_Wyeth_used_ghostwriters_to_tout_hormone_drugs.html

Pharmaceutical giant Pfizer has agreed to pay $75 million to settle a class action lawsuit filed against it by Nigerian parents who claim the company caused harm to their children by using them as guinea pigs in a nonconsensual, unlicensed drug trial.

http://www.naturalnews.com/026685_Pfizer_Nigeria_United_States.html

www.independent.co.uk


The hidden truth behind drug company profits.</EM>

Ring-fencing medical knowledge is one of the great grotesqueries of our age.

http://www.independent.co.uk/opinion/commentators/johann-hari/johann-hari-the-hidden-truth-behind-drug-company-profits-1767257.html


And we are supposed to trust these guys? In my opinion,they don't give a f*** about our health or how safe their medicines are. It doesnt matter if a study on a certain drug is double blind, placebo controlled, peer reviewed, with enough money and pressure these companies will get whatever result they want. The switch to natural medicines is happening whether we like it or not. People are waking up to the BS.

SomeDose

Guys, I'm going to give my final contribution to this thread...for the simple reason that I think no matter what answer I or others give, there'll just be more moving of goalposts, questions and tangents created.

For the record, I think some of the sentiments expressed by Boardswalker and others are very valid i.e. that we shouldn't just blindly trust scientific studies & regulatory processes. Making one's own decisions and judgements is one of the core characteristics of a professional, and is part of what separates them from non-professionals. Any healthcare professional worth their salt will exercise a healthy degree of scepticism towards all kinds of evidence they encounter. But I honestly don't believe many CAM practitioners take the same attitude, unfortunately.

And please stop telling us how Big Pharma do evil things, because guess what...we already know! You're preaching to the converted here. In fact I recommend anyone (be they involved in conventional medicine, CAM or otherwise) have a read of "Prescription Games" by Jeffrey Robinson. It's a pretty damning commentary on Big Pharma, but it won't have me reaching for the tinfoil helmet just yet.

BTW Samson, in relation to that Independent opinion piece you linked to...you'll be pleased to hear I wrote an almost identical commentary some years ago about Tamiflu and avian influenza as part of a university assessment. Except mine was far more eloquent of course...;)

samson09

SomeDose wrote: »

Guys, I'm going to give my final contribution to this thread...for the simple reason that I think no matter what answer I or others give, there'll just be more moving of goalposts, questions and tangents created.

For the record, I think some of the sentiments expressed by Boardswalker and others are very valid i.e. that we shouldn't just blindly trust scientific studies & regulatory processes. Making one's own decisions and judgements is one of the core characteristics of a professional, and is part of what separates them from non-professionals. Any healthcare professional worth their salt will exercise a healthy degree of scepticism towards all kinds of evidence they encounter. But I honestly don't believe many CAM practitioners take the same attitude, unfortunately.

And please stop telling us how Big Pharma do evil things, because guess what...we already know! You're preaching to the converted here. In fact I recommend anyone (be they involved in conventional medicine, CAM or otherwise) have a read of "Prescription Games" by Jeffrey Robinson. It's a pretty damning commentary on Big Pharma, but it won't have me reaching for the tinfoil helmet just yet.

BTW Samson, in relation to that Independent opinion piece you linked to...you'll be pleased to hear I wrote an almost identical commentary some years ago about Tamiflu and avian influenza as part of a university assessment. Except mine was far more eloquent of course...;)

TBH, I think you're giving your final contribution because Boardswalker obviously knows what he's talking about and despite continued attempts by several people here to "win" this discussion, Boardswalker continues to prove his point in an articulate, intelligent and convincing way every single time. Apologies if I am wrong on this but its just my opinion.

I just can't understand how bright, intelligent people continue to operate in the conventional medical system, knowing it is corrupt and harmful to people while labelling those who practice natural medicine as crackpots. It's beyond ridiculous.

Dr Galen

samson09 wrote: »

TBH, I think you're giving your final contribution because Boardswalker obviously knows what he's talking about and despite continued attempts by several people here to "win" this discussion, Boardswalker continues to prove his point in an articulate, intelligent and convincing way every single time. Apologies if I am wrong on this but its just my opinion.

no, i'd say its exactly for the reasons that were stated. How yourself, boardswalker et al really believe that we in the conventional fields take every study as gospel is a bit hard to believe. The way in which the CAM studies that get posted here get pulled apart, well, the conventional ones get the same treatment. All the questions you guys get asked, are of asked of those studies too.

I just can't understand how bright, intelligent people continue to operate in the conventional medical system, knowing it is corrupt and harmful to people while labelling those who practice natural medicine as crackpots. It's beyond ridiculous.

i can't understand how bright, intelligent people take everything that the CAM community say as truer than true. How things are accepted without question, and how anyone who raises valid questions is labelled as a Big Pharma Lover.

Are you really trying to say that every aspect of conventional medicine is corrupt and harmful?

boardswalker

SomeDose wrote: »

there'll just be more moving of goalposts, questions and tangents created.

Now, who's moving the goalposts? You started off having concerns about the efficacy of Herbal Medicine, now you are questioning the integrity of practitioners. And you have offered absolutely nothing to support your sweeping conclusion.

SomeDose wrote: »

For the record, I think some of the sentiments expressed by Boardswalker and others are very valid i.e. that we shouldn't just blindly trust scientific studies & regulatory processes. Making one's own decisions and judgements is one of the core characteristics of a professional, and is part of what separates them from non-professionals. Any healthcare professional worth their salt will exercise a healthy degree of scepticism towards all kinds of evidence they encounter.

Again, all the articles I quoted show that very few physicians question the evidence put before them by the drugs companies. I suspect that you have not followed up on the information I have offered but its seems clear that only a minority question the "party line."

SomeDose wrote: »

But I honestly don't believe many CAM practitioners take the same attitude, unfortunately.

And this sweeping statement shows how far from true science the conventional medicine has strayed.

Conventional Medicine needs to spend more time understanding why CAM is so popular.

In December 2008, the National Center for Complementary and Alternative Medicine (NCCAM) and the National Center for Health Statistics (part of the Centers for Disease Control and Prevention) released new findings on Americans' use of complementary and alternative medicine (CAM).

The findings are from the 2007 National Health Interview Survey (NHIS), an annual in-person survey of Americans regarding their health- and illness-related experiences. The CAM section gathered information on 23,393 adults aged 18 years or older and 9,417 children aged 17 years and under. A similar CAM section was included in the 2002 NHIS, providing the opportunity to examine trends in CAM use, too.

"In the United States, approximately 38 percent of adults (about 4 in 10) and approximately 12 percent of children (about 1 in 9) are using some form of CAM."

"People of all backgrounds use CAM. However, CAM use among adults is greater among women and those with higher levels of education and higher incomes."

There's a message there if you want to find it.

boardswalker

Mystik Monkey wrote: »

How yourself, boardswalker et al really believe that we in the conventional fields take every study as gospel is a bit hard to believe. The way in which the CAM studies that get posted here get pulled apart, well, the conventional ones get the same treatment. All the questions you guys get asked, are of asked of those studies too.

Are you really trying to say that every aspect of conventional medicine is corrupt and harmful?

Mystik Monkey, if you think this is just little ol' me on the case, then you're badly mistaken. In 2007, the Institute of Medicine (IOM) in the US appointed the Committee on Conflict of Interest in Medical Research, Education, and Practice to examine conflicts of interest in medicine and to recommend steps to identify, limit, and manage conflicts of interest without negatively affecting constructive collaborations.

Here are relevant excerpts from the report which was published in April 2009.

And please note, Mystik Monkey, these are not my words. They come from a report of experts with lots of letters after their names. They’re not like me et al, at all at all. Take it up with your peers if you don’t like the message. But these guys seem to be getting the message. They have only just made their report so not much can have been done to implement any of the recommendations. The report echoes the points I have been making. These guys don’t believe that conventional studies get pulled apart. Read the report for yourself.

The introduction to the report states (my emphasis)

Financial conflicts of interest pose many challenges to health care professionals. They raise concerns about the objectivity and trustworthiness of research conduct and publications, the prudent management of scientific investigations and other activities in the public interest, and the commitment of health care professionals to the best interests of patients. In recent years the media has highlighted failures of individuals and institutions to disclose and appropriately manage financial ties with industry (including pharmaceutical, medical device, medical supply, and insurance companies). These failures contribute to questions about whether industry has undue influence in research and other activities.

As medical research, professional education, health care, and institutional management have become vastly more complex and expensive, the task of managing conflicts of interest has become more challenging. Industry is now the leading funder of medical research, and much research is conducted in nonacademic settings. Industry also is involved in funding the development of evidence reviews and practice guidelines that are intended to help translate research findings into practice. Such guidelines may shape clinical choices and may even be used to evaluate professional or institutional performance.

Other very relevant sections of the report.

“The Financial relationships with industry are extensive in medical education.
To reduce the risk for bias within the learning environment, academic medical centers and teaching hospitals should prohibit faculty from accepting gifts, making presentations that are controlled by industry, claiming authorship for ghost-written publications, and entering into consulting arrangements that are not governed by written contracts for expert services to be paid for at fair market value. Medical centers also should restrict visits by industry sales people and limit use of drug samples to patients who lack financial access to medications.

Many providers of accredited continuing medical education—a usual requirement for relicensure of physicians—receive the majority of their funding from industry.
The report recommends a broad-based consensus process to develop a new system for funding high-quality accredited continuing medical education that is free of industry influence. The committee recognizes that such a system may involve higher costs for physicians and require cost-cutting steps by education providers. Because current policies are highly variable and sometimes confus¬ing, the commit¬tee recommends standardizing the content, format, and procedures for disclosing finan¬cial relationships physicians and researchers have with industry.

Acceptance of meals and gifts and other relationships with industry are also common among physicians who practice outside medical centers. Data suggest that these relationships may influence physicians to prescribe a company’s medicines even when evidence indicates another drug would be more beneficial.
Therefore, the committee recommends eliminating these problematic relationships between physicians and industry. In addition, the committee recommends that community physicians should also follow the restrictions described previously regarding gifts, including meals, from companies; presentations or articles whose content is controlled by industry; meetings with sales representatives; and use of drug samples. Professional societies and health care facilities should adopt policies that reinforce this recommendation.

Clinical practice guidelines influence physician practice, quality measures, and insurance coverage decisions. Given this influence, clinical practice guidelines need to be developed with greater transparency and accountability.
The committee recommends that professional societies and other groups that develop practice guidelines not accept direct industry funding for guideline development and generally exclude individuals with conflicts of interest from the panels that draft the guidelines. In addition, these groups should make public their conflict of interest policies, their funding sources, and any financial relationships panel members have with industry.”
Full report available at http://www.nap.edu/catalog.php?record_id=12598#toc

I know I have probably been a PITA. But conventional medicine has problems. And simply trying to push the spotlight onto herbal and other alternative medicines is no longer working. You are going to have to deal with the issues in your own house. Let him who is without sin cast the first stone and all that.

KP81

Boardswalker,
Your reports are mostly old, unreliable or taken out of context. I work in pharma development and these days our sales guys aren't allowed to give doctors so much as a pen with our company's logo on it. Seriously, the whole gift area has been tightened up.

KP81

On the original topic of Alternative Medicines. Darragh O'Brien has a devestating line in his last DVD. 'If hebal medicine worked so well what was the life expectancy of the average Chinese guy in 1900 with their world class herbal treatments? Errrr it was about 35. What is it now? 75 and that aint because of any herb.' Case closed.

As an aside I do wish the public in general had a better appreciation of the painstaking and thorough, not to mind costly, process of drug development. The double blind testing process is one of the finest human achievements of all time and deserves more credit. It has saved million upon millions of lives. (Unlike herabal treatments.)

tallaght01

KP81, I know you're new. But we don't allow the kind of personal stuff you posted above, so I've edited it out.

doctor evil

boardswalker wrote: »

Today, CAM is becoming more popular in the United States.

This has a lot to do with costs of conventional medicine particularly in a country like America where over 44 million do not have health insurance. This happens in China too.

vitamin supplements (a type of CAM).

Marketing!

established safety profile

Is it not the nature of the safety profile that it is ongoing? Such as new drugs coming out that may interfere with an existing one or a complication in a medical condition.

but they don’t work in everybody".

Everyone is an individual. Does CAM work for everybody?

boardswalker

KP81 wrote: »

Boardswalker,
Your reports are mostly old, unreliable or taken out of context. I work in pharma development and these days our sales guys aren't allowed to give doctors so much as a pen with our company's logo on it. Seriously, the whole gift area has been tightened up.

The institute of medicine report was published in April 2009.
The report about Wyeth Ghostwriters was from Aug 5 2009.

I was in a doctors surgery on Friday.
The soap dispenser in the loo was promoting viagra.
There were lots of other promotional paraphenalia on display - lexapro pens etc.

boardswalker

KP81 wrote: »

On the original topic of Alternative Medicines. Darragh O'Brien has a devestating line in his last DVD. 'If hebal medicine worked so well what was the life expectancy of the average Chinese guy in 1900 with their world class herbal treatments? Errrr it was about 35. What is it now? 75 and that aint because of any herb.' Case closed.

As an aside I do wish the public in general had a better appreciation of the painstaking and thorough, not to mind costly, process of drug development. The double blind testing process is one of the finest human achievements of all time and deserves more credit. It has saved million upon millions of lives. (Unlike herabal treatments.)

So would someone please answer why the pharma companies have been trying to patent the active ingredients in herbal remedies.

boardswalker

doctor evil wrote: »

This has a lot to do with costs of conventional medicine particularly in a country like America where over 44 million do not have health insurance.

The report I quoted stated "However, CAM use among adults is greater among women and those with higher levels of education and higher incomes"

I don't think lack of health insurance is the issue.

boardswalker

And, a relevant story in Aug 24 New York Times.

"Physicians are allowed to use drugs in ways that are not specifically approved by the Food and Drug Administration, a practice called off-label prescribing. There is usually less scientific evidence to support nonapproved uses, and a new survey of physicians has found that many might not even know when they are prescribing off label.

U.S. physician knowledge of the FDA-approved indications and evidence base for commonly prescribed drugs: results of a national survey (Pharmacoepidemiology and Drug Safety)

The average physician in the survey identified the F.D.A. approval status correctly for only about half the drugs on a list provided by the researchers, according to a study in Pharmacoepidemiology and Drug Safety.

Confusion was greatest with psychiatric drugs, the survey of some 600 doctors found. Nearly one in five who prescribed Seroquel (quetiapine) in the previous year thought it was approved for patients with dementia and agitation, even though it was never approved for this use and even carried a “black box” warning that it was dangerous for elderly patients with dementia. And one in three doctors who used lorazepam (often marketed as Ativan) to treat chronic anxiety thought it had been approved for this use; in fact, the F.D.A. warning advises against using it for this purpose.

The study’s senior author, Dr. G. Caleb Alexander, assistant professor of medicine at the University of Chicago, said a concern was that off-label uses often did not have the same level of scientific scrutiny as F.D.A.-approved uses."

Study here http://www3.interscience.wiley.com/journal/122544649/abstract?

KP81

boardswalker wrote: »

So would someone please answer why the pharma companies have been trying to patent the active ingredients in herbal remedies.

Well because herbs can have active ingredients. One of the most effective chemo drugs ever, taxol, was derived from trees before a synthetic version became available. That doesn't mean if you chewed or boiled the tree up you'd be cured of cancer. If you want a consistent, non-contaminated product you have to process the raw material in some way. The people who do this are pharma companies. We are not some evil bunch of people trying to poison the world (though I agree that marketing depts can oversimplify things but that's because the general public generally don't appreciate the science and panic easily ). BTW you never addressed the main point of my comment which was why herbal treatments failed to improve life expectencies before being systematically evaluated.

Also, your issue with adverse drug reactions do not state what the severity of these reactions were. This is important because patients will report adverse reactions even when taking placebos. This is a well known phenomenon and this is why most of the adverse reactions listed state things like vomiting, headaches, rash, blah. The risk of a serious adverse reaction is in reality miniscule; despite scaremongering press reports which quote raw percentages and not total risks (e.g. a 6% increased risk of some BAD thing happening instead of an increase from 1 in 100000 to 1.06 in a 100000).

On doctors prescribing off label: Yes there are GPs who probably only have a foggy notion of what certain drugs do and their interactions but that does not mean the entire medical enterprise is compromised. I doubt anyone would know the status of a long list of drugs off the top of their head. That's why there are pharmacopoeias, rxlist and pharmacists to advise of potential contraindications. Again you don't seem familiar with the legislation and regulatory bodies that control prescribing. The IMB are pretty hot at pulling drugs linked to serious ADRs and no one would get away with dangerous off label prescribing in this litigous country of ours.

KP81

boardswalker wrote: »

The institute of medicine report was published in April 2009.
The report about Wyeth Ghostwriters was from Aug 5 2009.

I was in a doctors surgery on Friday.
The soap dispenser in the loo was promoting viagra.
There were lots of other promotional paraphenalia on display - lexapro pens etc.

Glad, though somewhat surprised, to hear you actually attend a GP. You are in Ireland right? There is a blanket ban of drug companies advertising here last I heard. This does not go for palces like the US though. Of course marketing can fly pretty close to the wind here sometimes. Typically this involves sponsoring some advice forum for a particular problem e.g. erectile dysfunction. All perfectly legal. If you don't like it lobby your TD to further tighten things up.

On your oft used report quotes: Some are indeed high quality journals. However, I see no smoking guns as such in any of your quotes. Please realise science is an iterative process. It gets things wrong all the time. Crucially it knows this and endevours to improve and optimise all the time. This is why you can find negative reports and studies. This is how we learn things and if mistakes are made fix them. I admire your scepticism and wish more people shared your ability to probe a subject. However, could I make the humble suggestion that you turn your analytical prowess on an area more deserving of scrutiny, religion perhaps.
Truly,
KP81

nesf

boardswalker wrote: »

So would someone please answer why the pharma companies have been trying to patent the active ingredients in herbal remedies.

Because they're trying to squeeze money out of the area by using the patent system. No one here claims otherwise. At their core these companies exist to make money, no doctor will tell you otherwise.

kipple

KP81 wrote: »

There is a blanket ban of drug companies advertising here last I heard.
KP81

You heard wrong. As I type this my laptop in on a coffee table along with a bunch of USB sticks, my diary, a pen and post it notes. All with drug company advertising on them. This give that stuff out like candy.

KP81 wrote: »

However, could I make the humble suggestion that you turn your analytical prowess on an area more deserving of scrutiny, religion perhaps.
KP81

Or big drug companies! Here is one of many Ben Goldacre piece on the evils of the drug companies:
http://www.guardian.co.uk/commentisfree/2009/may/09/bad-science-medical-journals-companies

and just to be somewhat fair, the problem with herbalists:
http://www.guardian.co.uk/science/2007/oct/06/herbalists

anyway the bad science column in the guardian is really well worth reading, here is a link to the archives:
http://www.guardian.co.uk/science/series/badscience

boardswalker

KP81 wrote: »

Well because herbs can have active ingredients. One of the most effective chemo drugs ever, taxol, was derived from trees before a synthetic version became available.

Thank you. Pharma companies are trying to patent the active ingredients because they have strong reason to believe they work. They are spending money lobbying everyone to believe they don’t work because they don’t want us to use stuff they can’t make money from.

KP81 wrote: »

BTW you never addressed the main point of my comment which was why herbal treatments failed to improve life expectencies before being systematically evaluated.

I am surprised that someone working for a pharma company would not know the answer to this question. Public health measures are credited with much of the recent increase in life expectancy. Lack of basic sanitation, basic nutrition and war or lawlessness are all reasons why people die younger in less developed countries.

It is interesting that despite the many pharma developments in recent years we don’t seem to be having much of an impact on life expectancy. The biggest advances came from basic things.

KP81 wrote: »

Also, your issue with adverse drug reactions do not state what the severity of these reactions were. …. The risk of a serious adverse reaction is in reality miniscule

Again, I am surprised that at this late stage in the thread, you are not familiar with all of the problems caused by the various pharma disasters. I recommend you google Thalidomide, Vioxx, Ritalin, Avastin, Tylenol and many more. I think you will find a smoking cannon rather than a smoking gun.

Early on in this thread, I posted a link to a page listing all the infamous recalls over the last thirty. It might be worth your while searching for it.

KP81 wrote: »

On doctors prescribing off label: Yes there are GPs who probably only have a foggy notion of what certain drugs do and their interactions but that does not mean the entire medical enterprise is compromised. I doubt anyone would know the status of a long list of drugs off the top of their head.

Firstly, I am surprised that medical practitioners did not take offense at your bland assertion that they have only a foggy notion about what certain drugs do and their interactions. I think your sentence highlight the esteem in which big pharma hold medical practitioners.
Secondly, I wonder what the Professional Indemnity underwriters would make of your assertions.

KP81 wrote: »

We are not some evil bunch of people trying to poison the world

I think that if you read the reports of the various litigations and investigations of the big pharmas, you might reconsider this belief. The activities of the pharma companies - suppressing reports, intimidating unfriendly opinion holders, ghost writing articles, paying large monies to academics for favourable comments, reviews etc. – are all well documented.

boardswalker

KP81 wrote: »

You are in Ireland right? There is a blanket ban of drug companies advertising here last I heard.

As someone has already noted, you're not particularly well informed.

KP81 wrote: »

However, could I make the humble suggestion that you turn your analytical prowess on an area more deserving of scrutiny, religion perhaps.

If, at this late stage in the thread, you do not understand the necessity of scrutinising big pharma, then..... Oh my god.

nesf

boardswalker wrote: »

They are spending money lobbying everyone to believe they don’t work because they don’t want us to use stuff they can’t make money from.

They're not because they have a stake in many of the vitamin companies etc! Big Pharma don't just have their fingers in the prescription only medicine pie!

boardswalker

nesf wrote: »

Because they're trying to squeeze money out of the area by using the patent system. No one here claims otherwise. At their core these companies exist to make money, no doctor will tell you otherwise.

i think the key point for me is that they believe them to be effective.
despite what they want everyone else to believe.