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  • Exclude tobacco from the Trans Pacific Partnership

    The U.S. Trade Representative intends to introduce a proposal on tobacco at negotiations to create the Trans Pacific Partnership (TPP), a trade agreement among 12 nations, at meetings in Brunei this week. The proposal capitulates to multinational tobacco corporations, jeopardizing the nation's health and economic welfare.

    Tobacco companies have recently accelerated their use of trade rules to attempt to delay and reverse tobacco control measures that limit marketing in the U.S., Australia, Uruguay, Norway, and Ireland. Trade rules grant corporations rights to contest nations' public health and other policies. Countries that lose trade challenges face stiff financial penalties, payable to the complaining corporation.

    Public health and medical advocates in the U.S. and abroad have urged the USTR to exclude tobacco control protections from trade challenges under the TPP. The USTR informally floated a policy in 2012 that could create a "safe harbor" for some tobacco control regulations. Many legal and medical experts noted that tobacco companies could easily exploit the remaining substantial loopholes.

    But the tobacco industry marshaled opposition claiming that the U.S. proposal might actually reduce tobacco use, tobacco-related deaths, and tobacco sales. Other corporations backed up Big Tobacco, expressing concern that addressing the uniquely lethal effects of tobacco in trade agreements could set a precedent for reining in their own practices. On Aug. 15, USTR announced it would not advance that proposal.

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  • Why I'm Opting Out of the AMA Masterfile

    It’s hard for me to believe that I’ll have the privilege of calling myself someone’s doctor in a few short months. As a graduating medical student, I look back on my education and see that it was driven by a spark shared by all in all AMSA members: the fervent hope to help my future patients. And it’s precisely this hope that drives me to pledge to opt out of drug company access to my future prescribing information. I urge you to join me.

    When I started medical school, I had no idea that pharmaceutical companies know exactly what medicines each doctor prescribes to his or her patients. I was even more surprised to learn that this capacity is enabled by the American Medical Association through the sale of a database called the “Masterfile.” All medical students and doctors are automatically enrolled in the Masterfile—regardless of whether or not we are AMA members. Each year, the AMA makes more than $40 million selling this information, which allows pharmaceutical companies to link prescribing records to doctors’ identities. The result is targeted marketing pitches, often designed to promote more expensive medicines that aren't necessarily more effective. 

    The spooky nature of being watched by Big Brother/Big Pharma might be reason enough for many to opt out of this practice. But if that weren’t sufficient enough, this type of data mining hurts also hurts patients. First, prescribing more expensive medicines increases the cost of care without necessarily improving outcomes. Drug companies spend more than $30 billion marketing to doctors each year, and these expenses are surely reflected in the high price of medicines. Notably, the tremendous amount spent by these companies on advertising dwarfs by almost two-fold the amount they invest in research and development, which is often cited as why drugs are so expensive. 

    Second, this type of data mining encourages a brand of medicine that is neither evidence-based nor patient-centered. Surveys already show that 7 out of 10 patients feel that doctors’ prescribing habits are too-influenced by drug companies. Allowing drug companies to use the Masterfile for marketing purposes will further corrode the trust at the heart of the doctor-patient relationship. A new study further shows that an increasing number of patients are skimping on medicines in this tough economic climate. Why allow drug reps to leverage your own prescribing practices to promote expensive medicines through one-sided presentations?

    Today, I’m pledging to opt out of drug rep access to my future prescribing practices. As AMSA President Dr. Liz Wiley has stated, “Physicians should practice evidence-based medicine using the best existing clinical evidence—not carefully-packaged advertising—and continue to uphold personal and professional integrity.” I couldn't agree more.

    The AMA has made a mechanism by which residents and doctors can opt-out of drug salesperson access to prescribing information of doctors. Unfortunately, students cannot use this Prescription Data Restriction Program even though they have already been included in the AMA’s Masterfile. However, AMSA has set up a mailing list that will remind you to opt out through the PDRP when you’re able to do so. I hope that you will consider adding your name to this list and encourage your classmates to do the same.

    David Tian is a fourth-year student at Harvard Medical School and the Chair of AMSA’s PharmFree Campaign.

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  • We Can End AIDS!!!

    We at the American Medical Student Association (AMSA) are very excited for tomorrow's We Can End AIDS March in Washington, DC! AMSA will be joining thousands of other marchers and asking for "accountability from Big Pharma and government officials around the world."

    What does this mean?

    We want our governments to put patients ahead of pharmaceutical profits. Instead of being influenced by Big Pharma to create trade policies and legislation that enables access to affordable medicines rather than expensive, brand name alternatives. Only 7.4 million of the 34 million infected with HIV worldwide are currently receiving ARVs. We know thanks to the NIH funded HPTN052 study that treatment is prevention. We need our policymakers take this science and put this into practice through laws that allow for patients worldwide to have access to cheaper generics.

    To find out more or join us in DC tomorrow - http://www.amsa.org/AMSA/Homepage/Events/IAC.aspx

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  • President Obama: Make Publicly Funded Research Free, Available

    Christopher A. Hesh
    University of Maryland School of Medicine c/o 2015
    Co-President of UMD AMSA

    Barriers to healthcare access manifest in many forms and AMSA stands at the forefront of the fight to tear down these barriers in the effort to establish healthcare as a human right. Integral to this fight for access is the engine that drives discovery of healthcare delivery methods and new treatment programs: taxpayer-funded research.

    The American public spends $60 billion each year on non-defense research through government programs like the National Institutes of Health (NIH), the National Science Foundation (NSF), and the Department of Energy (DOE). [1] Accessing this research can cost anywhere from $15 to $32 for a single article to multi-thousand dollar subscription fees for a single journal, forcing taxpayers to pay twice: once to fund the research and again to see the results. [2] This necessity of paying multiple times for access to life-saving research furthermore serves as a direct barrier to healthcare access for patients, who rely on their physicians to provide them with timely treatment programs informed by federally-funded research.

    We know from the success of the NIH Public Access Policy, which requires all NIH-funded research to be open-access 12 months after publication, that the scientific community is a powerful instrument of change. Indeed, the Public Access Policy has proven an invaluable step in the fight toward complete open access. The NIH, however, is not the only federal agency responsible for medical research grants. Furthermore, recently introduced bills such as the Research Works Act (H.R. 3699) have targeted open-access in an attempt to not only roll back the NIH’s public access policy, but completely prohibit open-access mandates for federally funded research altogether. The Research Works Act was eventually pulled by its legislative sponsors in response to overwhelming opposition by patients, students and taxpayers, but the fight for open access is not over.

    AMSA believes the continued attack on open-access research equates to an attack on healthcare access. In response, we’re joining a coalition of individuals and organizations including the Public Library of Science and Wikimedia Foundation, along with over 20,000 current signatories, in supporting a ‘We The People’ petition urging President Obama sign a directive to require free, timely access over the internet to journal articles arising from taxpayer-funded research. Help us reach this goal by signing the petition, and spread the word so that we can reach our target of 25,000 signatures by June 19th.

    Sign the petition!

    [1] Bennof, Richard J. Proposed Federal R&D Funding for FY 2011 Dips to $143 Billion, with Cuts in National Defense R&D. InfoBrief. Washington, DC: National Science Foundation, September 2010. Available at: http://www.nsf.gov/statistics/infbrief/nsf10327/nsf10327.pdf

    [2] Examples of single article purchase prices come from the New England Journal of Medicine ($15 at http://www.nejm.org/doi/full/10.1056/NEJMoa1111961) and from The Lancet ($31.50 at http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2961625-5/fulltext).

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