tag:blogger.com,1999:blog-8770341086445997547.post7423204153517233534..comments2023-10-07T22:37:49.244+13:00Comments on The Hand Mirror: Red and Blue Pills - Thoughts on the Herceptin debatekatyhttp://www.blogger.com/profile/15742280289613450293noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-8770341086445997547.post-91411622004353989032008-08-12T10:09:00.000+12:002008-08-12T10:09:00.000+12:00A longer course of Herceptin may well be a good th...<I>A longer course of Herceptin may well be a good thing, but the influence of drug companies, marketers etc means we can't uncritically throw ourselves on any bandwagon, even when the cause (ie women's health) is a good one.</I><BR/><BR/>So true. The manipulation of sentiment by the big drug companies is constant, and makes it difficult to consider the issues clearly. I wrote this in 2006, when a flat-out astroturf project by Roche was pretty well ignored by the local news media:<BR/><BR/>http://publicaddress.net/3611Russell Brownhttps://www.blogger.com/profile/06272870489640380269noreply@blogger.comtag:blogger.com,1999:blog-8770341086445997547.post-76062645105220705612008-08-08T15:57:00.000+12:002008-08-08T15:57:00.000+12:00I'm relieved you've written about this Expat - I w...I'm relieved you've written about this Expat - I was wondering if I was the only person conflicted about it, and if I was being a heretic. My scientific knowledge is nil, so I'm not able to weigh up the medical reasoning used by the blue and red corners respectively. <BR/><BR/>Rationing of healthcare is an issue that even utopian lefties can't avoid considering, since demands for better health and greater longevity will always grow. But even if we accept the need for rationing, we still have to do it in such a way that no particular group is systematically disadvantaged.<BR/><BR/>A longer course of Herceptin may well be a good thing, but the influence of drug companies, marketers etc means we can't uncritically throw ourselves on any bandwagon, even when the cause (ie women's health) is a good one.Annahttps://www.blogger.com/profile/06076244041878300351noreply@blogger.comtag:blogger.com,1999:blog-8770341086445997547.post-30489420493995435942008-08-08T15:24:00.000+12:002008-08-08T15:24:00.000+12:00The reality is that all health/treatment decisions...The reality is that all health/treatment decisions are, to some extent, determined by funding. This is just as true in countries without public health care systems, although the mechanisms and effects are different (i.e. your health insurer decides what treatments it will fund, and your access to health insurance is determined by your income).<BR/><BR/>Doctors, DHBs, MoH and Pharmac all have to make decisions every day about how to make the best use of the funding that is available - and those decisions aren't easy ones. The relative benefit of a treatment to the individual and society must be balanced against its cost an availability. And that's not easy to do either, given the prevalence of drug company funded trials - which meta-analyses have shown to be generally biased in favour of the sponsor's product.<BR/><BR/>And speaking of meta-analyses, a recent one by the Cochrane Centre has found that there is no evidence for breast self-examination being beneficial in screening for breast cancer http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD003373/frame.html<BR/><BR/>But as I understand it, population screening by mammography, is useful for early detection of breat cander in OLDER women (over 50). Not that I am an expert. Which is why I'm glad that we do have experts (including the ones at Pharmac) who I hope try to consider the best evidence (which changes all the time) and make decisions on that basis - not on the basis of well funded pressure groups or popularity!Anonymousnoreply@blogger.com