News.Yahoo.com, April 28, 2011, New York – The FDA gives the nod to a machine that plucks bits of flesh off bald heads, helping doctors perform hair transplants. Is this better than Rogaine?

The image: The FDA has approved a device called the Artas System (see image below), which removes small pieces of skin from hairy parts of a balding man’s head, so they can be implanted in areas that need follicular assistance. As Tim Hornyak at CNET describes it, “the patient sits in the Artas chair, and his hair is cut to about 1 millimeter. A camera-equipped robotic arm under the control of a doctor then initiates ‘small dermal punches’ while harvesting individual follicles.” They are later manually transplanted, develop their own blood supply, and eventually grow their own hair. Artas’s function is one step in a process known as Follicular Unit Extraction, which avoids the sutures and bandages common to some hair-transplant procedures, like “strip harvesting.” As of now, the machine can only be used on patients with straight, brown or black hair — blonds and redheads need not apply.
The reaction: There’s “something about knowing that a robot arm will harvest your hair using ‘small dermal punches’ that’s a little bit unsettling,” says Graeme McMillan at TIME. “But to have a full head of hair for the first time in over a decade? I have to admit, I’d probably be okay with that.” Blond people are lucky in that they “still have a convenient excuse to not pay Artas a visit,” says Patrick Morgan at Discover Magazine. That is, “in addition to the whole ‘I’m not going near a flesh-harvesting robot’ thing.” See the Artas machine below:

FDA Panel Endorses Vertex Hepatitis C Drug

 

 

Chronic Hepatitis – Microscopic Photo. Chronic hepatitis C. Reticulin stain demonstrates bridging fibrosis with architectural distortion, no obvious cirrhosis (Stage 4). Reticulin Stain. Jian-Hua Qiao, MD, FCAP, Los Angeles, CA, USA (乔建华医师,病理学家)




 

 

 

GoogleNews.com, FORBES.com, April 28, 2011, WASHINGTON — Federal health experts say an experimental hepatitis C drug from Vertex Pharmaceuticals Inc. is a significant step forward in treating the virus, despite a high rate of rashes among patients taking the tablet.

The Food and Drug Administration’s panel of viral experts voted unanimously, 18-0, that the drug is a safe and effective treatment for hepatitis C. The agency generally follows the recommendations of its panels. A final decision is expected by May 23.

The most significant side effect with the drug was a sometimes severe rash in roughly half of patients.

The FDA convened a two-day meeting to review two new drugs that block the enzyme which allows the hepatitis virus to reproduce. On Wednesday the same panel unanimously recommended approval for Merck ( MRKnews people )’s drug boceprevir.

 

 

 

WASHINGTON – Federal health officials said Tuesday a highly anticipated hepatitis C drug from Vertex Pharmaceuticals successfully treats the majority of patients with the virus in less time than older medicines that have been used for 20 years.

The Food and Drug Administration posted its review of Vertex’s telaprevir ahead of a meeting Thursday where outside experts will vote on the benefits of the experimental drug. On Wednesday the experts will review a similar drug from Merck & Co. Inc.

Both new drugs work by blocking the enzyme protease, which allows the hepatitis virus to reproduce. The new approach represents a breakthrough from older medicines, which are designed to help boost the immune system to fight hepatitis.

Like HIV drugs, the new drugs will be prescribed as part of a cocktail with the two older drugs to help lower viral levels.

“A drug like telaprevir does an amazing job clearing the virus, but there’s a small portion that is just intrinsically less responsive and it’s the job of the older drugs to clear up that mess that’s left behind,” said Dr. Camilla Graham, Vertex’s vice president for global medical affairs.

The current two-drug treatment for the virus cures only about 40 percent of people and causes side effects like nausea, fatigue and vomiting.

FDA scientists said 79 percent of first-time hepatitis C patients taking telaprevir and the older medicines were cured, compared to 46 percent of those taking the older medications alone, according to Vertex’s studies. Among patients who had already been treated for hepatitis C once, 65 percent achieved a cure after taking telaprevir, compared with 17 percent of those taking the older medications.

In general, telaprevir’s cure rates are higher than those seen with Merck’s boceprevir. The two drugs are expected to compete in a multibillion dollar global market.

Shares of Vertex Pharmaceuticals Inc. rose $5.96, or 12.4 percent, to $54 in midday trading.

Vertex’s studies were designed to show that adding telaprevir to the older drug combination could cure most patients in six months — cutting the standard treatment time in half and reducing exposure to negative side effects.

According to the FDA, 58 percent of new patients were eligible for this shorter treatment regimen based on reduced viral levels after four or 12 weeks. The FDA’s review states that patients who have previously been treated for the disease should respond similarly.

FDA notes that the drug was significantly less effective for African Americans. The most common side effect with the drug was a skin rash and fatigue.

The agency will ask its panel to comment on those issues on Thursday. The FDA is not required to follow the advice of its panelists, though it usually does

Hepatitis C is a major cause of liver transplants, and it kills about 12,000 U.S. patients a year, a number expected to triple by 2030 as baby boomers succumb to the disease.

The disease is often associated with users of illegal injectable drugs like heroin, though it could also be picked up from blood transfusions before 1992, when testing of the blood supply began.

Most people with hepatitis C don’t even know they have the virus until years later when liver damage has occurred, which can cause abdominal pain, fatigue, itching and dark urine.

Vertex Pharmaceuticals is based in Cambridge, Mass., and was founded in 1989 by a former Merck scientist. If approved, telaprevir would be the company’s first commercialized product in the U.S. Vertex holds marketing rights for North America, while Johnson & Johnson will market the drug in other parts of the world.

 

 

Mehmet Oz at the 2010 Time 100 Gala

Mehmet Cengiz Oz (Turkish: Öz, pronounced [ˈøz]; born June 11, 1960), best known as Dr. Oz, is a Turkish – American cardiothoracic surgeon, author, and host and commentator for the syndicated daily television program focusing on medical issues/personal health, The Dr. Oz Show.

Oz first appeared on the The Oprah Winfrey Show in 2004, and later on Larry King Live and other TV programs. In 2009, Winfrey’s Harpo Productions and Sony Pictures launched The Dr. Oz Show.

Early life

Mehmet Oz was born in Cleveland, Ohio, to Turkish parents, Suna and Mustafa, who had emigrated from Konya, Turkey.  Mustafa Öz was born in Bozkır, a small town in central Turkey. Mustafa did very well in school and earned scholarships that allowed him to emigrate to the United States as a medical resident in 1955. Suna comes from a wealthy family that includes writers, civil engineers, and businessmen. Several of her great-grandparents came from the Caucasus mountains, leaving the region after the Russian Empire took it over in the 1860s.

Oz was educated at Tower Hill School in Wilmington, Delaware. In 1982 he received his undergraduate degree from Harvard University. In 1986 he obtained a joint MD and MBA degree from the University of Pennsylvania School of Medicine and The Wharton School. He was awarded the Captain’s Athletic Award for leadership in college and was Class President followed by President of the Student Body during medical school.

Career

Oz is Vice-Chair and Professor of Surgery at Columbia University. He directs the Cardiovascular Institute and Complementary Medicine Program at New York-Presbyterian Hospital. His research interests include heart replacement surgery, minimally invasive cardiac surgery, and health care policy. He has authored over 400 original publications, book chapters, and medical books and has received several patents. He performed around 250 heart operations annually.

Oz is the founder and chairman of HealthCorps, a non-profit organization that pays a small stipend to recent college graduates to spend two years in high schools mentoring students about health, nutrition, and fitness.

In 2009, Oz joined Jeffrey T. Arnold (founder of WebMD) as co-founder of Sharecare, Inc., providing an interactive QA platform that allows industry experts to answer health-related questions.

Television, radio and movies

Oz appeared as a health expert on The Oprah Winfrey Show for five seasons. On the show, he addressed issues like diabetes and promoted resveratrol supplements, which he claimed were anti-aging. His Transplant! television series won both a Freddie and a Silver Telly award. He has appeared on Good Morning America, the Today show, Larry King Live and The View, as well as guest-hosting the Charlie Rose show. In addition, he served as medical director of Denzel Washington’s John Q and participated in several other feature films. He currently hosts The Dr. Oz Show on television and a talk show on Sirius XM Radio. In January 2011, Oz premiered as part of a weekly show on the Oprah Winfrey Network called “Oprah’s Allstars”. In each episode, he, Suze Orman and Dr. Phil answer various questions about life, health and finance.

Author

Oz authored six New York Times best sellers including YOU: The Owner’s Manual, YOU: The Smart Patient, YOU: On a Diet, YOU: Staying Young, YOU: Being Beautiful as well as the award winning Healing from the Heart. His new book, YOU: Having a Baby, was published by Free Press on December 1, 2009. He has a regular column in Esquire magazine and O, The Oprah Magazine and his article “Retool, Reboot, and Rebuild” was awarded the 2009 National Magazine Award for Personal Service.

Awards and honors

 

 

Mehmet Oz at ServiceNation in 2008

Time magazine ranked Oz 44th on its list of the 100 Most Influential People in 2008 and Esquire magazine placed him on its list of the 75 Most Influential People of the 21st Century. He was called a Global Leader of Tomorrow by the World Economic Forum and one of “The Harvard 100 Most Influential Alumni” by 02138 magazine. He won the Gross Surgical Research Scholarship. He was listed in “Doctors of the Year” by Hippocrates magazine and in “Healers of the Millennium” by Healthy Living magazine. Oz is annually listed in the Castle Connolly Guide of the top United States doctors, as well as other ranking groups.

Other awards and honors include:

  • Honored by the New York Open Center for “outstanding research in writing and communication (and for) bridging Western and alternative/complementary medicine”, 2007
  • Listed in Best Doctors of the Year, New York Magazine
  • Turkish American of the Year, 1996
  • Books for a Better America award for Healing from the Heart, 1999
  • Robert E. Gross Research Scholarship, American Association for Thoracic Surgery, 1994–1996
  • Research Award, American Society of Laser Medicine and Surgery, 1991
  • Blakemore Research Awards, Columbia University College of Physicians and Surgeons, 1988–1991
  • One of the 500 most influential Muslims 2009
  • 2010 Daytime Emmy Award For Outstanding Talk Show Host
  • 2011 James Randi Educational Foundation Media Pigasus Award, which the foundation states is for promoting “nonsense”. The foundation complained about Oz’s support of energy medicine, faith healing and psychic mediums, among other controversial practices. Oz is the first person to receive a Pigasus Award two years in a row.

Personal life

Oz lives in Cliffside Park, New Jersey with his wife Lisa. They have been married since 1985 and have four children: Daphne Nur, Arabella Sezen, Zoe Yasemin, and Oliver Mustafa.

Oz is fluent in both English and Turkish. He is a holder of both Turkish and American citizenship, having served time in the Turkish Army to retain his Turkish citizenship.

His father’s family believes in the integration of Islam and government, his mother’s family are secular Muslims. He has been influenced by the mysticism of Sufi Muslims, as well as the ideas of Emanuel Swedenborg, the Swedish scientist, philosopher, and Christian theologian. He recently wrote in Spirituality and Health Magazine that “As I came into contact with Swedenborg’s many writings, I began to understand Swedenborg’s profound insights and how they applied directly to my life”. He mentions Swedenborg’s ideas that marriage lasts to eternity, everyone has a purpose in this world, God is love, and Swedenborg’s answers to “Why do bad things happen?”.

Oz is a practitioner of Transcendental Meditation. “When I meditate, I go to that place where truth lives,” he said. “I can see what reality really is, and it is so much easier to form good relationships then.”

Health

In August 2010, Oz was diagnosed with a pre-cancerous polyp in the colon during a routine colonoscopy which was performed as part of his show. Oz said that the procedure likely saved his life.

Controversy

RealAge drug marketing

Oz is a spokesman and advisor, with Michael Roizen MD (of the Cleveland Clinic), of their website RealAge.com, which The New York Times has criticized for its pharmaceutical marketing practices. The site solicits medical information from visitors to determine a visitor’s biological age and then uses the visitor’s medical profile for pharmaceutical marketing purposes. As The Times reporter explained the significance of this fact: “While few people would fill out a detailed questionnaire about their health and hand it over to a drug company looking for suggestions for new medications, that is essentially what RealAge is doing.”

Integrative medicine

Oz is a supporter of integrative medicine, combining alternative therapies with conventional medical treatments. Some conventional medical practitioners allege that Oz is promoting unproven and harmful alternative medicine practices on The Oprah Winfrey Show and elsewhere. Appearing in surgical scrubs on the show’s set in Chicago, Oz has promoted self-described energy based practices and acupuncture on the show.

 

Dr. Mehmet Oz On Lap Band Surgery:

FDA Says You Could Be Eligible

 

 

The Dr. Oz Show, April 2011 —  Dr. Oz, “Lap Band Surgery; Is Weight Loss Surgery for You?”
Once only for the morbidly obese, people only 30-pounds overweight may now be eligible for gastric-band surgery. The FDA says you could be eligible for lap band surgery if you are 30 pounds over weight. This could help 25 million people help shed the pounds and keep them off. Comments from: Dr. Shawn Garber, Dr. Louis Aronne, Dr. Diana Zuckerman.

Doctor Oz asks,  “Are You A Candidate For Weight Loss Surgery?”

 

 

Normally for patients to be eligible for gastric band surgery you had to be morbidly obese with a body mass index of 40 or more. The FDA has broadened the approval to include people with a BMI of 3o as long as they have at least one health related condition such as diabetes or high blood pressure. Kathy weighs 200 pounds and her problem is that she has battled with her weight all her life, lose 10-20 pounds and then gain it all back. She now has high blood pressure and considering weight loss surgery, and does not not want to wait until she is morbidly obese to have lap band surgery.

Dr. Oz Is Gastric Band Surgery The Right Surgery For Me?

Is gastric band surgery the most effective way to lose weight? Dr. Oz had two women ask this question today, is the lap band the right thing -Vanessa weighs 193 pounds whose said she has tried every diet out there and nothing seems to work.

Gastric-band surgery was once only for the morbidly obese. Now, new rules say people only 30-pounds over weight may be eligible for this procedure.

Dr. Oz asks his guests, “How does a Lap-Band work?”

A Lap-Band on your stomach reduces the room for food so that you feel full after eating very small amounts. If you eat too much, especially too much of certain kinds of food, you will feel nauseous or will vomit. Unfortunately, these are factors that will help you lose weight.

Dr. Zuckerman testified before the FDA that the lap band requirements should not be be lowered.

Dr. Oz asked Dr. Louis Aronne “Why would someone 30 pounds over weight may be a candidate for lap band surgery?

Dr. Louis Aronne says “we will be catching people in a good spot where there is a lot of risk. The FDA has approved lap band surgery for people with diabetes, sleep apnea, heart disease, people who are already sick and if they lose weight with this and the evidence is that they will lose 40 pounds, that’s very good weight loss, not only will that problem get better about three quarters of the people in the study diabetes goes away, but the other problems will also get better.”

Dr. Louis Aronne went to say “why wait until someone is morbidly obese and gets really sick, we are waiting too long to treat obesity. Evidence from places like Columbia is that the more weight you gain the harder it is to control your weight, you’ve got to intervene sooner.”

FDA Guidelines For Lap Band Surgery

 

 

Requirements
BMI over 40
For the average 5’4″ women 233 pounds
Someone who is 204 pounds with one of the following-hypertension, type 2 diabetes, heart disease, sleep apnea.

New FDA Lap Band Surgery Guidelines

Requirements:

175 pounds-30 pounds over weight with one of these complications-hypertension, type 2 diabetes, heart disease, sleep apnea.

Dr. Diana Zuckerman argues that people with only 30 pounds or even 50 pounds should not be eligible for lap band surgery. She agrees that it is a great idea to lose the weight sooner but the problem is that the science just isn’t there.

Dr. Zuckerman told the FDA ” They studied 145 people for about a year and that included about 14 men, they have very little information, there are complications and many insurance companies will only pay for one bariatric surgeries. If a patient gets a lap band and hates it because they feel nauseous all the time, or don’t like not being able to have meals with their family, or it’s starts deteriorating in their body body they have a real problem their insurance company can say too bad.”

Dr. Oz’s biggest concern is how sustainably effective is lap band surgery and asks Dr. Aronne what is the long term success of weight loss surgery.

Dr. Aronne said “What was presented at the FDA hearings was 2 year evidence that people were able to maintain a twenty percent weight loss, if you were 200 pounds you would lose about 40 pounds. About 600,000 people around the world have had lap band surgery and on average the long term evidence is exactly the same. There is somewhere between 17 and 20 percent weight loss and maintain this over 6 years. The evidence is showing that people who are heavier have more difficulty with the lap band, it’s easier when your in the lower weight ranges. ”

“This is not the cure, it is something that helps you to stick to a diet, so if you think you are going to go into this and this is the miracle cure and you can eat whatever you want, that is not going to work. Dr. Oz & Dr. Shawn Garber

 

 

Dr. Garber Bariatric Surgeon has performed over 200 lap band procedures and joined Dr. Oz on stage. Oz threw the question at him “What do you have to say to someone who can’t get rid of those last 30 pounds and who thinks the lap band is a solution?”

New York Bariatric Group: “We try to offer advice on diets, exercise, and offer information on weight loss surgeries beyond what you might find on the more formal sections of our site…Dr. Shawn Garber’s Blog

Dr. Garber Said “I think now more than ever the lap band is a great option for patients, it is minimally invasive we go in through the belly button, virtually scarless, no scars, more than ever it’s a great procedure for the patients. The data from FDA study for the lower BMI showed 85 percent of patients were successful with the lap band as apposed to regular diets, non surgical diets which has an over 85 percent failure rate. Were giving them something that is a great option and to remember bariatric surgery is a tool not a cure.”

Doctor Oz asks his guests, “What Are The Complications Of Lap Band Surgery?”

Complaints Of Heartburn
Acid Reflux
Vomiting If They Eat Too Much
Don’t Chew Their Food
Eat Too Fast
Difficulty Swallowing

Dr. Garber some of these complications can be fixed with an office visit by adjusting the bad, if the bad is too tight it will cause heartburn or vomiting. So just by adjusting the bad these symptoms can be alleviated or by medications.

More serious complications from lap band surgery is that the band can erode through the stomach wall. Dr. Garber said in over his 2000 surgeries he has never seen a band erode through the stomach wall. There is a 1 percent chance the band could slip on the stomach out of position which is very easy to fix, to take a band out is a very simple 15 minute operation. It takes 20 to 30 minutes to put a lap band in, it is easier to take a lap band out than it is to put it in.

Dr. Oz asked Vanessa and Kathy what conclusion they have come too after hearing what Dr. Shawn Garber, Dr. Aronne, Dr. Zuckerman had to say about lap band surgery and Vanessa says the benefits of weight loss surgery out weighs the risks, Kathy feels the same way.

 

The Wall Street Journal Health Blog, April 28, 2011, By Laura Landro

 

New efforts are underway to help patients to take their prescription drugs correctly, amid a rise in emergency room visits and hospitalizations related to adverse outcomes from taking medications, today’s Informed Patient column reports.

The FDA, through its Safe Use Initiative, is working with the Brookings Institution to evaluate a new single-page standard medication-information document — to be known as PMI, for Patient Medical Information. It would replace the plethora of material now handed out to patients with their prescriptions, including the FDA-approved package inserts from drug companies.

In February, Brookings’ Engelberg Center for Health Reform convened a workshop to discuss pilot programs testing the distribution to patients of prototypes of the one-page format. But it won’t be an easy undertaking: federal funds for the project are yet to be approved, and some in the industry believe more work needs to be done to test the effectiveness of the PMI concept, especially the scaled-down format.

While FDA officials acknowledge that there is no evidence regarding optimal page length, the agency says a single-sided page of information would provide essential information; for more detailed resources, patients could be referred online. “We think we can get the paper document down to one page [if] you take out [what] we feel is repetitive information, or information that a typical patient wouldn’t want or need to know,” FDA senior program manager Denise Hinton tells the Health Blog.

She says the FDA doesn’t plan to have a review or approval process for the PMI documents, which would cover thousands of drugs, and instead will develop standards for drug manufacturers to comply with.

That also worries some, including third party independent drug information publishers. Gerald McEvoy, assistant vice president of the American Society of Health-System Pharmacists, which provides the medication information on the National Library of Medicine’s MedlinePlus website, says he is concerned that one page may not be enough for more complex or risky drugs. He also questions the ability of manufacturers to provide “objective, balanced information about their drugs in an unregulated setting.”

In a  presentation at an FDA hearing last year, McEvoy warned that consumers don’t trust manufacturers’ information and called on the FDA to ensure that new proposed content standards provide all information that is essential for patients and that they not be inferior to existing materials about safe and effective medication use.

Dorothy Smith, founder and president of Consumer Health Information Corp., which develops patient medication instructions and patient education programs, agrees the one-page format is too constricting. But she says all the consumer medical information in the world won’t ensure that patients take their medications correctly unless they’ve been verbally counseled by health professionals such as doctors and pharmacists.

What about consumers who are embarrassed about asking a pharmacist about their medications in front of others? Smith suggests asking to be counseled in a private room or area behind the counter. “Don’t leave the pharmacy or doctor’s office until you understand what the drug is for and how you should be taking it,” she tells the Health Blog.

It could take years before a final rule on the PMI goes into effect, and in the meantime, other efforts are underway to provide consumers with easy-to-understand information at the pharmacy. The Institute for Safe Medication Practices has designed more than a dozen eye-catching, colorful single sheets — printed on both sides — for so-called high-alert medications (such as Fentanyl pain patches and the long-acting insulin Levemir) that pose the greatest risks if used incorrectly. ( Here’s an example.)

ISMP President Michael Cohen tells the Health Blog the sheets, which will be tested with pharmacists and patients, were designed to educate patients about side effects and the avoidance of the serious medication errors that are common with those drugs.

“Our hypothesis is that a more attractive, bulleted, easier-to-read document will be more helpful in communicating safety information to patients than what you get at the drugstore,” Cohen says.

 

 

 

 

Suggestions for Making Prescription-Drug Labels More Clear

 

The Wall Street Journal Health Blog, By Katherine Hobson

 

 

A  report by the Institute of Medicine estimates that 90 million Americans can’t fully understand and act upon health information. The U.S. Pharmacopeial Convention, which sets drug standards, today proposed changes to chip away at some of that confusion, at least when it comes to the labels that pharmacists put on prescriptions they fill.

The USP is offering standards that it says will make label information and instructions more comprehensible. For example, instructions to “Take two tablets twice daily” can raise confusion; saying “Take 2 tablets in the morning and 2 tablets in the evening” makes the numbers more explicit and also specifies exactly when to take the medications.

The recommendations also suggest that if it’s okay with the patient, labels should include the purpose of the drug, and in plain language, i.e. “for high blood pressure” rather than “for hypertension.”

And, the proposed standards recommend formatting that can make labels easier to read, including using regular sentence structure, and laying out labels so users don’t have to rotate the container to read them.

Here are the details (click on the link below) of the USP’s proposed standards.  If they are finalized, they could be adopted by state pharmacy boards or other authorities.

http://www.usp.org/pdf/EN/USPNF/M5531.pdf

 

 

Confusion Over Sound-Alike Drug Names Can Harm Patients

 

 

Wall Street Journal Health Blog, By Jacob Goldstein


A doctor means to prescribe primidone, an anti-seizure drug. But because of a miscommunication somewhere along the line, the patient gets prednisone, a steroid that affects the immune system and reduces inflammation — a potentially deadly mistake, according to a report from the U.S. Pharmacopeia, a group that sets drug standards.

The report mined records from a national database between 2003-2006 and found more than 25,000 “look alike /sound alike” errors. (Reporting is voluntary and doesn’t include all errors.) The vast majority of those errors didn’t cause patients any harm, but several hundred did. Primidone-prednisone was one of a handful of mix-ups that may have contributed to a patient’s death.

When the Health Blog first looked at the report, we assumed that this sort of problem was an artifact of docs’ messy handwriting and other hold-overs from the pre-computer era. But though computers may solve some problems, they can create others: “look-alike drug names in computerized direct order entry systems are a source of confusion for prescribers,” the report says.

The report also lists several ways to minimize the errors. One common-sense step: Doctors should write not only the name of the drug they’re prescribing, but what it’s being used for. And this information should be communicated down the line to patients picking up prescriptions. That would make it significantly less likely that a patient who needed a drug to control seizures, for example, would wind up with pills that reduce inflammation.

Bonus confusion: The report lists drugs that may be especially likely to be confused because their names look or sound like the names of so many other drugs. Topping the list was the antimicrobial cefalozin, a name that looks or sounds like 15 other drugs. That was followed by lisinopril with 13 and enalapril, prednisone, and trazodone with 12 a piece.

 

Justices’ Debate Turns to Privacy for Doctors

The New York Times, By ADAM LIPTAK
Published: April 27, 2011

 

 

WASHINGTON — A somewhat esoteric Supreme Court case on Tuesday about data mining by drug companies turned into a debate over a fundamental First Amendment principle that has much engaged the justices lately: What role may the government play in regulating the marketplace of ideas?

In assessing the Vermont law at issue Tuesday (Sorrell v. IMS Health, No. 10-779), which bars some but not all uses of prescription drug data, several justices indicated that they viewed government efforts to alter the mix of available information as constitutionally problematic.

That principle animated last term’s decision in Citizens United, which struck down part of a federal law regulating speech about politics by corporations and unions. The tenor of Tuesday’s arguments suggested that a majority of the justices had similar concerns about the Vermont law, which regulates the use of information collected about doctors by records kept by pharmacies.

The case is not about patients’ privacy rights, as individual information about them is meant to be stripped from the data. Rather, the Vermont law restricts tailored efforts to market drugs to doctors aided by databases showing what medicines they have been prescribing.

The state law forbids the sale of prescription data to market drugs and bars drug companies from using the data to market drugs, unless the prescribing doctor consents. But other uses of the same data are allowed, including ones by law enforcement, insurance companies and journalists. And drug companies remain free to market their drugs in a more indiscriminate fashion, without knowing the prescribing habits of individual doctors.

Bridget C. Asay, an assistant state attorney general defending the law, tried to frame it as one meant to protect doctors’ privacy. But the argument gained little traction, and several justices noted that the law permitted uses that seemed to invade doctors’ privacy as much as the forbidden ones, and in any event doctors remain free to decline to meet with marketers.

Some of the justices also seemed concerned about what the law meant to achieve, as reflected in legislative findings justifying the law.

There is, the state Legislature said, a “massive imbalance in information presented to doctors” and “the marketplace for ideas on medicine safety and effectiveness is frequently one-sided.” The point of the law, several justices suggested, was therefore to protect doctors from hearing from drug marketers that might suggest more expensive drugs even as the state pushed cheaper generic drugs.

“You want to lower your health care costs, not by direct regulation, but by restricting the flow of information to the doctors,” Chief Justice John G. Roberts Jr. told Ms. Asay. “To use a pejorative word,” he went on, the state is “censoring what they can hear to make sure they don’t have full information.”

The chief justice’s two most senior colleagues, Justices Antonin Scalia and Anthony M. Kennedy, forcefully made similar points. The three justices sit at the center of the Supreme Court bench and at times they seemed a juggernaut bearing down on Ms. Asay.

Other members of the court were also skeptical about the way Vermont had chosen to regulate the distribution of prescription data.

Justice Ruth Bader Ginsburg said the state “is interested in promoting the sale of generic drugs and correspondingly to reduce the sale of brand-name drugs.” But she said that goal ran up against a basic First Amendment problem.

“You can’t lower the decibel level of one speaker,” she said, “so that another speaker, in this case the generics, can be heard better.”

Thomas C. Goldstein, a lawyer for several data mining companies challenging the law, said that sort of government manipulation of information is impermissible.

“The way the First Amendment works in the marketplace of ideas that so upsets Vermont is that both sides get to tell their story,” he said. “The thing that is supposed to be biased here is that the drug companies have too much money. That is not a basis for restricting speech.”

New Hampshire and Maine have laws similar to the one in Vermont, and those have been upheld by the federal appeals court in Boston. The Vermont law at issue in Tuesday’s case was struck down last year by a divided panel of the federal appeals court in New York.