Moan as we do about the National Institute for Clinical Excellence (NICE), which decides which drugs should be available on the NHS, the idea that there should be a rationale about rationing has been received rather differently across the Atlantic. In the US $2,000bn is spent annually on healthcare, but only 0.1% of this is […]
Continue Reading →Column: Are statins for everyone?
Pretty soon, it might well make more sense to ask who isn’t on statins, rather than who is. More than three million people are estimated to take these cholesterol-lowering pills – mainly to help reduce the risk of heart disease – and recent plans to offer everyone over 40 a cardiac risk assessment could more […]
Continue Reading →Over-the-counter Chlamydia treatments: is it all good news?
Pharmacists were reportedly delighted with a new scheme, just announced, to allow for azithromycin, an antibiotic, to be made available without a doctors’ prescription. This drug is a treatment for the sexually transmitted infection Chlamydia. Since Chlamydia infection can be without symptoms, and since, if it is left untreated over time, it can lead to […]
Continue Reading →Matters of life, death, and knickers
This week’s BMJ carries a review I’ve written on Iona Heath’s new book ‘Matters of Life and Death: Key Writings’. Dr Heath is a GP in London and is someone whose attitude towards medicine I’ve admired for many years. This book has made me think hard about what it is that doctors are meant to […]
Continue Reading →Nurses at the door
It was reported today that East Lancashire Primary Care Trust have a plan to deal with overweight schoolchildren. When the children return to school after the summer holidays they are to be weighed, and, if overweight, apparently they and their families will be ‘cold-called’ by nurses, who will then encourage them to lose weight. But […]
Continue Reading →Column: Can Viagra work for women?
Sex sells. I suppose this is why the results of a study entitled ”Sildenafil Treatment of Women with Antidepressant Associated Sexual Dysfunction” were reported with great enthusiasm around the world after they were published in the Journal of the American Medical Association (Jama). Yet the study is interesting for a number of reasons. Rest of […]
Continue Reading →Should pharmaceutical firms make cancer drugs more affordable?
The National Institute for Clinical Excellence is proposing that four drugs licensed for the treatment of renal cancer are not to be funded; they are not, we are told, ‘cost effective’. Charities, doctors groups and patients are reported today as condemning the situation with strong criticism of NICE. However, there are surely other criticisms due. If the […]
Continue Reading →Prostate cancer screening – maybe not, says the USA
Prostate cancer screening via use of a PSA (prostatic specific antigen) testing – a biological marker found in blood – is one of the most contentious things around. There is no such contention over seeking diagnosis and treatment for prostate symptoms. It is screening for problems when no symptoms exist that is the issue. While […]
Continue Reading →Trials and tribulations
There’s an interesting comment piece by Professor Mary Dixon-Woods in the Lancet Oncology this week. The ‘Research Ethics Committee’ approval, which is required before a clinical trial can begin, has been criticised by some doctors as being too slow, too burdensome, and inconsistent. The concern has been that the process of gaining ethical approval for a study […]
Continue Reading →The “Botox Dollar”
There is an interesting and worrying piece in the New York Times about dermatologists in the US. The charge is that patients attending with medical skin complaints are treated as second class compared with those patients seeking cosmetic interventions. The latter make more money for the MDs. The insurance company payout for seeing people with ‘ordinary’ medical skin […]
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