E-DMN - March 17, 2008

March 17, 2008

Editor's Column: Next Drug Raid Target: The FDA
Julie Novak Named MSMS Acting Director
WSUSOM Displays AIDS Quilt
Tanning Parlor Legislation Offers Key Protections
Meet Pols At April 10 Meeting
GDAHC Futures Conference May 1

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Editor's Column: Next Drug Raid Target: The FDA

By JOSEPH WEISS, MD
Only someone inhaling the worse grade of pot could have proposed what the Food and Drug Administration just brought forth. Furthermore, everyone on the FDA board must have been stoned to let the proposal pass on to the public. I am referring to the announcement by the FDA that it is considering allowing drug companies to give doctors information about unapproved uses of prescription drugs.

As you know, drug companies are not allowed to advertise or market “off label” uses of their medications, but doctors are free to prescribe drugs for conditions the physician determines is an appropriate use of the drug.

The FDA would allow drug company representatives to show physicians reprints from medical journals discussing the off label use. Piously, the FDA concludes that the decision to use the drug would be at the physician’s discretion.

I understand that circumstances arise when the off label drug is really the drug of choice. In my field, the best example is the anti-Tumor Necrosis Factor medications (the biologics)These medications are the best therapies for psoriatic arthritis but remain off label officially. Such examples are few. In general off label means proof of efficacy remains lacking. In general, the use of off label is limited to specialists who are in position to know the latest findings on drugs concerning the conditions the specialist treats.

To turn the task of education to drug representatives is absurd. The representatives are not physicians but individuals from a wide variety of non-medical backgrounds chosen because they are affable and able to remember what the drug company determines the representatives should say. To ask a drug representative to provide the physician-customer with unbiased information is assuming a goodness that cannot exist on the marketplace. The drug company representative will be told that the article he or she puts in front of the doctor is the best science from a well-respected journal. We know better.

So should the FDA whether its administrators are stoned or not.

We should encourage the AMA to continue its opposition to this FDA proposal. Off label use is often appropriate. Physicians need not change how we view off label use: look to our specialty societies and the announcements and journals under their sponsorship for guidelines to tell us what is novel but reasonable to prescribe. No other source can substitute; certainly not the pharmaceutical companies and their drug representatives. Their job is to sell drugs not truth.

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Julie Novak Named MSMS Acting Director

Editor’s note: The following is a message from MSMS Board Chair Gregory Forzley, MD.

At our meeting on March 12, the MSMS Board of Directors appointed Julie L. Novak as Acting Executive Director of the Michigan State Medical Society to serve until Kevin A. Kelly returns to resume his position as Executive Director.

The Board took this action to ensure the continuity and certainty of executive decision-making and staff leadership for the organization while Kevin continues to recuperate from surgery. He continues to progress and hopes to be discharged from the hospital soon.

Julie and I met with Kevin and he asked me to thank you for your support and for your continued good work in his absence. He shares with the Board complete confidence in Julie, the department directors, staff, and county executives to maintain the excellence of MSMS during his extended recovery.

We wish Kevin the best of health. Until he returns, we hope you will join us in showing Julie the same faith, loyalty, and allegiance Kevin enjoyed.

Thanks for all you do for Michigan physicians and their patients.

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WSUSOM Displays AIDS Quilt

AMSA Presents...

THE AIDS MEMORIAL QUILT DISPLAY AT

WSU-SOM!!!!

We've already learned about the biochemistry behind HIV and AIDS. Now, come to the reception to hear about the life experiences of someone who is HIV+. Viewing the Quilt display will provide a more humanistic approach of how AIDS impacts the family and friends of those who have lost their lives to this terrible disease!

AIDS QUILT RECEPTION!

When: Wednesday, March 26th from 4:30 PM to 6:30 PM

Where: Scott Hall Cafeteria

Speakers: Elizabeth Dawsey from Positive Perspectives will be giving a talk about her experiences being HIV+. Dr. Robert Frank, MD, Executive Vice Dean for WSU-SOM, will be making the opening remarks.

Hors d'oeuvres and beverages will be provided.

Additional Viewing Times for the AIDS Quilt Display:

Dates and Times: March 21st, 24th thru 28th--7:30 AM to 11:00 PM

March 22nd--10:00 AM to 2:00 PM

Location: Scott Hall Cafeteria

What is the AIDS Memorial Quilt all about? Visit www.aidsquilt.org to find out!

PLEASE ATTEND!!!!!!

This event was made possible by contributions from AMSA, WSU-SOM Student Senate, Dr. Bill Kupsky, MD, and Dr. Ali Moiin, MD.

David S. Goodyear V, MS I

LGBT Action Committee Chair, AMSA

Wayne State University

School of Medicine

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Tanning Parlor Legislation Offers Key Protections

One of the deadliest for ms of cancer, melanoma, is on the rise. House Bill 4146 was introduced last year by Michigan Rep. Frank Accavitti, Jr., of Eastpointe, which addresses the risks of indoor tanning in Michigan. This legislation is in line with 25 states and numerous counties across the country that restrict youth access to indoor tanning facilities. Aspects of the bill include:

Tanning salons would have to pay an annual state registration fee estimated at $150. The Michigan Department of Community Health could be asked to come up with rules establishing safety standards.

A written warning statement, including the risks of ultraviolet radiation, would have to be signed by each customer on the first visit.
Customers under 18 also would need to have a parent or guardian attend on the first visit and sign the consent form. A similar law already on the books related to customers under 18 would be replaced.

Warning posters related to ultraviolet radiation would have to be displayed inside salons.

Fines would be imposed for violations.

A legislative analysis says preliminary information suggests there are about 1,300 tanning salons in Michigan, although some lobbyists say the number is closer to 1,800.

Melanoma, the deadliest form, has increased almost 700 percent in the past 50 years. At current rates, 1 in 5 Americans will develop some form of skin cancer, and 1 in 33 will develop melanoma.

One American dies every 65 minutes of a melanoma. Over the past 20 years, the incidence of pediatric melanoma has increased 100 percent. Melanoma is now the second most common cancer in women ages 20-29.

Despite these deadly facts, 30 million Americans, including 2.3 million teenagers, continue to tan indoors each year. Ultraviolet (UV) radiation, the primary factor in the development of skin cancer, is 15 times greater in a tanning booth than outdoors.

The Michigan Dermatological Society, is working with the Michigan State Medical Society on legislation that supports stronger regulation of tanning facilities -- House Bill 4146 - Tanning Parlor Legislation.

--Kay Watnick, MD
Chair, MI Derm Soc PAC Committee

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Meet Pols At April 10 Meet-n-Greet

MSMS will hold the 11th annual Greater Detroit Meet-n-Greet on Thursday, April 10, 6:30-9 pm, at Fishbone’s Rhythm Kitchen in Detroit’s Greektown. This event is designed to foster a connection between the medical community in the greater Detroit metropolitan area and their state lawmakers. Also, participants will have the opportunity to discuss health care legislation and state budget issues. (View the

2008 MSMS Legislative Agenda online at www.msms.org/legagenda.) Hors d’oeuvres and refreshments will be provided during the event,co-sponsored by MSMS, the Detroit Medical Society, Wayne County Medical Society, and Wayne County Osteopathic Society. To RSVP, contact Anne Lavender at MSMS at 517-336-5736 oralavender@msms.org. For more information about legislative advocacy,contact Colin Ford at MSMS at

517-336-5737 or cford@msms.org. Or visit www.msms.org/advocacy.

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GDAHC Futures Conference May 1

The Greater Detroit Area Health Council (GDAHC) will hold its Annual Health Futures Conference on Thursday, May 1.

Theme: “Looking for a Medical Home? -- Primary Care Quality Improvement, Is it the Next Step in Improving Health Care Quality and Cost?”

The conference will explore issues related to: chronic care management and how it helps to improve quality and save dollars, electronic medical records, e-prescribing networks and other health information technology tools, the patient-centered medical home, organized systems of care, and the doctor-patient relationship in quality improvement.

Confirmed featured speakers and panelists include:

Dr. Arnold Milstein, Medical Director, Pacific Business Group on Health, and Chief Physician at Mercer Health and Benefits
Dave Morin, President and CEO, CieloMedSolutions
Joe Fortuna, MD, Medical Director, Delphi
Steven Grant, MD – President and CEO, United Physicians
Jack Billi, MD, Associate Vice President, Medical Affairs, University of Michigan
John Coumbe-Lilley, Principal, Practice Transformation Institute
Ewa Matuszewski, CEO, Medical Network One

Registration will begin March 21. On March 21, you can go to www.gdahc.org to register. The conference will be held at the Hyatt Regency in Dearborn. Additional conference details will be available within the next few weeks.

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