Overdosed America (48 page)

62
“Marketing a disease:
Love,
Dr. Susan Love’s Hormone Book,
op. cit., p. 28.

62
To educate the doctors:
Ibid.

63
public relations firm:
See Spake, op. cit.

63
The campaign was successful:
Ibid.

63
The National Osteoporosis Foundation:
The National Osteoporosis Foundation’s 2001
Annual Report
lists a number of pharmaceutical companies among its major donors: Aventis Pharmaceuticals; Eli Lilly; GlaxoSmithKline, Merck; Novartis Pharmaceuticals; Pfizer, Procter & Gamble Pharmaceuticals; Solvay Pharmaceuticals; Wyeth Pharmaceuticals; and Wyeth (formerly American Home Products).

63
a 1985 report in NEJM:
M. J. Stampfer, W. C. Willett, G. A. Colditz, et al., “A Prospective Study of Postmenopausal Estrogen Therapy and Coronary Heart Disease,”
New England Journal of
Medicine 313(17):1044–1049, 1985.

63
Framingham Heart Study:
P. W. Wilson, R. J. Garrison, and W. P. Castelli, “Postmenopausal Estrogen Use, Cigarette Smoking, and Cardiovascular Morbidity in Women over 50,”
New England Journal of Medicine
313(17):1038–1043, 1985.

63
Premarin sales:
Spake, op. cit.

63
American College of Physicians issued guidelines:
American College of Physicians, “Guidelines for Counseling Postmenopausal Women About Preventive Hormone Therapy,”
Annals of Internal Medicine
117:1038–1041, 1992.

63
American College of Obstetrics and Gynecology:
Dr. Susan S. Love, “Sometimes Mother Nature Knows Best,”
New York Times,
op-ed, March 27, 1997.

63
Premarin use increased another 40 percent:
Spake, op. cit.

64
most frequently prescribed brand-name drug:
Love, op. cit.

64
in a 1997 article:
F. Grodstein, M. J. Stampfer, G. A. Colditz, et al., “Postmenopausal Hormone Therapy and Mortality,”
New England Journal of Medicine
336(25):1769–1775, 1997.

66
lower mortality rate among women taking HRT:
Grodstein, op. cit.

67
wealthier and better educated, were twice as likely to be white:
D. Friedman-Koss, C. J. Crespo, M. F. Bellantoni, and R. E. Anderson, “The Relationship of Race/Ethnicity and Social Class to Hormone Replacement Therapy: Results from the Third National Health and Nutrition Examination Survey 1988–1994,”
Menopause
9(4):264–272, 2002

67
received more preventative health care:
E. Barrett-Connor, “Postmenopausal Estrogen and Prevention Bias,”
Ann Intern Med
115:455–456, 1991.

67
Dr. Elizabeth Barrett-Connor:
Spake in “Making Sense of Menopause,” op. cit.

67
first randomized controlled clinical trial of HRT:
S. Hulley, D. Grady, T. Bush, et al., “Randomization Trial of Estrogen plus Progestin for Secondary Prevention of Coronary Heart Disease in Postmenopausal Women,”
Journal of the American Medical Association
280:605–613, 1998.

68
Wyeth-Ayerst had requested that the FDA approve:
National Women’s Health Network, “The Truth About Hormone Replacement Therapy,” Roseville, CA: Prima publishing, 2002, p.180.

68
Even aspirin:
Gina Kolata and Melody Petersen, “Hormone Replacement Study a Shock to the Medical System,”
New York Times,
July 10, 2002, p. 1.

68
The FDA ruled that a randomized controlled trial was necessary:
Ibid.

68
did not prevent heart disease:
Hulley, Grady, Bush, et al., op. cit.

68
8 percent per year increase in the risk of breast cancer in women:

68
still the third most frequently prescribed drug:
Family Practice News,
June 1, 2002.

69
government-sponsored Women’s Health Initiative study:
Writing Group for the Women’s Health Initiative, op. cit.

69
HRT not only did not prevent Alzheimer’s disease:
K. Yaffe, “Hormone Therapy and the Brain: Déjà Vu All Over Again?”
Journal of the American Medical Association
289(20):2717–2719, 2003.

69
Million Women Study:
Million Women Study Collaborators, op. cit.

70
women in the United States were about four times more likely:
Love,
Dr. Susan Love’s Hormone Book,
op. cit., p. 23.

70
women taking estrogen:
The Women’s Health Initiative Steering Committee, “Effects of Conjugated Equine Estrogen in Postmenopausal Women with Hysterectomy: The Women’s Health Initiative Randomized Controlled Trial,”
Journal of the American Medical Association
291:1701–1712, 2004.

76
Per-person health care expenditures:
K. Levit, C. Smith, C. Cowan, et al., “Trends in U.S. Health Care Spending, 2001,”
Health Affairs
22(1):154–164, 2002.

76
premiums rose a whopping 43 percent:
Kaiser Family Foundation and Health Research and Educational Trust, “Employer Health Benefits: 2003 Summary of Findings.”

76
Health care costs now account:
Heffler, Smith, Keehan, et al., op. cit.

77
HMOs, on the other hand, offered:
Initially, prepaid groups of health care providers were employed by the HMO and worked together in a central location or locations. These are called “staff” or “closed-model” HMOs. A variation of this arrangement, the “open-panel” HMO, evolved in which community-based doctors contracted to take care of HMO patients in their own offices, again with a prepaid arrangement to control costs. The open-panel plans were attractive to patients who wanted the broader coverage and cost savings of an HMO but did not want to leave their current doctor. Open-panel HMOs also have the advantage of avoiding the cost of establishing a central facility and are more practical in less densely populated areas.

77
Managed care plans differ from HMOs:
Within these broad categories of HMO and managed care plans there are an almost infinite number of variations: the plans can be for profit or not for profit; doctors can be prepaid a certain amount per patient per month or get paid on a fee-for-service basis out of a collective pot; fee-for-service payment can be at 100 percent of the fee schedule or a lesser percentage with a “withhold,” later returned based on individual and/or group financial performance, sometimes with an additional payment for higher quality of care; patients can be restricted to plan doctors or have greater choice for which they have to pay more; the co-pay for drugs can vary between generic and brand-name drugs, and between necessary and more optional drugs—like hair regrowth drugs or expensive drugs when less expensive alternatives are available. See R. A. Dudley and H. S. Luft, “Managed Care in Transition,”
New England Journal of Medicine
344:1087–1092, 2001.

77
increasing between 10 percent and 18 percent per year:
Kaiser Family Foundation and Health Research and Educational Trust, op. cit.

78
In the late 1970s, almost all:
J. Oberlander, “The U.S. Health Care System: On a Road to Nowhere?”
Canadian Medical Association Journal
167:163–168, 2002.

78
By the end of the 1990s:
Dudley and Luft, op. cit.

78
In 1990, stories about the new types:
M. Brodie, L. E. Brady, and Altman, “Media Coverage of Managed Care: Is There a Negative Bias?”
Health Affairs
17(1):9–25, 1998.

78
less than 2 percent by 1996:
Kaiser Family Foundation and Health Research and Educational Trust, op. cit.

79
93 percent of the cost:
E. R. Berndt, “The U.S. Pharmaceutical Industry: Why Major Growth in Times of Cost Containment,”
Health Affairs
20(2):100–114, 2001.

79
Between 1990 and 1997:
J. R. Gabel, P. B. Ginsburg, Pickreign, J. D. Reschovsky, “Trends in Out-of-Pocket Spending by Insured American Workers, 1990–1997,”
Health Affairs
20(2):47–57, 2001.

79
half again as many Americans as Europeans:
K. Minah, R. J. Blendon, and J. M. Benson, “How Interested Are Americans in New Medical Technologies? A Multicountry Comparison,”
Health Affairs
20(5):194–201, 2001.

79
more rather than less money:
Blendon and Benson, op. cit.

79
80 percent of the Internet sites that address back pain:
L. Li, E. Irvin, J. Guzman, and C. Bombardier, “Surfing for Back Pain Patients: The Nature and Quality of Back Pain Information on the Internet. Abstract,”
Spine
26:545–557, 2001.

80
In 1991 the drug companies spent:
“Direct-to-Consumer Ads—The Numbers,”
American Medical News,
February 10, 1997. Viewed at http://www.ama-assn.org/sci-pibs/amnews/pick_97?add0210.htm. Accessed March 2, 2001.

80
over $3 billion in 2003:
Scott Hensley, “As Drug Ad Spending Rises: A Look at Four Campaigns,”
Wall Street Journal,
February 9, 2004.

80
“The market sells dreams and hopes:
Daniel Callahan,
False Hopes,
New York: Simon & Schuster, 1998, pp. 40–41.

80
News stories about HMOs unreasonably withholding care:
M. Brodie, et. al., op. cit.

80
The public’s esteem for managed care companies:
R. J. Blendon and J. M. Benson, “Americans’ Views on Health Policy: A Fifty-Year Historical Perspective,”
Health Affairs
20(2):33–46, 2001.

81
quality of care neither improved nor deteriorated:
Dudley and Luft, op. cit. See also J. Oberlander, “The U.S. Health Care System: On a Road to Nowhere?”
Canadian Medical Association Journal
167(2)163–168, 2002.

81
frequency with which people saw their doctors:
D. Mechanic, D. D. McAlpine, and M. Rosenthal, “Are Patient Visits with Physicians Getting Shorter?”
New England Journal of Medicine
344:198–204, 2001.

81
fewer than one in 100 requests for referrals:
Dudley and Luft, op. cit.

81
“Regardless of the evidence:
Oberlander, op. cit.

82
In one survey in which 59 percent:
“Doctors, Media Seen Fueling Hostility to Managed Care,”
Physicians’ Financial News,
April 30, 2001, p S2.

82
Yearly increases in health insurance premiums:
Kaiser Family Foundation and Health Research and Educational Trust, op. cit.

82
access to comprehensive, family-oriented primary care:
B. Starfield and L. Shi, “Policy Relevant Determinants of Health: An International Perspective,”
Health Policy
60:201–218, 2002. See also L. Shi, “Primary Care, Specialty Care, and Life Chances,”
International Journal of Health Services
24(3):431–458, 1994.

83
In 1965 there were as many:
K. Grumbach, “Fighting Hand to Hand over Physician Workforce Policy,”
Health Affairs
21(5):13–27, 2002.

83
health policy experts recommend that between 42 percent and 50 percent:
“Summary of Eighth Report, Patient Care Physician Supply and Requirements: Testing COGME Recommendations,” November 1996. Viewed at http://www.cogme.gov/rpt8.htm. Accessed April 7, 2003.

83
Only 36 percent of U.S. medical students:
D. A. Newton and M. S. Grayson, “Trends in Career Choice by U.S. Medical School Graduates,”
Journal of the American Medical Association
290:1179–1182, 2003.

83
only three out of 1000 thought that good students:
S. D. Block, N. Clark-Chiarelli, A. S. Peters, and J. D. Singer, “Academia’s Chilly Climate for Primary Care,”
Journal of the American Medical Association
276:677–682, 1996.

83
average debt of over $100,000:
Braden J. Hexom (legislative affairs director, American Medical Student Association), “Letter to House Education and Workforce Committee,” August 12, 2003. Viewed at http://www.amsa.org/meded/studentdebtltr.cfm. Accessed September 29, 2003.

83
boundary between professional responsibilities and personal time:
E. R. Dorsey, D. Jarjoura, and G. W. Retecki, “Influence of Controllable Lifestyle on Recent Trends in Specialty Choice by U.S. Medical Students,”
Journal of the American Medical Association
290:1173–1178, 2003.

84
who do commit malpractice are not sued:
Philip K. Howard., “The Best Course of Treatment,”
New York Times,
July 21, 2003.

84
Three-fifths of doctors in the United States admit:
R. J. Blendon, K. Donelan. R. Leitman, et al., “Health Reform Lessons Learned from Physicians in Three Nations,”
Health Affairs
12(4):193–204, 1993

84
set off a cascade effect:
R. A. Deyo, “Cascade Effects of Medical Technology,”
Annual Review of Public Health
23:23–44, 2002.

85
“a servant of industry”:
R. Horton, “Lotronex and the FDA: A Fatal Erosion of Integrity,”
The Lancet
357:1544–1545, 2001.