Rick,
I totally agree that extremely few doctors will treat Rosacea by eradicating H. pylori from the patient. However, it is interesting to see H. pylori implicated in more and more ailments.
There's a good article about H. pylori in the 9 June 1997 edition of Fortune. It provides a history of Dr. Barry Marshall's discovery of H. pylori and his struggle to convince the medical community that H. pylori's the real cause of ulcers. Here are some interesting lines I found in the article and a few comments related to Quidel:
Why Doctors Aren't Curing Ulcers
pathfinder.com@@P70lbgQAy8LsI1yd/fortune/1997/970609/ulc.html
". . . . .He raised the beaker and gulped down the bacteria. "It tasted like swamp water," he later said. The move turned out to be one of the best--and worst--he ever made. . . . ."
". . . . .(His research also led to the discovery that H. pylori triggers most stomach cancers too.) Marshall's work is momentous. It has been compared with the development of polio vaccine and the eradication of smallpox. He is a serious contender for the Nobel Prize. . . . ."
". . . . .Marshall and his H. pylori were competing for attention with two of the greatest pharmaceutical accomplishments of all time: the anti-acid ulcer medicines Tagamet and Zantac. . . . ."
". . . . .The treatments that eventually grew out of Marshall's research often used generic, low-margin antibiotics whose manufacturers rarely spent money to educate doctors on their new use. Instead of seeing the world embrace his ideas, Barry Marshall got a hard lesson in medical economics. . . . ."
". . . . .Researchers made more ominous findings too. H. pylori is far more dangerous elsewhere in the world, where it can be a leading cause of cancer. . . . .In Peru, where nearly everyone has H. pylori, stomach cancer is the leading cause of death among men, and second among women. The U.S. has about 25,000 cases of stomach cancer, and 14,000 deaths, per year. . . . ."
". . . . .In 1994 the National Institutes of Health made an official proclamation: Ulcers are caused by H. pylori, and people with both an H. pylori infection and an ulcer should have the bacteria eradicated. . . . .Yet the thumbs up from the NIH did not bring about a sudden change in the treatment of ulcers. The Food and Drug Administration didn't approve any H. pylori medicine until April 1996, when it finally okayed the Biaxin/Prilosec combination. Last August a bismuth-Zantac-antibiotic combo from Glaxo, called Tritec, was approved. Procter & Gamble's Helidac, using Pepto-Bismol and two antibiotics, also got the green light. . . . ."
". . . . .but no matter how the data are massaged, surprisingly few ulcer patients are on antibiotics. . . . .One reason is that Tagamet, Zantac, and similar brands like Pepcid and Axid are so easy to use. Side effects are rare, the pills need be taken only once or twice a day, and the drugs relieve symptoms quickly and effectively. Prilosec, the newest acid stopper, is just as easy and works even better. Do family doctors, squeezed by managed care, really want to take the time to treat H. pylori--which involves testing for it with blood and breath samples or sending patients to specialists for endoscopies, educating patients, worrying that they will react adversely to antibiotics, and bringing them back for follow-up tests?. . . . ."
". . . . .it is a fact of medical life that most doctors learn about new treatments from pharmaceuticals companies, not scholarly journals or medical conferences in Honolulu. Few drug companies have aggressively promoted eradication. . . . ."
(It was just last February that Quidel and P&G kicked off their campaign to promote QUIDEL's CLIA waved QuickVue One-Step H. Pylori Test and P&G's Helidac Therapy. ( quidel.com ) Also, last month Abbott ran a two page advertisement in many mainstream magazines which explained that H. pylori's the cause of ulcers.)
". . . . .Will ulcers eventually go the way of polio and smallpox? Not likely. . . . . .Prospects are better in the U.S., where HMOs are almost certain to get religion about H. pylori if only because it costs less to kill the infection than to keep a patient on Zantac for a year. . . . ."
(Let's hope the HMO's get religion. From Quidel's 14 January 1997 news release, quidel.com : Helidac Therapy also has received preferred formulary status at many managed care organizations. This means that after diagnosing a patient with an active duodenal ulcer, a physician is recommended to use Helidac Therapy before other approved H. pylori eradication therapies are considered. In fact, PCS, the nation's largest pharmacy benefit management organization with responsibility for 56 million patients, has included Helidac Therapy in its Clinical Formulary And Prescribing Guidelines. )
Jeffery Holmes, in his 2 April 1997 research report on Quidel, forecasts Quidel's sales of H. pylori to increase from $1.8M in FY97 to $18.6M in FY01.
Mike |
