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Biotech / Medical : VVUS: VIVUS INC. (NASDAQ) -- Ignore unavailable to you. Want to Upgrade?

To: Anaxagoras who wrote (2754)	11/21/1997 1:40:00 PM
From: Tunica Albuginea	Read Replies (1) \| Respond to of 23519

Anaxagoras, you and several lay people ( read- non-physicians ) seem to have a hard time underastanding that " there is NOTHING that a physician can learn from a conference call that will ULTIMATELY lead him to put his signature to a prescription piece of paper to treat a pa tient ". For that we ultimately rely on the follwing, in order of importance: -- FDA approval, to give us the legal go ahead. -- More importantly, knowledge that the medication has been published in a PEER REVIEWED journal of established importance. --An FDA approval is not neccessarily a clear signal to go ahead and prescribe a medication. THERE HAVE BEEN SEVERAL DRUGS THAT WERE FIRST APPROVED by the FDA AND THEN W I T H D R A W N because of side effects that apppeared later, HTA WERE NOT SEEN IN THE CLINICAL TRIALS. Redux is tha most6 recent example. A clinical trial on 4500 people over 1 or 2 years DOES NOT ALWAYS TELL YOU what will hapen to 10 mill people over 3-5 years. --thus observed efficacy in actual practice is even more important in the long run.Physicians always ask each other: Does this work for you? The list is too long to mention of alleged FDA drugs that were approved to work and later found not to work or have side effects: A few: Proscar has not been the blockbuster for BPH it was touted to be.For Rogaine they are now looking at increasing the dose. -- Thus several physicians myself included will often wait a few months before prescribing a medication and let other Docs try it first on their patients> It is very embarassing for you to be the physician that has the winning lotto ticket: a sudden appearance of a devastating side effect, caused by the new drug, not mentioned up to now but over the next several weeks months attributed to the new drug.Again Redux is an example but not the only one.It is very difficult to back track to the patient and say: " Oops mr Jones, I am so sorry you are losing your heart or your kidnays or your liver or you are dying because of this new drug. Thus drug prescription is too serious an issue with us to want to even bother listening to analysts', brokers', CEO's etc etc. opinions on anything when we are having a hard time believing our own guys ( physicians ) sometimes. Read about the chief of Urology at Univ of Mich who was recently kicked out because he falsified his data and made self serving recconmmendations to Univ of Mich Hosp. This may appear ( it is ) as a long answer, but medicine is VERY complicated.It is a highly techniccal field.It can only be lesrned in Medical School. Only physicians, in the long run, can come to any sound conclusions. TA