Envisioning 2.0

I’m at HealthCareVox writing about new research from my firm Envision Solutions and JupiterKagan that indicates social media really matters in healthcare.  Click here to read the post.

at Workers’ Comp Insider.

A couple of weeks ago, I reported on a state-focused lobbying campaign Merck initiated to encourage legislators and other officials to require use of its cervical cancer vaccine Gardasil. At the time I suggested that Merck tread carefully as it risked drawing fire from critics who may charge that the campaign is a self serving attempt to increase revenues for its product.

It looks like Merck was paying close attention to the firestorm it generated by encouraging mandatory use of Gardasil. Earlier this week, the company announced that it would halt its lobbying campaign. According to the New York Times, Merck “acted after hearing from public health officials and medical organizations that its campaign was counterproductive.”

Jim Edwards, who writes the blog BrandweekNRx ( and is a senior editor for Brand Week), says that Merck’s decision “is a significant victory for the anti-science/pro-cancer crowd.” He doesn’t understand why the “pro-family people . . . want to get their daughters to get STDs and die of cancer.”

I disagree with Edwards. I think Merck recognized that the overall poor reputation of the pharmaceutical industry coupled with charges its lobbying efforts weren’t designed to aid public health made pushing for mandatory vaccination was a bad move. In addition, should Merck’s vaccine turn out to have some nasty, previously unknown side effects (see Vioxx) it could be in a lot of trouble. No, better to wait and take the high road. Good call Merck.

P.S.: See the comments section in my original post on Gardasil for an intriguing debate on the pros and cons of the vaccine.

Is getting a story by any means necessary appropriate? A New York judge doesn’t think so. In a scathing decision, a federal court ordered a doctor and lawyer who handed over confidential Zyprexa marketing materials to a New York Times reporter to return the documents to Eli Lilly and Company. In a revealing article (published in the Times no less), the judge blasted journalist Alex Berenson for engaging in “reprehensible” activities and for being “deeply involved in the effort to illegally obtain the documents.”

According to the Times Berenson “obtained the documents after he discussed with Dr. Egilman ways to circumvent a protective order. Mr. Berenson put Dr. Egilman in touch with Mr. Gottstein, the judge said, so that they might ‘employ a pretense to subpoena the documents.’ According to Judge Weinstein, the documents were sent to Mr. Gottstein via an expedited subpoena, which Lilly was unaware of. Mr. Gottstein then sent the papers to Mr. Berenson and others. No other news organizations received the documents, the judge said, because Mr. Berenson told Mr. Gottstein that if the material was not delivered exclusively to him, the newspaper would not publish an article.”

Lilly praised the judge’s decision saying: “Our adversaries carefully selected the documents to tell a story that they wanted to tell. These cherry-picked documents in no way reflect the strategies or activities of Eli Lilly & Company. Lilly feels vindicated because the judge issued an injunction that prohibits future wrongdoing by those who took the law into their own hands.”

Of course the decision amounts to little more than a moral victory for Lilly as the documents Berenson received are all over the Internet. To fight back, the company has launched a Website, Zyprexa Facts.com where it addresses news reports and defends its actions.

In related news, researchers have revealed why Zyprexa and drugs like it lead to massive weight gain. These medications increase the production of brain chemicals that control appetite.

A fascinating article published in the February edition of Health Affairs is a must-read for those interested in consumer-driven healthcare. The paper, “Self-Pay Markets In Healthcare: Consumer Nirvana Or Caveat Emptor?” examines patient experiences purchasing medical care for conditions/procedures where there is an established consumer-driven market. Ha T. Tu and colleagues examine LASIK surgery and other popular procedures that are not generally covered by insurance.
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From In the Pipeline:

“Hepatitis C has been one of the big targets for many years now. Various development programs have come and gone, but no one has been able to really nail this one. Vertex is now in the middle of trying to, and as Adam Feuerstein points out, they’re really betting a large part of the company on the attempt. Over the next few months, results should start coming out for their PROVE trials of telaprevir (VX-950), and for Vertex’s sake, the drug had better work. A herd of competitors, probably led by Schering-Plough, is ready to take over should anything slip.”

For my thoughts on this drug, please see the following posts:

-VX-950: Hep-C Treatment Moving Right Along
-Don’t Believe The Hype — Yet

Merck has come a long way in a short period of time. Although the company is still plagued by lawsuits relating to its marketing and promotion of Vioxx, its “one case at a time” strategy appears to be working. Most recently, the company has earned well-deserved praise for launching a novel vaccine for human papillomavirus, a leading cause of cervical cancer.

Merck’s marketing prowess was one reason Pharmaceutical Executive selected Gardasil as its first-ever brand of the year, saying:

“[We] selected Gardasil as the 2006 Brand of the Year, our first, because it embodies the kind of links between science, commercialization, and humanity that typify great pharmaceutical breakthroughs. It turned a medical success story into a campaign of empowerment for a generation of girls and young women. Merck’s researchers used visionary science to produce a vaccine with the potential to eradicate the third-most-common cause of cancer worldwide, while marketers taught girls and young women how to talk about sensitive issues in a forthright, unapologetic way.”
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Given that consumer-driven healthcare has been a major theme on this blog this week, I thought I’d highlight a column written by Robert Samuelson published in today’s Washington Post.  In his editorial, Samuelson exposes some of the common myths associated with American healthcare.  He argues:
-Contrary to conventional wisdom, the doubling of premiums for employer-provided coverage doesn’t mean companies shifted a greater share of costs to workers

-The uninsured don’t really use emergency rooms heavily. A study in the journal Health Affairs finds that their use is similar to that of people with private insurance — and half that of people with Medicaid.

In conclusion he asks:

“Our health-care system will inevitably combine government regulation and private enterprise. But what should the mix be? How important is health care compared with other public and private goals? Will an expanding health-care sector spur the economy — or, through high taxes and insurance premiums, retard it?”

Clearly, we are well into an era where policymakers and others are taking steps to expose the true costs and benefits of healthcare to Joe Public.  In fact, Michael E. Chernew Allison B. Rosen and A. Mark Fendrick recently published an article in Health Affairs arguing for “value-based” insurance.  These are plans that encourage “the use of services when the clinical benefits exceed the cost and likewise discourages the use of services when the benefits do not justify the cost.”  Of course the big question is: who will define value?

Source: The Health Affairs Blog