Pharmanipulation

Episode 8 features an interview with Shahram Ahari MD, an emergency medicine physician and former drug rep, that explores the world of pharmaceutical samples. We chat about why samples are the most important marketing tactic drug companies have, how samples are used to manipulate prescribing choices, and discuss whether or not drug samples should be banned. Pharmanipulation is produced by PharmedOut, a project at Georgetown University Medical Center that advances evidence-based prescribing. Additional Resources PharmedOut fact sheet on drug samples: ⁠https://georgetown.app.box.com/s/y51hkdvu2dju9sv26fjcc976ivlvwtkj Summaries of key articles on the topic of drug samples: ⁠https://georgetown.app.box.com/s/3052cjlgv9thfw0qf3k9fkuyio978mbr PharmedOut’s paper “Pharmaceutical marketing: the example of drug samples.” Link: https://joppp.biomedcentral.com/articles/10.1186/s40545-022-00479-z PharmedOut’s paper “Following the Script: How Drug Reps Make Friends and Influence Doctors.” Link: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0040150 PharmedOut’s paper “Why lunch matters: Assessing physicians' perceptions about industry relationships.” Link: https://onlinelibrary.wiley.com/doi/abs/10.1002/chp.20081 Dr. Ahari’s op-ed in The Washington Post “I was a drug rep. I know how pharma companies pushed opioids.” Link: https://www.washingtonpost.com/outlook/i-was-a-drug-rep-i-know-how-pharma-companies-pushed-opioids/2019/11/25/82b1da88-beb9-11e9-9b73-fd3c65ef8f9c_story.html

Episode 7 features an interview with Peter Whitehouse MD, PhD and Lon Schneider MD, MS exploring dementia and mild cognitive impairment. We chat about the medicalization of normal aging, the overdiagnosis of mild cognitive impairment, problems with new drugs and tests for Alzheimer’s disease, and how to prevent dementia. Pharmanipulation is produced by PharmedOut, a project at Georgetown University Medical Center that advances evidence-based prescribing. Additional Resources PharmedOut resources on Alzheimer’s and Mild Cognitive Impairment: https://sites.google.com/georgetown.edu/pharmedout/advocacy/alzheimers-and-mild-cognitive-impairment?authuser=0 Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Link: https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext Making the Case for Accelerated Withdrawal of Aducanumab. Link: https://content.iospress.com/articles/journal-of-alzheimers-disease/jad220262 Dr. Peter Whitehouse’s latest letter to the editor, “Cummings column on Alzheimer treatments skips over a few key things.” Link: https://www.cleveland.com/letters/2023/10/cummings-column-on-alzheimer-treatments-skips-over-a-few-key-things.html American Dementia: Brain Health in an Unhealthy Society by Danny George PhD and Peter Whitehouse MD, PhD. Link: https://www.press.jhu.edu/books/title/12394/american-dementia The Myth of Alzheimer’s: What You Aren't Being Told About Today's Most Dreaded Diagnosis by Peter Whitehouse MD, PhD and Danny George MSc. Link: https://us.macmillan.com/books/9780312368173/themythofalzheimers

Episode 6 invites Ragen Chastain, activist and author, and Joel Lexchin MD of York University, to discuss myths about weight and health, the hype around Ozempic and Wegovy, and the unclear connection between weight loss and health. Pharmanipulation is produced by PharmedOut, a project at Georgetown University Medical Center that advances evidence-based prescribing. To learn more about Ragen Chastain and her work, please visit her website: https://weightandhealthcare.substack.com/ Additional Resources Dances With Fat Monthly Workshop – September: Navigating Weight Stigma at the Doctor’s Office date changed from September 27 to October 11 to avoid overlap with ASDAH’s annual meeting. Link: https://danceswithfat.org/monthly-online-workshops/ Books “Fearing the Black Body: The Racial Origins of Fat Phobia” by Sabrina Strings. Link: https://nyupress.org/9781479886753/fearing-the-black-body/ “Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness” by Da'Shaun L. Harrison. Link: https://www.penguinrandomhouse.com/books/670607/belly-of-the-beast-by-dashaun-harrison/ Articles "Semaglutide: a new drug for the treatment of obesity" by Joel Lexchin and Barbara Mintzes. Drug Ther Bull. 2023 Oct 25:dtb-2023-000007. doi: 10.1136/dtb.2023.000007. Link: https://pubmed.ncbi.nlm.nih.gov/37879878/ “How the ‘It's Bigger Than Me’ Campaign Is Harming Fat People for Profit" by Ragen Chastain. Link: https://themighty.com/topic/eating-disorders/its-bigger-than-me-campaign-harms-fat-people-for-profit/ “Weighing the Consequences of Weight-Loss Drugs” by Judy Butler and Dr. Adriane Fugh-Berman. Link: https://www.medpagetoday.com/opinion/second-opinions/104482 Igho J. Onakpoya, Carl J. Heneghan and Jeffrey K. Aronson. Post-marketing withdrawal of anti-obesity medicinal products because of adverse drug reactions: a systematic review. BMC Medicine 2016;14:191. Link: https://pubmed.ncbi.nlm.nih.gov/27894343/ Prescrire’s "Semaglutide (Wegovy°) for excess body weight" Prescrire International 2023; 32 (245): 36-38. Link: https://english.prescrire.org/en/81/168/66102/0/NewsDetails.aspx Please note: the full article is available for subscribers only. PharmedOut is supported primarily by individual donations. To donate, please visit: https://sites.google/com/georgetown.edu/pharmedout/donate

Episode 5 invites Tony Scialli MD, an obstetrician-gynecologist and reproductive toxicologist, to talk about the overuse of gynecologic surgeries – namely hysterectomies and Cesarean sections. Pharmanipulation is produced by PharmedOut, a Georgetown University Medical Center rational prescribing project. For a transcript of this episode, please visit: https://georgetown.box.com/s/1bdbxvaezezlpu0qsm02q3101mmhsi3a To learn more about Dr. Tony Scialli, please visit his website: https://www.scialliconsulting.com/#about Additional Resources The Cultural Warping of Childbirth by Doris Haire. Link: https://www.abebooks.com/9789315600471/Cultural-Warping-Childbirth-Doris-Haire-9315600479/plp Our Bodies, Ourselves by Boston Women’s Health Collective. Link: https://www.simonandschuster.com/books/Our-Bodies-Ourselves/Boston-Womens-Health-Book-Collective/9781439190661 Spiritual Midwifery by Ina May Gaskin. Link: https://www.abebooks.com/servlet/BookDetailsPL?bi=31385160493&ref_=ps_ggl_17730880232&cm_mmc=ggl-_-US_Shopp_Trade_10to20-_-product_id=COM9781570671043USED-_-keyword=&gclid=Cj0KCQjw1_SkBhDwARIsANbGpFs4ExX1P9YXQFUuTueJytlUy2VdelLMIBU7neywgGu14aYawh1w7hkaArxfEALw_wcB National Women’s Health Network. Link: https://nwhn.org/ PharmedOut is supported primarily by individual donations. To donate, please visit: https://sites.google/com/georgetown.edu/pharmedout/donate

Episode 4 invites medical anthropologist Sylvia Önder PhD and cultural psychologist Yulia Chentsova Dutton PhD to discuss the differences among disease, sickness and illness and explore the concepts of invented diseases, folk illnesses, and the social value of certain diseases. Pharmanipulation is produced by PharmedOut, a Georgetown University Medical Center rational prescribing project. For a transcript of this episode, please visit: https://georgetown.box.com/s/ufrrmreu5d26cbfvorbu863uz32qkih9 PharmedOut Conference: https://sites.google.com/georgetown.edu/pharmedout/resources/conferences/2023-conference Bonnie O’Connor. Healing Traditions: Alternative Medicine and the Health Professions. 1995. Link: https://www.jstor.org/stable/j.ctt3fhvd3 Irving Zola. Medicine as an institution of social control. 1976. Link: https://www.jstor.org/stable/43618673 Michel Foucault. The Birth of the Clinic: An Archaeology of Medical Perception. Link: https://www.penguinrandomhouse.com/books/55034/the-birth-of-the-clinic-by-michel-foucault/ PharmedOut is supported primarily by individual donations. To donate, please visit: https://sites.google/com/georgetown.edu/pharmedout/donate

Episode 3 of Pharmanipulation invites Gretchen LeFever Watson PhD and Robert Whitaker to question diagnoses of attention deficit hyperactivity disorder and to critique drug treatment of behaviors associated with ADHD. Pharmanipulation is produced by PharmedOut, a Georgetown University Medical Center rational prescribing project. For a transcript of this episode, please visit: https://georgetown.box.com/s/jjei0u9zhtezfqg2i5p83h9per8nzugc For a list of resources and studies mentioned in this episode, please visit: ⁠https://bit.ly/Ep3Resources To learn more about Dr. LeFever Watson, please visit her website: https://drgretchenwatson.com/ To learn more about Robert Whitaker, please visit his website: https://www.madinamerica.com/robert-whitaker-new/ PharmedOut is supported primarily by individual donations. To donate, please visit: https://sites.google/com/georgetown.edu/pharmedout/donate

Episode 2 of Pharmanipulation invites Adewole S. Adamson MD, MPP, to discuss the relationship of sun exposure to melanoma, whether sunscreen actually prevents skin cancer, and the overdiagnosis of melanoma. Dr. Adamson is a board-certified dermatologist and an assistant professor in the department of Internal Medicine at Dell Medical School at the University of Texas at Austin where he studies skin cancer, evidence-based medicine, and health policy. He is also the Director of the Pigmented Lesion Clinic at the University of Texas at Austin, and he serves as an assistant editor at JAMA Dermatology. Pharmanipulation is produced by PharmedOut, a Georgetown University Medical Center rational prescribing project. For a transcript of this episode, please visit: https://georgetown.box.com/s/3bte8vynpulj33kv3qdtwdabamm2n9xx To learn more about Dr. Adamson, please visit his website: https://adeadamson.com/ Dr. Adamson’s paper on Estimating Overdiagnosis of Melanoma Using Trends Among Black and White Patients in the U.S. is available here: https://jamanetwork.com/journals/jamadermatology/fullarticle/2789995 Dr. Adamson’s paper on The Rapid Rise in Cutaneous Melanoma Diagnoses is available here: https://www.nejm.org/doi/10.1056/NEJMsb2019760?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed PharmedOut is supported primarily by individual donations. To make a donation please visit: https://sites.google/com/georgetown.edu/pharmedout/donate

Pharmanipulation is a new show created by PharmedOut, dedicated to the topics of evidence-based medicine and industry influence on medical information and public health. PharmedOut is a Georgetown University Medical Center rational prescribing project. Episode 1 covers pharmaceutical marketing tactics, industry influence on medical knowledge, and invented diseases. Join hosts Caroline Renko and Patricia Bencivenga as they interview Adriane Fugh-Berman MD, the Director of PharmedOut. Links PharmedOut website: https://www.pharmedout.org/ PharmedOut is supported primarily by individual donations. To make a donation please visit: https://sites.google.com/georgetown.edu/pharmedout/donate Pharma Marketing Hub (factsheets and summaries of important topics): https://sites.google.com/georgetown.edu/pharmedout/resources/pharma-marketing-hub?authuser=0 Patient Grooming Webinar: https://youtu.be/PD_tBqHDouY Transcript to this episode: https://georgetown.box.com/s/qsf6875gd5qgelemtx9urltgaxyl77lx