pretty loud coi…

Posted on Monday 24 October 2011

Since the post I want too talk about on Pharmalot comes from an article from the National Bureau of Economic Research, you might get a handle on who they are before proceeding:

A December 1, 2002, news story in the New York Times on the National Bureau of Economic Research, Inc., of Cambridge, MA, called the institution non-partisan but failed to identify a penny of the $10 million it receives in conservative philanthropic underwriting. "Reporter David Leonhardt found time to report that the bureau, headed by Martin S. Feldstein, guru to Bush-economics, is the ‘nation’s premier economic research organization,’ but couldn’t do a simple Google search to determine where it gets its money. But reporter Leonhardt ‘does’ have some interesting things to say about Harvard University:
    Still, Ec10, as it is known at Harvard, is hardly neutral – in its readings or its lectures – and its point of view contributes a good deal to his importance. Over the last two decades, thousands of Harvard undergraduates have received a decidedly anti-tax, free-market-leaning introduction to economics. And there’s this gem about Feldstein’s partisanship and his crappy economic analysis, ‘driven’ by partisanship":

    For his part, Mr. Feldstein has shown little taste since the 1980’s for straying from the Republican Party line. In 1992, he predicted that the Clinton administration’s tax increase would stifle economic growth and do little to erase the deficit… In 2001, when President Bush was forming his cabinet, Mr. Feldstein and his wife began a Boston Globe article by writing, ‘Paul O’Neill was an inspired choice for secretary of the Treasury.’ Mr. Feldstein is also on the board of Eli Lilly, the pharmaceutical company with strong Republican ties. And the next time you hear someone refer to Feldstein as from Harvard, remember that, according to Feldstein, "I have a Harvard office, but I hardly ever use it…"
Funding: Between 1985 and 2001, the organization received $9,963,301 in 73 grants from only four foundations:
Spotlight on Marty
By Eoghan W. Stafford
February 10, 2003

 Harvard students have known for nearly two decades that Ec10 is flagrantly biased. Disgruntled students have even gone so far as to organize Students for a Humane and Responsible Economics [SHARE]. It is a blotch on the University’s academic record that it has allowed Baker Professor of Economics Martin S. Feldstein ’61, since he began teaching the class in 1984, to use Harvard’s only introductory economics course as a forum to vent his personal views. Given students growing frustration, and the current review of the Core Curriculum, the administration must reform Ec10.

Even the national media is catching on. In a Dec. 1 profile of Professor Feldstein, the New York Times recognized that Ec10 is hardly neutral in its readings or its lectures. The article reports that over the last two decades, thousands of Harvard undergraduates have received a decidedly anti-tax, free-market-leaning introduction to economics. Professor Juliet Schor, an Economics professor from Boston College, was recently invited by students to speak at Philips Brooks House on the ideologically limited nature of Feldstein’s course. Schor, who actually used to teach a section of Ec10, said that she had encountered students complaining about this for years. Schor said that the complaints go back to the 1980s when Feldstein purged liberal ideas and readings from the curriculum and made his lectures a venue for his own views.

This clearly is an affront to Harvard’s rigorous academic standards. By excluding ideas and perspectives which do not match his own, Prof. Feldstein has failed to equip students with the full knowledge they need in order to understand a host of contemporary issues. By presenting a one-sided view of the discipline, he also risks putting off many students who would otherwise have pursued further studies in economics. But, what is most shameful is Professor Feldstein’s intellectual dishonesty. Suppressing the critical examination of alternative ideas is unbecoming of a Harvard professor, and should not be tolerated. Unfortunately, the administration has tolerated this state of affairs for nearly twenty years…

If that’s not enough, check him out on Wikipedia – he was a bit too Conservative for Reagan [and, by the way, he doesn’t teach Ec10 anymore]. He also has a profile as a Board Member on the Eli Lilly site. Now on to Pharmalot:
Did Antidepressant Warnings Lower School Grades?
By Ed Silverman
October 24th, 2011

Ever since the FDA added Black Box warnings to antidepressants in 2004 over concerns the drugs could lead to teenage suicidal thoughts and actions, there has been debate and controversy over the extent to which, if any, the warnings did a different kind of harm. To wit, some experts argued the publicity about side effects may have robbed teens of needed treatment. In particular, studies suggested teen suicides subsequently rose [see here and here].

Now, a new paper from the National Bureau of Economic Research attempts to measure the purported fallout in a different way. The researchers reviewed data from National Survey on Drug Use and Health from 2001 through 2007, and examined academic and behavioral outcomes in more than 100,000 youngsters between ages 12 and 17. They then designed a study to compare outcomes for those with and without a recent episode of probable depression, which was defined as having sought professional help for depression problems in the previous 12 months. And what did they find? “In the periods before the FDA warnings, there are no discernable trends in average grades for adolescents with and without probable depression. After the FDA warnings, the average grades dropped abruptly for depressed girls, though not for depressed boys,” they write. “…We find that in 2002 and 2003, adolescents with probable depression had grade point averages .14 to .20 points higher than adolescents with depression in the latter half of 2004 and 2005.” Put another way, the grade point averages fell roughly from a B to B-. Adolescents with a recent episode of probable depression were 8.6 percentage points less likely to earn a B or better and 3.5 percentage points less likely to earn a C or better after the FDA advisories in early 2004, they continue. The change was driven by depressed girls, who were 11 percentage points less likely to earn a B or better and 6 percentage points less likely to earn a C or better following the FDA warnings. There appears to be little effect of FDA advisories and the decline in depression treatment on the likelihood of reporting an A average, though. No explanation is given.

Grades were not the only focus. The researchers found “similar patterns” for substance use and delinquency for adolescents with probable depression, relative to other adolescents. For instance, although depressed adolescents are much more likely to binge drink than their peers, the FDA advisories appear to have had little effect on binge drinking. But there was no significant effect of the FDA warnings on attacks on others. However, among girls, the FDA advisories and decline in the treatment of depression increased the use of illicit drugs by 5.4 percentage points and increased non-medical prescription drug use by 4.3 percentage points, according to the paper. As with academic outcomes, the effects on illegal drug use and non-medical prescription drug use are driven mainly by girls rather than boys, although the effects on cigarette use are similar across gender. Those were depressed engaged in this sort of experience more often, according to the researcher. About 42 percent of boys and 34 percent of girls with a recent episode of depression reported one or more fights in the past 12 months, compared with 25 percent of boys and 17 percent of girls in the non-depressed group. Stealing and “attacking” with the intent to hurt someone was less common. Less than 10 percent of non-depressed youngsters reported this behavior, while 23 percent of boys and 15 percent of girls in the depressed group had attacked someone in the pevious 12 months. And substance use was more common among depressed adolescents, with 16 percent of boys and 19 percent of girls reporting binge drinking; , 21 percent of boys and 26 percent of girls reporting smoking cigarettes; 22 percent of boys and 21 percent of girls using an illicit drug; and 8 percent of boys and 9 percent of girls using prescription drugs inappropriately in the previous 30 days.

The upshot? “Among depressed girls, where the effects are concentrated,” the authors write, “treatment with antidepressants increases grades by a full point [from a C to a B, for example], reduces the chance of smoking and illicit drug use by 20 to 25 percentage points, and reduces the chance of stealing or fighting by even greater magnitudes [about 30 to 35 percentage points]. “These suggest both large effects of untreated or undertreated depression, as well as an impressive treatment effect of antidepressants in the community during the period leading up to advisories and warnings regarding antidepressants,” they conclude. The authors are Susan Busch, an associate professor of public health at Yale University; Ezra Golberstein, an assistant professor at the University of Minnesota School of Public Health, and Ellen Meara, an associate professor at the Dartmouth Institute for Health Policy and Clinical Practice [here is the NBER paper].

Not surprisingly, the paper has already generated some pushback. For instance, Bijan Esfandiari , an attorney with the Baum Hedland law firm, which has filed lawsuits against various drugmakers over antidepressants warnings and disclosure of clinical trial data, such as GlaxoSmithKline and its Paxil pill, argues the NBER paper wrongfully accepts the premise that teen suicides rose as a result of the warnings. Instead, he maintains that suicide rates fell after the FDA warnings were implemented. On his website, he writes that “the unwarranted conclusions from the underlying studies on which the working paper authors rely have resoundingly been debunked” by other scientists and the FDA, among others [look here]. Some of the papers he refers to were co-authored by academics who had extensive financial ties to drugmakers that sell antidepressants. Among them was Charles Nemeroff [see this]. “Any suggestion that reduced prescriptions of antidepressants have resulted in countless suicides is simply not supported by the data,” he argues.

The reason this blog is called 1boringoldman is that I drove myself and all my friends crazy during the second Bush term trying to keep up with the spin and the Rovisms that obfuscated almost anything political for those years. I’m over that. So I’m not going to wear myself out chasing this one. Bijan Esfandiari has done a fine job. Ditto him, and ditto my last post [the apogee…] about some of the earlier efforts to make the warnings on the antidepressants look like some kind of tree-hugger, lefty silliness. I read Ed’s post earlier, and that’s why I wrote the apogee…. I wanted to show how this works from the years of watching it happen in the political arena. They just keep hammering on the same thing from different directions, year after year, until they succeed in undermining what makes sense – get the other team so mad that they begin to rant, then point out that they’re ranting, ergo a bunch of raving idealists.

The suicidality induced by SSRIs in adolescents is very real. And I think the people who attribute it to akisthisia are dead on the money. When I first started volunteering about five years after I retired, I was seeing kids, adolescents, and adults in a general clinic. I was a "rusty pharmacologist" at best and bought the textbooks recommended by my friends in Atlanta to catch up. But they were old by modern standards. Textbooks lag by four or five years, and the warnings about SSRIs in adolescents weren’t in the ones I had. I’m not a big medication person, but I gave a few depressed adolescents SSRIs without much problem [or success].

Then came a young guy, 16 or 17. He was really depressed. Mom had remarried a retired drill sergeant [really], and he was driving them both crazy with his controlling ways and his drinking. The boy saw his way out – a Diesel Mechanic school out of state – but it was over a year away and he had become hopeless. He got called for an interview at the school, and I was afraid that he was so depressed that he wouldn’t be able to rise to the occasion, so I put him on Citalopram [$4/month at Kroger]. After just a few days, he became "crazy" and like a "madman." He couldn’t sleep and progressed to delirium. It cleared in a day and a half off the medication. "I was jumping out of my skin. I wanted to kill, me or someone else," he said later. I learned my lesson. The end of the case? Mom got a divorce and her son went off to school this fall. Both are doing well, and I’m the wiser. I’ve seen and heard in retrospect other cases, but that’s the one that stuck in my mind. It’s like the Paxil Withdrawal syndrome I was talking about a few days ago. You just have to see it once to become a true believer. Nowadays, the only adolescents on SSRIs prescribed by me are kids with OCD, and they and their parents are explicitly warned before starting the medication.

I just don’t believe the NBER article, primarily because the antidepressants don’t really help depressed kids or adolescents anyway [tuning the quartet…]:

And I’m kind of put off by the article’s direction of appeal – bad grades, drugs, booze, smoking [where’s the rock and roll?]. I see those kids in the clinics all the time. Biological Depression is rarely their problem and I don’t think SSRIs would change much about their lives. Many of the psychiatrists in this set preach depression = biology = medication. That’s just not right, particularly in kids. But I would predict that the assault on these Black Box warnings will continue so long as the Pharmaceutical Industry perceives that it cuts into their potential market. And, by the way, Martin S. Feldstein’s sitting on Eli Lilly’s Board is a pretty loud coi…

Update from Jazmo: See Feldstein’s take from Eli Lilly and A.I.G. here.
    October 24, 2011 | 9:37 PM

    thanks for the time and effort you put into being boring

    you work is very informative and motivating for me

    some feldstein information you might not have

    link below provides feldstein’s compensation as director of lilly (and also as director of AIG)

    by the way – did you know “On February 6, 2009, Feldstein was announced as one of U.S. President Obama’s advisors on the President’s Economic Recovery Advisory Board.[7] (wikipedia) (larry summers was one of his students)

    October 24, 2011 | 9:45 PM

    i inadvertently left the business week link out of my comment.

    added by 1boringoldman

    “Martin S. Feldstein, Ph.D. serves as Chief Executive Officer and President of National Bureau of Economic Research,US. Dr. Feldstein serves as Member of International Advisory Board of National Bank of Kuwait. Dr. Feldstein serves as Director of Council on Foreign Relations, Inc. and AIG Aviation, Inc. Dr. Feldstein has been Director of Eli Lilly & Co. since January 2002.Dr. Feldstein serves as Member of Economic and Business Advisory Board of Warburg Pincus LLC. Dr. Feldstein served as Director of TRW Aeronautical Systems since 1984. Dr. Feldstein served as Director of American International Group, Inc. since 1987, HCA, Inc. since 1998 and J.P. Morgan & Co. Inc. since 1993. Dr. Feldstein served as Director of Morgan Guaranty Trust Company of New York. . Dr. Feldstein served as Member of International Advisory Board of Rorento N.V. He was president of the American Economic Association since 2004. Dr. Feldstein has been professor of economics at Harvard University since 1967 and holds the George F. Baker chair in economics. From 1982 to 1984, he chaired the Council of Economic Advisers and was President Reagan’s chief economic adviser. He is a member of the American Philosophical Society, a corresponding fellow of the British Academy, a fellow of the Econometric Society, and a fellow of the National Association for Business Economics.He is the author of more than 300 research articles in economics, and received honorary degrees from the University of Rochester, Marquette University and Bachelor’s Degree, Summa Cum Laude, from Harvard College in 1961 and he received bachelor’s degree in 1963, a master’s degree in 1964, and a doctorate in 1967 from Oxford University.”

    October 25, 2011 | 11:50 AM

    The business about smoking, bad grades, etc is designed to push the “cost to society.” Remember when teachers were diagnosing ADHD and schools were insisting kids they’d “identified” be put on drugs? This is a similar push.

    October 25, 2011 | 11:54 AM

    Just the tip of the Harvard biased Iceberg: “The Broad Institute of MIT and Harvard has announced a $100 million gift from the Stanley Medical Research Institute in Chevy Chase, Maryland, for a new research center that will combine the strengths of genomics and chemical biology to advance the understanding and treatment of severe mental illnesses”

    Stanley Medical Research Institute, Joseph Biederman, Fuller Torrey and TAC

    When you look beneath all the fancy diatribe trappings…this isn’t a political party issue…both sides in this dirty game of corruption are up to their necks in it… of the many reasons nothing will change…the money influence freight train has a full head of steam and isn’t stopping for a few critics…

    October 25, 2011 | 2:00 PM

    More on pharma money and influence of U.S. Government politicians

    AstraZeneca’s elite sales force: doctors, institutions, research organizations and politicians

    In part

    AstraZeneca’s political contributions Q1 2011

    CA Rep. Zoe Lofgren (D) Lofgren for Congress $1,000
    CA Rep. Kevin McCarthy (R) Kevin McCarthy for Congress $5,000
    DC Moderate Democrats PAC $5,000
    Pharmaceutical Research & Manufacturers of America Better
    Government Committee $5,000
    New Democrat Coalition Political Action Committee AKA NDC
    PAC $5,000
    DC Democratic Congressional Campaign Committee $15,000
    DC National Republican Senatorial Committee $15,000
    DC Democratic Senatorial Campaign Committee $15,000
    DC National Republican Congressional Committee $15,000

    Also, Stanley Medical Research Institute (Fuller Torrey et al) donates $100 million which directly benefitted Biederman

    And Biederman has ties to the research foundation, which is to show how though Biederman is currently sanctioned by Hah vard…. Biederman still gets funds, just like how Lilly has grants they readily give to learning institutions, etc (Mass Gen is one of them)

    It’s a bipartisan issue, that everyone should understand is that pharma is generous with their donations to politicians because they want their hand in the cookie jar, their foot in the door for control over the U.S. Health system, all profit based, not patient based, profits, profits…

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