My lede:

White physicians, like white lawyers and white people with doctoral degrees, are not immune from an implicit preference for white people over black people, according to a study in the August Journal of Health Care for the Poor and Underserved.

Psychological testing shows that doctors do not differ from the general population or from other highly educated people in unconscious racial bias, the study said. But critics doubt whether these test results are associated with unequal treatment of black patients. Other research, including a new study of patients with breast or colon cancer, has concluded that disparities are driven not by racial bias, but by differences in where patients get medical care.

The whole shebang.

My lede:

A $2.3 billion settlement with Pfizer Inc. over off-label drug promotion has industry observers wondering whether the record-breaking deal will deter drugmakers from talking up unapproved medication uses with doctors.

A Pfizer subsidiary, Pharmacia & Upjohn Co., agreed to plead guilty in early September to a felony violation of the Food, Drug and Cosmetic Act for misbranding its COX-2 inhibitor, Bextra, for off-label uses. The company agreed to pay $1.3 billion in criminal fines for systematically promoting off-label Bextra use to physicians through marketing materials, drug rep talking points and more.

The whole shebang.

My lede:

Research participants want to be told about clinical investigators’ financial conflicts, and sharing that information usually enhances trust, a new study says.

But researchers behind the five-year, $3 million Conflict of Interest Notification Study, or COINS, warn that disclosure should not be the only strategy used to protect human subjects from the potential harms posed by investigators’ financial relationships with research sponsors.

The whole shebang.

This is a big feature story, so here is my longish lede:

Deciding whether to participate in a clinical trial is not easy, no matter where the study takes place. Patients are faced with a mountain of information about the potential risks and uncertain benefits of becoming research subjects.

Add to that heady brew the stark disparity among patients in rich countries and those in developing nations, and concerns mount quickly about the growing number of global clinical trials tapping the poor as research subjects.

Compare, for example, the United States and India.

The average American income is $47,000 a year — 16 times what the average Indian takes home, according to the CIA World Factbook. There is one doctor for every 384 Americans, while there are 1,667 patients for each Indian doctor, the World Health Organization says. The average American patient consumes nearly $7,000 in medical care each year; the average Indian’s annual health care tally is $39. Nearly every American adult can read, but 39% of Indians are illiterate.

What does it mean for research subjects around the world to give informed consent when the playing field is so uneven?

The whole shebang.

My lede:

A 2006 Archives of Internal Medicine study of 725 million prescriptions found that about one in five orders was written off-label — that is, for a condition that has not received the Food and Drug Administration’s approval as a safe and effective use of the drug. More than 70% of these off-label prescriptions were for indications in which the drug ordered had little or no scientific support.

The results of a new survey in the Aug. 21 Pharmacoepidemiology and Drug Safety add more cause for concern, experts said. Four in 10 doctors queried about 22 medications believed at least one of the drugs was FDA-approved for a given indication when it was not so labeled and lacked scientific evidence backing the prescribing decision.

The whole shebang.