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Healthy Skepticism Library item: 11428

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Hébert PC, Stanbrook M.
Indication creep: physician beware
CMAJ 2007 Sep 6; epub ahead of print
http://www.cmaj.ca/cgi/rapidpdf/cmaj.071223


Abstract:

This issue of CMAJ features a systematic review (page 725) of the use in critically ill patients of erythropoietin, a drug that is widely promoted without an approved indication in this patient population.1 Erythropoietin, a complex recombinant glycoprotein hormone, is approved for the treatment of anemia in patients on dialysis, in patients who have had major surgery or in patients undergoing cancer care. The systematic review highlights the finding that when this treatment, which costs about $400 per dose, is used offlabel for critically ill patients, it will save, on average, less than 1 unit of blood, will not improve clinical outcomes and will potentially result in more thrombotic complications…


Notes:

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...to influence multinational corporations effectively, the efforts of governments will have to be complemented by others, notably the many voluntary organisations that have shown they can effectively represent society’s public-health interests…
A small group known as Healthy Skepticism; formerly the Medical Lobby for Appropriate Marketing) has consistently and insistently drawn the attention of producers to promotional malpractice, calling for (and often securing) correction. These organisations [Healthy Skepticism, Médecins Sans Frontières and Health Action International] are small, but they are capable; they bear malice towards no one, and they are inscrutably honest. If industry is indeed persuaded to face up to its social responsibilities in the coming years it may well be because of these associations and others like them.
- Dukes MN. Accountability of the pharmaceutical industry. Lancet. 2002 Nov 23; 360(9346)1682-4.