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Biomedical subjects

J Lexchin

Publications and source records attributed to J Lexchin.

At least 19 recordsLinked to original sources
PubMed1992

NSAIDs and peptic ulcer.

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Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1992

Prescribing and drug costs in the province of Ontario.

The Report of the Pharmaceutical Inquiry of Ontario documented dramatic increases in the cost of the Ontario Drug Benefit (ODB) program. This article demonstrates that the rise in ODB costs for those 65 and over is due to two factors: more intensive prescribing--physicians prescribing to the elderly more often and writing more prescriptions each time they see an elderly patient--and physicians writing prescriptions for more expensive drugs. Neither of these two changes in prescribing behavior has resulted in any demonstrable improvement in the health of the elderly. Efforts to control costs through some form of copayment or by eliminating some drugs from the ODB formulary should not be undertaken since they probably will result in a reduction in the use of medically necessary drugs. Ultimately, drug costs will only be controlled by improving the appropriateness of physicians' prescribing.

Aged↗
PubMed1991

A sample argument.

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Drug Industry↗
PubMed1990

Responsiveness to physicians' requests for information concerning drug interactions: a comparison of brand and generic companies.

Research-based pharmaceutical companies maintain that there are important differences between themselves and their generic competitors. Prominent among them is an alleged greater ability to provide accurate and rapid responses to requests from physicians for information about drug products. This study evaluates pharmaceutical company behavior with regard to these issues. Two drug-drug interactions were identified, along with all of the companies in Canada marketing any of the four drugs involved. Each company received a letter describing symptoms suggestive of an interaction in a patient taking its particular product and the relevant second drug. The companies were asked if they were aware of any evidence of an interaction involving the two drugs. They were also asked to provide references regarding the interaction. Responses were received from all companies contacted except one. There were no significant differences (in the hypothesized direction) between the generic and brand companies with regard to either the accuracy or promptness of the response, or the usefulness of the references cited. On the contrary, generic firms were markedly quicker to respond than were brand manufacturers. The latter were slightly more likely to acknowledge evidence of an adverse drug interaction, and to provide useful references to relevant published research.

Canada↗
PubMed1990

Drug makers and drug regulators: too close for comfort. A study of the Canadian situation.

Canadian drug laws and regulations have been made increasingly more stringent over the past 40 years and are now considered among the strictest in the world. However, there are still major gaps in the Canadian regulatory process. These deficiencies exist primarily in the areas of the evaluation of the efficacy of 'old' (pre-1963) drugs; the reporting of adverse effects of both old and investigational new drugs; and the requirements for and monitoring of clinical drug trials. Each of these problems are discussed and where possible concrete examples are used to show how these gaps have either directly or potentially endangered the health of Canadians. It is the thesis of this paper that these deficiencies result from the close working relationship between the Health Protection Branch, which is responsible for regulating drug safety, quality and efficacy, and the Pharmaceutical Manufacturers Association of Canada, representing the multinational companies. These two groups interact primarily through an extensive system of liaison committees that allow the PMAC to participate in the early stages of drug policy formation. Other groups such as workers and consumers are excluded from such discussions. The HPB has also ceded responsibility for enforcement of regulations to the PMAC in the areas of quality control of manufacturing and pharmaceutical promotion. Restricting the interactions between HPB officials and the drug companies is not a viable option. As long as the present arrangement is in place with privately owned companies being regulated by government, a situation that is likely to prevail for the foreseeable future, then it will be necessary for the two groups to have frequent and close contacts.(ABSTRACT TRUNCATED AT 250 WORDS)

Canada↗
PubMed1989

Reducing drug costs.

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Costs and Cost Analysis↗
PubMed1989

Prescribing habits.

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Drug Information Services↗
PubMed1989

Doctors and detailers: therapeutic education or pharmaceutical promotion?

Pharmaceutical companies in industrialized countries generally view detailers as the most crucial element in the promotion of their products, with the result that over 50 percent of expenditures on promotion are devoted to detailers. Publicly the companies make claims for the scientific knowledge of detailers and for their role in passing on information to physicians, but the main purpose of detailers is to sell their company's products. This emphasis on sales is evident from statements of detailers themselves, from advertisements for detailers, from company documents, and by looking at the groups of physicians that companies specially target for visits by detailers. A variety of explanations are offered as to why physicians see detailers, but on examination none of the reasons is justifiable. Studies from a number of industrialized countries have shown that over 90 percent of physicians see detailers and a substantial percentage rely heavily on detailers as sources of information about therapeutics. Detailers are highly successful in altering physicians' prescribing habits, but almost all the literature available shows that the more reliant doctors are on commercial sources of information, the less appropriate they are as prescribers. Widespread use of DES (diethylstilbestrol) and the Dalkon Shield was encouraged by detailers. Although detailers have received the endorsement of both physicians' groups and government bodies, seeing detailers is detrimental to the practice of good medicine, and the best interests of doctors and their patients would be served if physicians had nothing further to do with detailers.

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