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Record number of patent expiration's could slash pharmaceutical industry profits in half

Traditionally, one of the largest and most profitable industries in America has been pharmaceuticals. Pharmaceutical companies are interesting in that they make products that no one wants, but hundreds of thousands of people must have to survive.

The pharmaceutical industry as we know it is due for some big changes. Last month, DailyTech reported that former Intel CEO Andrew S. Grove ripped the pharmaceutical industry for its underperforming research operations. The Wall Street Journal is reporting that high profile medications coming off patent between now and 2012 will result in a loss of about $67 billion USD in income for top U.S. pharmaceutical companies. That amount is about half what the pharmaceutical industry made in combined sales during 2007.

Few will feel sorry for the declining sales of these pharmaceutical giants since many Americans are literally forced to decide between food and their life saving medications each month. Medications moving from patented status to non-patented status allow much lower cost generic medications to come to market.

The Wall Street Journal says that 2010 could be the worst year for Pfizer when it loses its patent for the drug Lipitor -- the most successful medication ever. Drugs are given a patent of 20 years where no other manufacturer can legally make a generic version of the medication. The catch is that it can take large amounts of that 20-year period to get the drug to market. However, drug companies can reap profits on patented medications in the 90% to 95% range.

Three high profile medications from Merck & Co have patents expiring in 2012 including Fosamax, Singulair and Cozaar. Those three drugs combine to provide 44% of Merck’s revenue. To continue operating many of the pharmaceutical companies, like Merck, are diversifying and buying biotech companies, which are seen as the next big area of breakthrough for medications and disease treatments. The reason biotech firms are popular purchases for pharmaceutical giants is that there is currently no U.S. regulatory pathway for generic biotech drugs, effectively allowing biotech drug inventors to sell a brand only product indefinitely until new legislation is mandated.

Many pharmaceutical companies are cutting staff to maintain profits with companies like Eli Lilly & Co announcing it will cut 10% of its workforce and Bristol-Myers Squibb Co. announcing it will cut about 4300 jobs and close 27 manufacturing facilities. Some drug makers are also looking to outsource the manufacture of their medications overseas where the costs are much lower. Such costs saving measures are unlikely to mean lower drug prices for U.S. consumers where the brunt of the cost of development of a medication is made back by drug makers.

The U.S. is one of the few developed nations that doesn’t mandate medication prices. This is the reason so many U.S. consumers flock to Canadian pharmacies where they can get the same medications they would purchase in the U.S. at a fraction of the cost. Drug companies have spent millions lobbying congress to prevent the importation of drugs from Canada, not because of safety concerns but because of profit loss. Canada’s government negotiates the price for medications sold nationally making them significantly cheaper than buying the same medications here.

The fear for many is that the dropping profit margins will result in less research and development funding, leading to less new drugs being developed. This is not only a concern for disease conditions that have few or no treatments, but a concern for more common conditions requiring antibiotics. Antibiotics that worked well in the past are beginning to lose effectiveness as bacteria and viruses mutate into forms that are resistant to current antibiotics.

The FDA says it hasn’t changed the way it approves drugs to make requirements stricter, that drug companies simply don’t submit as many drugs for approval.



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good
By Homerboy on 12/6/2007 2:14:50 PM , Rating: 2
they've made enough profit for the past X years.




RE: good
By Cobra Commander on 12/6/2007 2:26:14 PM , Rating: 2
yeah... pretty confident they'll figure out a new way to screw us just as hard


RE: good
By PWNettle on 12/6/2007 5:54:55 PM , Rating: 3
Yup, they'll just come out with a slightly new and improved version with a new patent, and their pushers (er, the doctors) will help them keep the easy money flowing.


RE: good
By FITCamaro on 12/6/07, Rating: -1
RE: good
By Evangels on 12/6/2007 2:36:00 PM , Rating: 4
quote:
The fact is that drug research is extremely expensive. Not only do you spend years just paying scientists just to develop the drugs, you have to spend millions if not tens or hundreds of millions to get the drug approved for sale.


The research was also put into "wrong" direction. They are trying to invent the Drug that will make you feel better but won't cure you at all. That way you will have to keep buying them. If you know anyone works for those Companies Above.... you know what I mean.


RE: good
By steven975 on 12/6/2007 2:50:32 PM , Rating: 2
True, but only to a point.

Many things can't be cured by a pill. I've got vital organs that are destroyed and am only here due to the medications that have been developed in recent years.

IMO, the US drug companies need to grow a backbone and charge the other countries more appropriate prices. That could save US consumers a lot of money.


RE: good
By Lonyo on 12/6/2007 4:34:51 PM , Rating: 2
Other countries like where?
China will make knock=offs, countries with socialised healthcare just won't buy the drugs.
You can't just increase prices, because your product will just not get sold. There are many drugs with are not available in the UK because they are too expensive for the NHS to buy, so they go without.
Sure, individuals could purchase those same drugs at a vastly inflated cost, but the number of people who would be able to do that is quite small.
There have been many instances of very effective drugs which haven't been made available because they are already too expensive.


RE: good
By Samus on 12/7/2007 12:47:00 AM , Rating: 2
Such as drugs that treat Cervical Cancer and HIV...


RE: good
By Pneumothorax on 12/7/2007 9:23:35 AM , Rating: 1
Have you heard of Gardisil? It's basically a cure for cervical cancer, but as a doc practicing in the "Bible Belt" I've met stiff resistance from parents who feel that a vaccine against cervical cancer is going to make their daughters promiscuous. Kinda sounds like the Taliban if you ask me lol.


RE: good
By TomZ on 12/7/2007 9:33:26 AM , Rating: 2
Some of these people are probably even warped enough to see cervical cancer as "God's punishment" for being promiscious.


RE: good
By AsicsNow on 12/7/2007 2:33:04 PM , Rating: 3
Its actually not a cervical cancer drug at all. It is a genital warts vaccine. However, genital warts in females do often lead to cervical cancer because they can occur inside in the vagina where they are hard to detect, and even harder to treat with topical treatments available to males.

It won't cure cervical cancer at all, or really help if you already have genital warts, but it is a great preventative.

I totally agree that people need to be more open minded about the treatment, but I don't think its quite as big of a problem with doctors allowing the treatment in the bible belt as you state. The biggest problem is simply awareness of what the drug actually does, and getting young people to know about it.


RE: good
By Pneumothorax on 12/7/2007 4:25:06 PM , Rating: 1
What I meant is I am a doc practicing in upper state Georgia... I didn't mean to sound like a cure, but it's an awesome prevention. I try to offer it to all females 9-26, but I meet stiff resistance from many parents even after I blow 5 minutes trying to explain it for the 12 minutes I'm alloted by the insurance co's for the visit. It works MUCH better if given before "first contact" if you know what I mean.


RE: good
By Ringold on 12/6/2007 4:43:34 PM , Rating: 3
quote:
IMO, the US drug companies need to grow a backbone and charge the other countries more appropriate prices. That could save US consumers a lot of money.


I'm afraid that'd go one of two ways..

A) Socialist countries submit and allow the free market to operate

B) Socialist countries get pissed off, seize all pharma companies assets within their realm, flaunt international law and just start making it all themselves, nearly eradicating the industry.

There's more precedent, I think, for the latter than the former..


RE: good
By TomZ on 12/7/2007 12:48:46 PM , Rating: 3
Downrated...why? Seems like an insightful comment to me.


RE: good
By rcc on 12/7/2007 2:13:34 PM , Rating: 3
Because it didn't start with "Corporations are evil" take their money!


RE: good
By omnicronx on 12/6/2007 5:21:22 PM , Rating: 2
quote:
IMO, the US drug companies need to grow a backbone and charge the other countries more appropriate prices. That could save US consumers a lot of money.
Typical American... If everyone else is doing something else, you must be right! Just look at the Metric system! Like cmon counting in multiples of 10? What kind of idiot thought of that!!!

I am also sure that drug companies would share their newly found profits with all americans, because they are all honestly run community driven companies right?

American drug companies are the problem , nough said


RE: good
By clovell on 12/6/2007 5:22:49 PM , Rating: 4
> I am also sure that drug companies would share their newly found profits with all americans, because they are all honestly run community driven companies right?

Believe it or not, some are.

> American drug companies are the problem , nough said

That's a rather baseless generalization.


RE: good
By omnicronx on 12/6/2007 8:50:35 PM , Rating: 2
quote:
That's a rather baseless generalization.

Did you read the article? Is it any wonder how profits for said drug company is going to fall 44% (billion of dollars) because of one drug? That means that generic drug companies can make the same product for a fraction of the cost.

Once again, I work for a drug company, what do you do?
What are you basing you comments upon?


RE: good
By masher2 (blog) on 12/6/2007 11:19:25 PM , Rating: 2
> "That means that generic drug companies can make the same product for a fraction of the cost."

Of course. Because manufacturing is a tiny fraction of the total cost of bringing a new drug to market....not to mention the fact that most drugs never even make it that far. Drug companies routinely spend billions on drugs that never get approved. So when they get a winner, they have to make it up. Oh, and let's not forget their massive liability exposure. A class action suit for a problem that didn't turn up in drug testing can easily run to 9 or even 10 figures.


RE: good
By omnicronx on 12/7/2007 12:05:29 AM , Rating: 2
In this situation I would tend to agree with you, it was probably a bad example to use, but once again, you still pay higher prices for the same products than other countries. Even at half the cost, paying $300 elsewhere compared to $600 in the US can make all the difference to some people.


RE: good
By barclay on 12/7/2007 12:30:56 AM , Rating: 3
>"paying $300 elsewhere compared to $600 in the US can make all the difference to some people."

There is on average a 1-2 year lag time between when new medications become available in the US and when they are released (if ever) in other OECD countries.

1 to 2 years can make all the difference to some people.


RE: good
By rcc on 12/7/2007 12:20:15 PM , Rating: 2
Another example of the World wanting the benefits, but not wanting to pony up a share of the costs.


RE: good
By omnicronx on 12/7/07, Rating: -1
RE: good
By rcc on 12/7/2007 2:09:59 PM , Rating: 3
Nice. Out in left field. But a nice concisely written, educated response.

Indeed, personally I eat about one cheese burger a year, whether I need to or not. I do it specifically so I will have a requirement for drugs that I can then holler at you moochers about.

Was that the response you wanted? Or was their some underlying quality to your post that I missed?


RE: good
By Strunf on 12/8/2007 9:24:30 AM , Rating: 2
And with all that they still make billions of profit...


RE: good
By clovell on 12/8/2007 10:38:37 AM , Rating: 3
Because they invest billions.


RE: good
By clovell on 12/7/2007 10:56:26 AM , Rating: 2
I work for a drug company that is not mentioned in the article.


RE: good
By Kenenniah on 12/7/2007 12:24:12 PM , Rating: 2
Did YOU read the article?
"Is it any wonder how profits for said drug company is going to fall 44% (billion of dollars) because of one drug?"

The artice says revenue, not profits which is a giant difference. A company can rake in billions of revenue and still make no profit. Of course I'm not saying the companies aren't making money, but you can't base your feelings of them overcharging on revenue alone.


RE: good
By ChristopherO on 12/6/2007 7:47:31 PM , Rating: 2
quote:
I am also sure that drug companies would share their newly found profits with all americans


They do. It's called dividends. You need to own stock.

As for expensive drugs, I'd rather pay high prices and have a chance of living, than live in some country with socialized medicine where the government dictates what treatments you are allowed to have. If the US system were like the UK, nothing new would ever get invented. That's also the reason most of the world's drug companies are headquartered here. It's one of the last places where they can invent new medications and still make money.


RE: good
By omnicronx on 12/6/2007 9:09:30 PM , Rating: 4
Oh you know what i forgot, nothing was invented until the mighty U S OF A came along. Lincoln invented the wheel right?
quote:
That's also the reason most of the world's drug companies are headquartered here.
Headquarters are located in the states for one reason, drug prices are unregulated. It's not too hard to make billions of dollars and take over pretty much any company you want when you can charge 50 times more than companies from other countries.
quote:
It's one of the last places where they can invent new medications and still make money.
And the last 'big' drug that actually cured something came out when? Heres a list of the top 5 selling drugs in the united tates(Lipitor, plavex, nexium, advair, zocor). All have come out within the last 15 years, and all of them could be considered unneeded if the patient just had a healthy diet and did some exercising.

Great new medicines! I just never knew erectile dysfunction was a terminal illness.


RE: good
By ChristopherO on 12/6/2007 11:08:04 PM , Rating: 1
quote:
Headquarters are located in the states for one reason, drug prices are unregulated.


This is a good thing. No one is going to bother inventing anything if they aren't going to make money doing it. What should we do, pass price controls, and then send government agents to drug companies and use coercion to force workers to invent new medications?

Drug companies make a lot of money, they pay well, they pay their shareholders well. Contrary to popular opinion there are lots of ways to acquire cheap medications in this country. Most of the major drug companies have a means to offer discounted product to those in need. Obviously if you have money, you aren't going to be offered a break.

Lawyers also have a huge negative impact on drug prices. You can release something, improve hundreds of thousands of lives, ruin a handful, and you end up with billions of dollars of legal fees (see Vioxx).

quote:
Oh you know what i forgot, nothing was invented until the mighty U S OF A came along.


Phones, computers, electricity, cars, airplanes, most medications, television, radio, light, speakers, cell phones, fuel cells, pop can tops, suspended ceilings, frozen concentrated orange juice, and on and on were all invented here. I'm not saying other countries don't contribute, but we certainly lead the way in improving all facets of modern life.


RE: good
By omnicronx on 12/6/2007 11:19:43 PM , Rating: 2
quote:
This is a good thing. No one is going to bother inventing anything if they aren't going to make money doing it. What should we do, pass price controls, and then send government agents to drug companies and use coercion to force workers to invent new medications?
I could care less about new medications, I live in Canada. I look at drug our Canadian drug prices and laugh in comparison to what you pay. Really in the end i do not care, I am just pointing out you are getting ripped off, if thats fine with you then so be it.

I would also like to point out Canadian drug companies do quite well, even with regulated prices.


RE: good
By shocker38 on 12/7/2007 5:55:34 AM , Rating: 4
Im not going to have a go here but please for the love of god you did not invent the televison (John Logie Baird British), telephone (Alexander Graham Bell Though this is not confirmed), radio (Edward Hughes was British), electricity (William Gilbert British). America did not invent every thing and belive me there are other countires out there beyond your own borders of country and mind.


RE: good
By ChristopherO on 12/7/2007 1:55:45 PM , Rating: 2
I'm not saying foreign individuals didn't invent anything, however those individuals, when they invented something were in the US. Bell for instance... All his early telephone trials were here. Companies bearing his name, started here.

Modern electricity was Tesla. Foreign again, but alas, he was here.

The thing about the US, is that almost everyone here is fundamentally foreign. A "native" American is a tiny fraction of the population.


RE: good
By TITAN1080 on 12/7/07, Rating: 0
RE: good
By Drexial on 12/7/2007 12:11:10 PM , Rating: 3
aalot of those inventions were made by people that learned from other countries, but came here cause their country was blown up by bombs...

Car: France (Nicolas-Joseph Cugnot) or Germany (Germany for the first to use an internal combustion engine, Karl Benz) (china made a steam powered one in the 1600s)

Electricity: There was a battery discovered to be from 200 BC. But as electricity as we know it today there were a mix of people responsible a few of them American.

Pop cans: Originally just a standard food can which was invented by the French (Nicolas François Appert), the pull tab was later invented by a Canadian (Mikolaj Kondakow).

Computer: the first programmable computer was designed by the French (Joseph Marie Jacquard)

Airplane: The first glider and the 'inventor' of aerodynamic was British (George Cayley). Adding a motor to it isn't really invention, it may be innovation. But thats not what this list is about.

Fuel Cell: German-Swiss Scientist (Christian Friedrich Schönbein)

Light: The first incandescent light was not Edison or Swan it was British chemist Humphry Davy.

Telephone: There are 4 people listed as the inventors of the telephone: Antonio Meucci (Italian), Johann Philipp Reis (German), Elisha Gray (America), then there is Alexander Graham Bell, who did not move to the US until he was almost 30. All his education occurred in Scotland. So while he lived in the US he just happened to be here when it happened.

Television: The first concept of the modern television was described by Alan Archibald Campbell-Swinton, a Scottish electrical engineer. He came up with the idea of using cathode-ray tubes

Medicine: Edward Jenner (England) - Vaccination, Alexander Fleming (Scottish) - Penicillin, Charles Frederic Gerhardt (French) Aspirin.... ok i think thats enough for now, I've done enough searching with all these.

American inventions in that list Cellphone, Radio, Concentrated Orange Juice

Sorry I couldn't find anything on Drop Ceilings.

But I think the point is proven.


RE: good
By masher2 (blog) on 12/7/2007 12:21:21 PM , Rating: 2
> "aalot of those inventions were made by people that learned from other countries, but came here cause their country was blown up by bombs..."

Or they came because their country didn't offer an economic climate which allowed them to develop and exploit their idea.

Both of which goes to prove the point that a stable environment conducive to business is truly the mother of all invention.


RE: good
By Drexial on 12/7/2007 1:04:57 PM , Rating: 2
pretty sure thats, necessity is the mother of all invention.

I'm pretty sure instability is why things are invented, they are seen as solutions to problems, so if it was a stable environment, there would be no reason to invent.


RE: good
By masher2 (blog) on 12/7/2007 1:09:19 PM , Rating: 2
> " it was a stable environment, there would be no reason to invent. "

Ah, that explains why nations like Rwanda, Nigeria, and Haiti are the source of so much high-tech development.


RE: good
By Drexial on 12/7/2007 1:55:34 PM , Rating: 2
Thats a fairly ignorant statement. First off you limit it to technical invention, not every invention has to do with technology. Secondly the types of innovations that happen in nation in conflict are geared towards the problems they have. Tactical innovations are the biggest here. Inventing different strategies, political inventions.

inventing a flying car that used magnetic fields isn't too high on their list.

As another point I didn't say all instability resulted in invention, I just said that without instability there would be no invention.


RE: good
By masher2 (blog) on 12/7/2007 2:04:59 PM , Rating: 2
> "First off you limit it to technical invention, not every invention has to do with technology"

Technology is the application of invention to practical use. Inventions that serve no practical purpose have nothing to do with technology, agreed.

> "I just said that without instability there would be no invention."

Political and economic instability is not a prerequisite to innovation. Except in certain rare case, it's a hindrance, which explains why stable climates like the USA produce the majority of the world's technology.


RE: good
By ChristopherO on 12/7/2007 2:27:27 PM , Rating: 2
quote:
But I think the point is proven.

Not at all. Nitpick whatever you want about my statement. You're just trying to find prior-art by someone else (*anyone* else) so you can say you are correct. The difference between your list, is that those concepts never went anywhere, and my list, is that American inventors (pretty much all of which were foreign and moved here -- we're a country of immigrants) figured out how to take their idea and turn it into something that everyone on the planet can use.

A clay-pot battery from 200BC discovered in the Tigris-Euphrates river valley is not exactly a working model of electricity distribution.

As for pop cans, I was thinking of Ermal Fraze. Their family has their name on a lot of things. It's that crazy capitalism thing again... Come to the US, bring your ideas, and get rich. Darn them! Good motivation though. Why would I want to get rich in a country that took more than half my income in taxes?

If you break down all the modern drugs, an overwhelming majority are from here. I'm pretty certain you could find at least one invented in every single country if you tried. Tamiflu for instance, happens to be from Roche, which isn't a domestic company. Roche has done a lot of good. However, our domestic pharmaceutical industry is many times larger than every other pharma company from the rest of the world, combined.

My key statement:
quote:
but we certainly lead the way in improving all facets of modern life.

My list was practical, since with your list, you have no proof that you would have working electricity and be arguing with someone while sitting in front of a PC.

In a manner of speaking, one could listen to Plato. Every great idea has already been had by someone else, every invention from this point forward, can probably, if one tried really hard, be ascribed to some prior work. That doesn't mean the two are fundamentally related. After all, you can have only one winner, and everyone else loses. No matter how you look at it, one man or woman still changes the world.


RE: good
By masher2 (blog) on 12/6/2007 11:23:14 PM , Rating: 2
> "Headquarters are located in the states for one reason, drug prices are unregulated"

Oops, you seem to have forgotten that regardless of where "headquarters" is, a company can still sell drugs in the US. In fact, 5 of the 10 largest Pharma companies are NOT headquartered in the US.

> "all of them could be considered unneeded if the patient just had a healthy diet and did some exercising."

So now its the drug companies fault that people don't exercise and eat right?

> "Great new medicines! I just never knew erectile dysfunction was a terminal illness. "

So, if you don't want to buy any of these drugs, no one is making you.


RE: good
By omnicronx on 12/6/2007 11:47:46 PM , Rating: 3
quote:
"Headquarters are located in the states for one reason, drug prices are unregulated"
Doesn't matter where they are located, you still pay the same prices as you would for American made drugs.
quote:
So now its the drug companies fault that people don't exercise and eat right?
No its not, that was not my point. My point was that drug companies, as any profitable company would try to do is try to make money. Products such as lipitor are cash cows, so companies would rather put money into these sorts of drugs.

In the end the argument could go on forever and i was just pointing out to the previous poster what kind of 'new medications' have been recently invented. regulating prices will probably not change anything in the advancement of drugs, it would just lower prices.
quote:
So, if you don't want to buy any of these drugs, no one is making you.
I won't, as the post above describes, I am Canadian and I could not care less if Americans pay more than everyone else.


RE: good
By barclay on 12/7/2007 12:37:08 AM , Rating: 2
>"regulating prices will probably not change anything in the advancement of drugs"

This is completely untrue. See my post below.

http://www.ita.doc.gov/td/health/phRMA/PhRMA%20-%2...


RE: good
By ChristopherO on 12/7/2007 2:41:12 PM , Rating: 2
quote:
Doesn't matter where they are located, you still pay the same prices as you would for American made drugs.

You still miss the fundamental point. Unless we pay those prices, the companies, foreign or domestic, have no incentive to invent new ones. We subsidize worldwide R&D. You're living longer because we're footing the bill.

As a result, socializing *our* medical industry should scare the rest of the world. Assuming everyone likes living longer and having an opportunity to see experimental treatments. The rest of the world needs to pitch-in and stop being moochers when it comes to medication. If that were the case, perhaps they wouldn't *need* to gouge the American consumer, since they would have a reasonable chance of profiting elsewhere.


RE: good
By protosv on 12/7/2007 3:07:28 AM , Rating: 5
As a medical student currently taking a cardiovascular pathology course, I can definitely say that those top 5 drugs are ABSOLUTELY needed, not just "lifestyle" drugs like viagra and cialis.

Lipitor and Zocor belong to a class of drugs called statins, which not only lower cholesterol and reduce the risk of cardiovascular disease and heart attack, but also save the healthcare system tens of millions of dollars a year in coronary patients they don't have to treat. Also, you're incorrect about your statement regarding diet and exercise affecting cholesterol. While diet and exercise help lower cholesterol, the people who are taking these two drugs probably have genetically high cholesterol, and both proper diet and exercise will have a minimal effect for these patients.

Advair is an asthma drug, and if you know anyone who has a severe case of asthma, they can tell you that a severe attack literally chokes them, and they depend on their inhaler to keep them breathing.

Plavix is an anticoagulant drug, that helps thin the blood and prevent clots from forming. This is extremely important in patients who have had previous heart attacks, or who are at risk for heart attacks.

Even nexium (which I take), I wouldn't consider a lifestyle drug. This is for acid reflux, which is more than just an uncomfortable condition that can make eating food painful. Acid reflux increases your risk for cancer of the stomach and esophagus, which is a very severe form of cancer that is difficult to treat. So you might consider this a drug that prevents a severe condition.

Sorry for the whole science lesson, but I just wanted to point out that none of these top 5 drugs are "lifestyle" drugs, and ALL of them are involved directly or indirectly at preventing life-threatening conditions.


RE: good
By tedrodai on 12/10/2007 11:51:52 AM , Rating: 2
Thanks for that post. I hadn't checked the site since Thursday, but I'm glad someone brought this up in response to omnicronx's 'top 5 drugs' comment. His allusion about those drugs being for fat lazy people (essentially) who want a big red easy button really pissed me off.

I happen to know someone very well who, without steriod medicines for asthma like Advair, would never have made it to adulthood. I ran track with this person in high-school, and she qualified for the state meet in every event in which she participated (in track rather than field events), and helped her team earn runner-up two years in a row. Now, at 24 years old, she still has asthma despite regular excercise--and she will always need her inhaler nearby.

Also, she currently takes nexium or prevacid regularly, thanks to being a med student. This has nothing to do with an unhealthy diet (she's not far removed from being a health nut), and everything to do with work-related stress, as I'm sure protosv can attest to. Say what you will about doctor's salaries (a conversation with a different can of worms), but they work their asses off to get there and are constantly under an extreme amount of stress, which often causes acid reflux. Her diet is pretty much devoid of anything that will cause reflux in a normal person, because her body does it well enough by itself.

This woman, who is also my wife, is but one example among millions of different cases. So omni, take your ill-considered generalizations elsewhere.


RE: good
By Pneumothorax on 12/7/2007 9:32:37 AM , Rating: 2
quote:
(Lipitor, plavex, nexium, advair, zocor). All have come out within the last 15 years, and all of them could be considered unneeded if the patient just had a healthy diet and did some exercising.

Wow just wow. You need to do some research yourself. Vast majority of high cholesterol cases are from genetics as >80% of cholesterol comes from the liver. I have "Vegans"/rabid excercisers in my practice who have over 300+ cholesterol and their primary relatives have had heart attacks at <50 years old. Hmm what would they do without cholesterol meds? Should they just accept their fate and let things "lie?" Honestly, someone up there mentioned us docs "pushing" expensive drugs. I work in economically disadvantaged area and "push" for generics. In fact, it's the patients who're asking for the expensive brand names they see on tv lol. I believe pharma is a necessary evil as companies don't develop new things unless they're making money. What would you have doing the R&D? The government?! lol They would waste over 50% of R&D dollars as the government is accountable to no profit at all and oversight. Humanity is just too selfish for socialism to work well.


RE: good
By oab on 12/7/2007 10:49:30 AM , Rating: 2
"what would they do without cholesterol meds?"

However, as doctor, I'm sure you have heard of this vitamin called Niacin. One of the B-like vitamins, known to reduce LDLs, and raise HDLs in doses starting at 1000mg. It's cheap($7 for 100 500mg tablets), available at any pharmacy in the vitamin section. It is also water-soluable (you pee it out after metabolising it). If assuming the cholesterol hypothesis is correct (there is not much evidence that it is not), therefore one could conclude that Niacin will reduce the risk of heart disease caused by "bad" cholesterol.

Side effects include flushing of the face (it dilates blood vessels), and itchy skin 20 after ingestion. These side effects diminish the longer you take it, and go away quickly. If you have a history of liver disease, talk to your doctor before taking niacin. Time-release niacin is also available that basically eliminates the flushing.

It is possible to overdose on niacin, and therefore consult your healthcare practitioner before taking it, ask what dose you should take, and

(I am legally required to postface this by saying that I am not a doctor, I do not know your medical history. Talk to your healthcare practitioner before taking anything, tell him/her all medications you are taking, including herbal and all natural. These statements have not been evaluated by the FDA, etc. etc. etc.)


RE: good
By masher2 (blog) on 12/7/2007 10:57:42 AM , Rating: 2
> "as doctor, I'm sure you have heard of this vitamin called Niacin"

Niacin is pretty efficient at raising HDL, but does little to reduce LDL. Lipitor, on the other hand, can reduce LDL by 50% or more.

As for the conspiracy theory that only "profitable" drugs are pushed, my father's doctor has him on *both* Lipitor and niacin.


RE: good
By clovell on 12/7/2007 11:03:44 AM , Rating: 2
There's work being done on statin / niacin combo drugs.


RE: good
By Pneumothorax on 12/7/2007 4:33:09 PM , Rating: 2
Then I need to hire you for my clinic as spokesperson/coach I have about 10% compliance rate on niacin as most quit within the first month. And the previous poster is right, while it raises HDL, it doesn't really do much for the big bugaboo LDL.


RE: good
By clovell on 12/7/2007 4:50:03 PM , Rating: 3
Titrate the dosing regimen and use an extended-release formulation. Aspirin helps with flushing, too.


RE: good
By clovell on 12/7/2007 10:59:48 AM , Rating: 2
Dislipidemia is the largest pharmacuetical market in the world. Naturally, companies will make the most money off of dislipedemia drugs.

Don't forget that there are drug companies in the States that do at least half their business outside the States.


RE: good
By rcc on 12/7/2007 12:36:14 PM , Rating: 2
On behalf of asthma sufferers everywhere who have to work hard every day just to breathe, something most people take for granted, go pound sand.

The system's not perfect, however, having one country foot the bill while others skate gets a bit annoying.


RE: good
By Hare on 12/7/2007 12:39:41 AM , Rating: 2
quote:
with socialized medicine where the government dictates what treatments you are allowed to have.

Could you list a few of these countries? This is quite funny you know...


RE: good
By barclay on 12/7/2007 1:17:38 AM , Rating: 4
In the Canadian system, patients are given a limited number of government approved treatments to choose from for various conditions. There is a strong bias against new and/or expensive treatments.

Furthermore, in order to control costs, the government approves a specific number of "x" procedures for each year. Since demand often exceeds this amount, patients are placed on waiting lists. The wait times vary depending on the procedure, but it can be often measured in months or even years. This has many negative consequences on survivability and quality of life. Canada's wait times are a large reason their cancer survival rate is significantly lower than the US.

http://politicalcalculations.blogspot.com/2007/10/...

Also, Canadians cannot opt to pay for the procedure themselves to skip the wait time, as it is illegal for a doctor to accept private payment (although a 2005 court ruling struck this down for Quebec). This is the primary reason why sick Canadians often travel to the US and other countries seeking treatment.


RE: good
By masher2 (blog) on 12/7/2007 8:36:44 AM , Rating: 2
> "Could you list a few of these countries? This is quite funny you know... "

As far as I know, *every* nation with a socialized medicine program approves which treatments are allowed under the system.

If you believe socialized medicine is the answer, you might want to look at the British system. Even though healthcare is free for everyone, nearly 10% of the population (aka "those who can afford it") purchase private health insurance and visit private doctors. When I need surgery, my doctor schedules it and I get it within a day or two. An OECD survey reported that over 40% of Britons, though, reported waiting over 12 weeks for surgical treatment.


RE: good
By omnicronx on 12/7/2007 11:30:49 AM , Rating: 2
Masher your view is flawed. Your opinion means very little when you are obviously in the category of being 'well off'. You obviously can afford private health care with one hand tied behind your back, so of course you demand the best. It's just too bad you fall into an ever shrinking percentage of americans.

I believe mixed systems like briton's are perfect. Those willing to pay for private health care, get quite service but pay more. Those not willing or not able to pay for private health care, can wait a little longer for surguries, but can at least afford them. This way neither party can whine about their services, you get what you pay for. I would also like to add that if only 10% of britons use private health care, then you must imagine that the vast majority of people are happy with the current public health care system.

100% public health care is definatly not the answer for the united states, it barely works in Canada with a 10th of the population, therefore i would really doubt it would ever work in the US. That being said a regulated mixed system seems like the best answer..


RE: good
By masher2 (blog) on 12/7/2007 1:00:40 PM , Rating: 1
> "Masher your view is flawed. Your opinion means very little when you are obviously in the category of being 'well off'."

I realize that, to many people, anyone who earns more than the national average should lose their right to vote and have all their assets seized, but I still believe my opinion has at least as much merit as someone who flips burgers for a living. Or doesn't work at all.

Anyone in the US who stayed in school and got a decent education can afford health care. Hell, my Lexus salesman bragged to me he has only a 9th grade education, but makes $150K a year. Of course, he works long hours, rather than spending his life watching rap videos and whining about how poor he is.

Given I *already* pay some $10K a year towards the emergency healthcare of those who can't (or more often, won't) work, I really don't care to support a system that not only will vastly increase my costs, but reduce my chances of getting quality healthcare, as well as cripple the most productive medical research system on the planet.

Sorry, but...nothx.


RE: good
By omnicronx on 12/7/2007 1:52:11 PM , Rating: 2
Thanks mr upper middle class American, I realize now that the small percentage of Americans like you are the only ones that matter. What I am proposing is a mixed system to make both parties happy, what is it with this attitude that because you make more money, the current system is perfectly ok for everyone?


RE: good
By masher2 (blog) on 12/7/2007 2:07:37 PM , Rating: 2
> "What I am proposing is a mixed system to make both parties happy"

No. You're proposing a system whereby those of the first party have their property siezed and used to fulfill the needs of the second party. That doesn't make "both parties happy". Far from it.


RE: good
By TomZ on 12/7/2007 2:58:11 PM , Rating: 2
quote:
No. You're proposing a system whereby those of the first party have their property siezed and used to fulfill the needs of the second party. That doesn't make "both parties happy". Far from it.

Right on. Sounds like omni's advocating communism these days...to each according to his need and so forth.


RE: good
By clovell on 12/7/2007 2:39:10 PM , Rating: 2
I just want to add my two cents here.

People, you need health insurance. It needs to be one of the first things you pay for, after your mortgage / rent, food, and basic utilities (gas, water, electricity, and garbage disposal). The government already helps people who are in dire straits with these things, but they see it the same way - health insurance is a necessity of life - forget cable, forget credit cards, forget KFC for dinner, and forget your car - pay your $^*$%* health insurance bill.

Before you call the Wahhbulance, let me tell you a story. I worked up to three jobs at a time, clearing between 21~40k / year while finishing college and grad school - and I still made sure my family (which grew from 2 to 4) had health insurance. It wasn't cheap, but it's something you have to have.

Chances are, that if the government isn't already picking up the tab for your healthcare, then you can afford to buy your own. You may have to give up a lot - cable, car, KFC for dinner - but you need health insurance.


RE: good
By Ringold on 12/7/2007 2:45:38 PM , Rating: 2
If I weren't covered otherwise, I could get private insurance of respectable quality by simply forgoing my cell phone bill.

Of course, I'm in my 20s and not 300 pounds, but I don't have a very expensive cell phone bill either.


RE: good
By darkpaw on 12/7/2007 3:49:55 PM , Rating: 2
Yah, thats all well and good if you're what the insurance companies deem "healthy".

I've had genetic bone problems since I was a child, try getting some insurance then. Same for people with almost any condition that is permanent and not their fault like Type 1 diabetes.

I worked for a small company for years before I got a job with health insurance. The cheapest plan I could get in AZ that covered anything was $400/month and that was for 20 something and generally healthly other then a few issues dating to childhood. Even my current plan through work costs me a few hundred a month, with my employer picking up 75% of the tab and thats for a group plan that doesn't consider anything preexisting.

I definitely don't support fully paid for government healthcare, but there is a lot that needs to change in how insurance is sold. Having "tax credits" to buy insurance isn't going to help either. Most people are not going to have $400/month to put aside for insurance until tax time.


RE: good
By Pneumothorax on 12/7/2007 4:41:59 PM , Rating: 2
AMEN to that. Obviously getting the latest sneakers, paying directtv bill, and smokes are much more important to the general public than paying for health insurance. Notwithstanding the TRULY disabled in society or those inflicted with REAL chronic illnesses, this is more of those who don't want to work or spend their money on something else. Wanting "the have's" who work paying for it.


RE: good
By ATC on 12/6/2007 2:38:50 PM , Rating: 3
quote:
and outsourcing

I can just see the headlines now, "drug X recalled for lead contamination". That's all we need.


RE: good
By arazok on 12/6/2007 2:56:14 PM , Rating: 2
Patents for life with government price control is a horrible idea. It will just create another bureaucracy, and prices that are NEVER less then what the government mandates. I look at some Atlantic provinces in Canada where price controls are in effect for gasoline. Sure, the cost of gas never goes up....but it never goes down either.

A better idea is to provide patents for a number of years (50 at most), but the inventor must allow generics immediately. The generic manufacturers would just have to pay royalties while the patent is in effect. 5-10% tops. The inventors get their costs back with profit, and the market/competition drives prices overall.


RE: good
By Oregonian2 on 12/6/2007 3:30:47 PM , Rating: 2
It's more than making "profits" on the drugs that succeed. The system needs to fully fund research for new products as well as advanced research on methods that don't create short term products but only lead to products later on when the mechanisms and understanding discovered can be used. It's more than just a business. If microprocessors were stuck and we could only make what we have now, it'd be acceptable. If a bread company can only make the products they do now "forever" that'd be fine. Not so with medical companies. The tremendous amount of profits off the most profitable products don't go to paying dividends to the stockholders (AFAIK), nor to buying party supplies for the employees. It's money used for medical field investment. That investment money is an important cog in the system. Getting rid of it is good short term public bean-counter terms but perhaps not what is wanted in the long term view (for the companies or for the public).


RE: good
By Oregonian2 on 12/6/2007 5:57:37 PM , Rating: 2
P.S. - Their viagra patent expires in 2012. Not long off!


RE: good
By mindless1 on 12/7/2007 3:04:39 AM , Rating: 2
We could likewise say the profits from any product *need* to fund new research, but it isn't really true.

These companies made a start without these profits and can easily get by with less than their astronomical profits just as they did when they invented their cash cows.


RE: good
By masher2 (blog) on 12/7/2007 10:01:05 AM , Rating: 2
> "These companies made a start without these profits"

They did so because venture capitalists were convinced those profits were likely enough to take the extremely high risk involved. Remove the profits, and venture capital no longer invests in pharmaceutical companies.


RE: good
By TomZ on 12/7/2007 10:29:38 AM , Rating: 2
quote:
These companies made a start without these profits and can easily get by with less than their astronomical profits just as they did when they invented their cash cows.

Your parents obviously didn't teach you that money doesn't grow on trees. Exactly where do you think the money comes from for pharma R&D? It comes from investment - as Michael said - investment made by those who are expecting a return on that investment.


RE: good
By sinful on 12/7/2007 8:05:02 PM , Rating: 3
quote:
Exactly where do you think the money comes from for pharma R&D? It comes from investment - as Michael said - investment made by those who are expecting a return on that investment.


I think there's a big problem in this thread that people don't understand exactly what profits are.

Profit is the money that is left over after ALL expenses are taken care of.
For example, if Pfizer spends $10 million on salaries, $10 million on R&D, and $10 million on other stuff, their EXPENSES are $30 Million. If in the course of business, they make $50 Million, their PROFIT is $20 Million.

Please note that R&D is already accounted for as part of their EXPENSES. Please also note CEO Salary is ALSO included in their expenses.

When a company turns a profit, that money *could* have been used for R&D, bigger salaries, etc - but it WASN'T.

In other words, their "profit" is another way of saying "bonus".

Thus, the resulting question is really what is a "reasonable" bonus for these companies for what they do.
And it *is* a question that can be asked.

i.e. consider this: If the paper delivery kid comes around, and for the holidays I give him $10, is that reasonable? What if I gave him $100,000?
Now, you might say "I don't care what you do!", but what if you're my customer, and I charge you for using my products?
Wouldn't that imply that I've overcharged you an unreasonable amount, if I can give out unreasonable bonuses? What's it mean if my products are required for you to live? Has an ethical boundry been crossed?

In other words, if a company has "unreasonably" high bonuses, it's implied that people are being overcharged.
In other words, profits are the "extra" reward companies get - and while it's obvious that in an investor-based system there should be "extra rewards", you also have to stop and consider at what point the "reward" is excessive and exploitation taking place, and the ethics (or lack of) that were used to arrive at that conclusion.


RE: good
By Oregonian2 on 12/7/2007 9:34:37 PM , Rating: 2
Uh... no... not unless it's a company that takes profits and pays dividends with it. Otherwise the money either gets put aside for future spending (or a "rainy day fund") or will finance next year's investments. It doesn't get divided up and have the fat cats just take it home. Nor do the owners get it (unless through dividends or stock buy backs).

Another way of looking at it is that the R&D reported is the portion of the PREVIOUS year's profit that was spent in the last year for R&D purposes (would have been profit had R&D not spent it). If the profits were much lower the previous year, the R&D would have likely been cut too (because it's one of the easiest to cut back on when something has to be cut ... it doesn't affect short term revenues).

When there are net profits, that's money that can be in the next year's budget to get spent. Reporting is year by year, but money earned in a previous year is allowed to be spent in a future year.

Just think: where do those dollars of profit go to? It's owned by the company. Owners don't get it unless there's dividends. It's money that gets invested by the company in future operations. It doesn't have to be R&D, it may be new manufacturing expansion, new buildings, buying a startup company to get their products, it might pay off previous debts or sometimes buy its own stock. Whatever. It's money that's used by the company to further their pharmaceuticals business. They usually can't just "bank" the money to an excess because companies with too much cash tend to be targets for takeover (where the cash will be gutted).

Main point is, that without the profit stream, the R&D will be among the hardest hit because it doesn't affect short term revenue, and the bean counters and stock market watchers are very short term creatures.


RE: good
By TomZ on 12/8/2007 2:01:46 PM , Rating: 2
quote:
In other words, if a company has "unreasonably" high bonuses, it's implied that people are being overcharged.

I don't know where you got your notion of "reasonable profit," but the very idea is nonsense. And that's not how a free market works. The way it really works is that prices are set by the value of the product or service to the consumer, not directly based on the cost plus a "reasonable" markup.

So that means, for example, if I produce a widget that is worth $100 to you, then you'll pay the same $100 for it, regardless of whether it cost me $99 or even $1 to produce. Obviously if it cost me $1 to produce, then odds are that some other sellers will enter the market and sell a similar widget for less than me, and I will lose marketshare. That's just the nature of the market.


RE: good
By fic2 on 12/6/2007 2:59:05 PM , Rating: 2
quote:
The fact is that drug research is extremely expensive. Not only do you spend years just paying scientists just to develop the drugs, you have to spend millions if not tens or hundreds of millions to get the drug approved for sale.


You forgot the 2x the spend on marketing. From: http://www.carlmcmillan.com/drug_profits_vs.htm


RE: good
By Amiga500 on