Ethics in Medicine

Care Instead of Pills for Alzheimer's

Kristen Sparrow • March 19, 2009

This opinion piece in the LATimes by Ira Rosofsky March 19, 2009 crystallizes an argument that I would love to see have more mainstream traction. The argument is to weigh the cost of some of these new “wonder drugs” against how that money could be better spent in other types of care. This argument could be applied to a number of other conditions besides Alzheimer’s dementia. I’ve been seeing a recent push to medicate “pre-diabetic” patients. Seen as representing a huge target population ($$$) Big Pharma is rushing to find a way to get drugs to these patients. Hey, here’s an idea: why not put that money toward available, fresh produce. Where diabetes is most prevalent is often in the poorest areas of the country where access to fresh food is scarce.
Ira Rosofsky is a psychiatric nurse taking care of elderly patients. He sees them being medicated with expensive dementia drugs with a very dubious record of effectiveness. He also sees them being medicated with psychoactive drugs (anti-depressives, anti-psychotics) often just for being “ornery.” Even ignoring ever-present problem of side effects- especially in the elderly- the costs of these drugs is extremely high to the end consumer. If one takes into account the enormous marketing budgets in addition, these dementia medications represent a huge amount of money. This author makes the case very succinctly:
“But why not admit the failure of medication and instead spend some of those billions of dollars on more staff to hold the hands of both patients and their families? Beyond nurturance, much of the savings from giving up on cost-ineffective medications could be diverted to basic research that might yield not only statistically significant but meaningful and large improvements — even a cure.

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