“Integrity without knowledge is weak and useless,
and knowledge without integrity is dangerous and dreadful.”
Samuel Johnson
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| Washington State Capitol |
via NAMI Washington:
NAMI Washington 2012 legislative agenda
"Medication access — NAMI Washington opposes any defunding of Medicaid or other state medical prescription benefits, any “generics only” formulary, and any “fail first” requirements in any prescription formulary for people with serious mental illness- especially for atypical antipsychotics. Medications are an important part of the treatment plans for those living with mental illnesses. Taking away access to medications in general or even forcing those who are in recovery with non-generic medications to change to possibly ineffective medication in order to change to a generics only system is dangerous and counterproductive."
Guiding principles
NAMI-WA’s 2012 Legislative positions are guided by the following principles:
- Early intensive care and treatment - including hospitalization in some cases - has proven to reduce long-term illness and disability. It is the best way for the State to reduce its long-term costs for the mental health system and, most importantly, to promote the potential for recovery for as many people as possible. In order to ensure the highest possible quality of service, the State should require programs, treatments and other services to be evidence-based or promising practices."
via Clinical Psychiatry News.com:
Broad Analysis Refuels Debate on Atypicals
a few excerpts:
“The spurious invention of the atypicals can now be regarded as invention only, cleverly manipulated by the drug
industry for marketing purposes and now only being exposed,” Dr. Tyrer and Dr. Kendall wrote.
“On present evidence from all sources, it is difficult not to conclude that the trials of the second-generation antipsychotics seem to be driven more by marketing strategy than to clarify their role for clinicians and patients.”
The investigators criticized pcriticized previous literature reviews and meta-analyses that compared second- and first-generation antipsychotics, aside from Cochrane Reviews, for not assessing side effects thoroughly, even though they are important criteria in drug choice.
They also faulted previous attempts at distilling the results of trials for analyzing only one global efficacy outcome, despite claims that the main advantage of second-generation antipsychotics is their broad efficacy spectrum, especially for negative symptoms, depression, and quality of life. read here
It is plain that NAMI Washington's 'medication access policy' contradicts NAMI's 'guiding principle,' which state, 'the State should require programs, treatments and other services to be evidence-based or promising practices.' Washington State has adopted the same 'first line treatments' used in the State of Texas, using treatment algorithms developed for a marketing program known as TMAP. TMAP was developed to sell the newer more expensive drugs---not because they were better, but because they made more money for the drug companies and their share holders. TMAP, is nothing more that a fraudulent drug marketing strategy developed to facilitate Medicaid fraud and illegal marketing of psychotropic drugs. It is not 'evidence-based' or a 'promising practice.' Washington State's Medicaid formulary for psychiatric drugs is modeled after this corrupt program; and it requires Medicaid providers to prescribe the newest neuroleptic and other psychotropic drugs, which are more expensive, but are not any safer, or more efficacious.
The decision to have ONLY the newest neuroleptic and other psychotropic drugs listed as 'preferred' was not based on valid empirical evidence; and neither is NAMI Washington's medication access agenda. It is an agenda that NAMI's primary funding source, the drug industry, will benefit from; while the people of the State of Washington continue to be defrauded through it's publicly funded health care programs...
via Alliance for Human Research Protection:
Rolling Stone - Marketing a Phony "Miracle" Drug
"Now mainstream professors at Yale and Harvard are acknowledging the marketing success of antipsychotics are not justified by the evidence. None of the drugs used to treat schizophrenia work very well—and they all produce debilitating irreversible physical and neurological damage. The drugs’ failure is related to the lack of understanding about schizophrenia. Scientists acknowledge, “We actually have a profound ignorance of the specific molecular mechanism of schizophrenia.”
“We tend to think of drugs as solving discrete problems — penicillin to eliminate bacteria, insulin to modify diabetes — but the antipsychotics are shooting at an invisible target. With schizophrenia,” says Dr. William Eaton, chairman of Johns Hopkins, Department of Mental Health, "we don't know what the hell is going on."
"It is well to remember that effective drugs, such as antibiotics, don’t need multi-million marketing campaigns.
Wells sought to understand how, Zyprexa, a drug created to treat schizophrenia—in a very tiny population mostly inhabiting county jails and state prisons—wound up being used on depressed moms and misbehaving kids—and how Eli Lilly turned a flawed and dangerous drug into a $16 billion a year bonanza."
"But when those who conduct the trials sell their professional integrity, signing secret confidentiality agreements which prevent them from publishing the actual research findings; and when influential academics pen their name to industry-sponsored ghostwritten reports in those journals; and when prominent physicians are recruited to promote the drugs as “safe and effective” for unapproved uses--thereby broadening the number of patients exposed to the drugs’ harmful effects; the result is even worse than the deception by the tobacco industry. After all, smokers were not urged to “ask your doctor” if smoking is right for you… Prominent doctors with impressive academic credentials did not serve as paid consultants helping tobacco companies to promote smoking."
"To accomplish the extraordinary marketing feat and generating “irrational exuberance” among clinicians, drug manufacturers took control of the drug testing process—including data analysis, authorship (penned by prominent academic psychiatrists), publication placement in key journals—and key academic psychiatrists were recruited for their professional influence to persuade clinicians and public policy officials that a class of drugs—the new ‘atypical’ antipsychotics—were better and safer than the old drugs, despite evidence contradicting such claims. FDA’s impotence vis-à-vis this powerful industry was accomplished after the Reagan administration made it a policy to gut the FDA: “Simply put, the FDA was no longer in a position to independently evaluate the effectiveness — and risks — of a drug like Zyprexa.”
"It is understandable that well-meaning psychiatrists who treated patients with schizophrenia, sought better treatment without the debilitating side effects of the older drugs which they by then recognized as so painful that patients simply stopped taking them, were excited by the promise of an alternative. However, the marketing hype did not make sense from the very beginning: a top Lilly executive announced that its new schizophrenia drug, Zyprexa, has "the potential to be a billion-dollar-a-year drug." Dr. William Wirshing, a psychiatrist at UCLA, is quoted saying: "I almost pulled off the road and crashed into the side rail." At the time, the entire market for atypical antipsychotics was only $170 million. "How the hell do you make $1 billion? I mean, who are we gonna give it to? It's not like we're making any more schizophrenic brains.
"It would be nine years before a comprehensive government study (CATIE) would reverse many of the claims that surrounded Zyprexa and other atypical antipsychotics, and raise disturbing questions about their risks. And nine years, in the pharmaceutical industry, is a lifetime.
"An influential player missing from the Rolling Stones article, is Steven Hyman MD PhD, the Director of the National Institutes of Mental Health, a leading neuroscientist, and a Harvard Professor whose enthusiastic endorsement of both the SSRI antidepressants and atypical antipsychotics, was expressed in widely publicized 1998 letter to the Director of the Center for Medicaid State Operations at HCFA, in which he expressed concern that the high cost of the atypical antipsychotics might constrain their use:
"‘In some parts of the country, we understand that health care systems will not routinely allow new patients to be started on atypical antipsychotic medications until they have failed a course of the standard (less expensive generic) antipsychotic medications. We see no scientific justification for such a practice and consider it particularly ill advised. . . This is a situation in which HCFA and the NIH institutes working in concert can have a substantial beneficial effect on the health care of the American people.
"But in 2002, Allen Jones, an investigator in the Pennsylvania inspector general's office, became convinced that government officials had been enrolled in marketing the drugs. Jones uncovered evidence showing that TMAP promoters included not only prominent psychiatrists, but government officials who set state mental health policies. These officials served as paid “experts” declaring the new antipsychotics “superior.” Though contradicted by the scientific evidence, their opinions had the mantle of government authority, thus ensuring a market and a continuing flow of sales.
“Between 2000 and 2004, the deaths of 45 children were linked to the atypicals. Some were strikingly young. An eight-year-old boy died of cardiac arrest. A four-year-old boy died of complications from diabetes. Perhaps most vivid of all was the case of a 15-year-old boy in South Florida referred to by social workers as a "runner," a kid who kept fleeing his exasperated foster parents to return to his birth mother. Admitted to a psychiatric hospital by a judge, the boy was tethered to a chair and pumped full of atypical antipsychotics, presumably to calm him. When his lawyer came to visit him, she found the boy not only sedated, but suffering from another acknowledged side effect of the atypicals: His breasts had become engorged and started to leak milk. The boy was lactating.” (emphasis mine)
“Visiting the most celebrated mental-health centers in the United States, it is hard to conclude that, even after the innovation of the atypicals, the drugs make a decisive difference in care.” It is difficult, therefore, to brush off the profession’s failure to recognize the disparity between clinical evidence and marketing hype as “overbright enthusiasm” or “irrational exuberance” or to accept the excuse offered by prominent psychiatrists such as, Dr. Peter Tyrer, Imperial College in London: “Almost the whole scientific community was conned into thinking — as a consequence of good marketing — that this was a different and better set of drugs. The evidence, as it's all added up, has shown this to be untrue."
"If the whole scientific community was “conned,” they should hand in their license as they do not merit the status of “learned intermediaries.” Furthermore, leading psychiatrists who concealed their significant conflicts of interest, serving as industry’s consultants and promoters, who conducted rigged clinical trials and penned their name to fraudulent reports—reports that have polluted the scientific literature—continue to hold sway as prominent leaders within the profession. Shame on the psychiatric establishment for its failure to say, enough of the lies, enough corruption!
"The devastating consequences of deregulation--which gave free rein to predatory profit seekers—is demonstrated in both, the economic meltdown and the transformation of medicine from its therapeutic mission into an accomplice for Big Pharma. The dire consequences of predatory market manipulation are borne by American consumers and taxpayers.
"TIME Magazine has named 25 People to Blame for the Financial Crisis (24 men and one woman). Who will name the names in the medical community who are to blame for the drug-induced mental health crisis?" read here
“Visiting the most celebrated mental-health centers in the United States, it is hard to conclude that, even after the innovation of the atypicals, the drugs make a decisive difference in care.” It is difficult, therefore, to brush off the profession’s failure to recognize the disparity between clinical evidence and marketing hype as “overbright enthusiasm” or “irrational exuberance” or to accept the excuse offered by prominent psychiatrists such as, Dr. Peter Tyrer, Imperial College in London: “Almost the whole scientific community was conned into thinking — as a consequence of good marketing — that this was a different and better set of drugs. The evidence, as it's all added up, has shown this to be untrue."
"If the whole scientific community was “conned,” they should hand in their license as they do not merit the status of “learned intermediaries.” Furthermore, leading psychiatrists who concealed their significant conflicts of interest, serving as industry’s consultants and promoters, who conducted rigged clinical trials and penned their name to fraudulent reports—reports that have polluted the scientific literature—continue to hold sway as prominent leaders within the profession. Shame on the psychiatric establishment for its failure to say, enough of the lies, enough corruption!
"The devastating consequences of deregulation--which gave free rein to predatory profit seekers—is demonstrated in both, the economic meltdown and the transformation of medicine from its therapeutic mission into an accomplice for Big Pharma. The dire consequences of predatory market manipulation are borne by American consumers and taxpayers.
"TIME Magazine has named 25 People to Blame for the Financial Crisis (24 men and one woman). Who will name the names in the medical community who are to blame for the drug-induced mental health crisis?" read here
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