Monday, Monday

This week, our case of the Mondays came with the release of numbers on US health care spending, which topped out at $2.1 trillion in 2006, or 16 percent of the GDP. Prescription drug spending outpaced other health care sectors, growing at a rate of 8.5 percent, and nullifying an otherwise significant decrease in personal health-care spending.

Check out Health Affairs and AP coverage.

By a nose

SafeRx Act passed a second city council vote to become law in the District of Columbia this week. The law, which would license pharmaceutical representatives and impose penalties for misleading remarks made in sales pitches to doctors, is the first of its kind in the U.S. It was shepherded through by Councilmember David Catania (I – at-large), who also serves as the president of the National Legislative Association to Reduce Drug Prices. Read more about it in the Washington Business Journal, (buried in) the Washington Post, and an interview with Catania at Pharmalot.

Honeymoon over? Magazines look at doctor-drug-rep relations

Unlike so many news stories nowadays that rely heavily on anonymous sources, this AARP piece on drug reps is full of on-the-record MDs – six, plus a senator. But you don’t have to be good a bracketologist to get the less-than-uplifting conclusion  — proposed state gifts laws went 0-17 last year.

Also, a companion piece on samples featuring comment from RxP’s Susan Chimonas.

And Smart Money ran another well-sourced story on the courtship between drug reps and docs this week. RxP associate director David Rothman gives his take, as does former detailers Shahram Ahari, who said reps learn to keep track of a doc’s personal life, like “whether his kids, Susie and Johnny, go to ballet or play baseball, or details about his romantic life — anything we can use to form a bond and a connection when we get in that room.” That last part sounds more locker room than exam room.

Kickback, whistleblow, 1, 2, 3

Last week the Boston Globe reported that neurosurgeon Patrick Chan pled guilty to receiving kickbacks from medical device-maker Blackstone Medical based in Springfield, MA, winning reprieve from additional charges in exchange for testifying in the ongoing investigation into whether devicemakers defrauded Medicare and Medicaid. Dr. Chan’s testimony strengthens federal prosecutors’ case against device-makers, which has already led to the public disclosure of payments to medical practitioners.

So what’s in a name? The Bard said not much, but PostScript has begun to wonder with news of Blackwater, Blackstone, whether it’s just a matter of time till news of the Blackfire debacle breaks….

Primary season

With New Hampshire behind us and South Carolina up ahead, it’s the season of political endorsements. Over at the Carlat Psychiatry Blog, Dr. Carlat has one for the next APA president.

Alas, poor Jarvik

The House Energy and Commerce Committee is asking Pfizer wherefore Jarvik? Robert Jarvik, that Lipitor huckster who has given Americans new reason to channel surf during commercial breaks, is the subject of some questions from Committee chair Rep. John Dingell, who wonders if celebrity endorsements from physician posers are such a good idea. On one hand, no one, not even PostScript, doubts this dude is sketchy. Had to go to Bologna to get into med school? Never treated a patient? Those pupil-free peepers? On the other hand, this committee has a full plate—energy, say, or commerce, and one wonders if this isn’t a case of mountain-molehill-horse-out-of-the-barn-too-little-too-late for Congress, which loosened restriction on DTC in 1997, freeing up pharma to invade the tube with not just Jarvik and friends, but those unstoppable Flomax guys.

For more thoughts on the wisdom of picking on Jarvik, check out the comments section of the Healthblog post, which include observations on Bill Clinton, Bob Dole, and Huckabee-strongman Chuck Norris.

And for Postscript’s take on a study that showed half of doctors have prescribed placebos, and a fieldtrip to the U.S. Court of Appeals, just scroll down…