The cost of medical woo
Apr/15/09 22:45 Filed in: Pseudoscience | Pharmaceuticals | Quackery | Vaccines | Evidence based medicine
My blog entries wander between three broad topics: medical woo (pseudoscience, science denialism, vaccine denialism, and alternative medicine), market opportunities for medical products and healthcare policy. And one discussion about my beloved Syracuse Orange. My three broad interests in the medical arena are interrelated in such a fashion that medical companies (both pharmaceutical and medical devices) need to prepare strategic plans that maximize their success despite some difficult market forces.
First, let’s talk about the whole area of medical woo. The anti-vaccine movement (which I will continue to label as vaccine denialism), if it continues to gain traction in social consciousness, will require more investment in studies that continue to confirm that there is no link between vaccines and autism (OK, yes the proper scientific method would force me to say that there is a possibility that a link could be found, but after 100’s of clinical papers, I’m firmly on the side that this issue has been decided). If this movement becomes problematic, we might be dealing with infectious disease epidemics unseen in a generation. Can hospitals and clinics deal with these diseases? How large are the infectious disease wards in hospitals? How many infectious disease specialists are there? And what kinds of medical products will need to be available to treat these diseases?
It’s hard to predict how much effect the vaccine denialists are having on the vaccination rate. The herd immunity level, that is, the minimum rate of vaccination in a population that will probably provide protection to the unvaccinated minority, runs between 75 and 95%, depending on the disease. If the vaccination rate falls significantly below those levels, which means the Jenny McCarthy crowd does not have to convince a majority of individuals to quit vaccinating their children, just a significant minority. The most recent data from 2007 seems to indicate that the rate is above the 75% level, but just barely. There is also some large variation between states, which might be a cause for concern.
In the one case of woo, vaccine denialism, any further public relation successes by the anti-vaccine group, however small, might push the USA’s rate of vaccination below the herd immunity level, leading to a large increase in childhood diseases. This situation will stress medical services, push up spending in healthcare, and harm healthcare policy to such a point that any reasonable fix to the system will be difficult, if not impossible, to implement.
See, it’s all related. Even other types of medical woo, such as naturopathy, practitioners of which are trying to become primary care physicians (PCP’s) with respect to managed care, can lead to cost increases in healthcare coverage. Since naturopathy lacks the diagnostic capabilities of evidence-based medicine, and places reliance on “homeopathic potions” for treatment, all of which may result in a delay in real medical treatments, patients will either become more seriously ill or miss treatments that may reduce long-term medical issues. These delays lead to increased costs.
The medical industry, to be successful, has to be a part of evidence based medicine. Right now it is. Well, there is that annoying Big Pharm commercial that pushes an over-50 vitamin pill containing gingko. It’s supposed to help memory. Except for the tiny issue that gingko has no effect on cognitive impairment.
By Michael W Simpson
First, let’s talk about the whole area of medical woo. The anti-vaccine movement (which I will continue to label as vaccine denialism), if it continues to gain traction in social consciousness, will require more investment in studies that continue to confirm that there is no link between vaccines and autism (OK, yes the proper scientific method would force me to say that there is a possibility that a link could be found, but after 100’s of clinical papers, I’m firmly on the side that this issue has been decided). If this movement becomes problematic, we might be dealing with infectious disease epidemics unseen in a generation. Can hospitals and clinics deal with these diseases? How large are the infectious disease wards in hospitals? How many infectious disease specialists are there? And what kinds of medical products will need to be available to treat these diseases?
It’s hard to predict how much effect the vaccine denialists are having on the vaccination rate. The herd immunity level, that is, the minimum rate of vaccination in a population that will probably provide protection to the unvaccinated minority, runs between 75 and 95%, depending on the disease. If the vaccination rate falls significantly below those levels, which means the Jenny McCarthy crowd does not have to convince a majority of individuals to quit vaccinating their children, just a significant minority. The most recent data from 2007 seems to indicate that the rate is above the 75% level, but just barely. There is also some large variation between states, which might be a cause for concern.
In the one case of woo, vaccine denialism, any further public relation successes by the anti-vaccine group, however small, might push the USA’s rate of vaccination below the herd immunity level, leading to a large increase in childhood diseases. This situation will stress medical services, push up spending in healthcare, and harm healthcare policy to such a point that any reasonable fix to the system will be difficult, if not impossible, to implement.
See, it’s all related. Even other types of medical woo, such as naturopathy, practitioners of which are trying to become primary care physicians (PCP’s) with respect to managed care, can lead to cost increases in healthcare coverage. Since naturopathy lacks the diagnostic capabilities of evidence-based medicine, and places reliance on “homeopathic potions” for treatment, all of which may result in a delay in real medical treatments, patients will either become more seriously ill or miss treatments that may reduce long-term medical issues. These delays lead to increased costs.
The medical industry, to be successful, has to be a part of evidence based medicine. Right now it is. Well, there is that annoying Big Pharm commercial that pushes an over-50 vitamin pill containing gingko. It’s supposed to help memory. Except for the tiny issue that gingko has no effect on cognitive impairment.
By Michael W Simpson