Healthy Skepticism Library item: 9878

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

Calaf J, Ferrer M.
Pharmacological treatment of menopause in Spain in 2002
Clinica e Investigacion en Ginecologia y Obstetricia 2004; 30:(9):299-306

Abstract:

Rationale and goals: The treatment of menopausal consequences with estrogens is controversial. The recent publication of randomized clinical trials and new therapeutical approaches has raised our interest in evaluating the evolution of its prescription in Spain during recent years as a reflection of the perception of clinicians on this topic. Methods: We have investigated the sales of prescription products with the indication of menopausal symptoms and osteoporosis from databases generated by International Marketing Services (IMS). We have gathered the annual data between 1990 and 2002 for women aged between 45 and 64. The number of units sold have been transformed in ETY’s (estimated treatment years) and calculated the use trend for years. Results: The use of estrogens has increased steadily since 1990 (1.3%) until 2000 (7.8%) and then decreased slightly (7.4%). There has been a goegraphical distribution with a trend to decrease in use from north to south and from east to west. The utilization rates of hormone replacement therapy is lower than that in countries of a similar economical environment and annual income levels. There are no objective data to explain these differences. The therapeutical family of estrogens and similar molecules is the most prescribed during the peri and early post-menopausal period. Thereafter raloxifene and biphosphonates are predominantly prescribed. Conclusions: The prescibing patterns of hormone replacement, raloxifene and biphosphonates tend to coincide with a strategy based on quality evidences. Apparently prescription attitudes follow rational criteria and are based on clinicians objectives.

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909