Study Links Drug Maker Gifts for Doctors to More Overdose Deaths

Counties where doctors got more meals, trips and consulting fees from opioid makers had higher overdose deaths involving prescription opioids.


WASHINGTON — A new study offers some of the strongest evidence yet of the connection between the marketing of opioids to doctors and the nation’s addiction epidemic.

It found that counties where opioid manufacturers offered a large number of gifts and payments to doctors had more overdose deaths involving the drugs than counties where direct-to-physician marketing was less aggressive.

The study, published Friday in JAMA Network Open, said the industry spent about $40 million promoting opioid medications to nearly 68,000 doctors from 2013 through 2015, including by paying for meals, trips and consulting fees. And it found that for every three additional payments that companies made to doctors per 100,000 people in a county, overdose deaths involving prescription opioids there a year later were 18 percent higher.

Even as the opioid epidemic was killing more and more Americans, such marketing practices remained widespread. From 2013 through 2015, roughly 1 in 12 doctors received opioid-related marketing, according to the study, including 1 in 5 family practice doctors.



Malaysian think tank among recipients of tobacco industry’s donations, says UK paper

KUALA LUMPUR, Jan 24 — Malaysia’s Institute for Democracy and Economic Affairs (Ideas) are among free-market think tanks globally that have received donations from tobacco companies and had opposed measures to curb smoking such as higher cigarette taxes, reports by UK daily Guardian has found.

The Guardian highlighted Ideas’ statements and work in objecting to the Malaysian government’s 2017 proposal to impose a hike in cigarette tax, in the latter’s bid to cut down on the death toll of over 27,200 Malaysians annually from smoking.

Malaysia’s then deputy health minister Datuk Seri Dr Hilmi Yahaya had in March 2017 spoke of plans to increase the price of a pack of cigarettes from RM17 to RM21.50, with Guardian noting that experts had backed taxes as a proven measure to reduce smoking and smoking-related health problems and deaths.

But the-then Ideas executive director Wan Saiful Wan Jan had reportedly opposed the idea, saying that the proposed solution of higher taxes was “wrong because it will only encourage illegal activities without reducing the number of smokers”, with the argument that “one out of every two packs” of cigarettes in Malaysia is smuggled and a tax hike would boost the illicit trade.

The Guardian noted that the Malaysian government withdrew its proposal for higher cigarette taxes after 10 days, but said Ideas continued to speak up for months against the idea by issuing statements, opinion pieces and two reports which used tobacco firm-funded data to say taxes would intensify illegal trade.

How tobacco industry donations cloud debates over cigarette controls

Free-market thinktanks from Malaysia to Chile and Australia received funding from the industry alongside governments as they argued against tobacco controls.

Smoking kills more than 27,200 Malaysians every year.

In March 2017, Malaysia’s health ministry hoped to reduce that grim tally by floating a plan to sharply increase cigarettes taxes as recommended by the World Health Organization (WHO), and proposed by the deputy health minister, Dr Hilmi Yahaya, in the nation’s legislature.

But not everyone thought this was a good idea.

Opponents included a politically connected thinktank called the Institute for Democracy and Economic Affairs (Ideas), a partner of the Atlas Network, a global network of free-market advocacy groups based in Arlington, Virginia, near Washington DC.

Then executive director Wan Saiful Wan Jan warned that while the health department had “good intentions”, “their proposed solution is wrong because it will only encourage illegal activities without reducing the number of smokers”.

The thinktank accepted donations from Philip Morris Singapore, Philip Morris Malaysia and Japan Tobacco International alongside money from the American, British and Canadian governments, according to financial disclosures by the thinktank.

The proposal to increase taxes was dropped after just 10 days. But Ideas continued to advocate against tax hikes for months afterward, issuing statements, opinion pieces and two lengthy reports which used data paid for by tobacco companies to conclude taxes would fuel a black market.


Johnson & Johnson knew for decades that asbestos lurked in its Baby Powder

Facing thousands of lawsuits alleging that its talc caused cancer, J&J insists on the safety and purity of its iconic product. But internal documents examined by Reuters show that the company’s powder was sometimes tainted with carcinogenic asbestos and that J&J kept that information from regulators and the public.

(Note: This same happened with the tobacco industry. They knew all along that smoking causes cancer and they did everything they could to dispute this fact).



What These Medical Journals Don’t Reveal: Top Doctors’ Ties to Industry

By Charles Ornstein and Katie Thomas, Dec. 8, 2018

One is dean of Yale’s medical school. Another is the director of a cancer center in Texas. A third is the next president of the most prominent society of cancer doctors.

These leading medical figures are among dozens of doctors who have failed in recent years to report their financial relationships with pharmaceutical and health care companies when their studies are published in medical journals, according to a review by The New York Times and ProPublica and data from other recent research.

Dr. Howard A. “Skip” Burris III, the president-elect of the American Society of Clinical Oncology, for instance, declared that he had no conflicts of interest in more than 50 journal articles in recent years, including in the prestigious New England Journal of Medicine.

However, drug companies have paid his employer nearly $114,000 for consulting and speaking, and nearly $8 million for his research during the period for which disclosure was required. His omissions extended to the Journal of Clinical Oncology, which is published by the group he will lead.

Medical journals, which are the main conduit for communicating the latest scientific discoveries to the public, often have an interdependent relationship with the researchers who publish in their pages. Reporting a study in a leading journal can heighten their profile — not to mention that of the drug or other product being tested.

“The system is broken,” said Dr. Mehraneh Dorna Jafari, an assistant professor of surgery at the University of California, Irvine, School of Medicine. She and her colleagues published a study in August that found that, of the 100 doctors who received the most compensation from device makers in 2015, conflicts were disclosed in only 37 percent of the articles published in the next year.

Calls for transparency stem from concerns that researchers’ ties to the health and drug industries increase the odds they will, consciously or not, skew results to favor the companies with whom they do business. Studies have found that industry-sponsored research tends to be more positive than research financed by other sources. And that in turn can sway which treatments become available to patients.

Concerns about the influence of drug companies on medical research have persisted for decades.


Rectal rupture: woman, 86, injured during imaging procedure at Hong Kong public hospital

An elderly woman has suffered a rupture to her rectum during a medical imaging procedure at a Hong Kong public hospital.

The 86-year-old was undergoing a computerised tomography virtual colonoscopy at Pamela Youde Nethersole Eastern Hospital in Chai Wan on Friday.

The procedure requires pumping gas into the colon to inflate it for better imaging. A small water-filled balloon was placed in the woman’s anus to stop any gas leaking, a spokesman for the Hospital Authority said.

Doctors believe the balloon accidentally became filled with gas and then ruptured, causing a perforation of the rectum.

An emergency operation was carried out to repair it. The woman was stable on Friday night.

The spokesman said the hospital was “very concerned” about the case and had met the woman’s family to explain and apologise. The incident was reported to the authority’s head office.


Why Hospitals Should Let You Sleep

Frequent disruptions are more than just annoying for patients. They can also cause harm.

By Austin Frakt



If part of a hospital stay is to recover from a procedure or illness, why is it so hard to get any rest?

There is more noise and light than is conducive for sleep. And nurses and others visit frequently to give medications, take vitals, draw blood or perform tests and checkups — in many cases waking patients to do so.

Some monitoring is necessary, of course. Medication must be given; some vital signs do need to be checked. And frequent monitoring is warranted for some patients — such as those in intensive care units. But others are best left mostly alone. Yet many hospitals don’t distinguish between the two, disrupting everyone on a predefined schedule.

Peter Ubel understands the problem as both a physician and patient. When he spent a night in the hospital recovering from surgery in 2013, he was interrupted multiple times by blood draws, vital sign checks, other lab tests, as well as by the beeping of machines. “Not an hour went by without some kind of disruption,” said Dr. Ubel, a physician with Duke University. “It’s a terrible way to start recovery.”

It’s more than annoying — such disruptions can harm patients. Short sleep durations are associated with reduced immune functiondeliriumhypertension and mood disorders.

Hospital conditions, including sleep disruptions, may contribute to “posthospital syndrome” — the period of vulnerability to a host of health problems after hospitalization that are not related to the reason for that hospitalization.

“In addressing a patient’s acute illness, we may inadvertently be causing harm by ignoring the important restorative powers of a healing environment,” said Harlan Krumholz, a Yale University physician who has been calling attention to posthospital syndrome for several years. “The key to a successful recovery after illness may be a less stressful, more supportive, more humane experience during the hospitalization.”

To help patients deal with the stresses of hospitalization, sedatives are often prescribed. These medications, including opioids, carry their own risks, such as addiction.

“Instead, we could make the environment more conducive to rest and reduce the use of sedatives,” Dr. Ubel said.

Being sick and hospitalized is bad enough. Being subjected to sleep deprivation adds insult (or more injury) to injury.



October 22nd, 2018


When it comes to cancer, there is reason for hope. But this hopeful narrative is tempered by the sobering reality that more than 600,000 people will die from cancer in the United States this year and over 1.7 million new cases will be diagnosed.

And for those with metastatic or stage 4 cancer, it is still the case that the majority will eventually succumb to the disease. These statistics cannot be ignored in the messaging of hope for cancer patients.

As the cancer death rate has declined, advertising spending by cancer centers has increased — exponentially. Between 2005 and 2014, the amount spent by U.S. cancer centers on advertising soared 320 percent, from $54 million in 2005 to $173 million in 2014. Today, there are more than 1,200 accredited cancer centers competing against each other for patients, who pay billions of dollars in out-of-pocket expenses for cancer treatment every year.


  • What found was that 90 percent of the cancer centers still in business in 2018 – 43 out of 48 – were deceptively promoting atypical patient experiences through the use of powerful testimonials.
  • org has catalogued more than 700 testimonialsfeaturing patients with cancer types that have a less than 50 percent five-year survival rate that have been deceptively used in marketing materials to advance the narrative, either explicitly or implicitly, that treatment at a particular cancer center will provide patients with a therapeutic advantage, allowing them to beat the odds and live beyond five years.

As the largest cancer center advertiser in the country, spending on average more than $90 million a year over the last three years, CTCA has paved the way for cancer centers across the nation to use the same deceptive tactics to lure patients to their facilities.

Playing on cancer patients’ hopes and fears

Any cancer center can find a patient who has beat the odds. But using that atypical experience to play on the hopes and fears of such a susceptible patient population has real consequences.

Studies show that consumers in general put more trust in the motives of medical institutions than they do other types of marketers.

And cancer patients in particular, who are deciding where to go for treatment or for a second opinion, may look at these testimonials not as advertising designed to generate revenue but as educational material that provides objective information about typical results.

Enough is enough

That cancer centers would manipulate a message of hope in their advertising to attract new patients to their facilities is simply not acceptable.

Cancer patients who face devastating odds of survival have a right to know the truth and not have their vulnerable situation exploited as they seek out treatment.