Sure the HMOs can manipulate patient prepays to encourage or discourage the use of certain drugs and their bias will always tilt toward generics, but what intrigues me the most about HMOs are the data mines they possess. FDA's Whistleblower-in-Chief, David Graham, has obviously learned to put such data to good use, as shown in the following excerpt.
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Graham's research has been unique in its ability to overcome problems in side effect detection. Drug risks are notoriously hard to track. It's easy to find isolated cases, but hard to know how often a problem is occurring.
Graham has overcome this problem by using only large samples of data collected by managed-care organizations. When big, controlled clinical trials designed to compare two medicines emerge, the results often resemble what Graham managed with a supposedly less-sensitive study. "You don't have a better standard than that," says Bruce Psaty, a safety researcher at the University of Washington.
This technique has allowed Graham to raise the alarm early and often about potentially dangerous drugs. He has rarely cried wolf--most of the medicines he flagged were eventually pulled from the market. Graham can be credited to some degree with the withdrawals of Abbott Laboratories' (nyse: ABT - news - people ) Omniflox, Wyeth's (nyse: WYE - news - people ) Fen-Phen and Redux, Warner-Lambert's Rezulin, the over-the-counter drug PPA and, of course, Merck's (nyse: MRK - news - people ) Vioxx).
forbes.com
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This job is much too important for the underappreciated David Graham to do all by himself . Would it not be possible to better harness the invisible hand of the market to better serve the nation's health while disintermediating the costly, cumbersome and conflicted FDA by regularly getting such data out to consumers, health agencies, scholars and hedge funds?
Sam |
