Comments by Edward Opton, JD, PhD

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  • Some of us would like to inject reason into the public debate. Dr. Pies is unlikely ever to acknowledge that his career has veered off onto a track that is lucrative and prestigious but will come to a dead end.

    Fortunately, most people are more open to persuasion than the comparative few who have staked their careers on the 21st Century equivalent of snake oil. (Clinical experience with snake oil, by the way, was excellent. Its purveyors may have been as sincere as Dr. Pies. Consider venipuncture, too. Bleeding the sick, draining the bad blood, was a prime treatment for most ailments for at least 2,000 years. The clinical experiences of its host of practitioners validated its efficacy. Most patients recovered. Those who died–George Washington, for example–were unlikely to complain.)

    The challenge for those of us who want to reduce the harm from “antipsychotics” and other ineffective practices is to reach much larger audiences as well as small but powerful groups such as legislators.

    I suggest that those who would take action study the tobacco wars, the efforts to get lead removed from paint and gasoline, and other successful campaigns to curb profitable but harmful businesses. MadinAmerica readers who are interested in action are invited to contact me: [email protected].

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  • Prior authorization policies vary. Some can come near to prohibiting a drug entirely. Others can be window-dressing, presenting the appearance of regulation to appease people like Mad in America’s readers while doing nothing to interfere with the flood of pharmaceutical profits. The devil is in the details. Reform will have a chance when states and/or the federal government make data available so that researchers can determine which prior authorization policies are effective and which are illusory.

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