Your Weekly Update of News and Reviews
January 13, 2019
Consumer Health Digest is a free weekly e-mail newsletter edited by William M. London, Ed.D., M.P.H., with help from Stephen Barrett, M.D. It summarizes scientific reports; legislative developments; enforcement actions; news reports; Web site evaluations; recommended and nonrecommended books; and other information relevant to consumer protection and consumer decision-making. Its primary focus is on health, but occasionally it includes non-health scams and practical tips.
Excessive cancer drug pricing quantified. A team of researchers studied all 99 cancer drugs approved by the US Food and Drug Administration from 1989 to 2017 for which sales data were available for more than half the years since approval. They found that for every dollar in research and development spending, the median income return to the companies by the end of 2017 was found to be $14.50 with a range of $3.30 to $55.10. By the end of 2017, 73 of the drugs included in their analysis had fully recovered the median research and development cost. For those 73 drugs, the median time to generate sales income to fully cover risk-adjusted research and development cost was found to be only 3 years with a range of 2 to 10 years. [Tay-Teo, K and others. Comparison of sales income and research and development costs for FDA-approved cancer drugs sold by originator drug companies. JAMA Network Open 2(1):e186875, 2019] The researchers concluded:
Cancer drugs, through high prices, have generated incomes for the companies far in excess of research and development costs; lowering prices of cancer drugs and facilitating greater competition are essential for improving patient access, health system’s financial sustainability, and future innovation.
“Complementary medicines” position statement issued. The Pharmaceutical Society of Australia (PSA) has issued a position statement describing the role of pharmacists related to “complementary medicines.” [Pharmaceutical Society of Australia. Complementary medicines position statement. October 2018] Key points in the statement include:
- PSA’s Code of Ethics for Pharmacists states that a pharmacist will only purchase, supply or promote any complementary medicine or herbal remedy where there is credible evidence of efficacy and the benefit of use outweighs the risk.
- PSA does not support the provision or promotion of homeopathy products by pharmacists.
- The pharmacist’s first priority is the health and wellbeing of the consumer. When discussing the use of complementary medicines, the pharmacist must ensure the consumer is provided with the best available information about the current evidence for efficacy, as well as information on any potential side effects, drug interactions and risks of harm, to assist in making informed decisions.
- A pharmacist respects the consumer’s choice. When a consumer chooses to use a product with limited evidence, the pharmacist must advise on the risks of rejecting or delaying treatments for which there is good evidence for safety and effectiveness.
Detoxing debunked. Vox has published a brief article accompanied by an informative four-minute YouTube video explaining that the unless you are a heroin addict or are at risk of alcohol poisoning, you probably don’t need a ‘detox.’ [Belluz J, Haubursin C. Products that promise “detox” are a sham. Yes, all of them. Vox. Jan 2, 2019]
Fluoridation benefits and safety reaffirmed. Public Health Ontario has completed an evidence review that reaffirms the benefits and safety of optimally fluoridated water. The report’s key messages are:
- The existing literature (to May 10, 2017) indicates that mild dental fluorosis (generally unnoticeable white specks on teeth) is the only adverse effect experienced from consuming optimally fluoridated water (Health Canada recommends the optimal level of fluoride in water at 0.7 mg/L).
- Infant formulas prepared with optimally fluoridated water may increase the chance of the mild form of dental fluorosis if they are the child’s main food source. If prevention of mild fluorosis is desired, then infant formula can be occasionally prepared with low-fluoridated bottled water and early exposure to other forms of fluoride (including fluoride toothpaste, fluoride rinse, and fluoride supplements) should be monitored.
The report also notes that the recommended optimal level considers the dose-response relationship between fluoride intake and health effects and provides a trade-off that maximizes benefits and minimizes adverse effects. [Public Health Ontario. Evidence review for adverse health effects of drinking optimally fluoridated water (2010-2017). October 2018]
Dental fluorosis is an alteration of dental enamel caused by ingestion of more than the optimal amount of fluoride during tooth development. In mild fluorosis, the teeth may appear whiter than otherwise but are neither unattractive nor structurally damaged. [Barrett S., Baratz RS. Dental fluorosis: much ado about nothing. Dental Watch, Jan 13, 2019]
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