As a good example of what a poor job the medical press does in telling us the truth about drug company activity, when an alert reader sent me the link to the actual VT state report on drug company expenditures, I learned that in Vermont, Januvia is the third most heavily marketed drug in terms of drug company money spent promoting it. In fact, it is the single most heavily promoted drug for a medical condition. The two other most heavily promoted drugs were the psychiatric drugs being pushed on kids.
Yet not a single piece of reporting that discussed the Vermont report mentioned Januvia! More importantly, buried in the report, and again, not reported in the media, was the fact that the third group of doctors who were paid the most by the drug companies were family doctors--specialists in internal medicine--who received an average of $13,209 apiece from drug companies.
Not so surprisingly, it is those internists who are writing the bulk of the prescriptions for Januvia--internists who, by the way, do not have a clue what this extremely dangerous drug does, besides lowering blood sugar.
In fact, Januvia lowers blood sugar by impeding the action of an enzyme, DPP-4, which is an essential part of the immune systems mechanism for destroying cells that have become cancerous. In particular, DPP-4 is heavily involved in destroying metatastic melanocytes which cause melanoma, it also is involved in controlling the cancerous cells that cause ovarian and prostate cancer. I have been pointing this out for more than a year.
Recently I received an email from a reader who pointed me to a letter from a physician, Dr. Mark R. Goldstein to Annals of Internal Medicine on the subject of how DPP-4 inhibitors may promote cancer. You can read that letter HERE
I contacted Dr. Goldstein and he wrote me back, "My interpretation and analysis of the New Drug Application submitted to the FDA for Januvia (reference # 8 in my letter), is that Januvia promoted 10 cancers for every 1000 subjects treated for a year. Compared to placebo, the annualized cancer incidence increased from 9 to 19 of 1000 subjects treated for a year.
"There may be 3 million taking Januvia at this time and it is highly advertised. Extrapolating the data from the New Drug Application suggests that this has the potential to cause 30,000 extra cancers each year in the US. Since there are about 1.5 million new cases of cancer each year in this country, 30,000 more doesn't make much of a "blip" on the radar screen."
It is nothing more than "a blip" and that means the drug companies know that the connection of their drug to cancers is not likely to show up, since family doctors won't even connect new cancers in their patients with a diabetes drug they prescribed two or three years before and the overburdened FDA doesn't track cancer incidence in people prescribed new drugs.
But think of the toll paid by the 30,000 people who may die because their family doctor prescribed this new, not very effective, but highly dangerous drug after being paid all those thousands of dollars by drug companies and being targeted by the many millions of dollars those drug companies spend promoting those drugs.
The whole Vermont report is available HERE. As you read it remember that Vermont is a tiny state with very few doctors. The drug company doctor payoffs documented here are only a tiny fraction of those going on in larger states with more population and more doctors. For that matter, they are a small number of the drug company doctor payoffs in Vermont, since they only had to list (by specialty only) the top 100 doctors.
And please, if you or someone you love is freshly diagnosed with diabetes and put on Januvia, ask your family doctor if they are aware of the research connecting DPP-4 inhibition with cancer and direct them to Dr. Goldstein's article with its cites of the research literature. And if the doctor still insists Januvia is safe, ask them how much they received from Merck the past year. And how many visits they get every month from Merck sales reps.
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