(This column was first published by John Weeks on TheIntegratorBlog.com.)
John Weeks’ Introduction:
The idea of "comparative effectiveness research" (CER), the new $1.1 billion economic stimulus program, strikes a happy chord for many in the integrative practice community. Isn't this the appropriate research terrain for showing value of integrative care? In this first of two part Integrator series, reporter and regular Integrator contributor Daphne White, CHTP, shares how she attended the "listening session" of the government's CER advisory board to understand what was going on and see if the integrative practice community was showing up. White ended up taking off her journalist hat and testifying. She shares her perspectives on why and how the integrative practice community should be involved. White's second is a very well-reported analysis of the "kabuki dance" she witnessed as vested medical interests developed their strategies to make sure that the CER initiative does not gore their own oxes.
CAM AND COMPARATIVE EFFECTIVENESS RESEARCH: Are we Going to Play?
By Daphne White, CHTP
When I walked into the HHS “Listening Session” on Comparative Effectiveness Research on April 14, the first thing I saw was a written statement from the American Academy of Orthopedic Surgeons and, for good measure, another from the American Association of Hip and Knee Surgeons. I picked up a list of the presenting panelists, and found speakers from PhRMA, Johnson & Johnson, the Personalized Medicine Coalition, the Medical Device Manufacturers Association, the National Pharmaceutical Council, and a variety of patient groups (at least some of whom are heavily subsidized by the pharmaceutical and/or device industries.)
Where was the CAM and integrative practice community? Missing in action, as far as I could tell: if anyone was representing the acupuncturists, chiropractors, homeopaths or other CAM providers, they certainly weren’t leaving a paper trail. Although I serve on the Advisory Board of Healing Touch International, I had not come with the intention of making a presentation. I did not have an official (or even unofficial) statement.
But since I was present and my CAM and integrative practice community did not seem to be accounted for, I took a risk and put my name on the list of possible last-minute presenters. Naturally, my name was selected and I had one hour to come up with a three-minute statement. It seemed important, somehow, that CAM was represented at this “listening session.” As John Weeks said in a recent post, we need to start playing in all the playgrounds, just like the hip and knee surgeons.
The emerging policy debate around CER
Comparative effectiveness research (CER) is becoming a huge issue. Senator John Kyl (R-AZ) actually voted against the nomination of Kathleen Sebelius as HHS secretary because of her position on this very issue. At the other end of the spectrum, it turns out that CER is a “pet cause” of Peter Orszag, the director of Obama’s Office of Management and Budget. Orszag sees CER as “an opening to reforming American health care,” and a means of cutting unnecessary fat out of the system. “They’re going to go after the provider community in a big way,” predicted James Capretta, who worked at OMB during President George W. Bush’s first term.
In fact, there is increasing talk among policymakers about placing more emphasis on wellness, prevention and primary care. Isn’t that one of the areas where CAM and integrative modalities excel? Shouldn’t we be part of that comparative conversation?
In their 2005 report called Complementary and Alternative Medicine in the United States, the Institute of Medicine noted that “the extent to which CAM use is a trigger for positive behavioral change is unknown […] and constitutes an important research issue because of the benefit of positive behavioral change to the public’s health.” Can we really expect the hip and knee surgeons to advocate for this kind of research?
We talk among ourselves about “wellness” and “prevention” and “a heath care system, not a sick care system.” Isn’t it time we took this private conversation public?
The fact is we are already players: 30 to 62 percent of adults in the U.S. already use CAM, according to the IOM report. And total out-of-pocket expenditures for CAM therapies and integrative practices were “conservatively estimated to be $27 billion in 1997,” according to the IOM. “This is comparable to the projected out-of-pocket expenditures for all U.S. physician services.”
International Low Dose Naltrexone Awareness Week: October 19-25th, 2009
an old drug
a controversial treatment
successful across a range of diseases linked
by immune system dysfunction
BUT
YOU won't hear of it, and YOU won't be offered it
On October 19th, patients, physicians and researchers alike will convene at the National Institutes of Health in Bethesda, MD, for the Fifth Annual Conference on Low Dose Naltrexone.
October 19th will also kick off the First International LDN Awareness Week – a concerted push to get the word out through the media, about thousands of patients with autoimmune diseases who are benefitting from the off-label use of one inexpensive generic drug protocol, low dose naltrexone (commonly referred to as LDN).
It is estimated that thousands of patients worldwide are now enjoying improved health due to LDN. Most learn about it through a combination of word of mouth, success stories, internet research, online forums, and an ever-growing number of doctors who are prescribing it for their patients with autoimmune diseases.
The LDN protocol employs approximately 1/10 the dose of naltrexone, a drug that was approved in 1984 by the FDA to treat alcoholism and drug addiction. Today, thanks to the work of patient advocates, dedicated physicians and researchers, thousands of patients are taking LDN to successfully halt the progression of diseases that are compromised by an impaired immune system, such as Multiple Sclerosis, HIV, Rheumatoid Arthritis, Crohn’s Disease, Lupus and Fibromyalgia.
Low Dose Naltrexone (LDN) is literally changing their lives.
“Before I started taking LDN in 2003, I was an invalid,” says Linda Elsegood, one of the founders of the LDN Research Trust, a non-profit charity in England, which was formed in 2004 to raise both awareness of and research for LDN. “I had just about every symptom of Multiple Sclerosis that a person
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