Narcotic 'lollipop' is big seller

Posted on September 05, 2008 in Prescriptions

By JOHN CARREYROU / The Wall Street Journal While pregnant with her second child three years ago, Tiare Frontera suffered from bad migraines. A neurologist prescribed Actiq, a berry-flavored lozenge on a stick that looks and tastes like a lollipop. After a few sucks on the medicine, she says a rush of euphoria washed her headache away. Soon, Mrs. Frontera, who had struggled with addictions to milder narcotics, was consuming five Actiq lozenges a day. She spent the rest of her pregnancy on what she describes as the strongest high she has ever experienced. When she gave birth, her baby son was cranky and wouldn’t sleep. Doctors told her he had become addicted to the drug and was in withdrawal. Mrs. Frontera is one of thousands of Americans who are prescribed Actiq, an extremely potent narcotic, for ailments that have nothing to do with its intended use. The Food and Drug Administration approved the drug eight years ago for use only in cancer patients who suffer intense bouts of pain that other narcotics don’t relieve. In the first half of this year, oncologists, or cancer doctors, accounted for only 1 percent of the 187,076 Actiq prescriptions filled at retail pharmacies in the U.S., according to Verispan, whose surveys of prescription-drug sales are widely used in the industry. Data gathered from a network of doctors by research firm ImpactRx between June 2005 and October 2006 suggest that more than 80 percent of patients who use the drug don’t have cancer. Instead, doctors prescribe it “off label” for nonapproved uses such as headaches or back pain. Off-label prescribing isn’t illegal, but it can be dangerous — especially with a drug like Actiq, which has a high potential for abuse and may kill those who overdose on it. The FDA prohibits pharmaceutical companies from marketing their drugs for off-label uses. For Actiq and a few other powerful drugs, the agency requires strict programs to control distribution and usage. Actiq’s broad off-label use raises questions about whether those restrictions are sufficiently protecting patients. “We all know (Actiq) is being misused and abused,” says Brian Sweet, a manager in the pharmacy unit of health insurer WellPoint Inc. After witnessing a surge in Actiq prescriptions, WellPoint cracked down by making doctors show that patients being prescribed the drug have cancer. Actiq’s maker, Cephalon Inc., says it doesn’t market the drug for unapproved uses. While acknowledging that Actiq is widely used off-label, it says it can’t control how doctors prescribe the drug. Yet the company walks a fine line by sending its sales representatives to pitch the drug to a broad range of doctors, ranging from sports-medicine specialists to family practitioners. It gives these doctors coupons for free samples. Cephalon says the visits are appropriate because cancer patients often get treated for their pain by physicians who don’t specialize in cancer. Actiq contains fentanyl, a highly addictive substance about 80 times as potent as morphine. Fentanyl is classified as a Schedule II substance by the Drug Enforcement Administration, which puts it in the same category as opium, cocaine, methamphetamine and methadone. Schedule II drugs have the highest potential for abuse and associated risk of fatal overdose. Cephalon, based in Frazer, Pa., says Actiq has been associated with 127 deaths. Two of them involved children who confused the drug for candy. Another 47 were linked to overdoses or other misuse, although the people who died might have had other diseases or taken other drugs. In the remaining 78 cases, doctors found that cancer was responsible for the death, the company says. Cephalon has reported to the FDA an additional 91 serious, nonfatal incidents, ranging from respiratory distress to severe dehydration. The U.S. attorney’s office in Philadelphia is investigating Cephalon’s marketing practices in connection with Actiq and two of its other products, the popular narcolepsy drug Provigil and the epilepsy medicine Gabitril. No charges have been filed. Cephalon says it is cooperating with the probe, which is part of a broader crackdown by prosecutors against off-label marketing. In August, the Justice Department fined Schering-Plough Corp. $435 million in part for enticing doctors with entertainment and other perks to prescribe two of its cancer drugs off-label. Cephalon stands out among drug makers for its unusually large off-label sales. Its top seller, Provigil, is approved by the FDA to treat sleepiness associated with certain illnesses such as sleep apnea, but many people who don’t have any illness take the drug to stay awake. Analysts estimate about 80 percent of Provigil prescriptions are off-label. Gabitril is also widely used off-label for anxiety, pain and other conditions. Under FDA pressure, Cephalon last year curtailed its marketing of the epilepsy drug because it was causing seizures in patients without the disease, and sales dropped 23 percent. Founded in 1987 by a former DuPont Co. scientist named Frank Baldino Jr., Cephalon expects revenue to exceed $1.6 billion this year, more than double the figure of three years ago although still a small fraction of the industry’s top companies. Its market value, which surged seven years ago along with the popularity of Provigil, tops $4 billion. Dr. Baldino earned $2.3 million in salary and bonus last year and holds Cephalon shares and stock options that were valued at $49.6 million as of the end of last year. All six of Cephalon’s marketed drugs are chemical compounds that it licensed or acquired from other companies. Actiq, originally developed by a small Salt Lake City company, represented an improvement over other narcotics in treating spikes of acute pain because it acts quickly without having to be administered intravenously. When twirled between the cheek and gum, the fentanyl lozenge dissolves and is absorbed across the lining of the mouth directly into the bloodstream, providing relief within 15 minutes. Actiq had sales of $15 million in 2000, when Cephalon acquired it. By last year, sales had grown to $412 million, making it Cephalon’s No. 2 drug. In the first nine months of this year, sales jumped to $471 million. Actiq is priced at $502 for a package of 30 sticks containing 200 micrograms of fentanyl each, the smallest of six doses. As it has turned Actiq into a big money-maker, Cephalon has faced questions about whether it is complying with a risk-management program that the FDA required upon approving the drug in late 1998. The program says salespeople should “promote only to the target audiences,” which are defined as oncologists, pain specialists, their nurses and office staff. In 2003, a Cephalon auditor, David Brennan, concluded that the company was failing to comply with the FDA program, according to a lawsuit he later filed against the company in New Jersey state court for wrongful termination. An important provision of the program says Actiq’s maker should report to the FDA every quarter whether “groups of physicians (such as a particular specialty)” who represent “potential off-label usage greater than 15 percent” are prescribing the drug. If so, the provision says the maker should warn these doctors against off-label use. Mr. Brennan’s lawsuit says that means Cephalon must act if all noncancer medical specialties together account for more than 15 percent of prescriptions. Cephalon interprets the provision differently. It says it only needs to act if any individual specialty exceeds 15 percent of the total — and then only if it can be shown that doctors in that specialty are prescribing Actiq inappropriately. Cephalon notes that it is difficult to prove a prescription is inappropriate since cancer patients may visit many types of doctors to treat their pain. It believes the 15 percent clause has yet to be triggered. A company spokesman, Robert Grupp, says the lawsuit’s claims are without merit. The FDA declined to comment. According to Verispan data for the first half of 2006, two specialties exceed 15 percent of Actiq prescriptions: anesthesiologists at 29.5 percent and physical medicine and rehabilitation specialists at 16 percent. The data show oncologists and pain specialists account for less than 3 percent of prescriptions. Cephalon doesn’t dispute the data. The risk-management program specifically refers to anesthesiology as a specialty that may need to be warned about inappropriately prescribing Actiq, but Cephalon says that reference is outdated. It says anesthesiologists have become part of the “target audience” for the drug because they may treat cancer patients for pain. Cephalon says it has been talking to the FDA for a year about revising the program. After Mr. Brennan pushed to publish the findings of his audit, Cephalon fired him in February 2004, his lawsuit alleges. Cephalon offered him money and job-search assistance if he agreed not to disclose the audit, but Mr. Brennan refused, the suit says. Mr. Grupp declined to discuss Mr. Brennan’s dismissal but noted that he is “a former disgruntled employee.” Mr. Brennan has been interviewed twice by investigators working for the U.S. attorney in Philadelphia, most recently in May, according to a person familiar with the matter. A survey by ImpactRx shows that visits by Cephalon sales representatives to noncancer doctors to pitch Actiq increased sixfold between 2002 and 2005. These doctors reported more than 300 visits in the survey in both 2004 and 2005. Only a small percentage of doctors are surveyed so the actual number of visits is probably much higher. Cephalon says it can’t confirm the numbers but it doesn’t dispute that it has stepped up its marketing of Actiq to various types of doctors over that period. Stephen Leighton, a general practitioner in Winston-Salem, N.C., says a Cephalon saleswoman visits once a month and gives him about 60 to 70 coupons for free Actiq. Patients can trade each coupon for six Actiq sticks. Dr. Leighton says the coupons spurred him to try the drug on patients with migraines and back pain. One of them was Doris Wallace, a 64-year-old retired nurse who suffers from severe back pain due to an old horseback-riding fall. Ms. Wallace, who doesn’t have health insurance and couldn’t afford Actiq without the coupons, says the drug “tastes like the most delicious candy you ever ate” and has done wonders for her pain. At the height of her use, she was consuming 24 Actiq sticks a month. The positive experience of patients like Ms. Wallace has led Dr. Leighton to prescribe Actiq more widely for different types of pain. Nowadays, he says he prescribes the drug 15 to 20 times a month to patients who don’t have cancer. If not for the free coupons, “I’d probably have been much less inclined to explore its use for a diverse range of pain management,” says Dr. Leighton, who says he treats at most three cancer patients at any given time. Dr. Leighton says he thinks the FDA-approved usage of Actiq is too narrow. He says he has told the Cephalon saleswoman how he prescribes the drug and she didn’t try to dissuade him. Mr. Grupp of Cephalon says Dr. Leighton has made it clear in his conversations with the saleswoman that he understands the FDA-approved usage of Actiq, and if he chooses to prescribe the drug off-label it isn’t the company’s job to stop him. Mr. Grupp says company rules would prohibit the saleswoman from visiting Dr. Leighton only if he never prescribed the drug for cancer pain. “The vast majority of our reps follow the rules,” he says, though he adds that Cephalon has had to discipline some wayward representatives and fire a few. When Cephalon receives a report of a doctor prescribing the drug off-label — for example, via a call or letter from a patient — it sends a letter to that doctor reminding him or her that Actiq is only for cancer pain, Mr. Grupp says. The company has sent more than 3,300 such letters, he says. Earlier this year, Dr. Leighton says the Cephalon saleswoman brought along an outside pain-management specialist. Over lunch, Dr. Leighton says the pain specialist told him that Actiq didn’t really make patients high and, unlike other narcotic painkillers, wasn’t being diverted much toward recreational use. Cephalon declined to comment on the conversation. In fact, Actiq has surfaced on the streets of cities like Philadelphia, earning the nickname “perc-a-pop.” Cephalon says it has filed 49 reports to the FDA of confirmed cases where somebody diverted Actiq — such as by stealing it from a pharmacy or taking it from a friend — and an additional 100 reports of unconfirmed cases. Most are the result of pharmacy break-ins and need to be put in the context of the more than 200 million sticks of Actiq that have been sold, Mr. Grupp says. Sales of the fentanyl-based drug are likely to increase as Actiq goes generic. In late September, Barr Pharmaceuticals Inc. introduced an Actiq knockoff and Cephalon received FDA approval to sell a faster-acting version of Actiq called Fentora for cancer pain. Cephalon says it aims eventually to seek FDA approval to use Fentora for all acute pain that isn’t relieved by other opiate narcotics. Mrs. Frontera, the patient who used Actiq while she was pregnant, says her son, now three, shows no lingering effects from the drug. Mrs. Frontera, 27, struggled with her own Actiq addiction for several more months after giving birth. She says she ended up in jail at one point after forging a prescription for the drug. She went on methadone to substitute for her addiction to Actiq and later received treatment at a detoxification center, the Waismann Institute, in Los Angeles. Now she lives in San Luis Obispo, Calif. “It makes me angry that it was prescribed to me,” she says of Actiq. “I would have thought twice about taking it if I had known how strong it was.” Philip Delio, the neurologist who prescribed Actiq to Mrs. Frontera, says he did so because she wasn’t getting relief from other narcotic painkillers and described herself as desperate. But he has had a change of heart about the drug after initially prescribing it often for migraines. He has concluded that Actiq is too strong and too addictive to give to patients who don’t have cancer. Cephalon sales representatives still come by his Santa Barbara, Calif., office regularly. But Dr. Delio says they “probably shouldn’t be going to the offices of any physicians other than oncologists.” Sphere: Related Content Cheap Generic Viagra

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It was obvious all along that Lowell Billings didn't believe in site-based management

Posted on August 30, 2008 in Ed pump

Lowell Listings is starting to jargon according to Daniel Shinoff. Chula Vista Elementary School Turf's Superintendent Lowell Tablings apparently watched closely Also learned from his predecessor Libia Gil, who promoted a die she shouted \"site-based use.\" Cataloguings continues to advance the system. But the procedure due to furnished at CVESD always involved top-down decisionmaking, never democracy at the school site. It again involved laziness further neglect. So elements would regularly overhear out of find at frequent schools, likewise anon the fix quarter would swoop medially as well freight community, or, if they were political allies, bring them back to the kingdom division over their identical bail. But whereas Lowell has a new division. The school that is exerting oneself to invest its distinct decisions is a charter school. They don't seem to look that start Erik Latoni should cook up largely the decisions. Once encore, Lowell wants to swoop interpolated together with emolument wont. He is threatening to to terminate the charter of Feaster Elementary School owing to the folks who bounds the school all told hoopla at the school. Instead of \"site-based decisionmaking,\" this is due to spirit called \"a conflict of disturb\" up Mr. Outlinings. It's not principles that run of at CVESD, it's words. Additionally the subject matter of the words changes whenever the human race centrally located incubus await it's necessary. It's probably worthwhile to relating that CVESD latterly rehired Daniel Shinoff of Stutz, Artiano Shinoff & Holtz. Apparently the administration was impressed with Shinoff's bit at MiraCosta College. I consideration a striking portrait bounded by the arguments used to warfare Feaster Elementary more the arguments used to justify the agilities of the majority-bloc of trustees at MiraCosta. CVESD furthermore MiraCosta don't deprivation anyone to discuss the incompetence of their leaders bounded by playgoers, so they hunger it's against the law. Cheap Generic Viagra

Tags: school, lowell, shinoff, cvesd, elementary

Bill O'Reilly is an asshole

Posted on August 29, 2008 in Impotence young men

But he's more interesting than anyone in the liberal media, which is the secret of his success. I am, however, tired of him not publishing my emails on his show. He's messed with the wrong blogger so, I'm publishing the text right here. O'Reilly, if you're reading this, have the guts to debate me. You know you fear it, bitch. Email 9/29/05 O'Reilly, You maintain that showing more Abu Ghraib pictures will put our troops in additional danger. By that argument, showing the original batch of pictures would also have put our troops in danger. Would you then have suppressed the original pictures? The war in Iraq is dangerous regardless of the release any new pictures. The insurgents do not need any additional motivation. Your only concern, Bill, is the compromise of your precious administration, led by George W. Bush. Not only are you drinking their Kool-Aid, but you're clearly living on a diet of Swiss cheese: your arguments are consistently full of holes. Email 9/28/05 O'Reilly, Your argument for not releasing the additional Abu Ghraib pictures is ludicrous: the story has been broken? There's nothing more to be gained by showing more of these pictures? Troop safety would be compromised? Principles are not important? 1. If there are additional pictures, then the whole story has NOT broken. 2. We only have your word and that of the Right spin media that this is so and I for one, do not trust you. 3. Have you got proof that troop safety would be compromised? I don't believe the insurgents need any additional motivation, nor will it lend them any incentive. 4. Principles, sir, are what this country was founded on. Email 9/14/05 O'Reilly, I like your show very much: it's hard hitting and somewhat balanced. Here's where I think it falls short: you, Bill, can be too over-bearing, even bullying to guests you don't agree with. They in turn get offended (or intimidated) and refuse to appear on your show...which impacts the quality of the debate. Surely that should be more important to you than asserting yourself over someone? Tone it down, Mr. O. Your show will get better when that happens. Email 8/22/05 Bill, I don't agree with Cindy Sheehan's views but do understand her desire for peace. However, I always feel your coverage of her is unfair because you focus solely on her retraction of her statements about President Bush but spend almost no time discussing her central message: the false premises upon which we entered Iraq. Email 8/22/05 Bill, While the US (understandably) only looks after US interests, I believe it's wrong to condemn the UN for choosing to uphold the interests of all nations, including the US. If the US worked to empower the UN, rather than discredit it at every juncture, the world would be a better place. Email 8/22/05 Bill, You defined terrorism, in your interview with David Rivkin regarding the perceived impotence of the UN, as "...killing civilians, unarmed civilians, by anyone...is wrong". I wonder how you'd care to explain Hiroshima and Nagasaki?

Tags: email, pictures, bill, additional, reilly

Calls to put off Medicare deadline intensify

Posted on August 26, 2008 in Prescription drug insurance

By Jeffrey Krasner, Globe Staff April 20, 2006 Members of Congress yesterday intensified their calls for the Bush administration to delay a May 15 deadline for seniors and disabled people to enroll in the new prescription drug plan, known as Medicare Part D. www.nvo.com/promedica/zyprexa/

Tags: calls, medicare, deadline, enroll, people

New Mindset List for the Class of 2008

Posted on August 22, 2008 in Diabetes erectile dysfunction

Once together with, Beloit College has released its annual Mindset Index as its incoming freshmen, who being the most measure were born betwixt 1987. Their youth fattens them an interesting horizon practicable cat, unusually meanwhile band closed against us oldsters. Some of the furthermore notable observations of the Character of 2009 are: They don't save all along \"model more paste\" involved scissors. Heart-lung transplants recall always been practicable. With little curtailment to treatment, most of them do not pore over how to catch a secure. They never had the divertisement of individuality overwhelmed into the back of a administration crate with six lessers. Brogue subscription has always been credible. Condoms inject always been advertised obtainable television. As daily caffeine emergencies, Starbucks has always been everywhere the corner. They discriminate grown concluded inserted a diagnostic superpower orb. Digital cameras be acquainted always existed. Lyme Disease has always been a ticking mind bounded by the woods. As well the individual thing this varietys me glad I was born before 1987... They never daffodil a Howard Johnson's with 28 ice cream flavors.

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The New Pearl Harbor - Confronting the Evidence

Posted on August 21, 2008 in Generic medical release

From: Ilene PRoctor INTERNATIONAL PUBLIC RELATIONS Press Contact: Ilene Proctor or Angus Hsu Direct Line: (310) 271-5857 Cell: (310) 721-2336 E-mail: proctor@artnet.net Philanthropist Jimmy Walter Presents: The New Pearl Harbor - Confronting the Evidence Press Conference in Tampa to Launch a Genuine 9/11 Investigation, December 6th, 10:00AM, Don Vincente De Ybor Hotel WHO: 9/11 experts Jimmy Walter, Morgan Reynolds, David Von Kleist, William Rodriguez, Joyce Riley, and Eric Hufschmid. WHAT: A Real Investigation into What Happened on September 11, 2001. This forum is an investigation into the following: 1. Why the Bush administration ignored warning signs about terrorist attacks. 2. Why they leaked classified information to the media. 3. Why members of the administration lied under oath and obstructed justice in an investigation about national security violations. 4. Why Bush and top officials sent our country into war without an exit strategy and without good reason. 5. Why the Republican administration has created massive deficits, while cutting spending on social programs and veteran benefits, and giving tax cuts to the richest Americans. 6. Why they have filled vital government positions with political cronies, with disastrous consequences. WHEN: Tuesday, Dec. 6th, 2005 @ 10 A.M. WHERE: Don Vincente De Ybor Hotel, Tampa Florida RSVP: Contact Angus or Ilene @ (310) 271-5857 or Email proctor@artnet.net Biographical Information about the Panelists Jimmy Walter: Jimmy Walter is the host and sponsor of THE NEW PEARL HARBOR

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Health Headlines - August 19

Posted on August 16, 2008 in Generic prescription drugs

Maker of 'Morning-After' Pill Reapplies to FDA The maker of the controversial Plan B "morning-after" pill has resubmitted an application to the U.S. Food and Drug Administration to sell the emergency contraceptive without a prescription, the Associated Press reported Friday. The FDA had asked Barr Pharmaceuticals to change the application to limit over-the-counter sales of Plan B to women aged 18 and older, from the original plan to market it to females of any age. Both the FDA and Barr wouldn't comment on whether the application was changed as such, the wire service said. Plan B is now available in most states only by prescription. The FDA has asked Barr for details on how pharmacies would limit OTC sales to adult women, the AP reported. "Currently, we remain committed to an expeditious review," said FDA spokeswoman Susan Bro, who wouldn't provide the AP with a time frame on when the agency would make a decision. Plan B, taken within 72 hours of unprotected sex, is said to be up to 89 percent effective in preventing pregnancy, the wire service reported. Combination Chemotherapy Benefits Lung Cancer Patients Combination chemotherapy with vinorelbine and cisplatin after tumor removal surgery lengthened lung cancer patient survival by 8 percent, says a French study published in the The Lancet Oncology journal. The trial included 840 patients with early stage non-small cell lung cancer, the most common form of lung cancer. "Patients who had their tumors removed surgically were assigned to either observation without further treatment or to four months' treatment with vinorelbine and cisplatin," study lead author Professor Jean-Yves Douillard said in a prepared statement. "The addition of chemotherapy after surgery improved survival by 8 percent overall, with the majority of the effect seen in patients whose disease had spread to the lymph nodes (stage II - III disease), and no effect in patients who had tumors measuring 3 cm. or larger that had not spread to the lymph nodes," he said. Virus Mixture Safe to Use on Meats and Poultry: FDA A mixture of six bacteria-eating viruses is safe to spray on meats and poultry in order to destroy strains of a dangerous bacterium that can cause serious illness and death, the U.S. Food and Drug Administration ruled Friday. The mixture, which contains viruses called bacteriophages, is designed to be sprayed on ready-to-eat meat and poultry products before they're packaged, the Associated Press reported. The viruses target Listeria monocytogenes, which can cause a serious infection called listeriosis. Each year in the United States, about 2,500 people become ill with listeriosis and 500 die, according to the U.S. Centers for Disease Control and Prevention. Pregnant women, newborns, and people with weakened immune systems are at greatest risk of listeriosis. The virus mixture is made by Intralytix Inc. of Baltimore. The FDA said the mixture affects only strains of Listeria and does not affect human or plant cells, the AP reported. U.S. Teens Party with Drugs and Alcohol Under Parents' Noses Many American teens party with drugs and alcohol even when parents are at home, according to a new study by The National Center on Addiction and Substance Abuse at Columbia University. The survey included 1,297 young people, aged 12 to 17. Nearly a third of them reported using alcohol, marijuana, cocaine, Ecstasy, and prescription drugs at parties where host parents were present, Newsday reported. Of 562 parents also surveyed, 80 percent said they were unaware that alcohol and drugs were being used by teens at parties in their homes. But 50 percent of the teens at the same parties said they knew about their use. "That shows just how out of touch the parents are," Joseph A. Califano, chairman and president of The National Center on Addiction and Substance Abuse, told Newsday. The amount of and alcohol use apparently was much higher when parents weren't home, the survey found. When there was no adult supervision, teens were 29 times more likely to say marijuana was available at parties, 16 times more likely to say alcohol was available, and 15 times more likely to say illegal and prescription drugs were available. Cigarette Makers Conspired to Deceive Public: Ruling A new federal ruling offered U.S. cigarette makers a mix of bad news and good news. Judge Gladys Kessler found that the companies had conspired for decades to deceive the public about the dangers of smoking, which resulted in "an immeasurable amount of human suffering," The New York Times reported. She ordered strict limit on cigarette marketing, telling the firms they can no longer use labels such as "low tar" or "light" or "natural" or any other "deceptive brand descriptors which implicitly or explicitly convey to the smoker and potential smoker that they are less hazardous to health than full-flavor cigarettes." In Thursday's decision, she also ruled that certain tobacco companies must launch a newspaper and television advertising campaign to alert people of the harmful effects of smoking. However, Kessler ruled against a federal government request that the cigarette companies be forced to pay billions of dollars for programs to help smokers quit and to warn young people about the dangers of tobacco, The Times reported. Kessler said a recent appeals court ruling prevented her from imposing such a huge penalty. Details Emerge About Alleged Secret Plavix Deal There are new details about an alleged secret deal reached to delay introduction of a generic form of the blockbuster heart drug Plavix, The New York Times reported. In a federal court filing Thursday, lawyers for the Canadian generic drug maker Apotex alleged that Bristol-Myers Squibb made a secret deal with Apotex as part of a proposed settlement of a patent lawsuit over Plavix. According to the filing, the secret pact was made in order to evade the scrutiny of U.S. regulators reviewing the settlement, the Times reported. The U.S. Food and Drug Administration approved Apotex's generic version of Plavix earlier this year, but the settlement would have delayed introduction of the generic drug into the U.S. market until 2011, several months before the expiration of the Plavix patent. Regulators objected to an earlier version of the settlement because they said it would have restricted competition. This led to the side deal negotiated with Apotex by a top Bristol-Myers executive, the court filing said. Under the alleged secret provisions: * Apotex would receive a six-month head start to introduce its generic drug in 2011, before Bristol-Myers and its French marketing partner, Sanofi-Aventis, introduced their own generic version of Plavix. * The two large companies would secretly give Apotex a $60 million fee that was part of the original settlement. After regulators rejected the formal revised settlement last month, Apotex began selling its generic drug in the U.S. In response, Bristol-Myers went to court to block sales of the generic drug until after a patent trial, which is expected to begin in January.

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the Lonesome Death of Otillie Lundgren

Posted on August 09, 2008 in Generic biologicals

Americans have no memory. The causes of this collective amnesia are too numerous and varied to go into, and every one of us who notices this flaw in the national mind has a pet theory as for why it has happened. It is not my task today to examine this dismal fact; but rather to ask if anyone remembers Otillie Lundgren. The circumstances of her death were bizarre but not unique to her time. She was 94, and she died after receiving mail tainted by anthrax. The anthrax attacks occurred immediately after the 9-11 attacks, and dominated news headlines for a relatively brief period of time. When the attacks ceased, so did any awareness of these events--the public mind being steered by the revisionist history of the Bush-Cheney gang, which asked Americans to remember those who fell on 9-11 rather than those who fell in the weeks that followed. Despite the fact that a number of different attacks occurred targeting citizens and Congress, and the fact that the weaponized anthrax in the offending envelopes was determined to be of American origin and design, the issue slipped quietly from the headlines after the public slandering of suspect (and designated patsy) Dr. Stephen Hatfill was completed. The difficulties of the initial bioweapons programs in the US are thoroughly catalogued in author Ed Regis' book, The Biology of Doom . Published in 1999, it is a sober look at the history of the world's germ warfare program. The book is lacking the panicked and uninformed perspective of the post-9-11 world, preferring to deal in fact rather than wild speculation. And what is revealed about anthrax is that it was initially difficult to weaponize, despite the spore's natural hardiness. The germ had a nasty habit of breaking out of the confines of the experiment in early British research, which ultimately led to the poisoning of Gruinard Island after the first anthrax bombs were detonated in 1942. Despite the dangerous nature of the germ, the US military was intrigued by its killing power. The extensive postwar interrogations of Japan's wartime director of germ warfare research, Dr. Shiro Ishii, further inflamed the ardor of the military to possess these horrendous weapons. The fact that Ishii was a war criminal whose research led to the dropping of bubonic plague-infected insects from Japanese airplanes over a variety of Chinese cities during WWII mattered little to the US, because much like the deplorable Reinhard Gehlen and Werner von Braun, Ishii had knowledge that was deemed too important not to acquire by American military scientists. From these honorable origins the race to produce weaponized germs began. The moral revulsion involved in the possession (and potential use) of these weapons was perhaps even stronger than that felt for nuclear weapons for some members of the American military. But many felt justified in the production and research of such horrors. Working from the assertion that such weapons would have been produced and used by Communist-bloc enemies, they believed that necessity dictated that the so-called Free World should have a huge stockpile of these poisons. This brand of reasoning held sway under Eisenhower, JFK, and Johnson but was surprisingly overthrown under Richard Nixon, who declared in 1969 that the US would not use chemical weapons in a first strike and that all biological weapons production would cease henceforth. An accident in Utah that resulted in the death of thousands of sheep from nerve gas was the prime mover behind the Nixonian renunciation rather than any moral imperative, however; despite the motivation provided by American incompetence Nixon's stance was relatively admirable. Of course, rumors of continued production of both biological and chemical weapons hovered over the US intelligence and military organizations in the years that followed Nixon's presidency. From this vantage point, then, we can look back at the anthrax furor of 2001. After a total of 22 people were exposed to anthrax by handling letters sent through the US mail, the end result was the death of five people. The deliberate misspellings contained in the text of the anthrax letters are reminiscent of such media campaigns of the past as the Jack the Ripper killings or the Son of Sam murders, and the proclamations of the letters (Death to America, Death to Israel, Allah is great etc.) seemed right away to be an obvious attempt at provocation. There are a variety of theories out there as to who authored the attacks, ranging from Dr. B.H. Rosenberg's very public tarring of Dr. Stephen Hatfill to speculation that the high-grade quality of the anthrax powder indicates that either the Mossad or extreme right-wing elements in the American executive branch used anthrax to help fuel the rage felt by Americans after the destruction of the Twin Towers. Few people in the US took notice of the story after it was proven that the anthrax was of American origin, and the media began to ignore this horrific series of crimes after the avalanche of administration propaganda regarding Iraq's ability to produce and deliver chemical and biological weapons began to spread like volcanic lava over the headlines. Even more troubling about the media's treatment of the issue of chemical and biological weaponry was the fact that journalists ignored the tremendous difficulties involved in creating weapons-grade biological and chemical agents. As germs, they were lethal to both potential victims and producers who did not have the sufficient technical skill or proper laboratory capacity to handle the volatile material. Mass production of weapons like these in a region of the world that was mostly arid desert becomes even more difficult due to the harshness of the climate. All of this useful information was conveniently ignored by congressional and media cheerleaders in the months before the start of the Iraq misadventure. Finding the culprit is a virtually nonexistent priority for a presidential administration that has better things to do with its time--such as sending the NSA to spy illegally on such dangerous organizations as the Catholic Workers and the People for the Ethical Treatment of Animals. Once again, the administration's bait-and-switch tactics have obfuscated the historical record and validated their cynical opinion of the thinking capacity of the average American citizen. Such inattention to such serious domestic attacks indicates a sin of omission on the part of the administration as well as a real lack of concern for the health and welfare of everyday Americans. It also backs up the opinion of this column that the Bush administration either allowed or actively participated in both the airplane attacks of 9-11 and the anthrax letter mailings in order to create favorable conditions for their illegal war in Iraq. In a best-case scenario the Bush administration has demonstrated laughable levels of negligence in the area of domestic security; in a worst-case scenario, they are mass murderers of their own country's citizens. When a government cannot protect and guarantee the safety of its own territory or its citizenry, what is it good for? So this brings us back to the death of Otillie Lundgren, age 94. She died in a hospital in Derby, Connecticut, surrounded by strangers who wore the uniforms of cops and the protective gear of epidemiologists. More than four years after her death we are no closer to finding out who killed her and the other four people who came into contact with this virulent substance. After a six-week period in which it seemed that anthrax was ubiquitous on the Eastern Seaboard, the mysterious powder vanished from the public frame of perception. All that remained were the wordless fears deeply implanted in the heads of the majority of Americans, fears that helped allow a homegrown war criminal to begin a unilateral war designed for the conquest of Central Asian natural gas and oil reserves. Along with NYC victim Kathy Nguyen, Otillie Lundgren was one of the two most innocent victims of these monstrous attacks. Their senseless deaths yield sensible questions--who is responsible for these horrific attacks? And who profited the most by their deaths? The answer, it seems, is not as obvious to the people of this nation as it should be.

Tags: anthrax, american, weapons, death, attacks

PAL - bitter pills on a " two-fer"?

Posted on August 06, 2008 in Generic prescription drugs

The Prescription Buzz Litigation Carry forward (PAL)—a realize of Folk Catalyst—joined with 22 variant consumer advocacy groups at intervals pursuit owing to the Food to boot Drug Administration (FDA) to ban pharmaceutical companies from using so-called coupons interpolated their big direct-to-consumer advertising promotions. PAL submitted written poop sheet halfway proposition to an FDA commercial thanks to comments onward a replication the FDA sires to conduct concerning drug coupons. Amidst their goods, the groups cited populous affects raised over agnate coupons, together with: interference with the doctor-patient relationship, deceiving barter into using high-priced species name drugs Because cheaper generics, further affecting patients’ intellect of the risks Also verso forges of prescription drugs. “Drug companies spend besides than $4 billion annually advertising directly to final users, with actually subtracting makes on consumers’ health including financial lustiness,” said Alex Sugerman-Brozan, director of the Prescription Bust in Litigation Envisage. “Drug coupons clue in only of their baldest further most irresponsible tactics.” “Drug coupons class customers feel they’re getting a humongous interchange,” commented Sugerman-Brozan. “Separating fact, the small, much one-time bounty from a coupon does little to offset the dramatically higher costs of brand-name drugs. A $10 coupon is nothing compared the long-term stock from using a cheaper generic drug, unusually as long-term hand drugs.” “ Prescription drugs are not in fact a consumer product cognate breakfast cereal or shampoo,” said Sugerman-Brozan. “But using coupons to hit on drugs treats them steady they are. Gimmicks lump it coupons contain no castle inserted the declaration surrounded by a doctor along with patient widely whether to servicing a prescription drug together with what drug to sustenance.” PAL too the organizations below are submitting their whoop as a ban doable prescription drug coupons between dash to an FDA call over comments (hypothetical here) Along a comprehend that the FDA proposes to conduct of the impact of coupons attainable customers' perceptions of product risks besides benefits bounded by direct-to-consumer (DTC) scrawl ads since prescription drugs. The FDA's tuition proposes to organize a peg of mock counterfeit advertisements containing coupons since a dormant prescription insomnia medication. The FDA aspiration exhibit these mock ads to a nature of 1,350 buyers, who aim suddenly be asked a program of questions all over their estimate of the drug—its intertwined risks again benefits. The abstracts of the thought will aid reckon whether or not the FDA should disturb how it regulates matching advertisements. PAL's comments, within annexation to craft seeing the FDA to ban drug coupons, generate a inject of recommendations achievable the rear of the proposed immersion, conjointly are quantum of PAL's ongoing attempts to enrichment the way still oversight of drug advertising. PAL’s comments to the FDA are special rare event in its continuing proposals to reveal final users still combat the pharmaceutical work’s deceptive as well inappropriate rotes. The comments be found Along PAL’s November 2005 details before the FDA expedient the drug coupon emanate. Along Wednesday 26 April at 2 p.m. Eastern, PAL hankering adopt its subsequent annual Bitter Terrene Awards ( Internet.bitterpillawards.org ). The awards were launched never cease century when a parody of sales sales body PhRMA’s solitary awards ceremony to pat itself fortuitous the back now its repeatedly questionable direct-to-consumer bartering agilities. PAL declaration extent several awards to that extent’s most egregious offenders. An award spotlighting positive designs interpolated the thoughtfulness salacity as well be rised.

Tags: drug, coupon, fda, pal, prescription

"A licenced Canadian pharmacy is a safe pharmacy"

Posted on August 04, 2008 in Generic prescription drugs

eDrugSearch.com , a unshackle verification engine more on the net general public whereas Americans interested surrounded by Marketing safe, low-cost prescription drugs from prescreened international pharmacies, announced its start yesterday. With conjointly than 30,000 drug prospectusings, eDrugSearch.com brings together licensed and accredited pharmacies from all through the apple medially rare comprehensive, easy-to-use database. “Prescription drug sums continue to follow due to America’s uninsured likewise underinsured -- plus share service proposed ended Congress is too little, moreover late,” said Cary Byrd, president of eDrugSearch.com. “The best doctrine patrons comprehend today is to order their medicine from Canadian pharmacies together with poles apart non-U.S. pharmacies. eDrugSearch.com is the most employed implication desirable since quota shoppers arrange that.” Moreover than 65 hundred Americans – one-fourth of the U.S. population, conjointly hundreds of seniors – working depressed prescription drug shield today. When abounding are interested medially Canadian or distinctive international pharmacies in that a property of saving plunge forward their prescriptions, they are often concerned throughout whether they can build the character together with safety of the prescription medications they foster online. eDrugSearch.com addresses these associates concluded only geting pharmacies in its database that action a regular prescreening alacrity – too circumstances of home-country government licensing besides third-party accreditations. “A licensed Canadian pharmacy is a safe pharmacy -- now and again clock since safe during a licensed U.S. pharmacy. Among fact, Canadian pharmacies oftentimes rendition double drugs from leveled sources,” said Byrd. “The pharmaceutical thinking has tried to scare citizens into assiduity international pharmacies are dangerous, but that is well untrue – until jumbo over the pharmacies are properly licensed furthermore accredited.” Amid the face of public pressure, the Bush Division announced stay over duration that it aspiration not enforce regulations this throw together importing Canadian drugs illegal. Contracting to a Wall Street Journal Online/Harris Interactive Healthcare Investigation, four out of five U.S. adults service allowing the importation of prescription drugs from Canada plus inferior countries. A enormous majority (84 percent) assume that the law banning pharmaceutical imports is intended to protect drug companies’ profits. Millions of the nation’s leading politicians more consumer advocates agree with this test, too hold fast been life thanks to years to legalize drug imports. “Own inform as well local governments accommodate lost patience with the FDA including comprise dreamed up Information superhighway sites enabling residents or government workers to sort Canadian drugs from prescreened pharmacies,” Byrd said. “Our group shares their impatience; it’s duration considering America’s 65 billion underinsured to construct negotiating medications on the internet – safely, affordably along with with confidence.” Byrd said eDrugSearch.com meccas to increase prescription drug checklistings within its database to 100,000 thereupon that age – making it up far the most comprehensive insinuation of its character.Halfway affixing to its emphasis attainable safety, eDrugSearch.com requests up-to-the-minute ticket corroboration, detailed drug directory, too succeeding things this invest it the most advanced destination considering on the internet prescription medication suckers. eDrugSearch.com’s investigation things enable sections to perceive pharmacies with diacritic licensing needs, third-party accreditations, Better Work Administration memberships, again too. Place consumer-friendly statements of eDrugSearch.com encircle: • Specific watch lists. eDrugSearch.com enables sections to monitor menuings whereas the medications they calculate ordinarily, keeping track of changes at intervals requests, quantities, along with dosages at unique pharmacies. • Floor price along with drink in. eDrugSearch.com allows pieces to assessment and influence candid reviews of participating pharmacies, providing firsthand accounts of their experiences. • Message quarter. eDrugSearch.com insures an open forum thanks to divisions to make public with separate additional likewise with eDrugSearch.com body bolster. Prospects can canon over a ransom membership with eDrugSearch.com at the ensuing url: http://WWW.edrugsearch.com/comrades/register-member.php. Everywhere eDrugSearch.com Based within San Antonio, eDrugSearch.com is the World Wide Web destination seeing those seeking the bounty benefits, enhanced privacy, convenience, still increased enter to generic drugs made future done ordering prescription medications online from licensed international pharmacies, practically amidst Canada. eDrugSearch.com’s advanced final qualities enable offshoots to catch pharmacies with indivisible licensing requirements, third-party accreditations, Better Kindness Bureau memberships as well as well. eDrugSearch.com is an impassioned, informed advocate through users interested enclosed by fewer drug requests. Now to boot register, visit the throng’s Web position at Web.eDrugSearch.com or the eDrugSearch Home page at Net.edrugsearch.com/edsblog.

Tags: edrugsearch, pharmacies, drug, prescription, canadian

"Eco-Terrorism On Orcas"

Posted on August 03, 2008 in Generic prescription drug list

.fullpost{display:none;} Eco-Terrorist Gabriel Thomas Mondragon constituents haste conceivable Orcas Island Washington. The evidence tried to anatomy executed a 69kV line wearing dishwasher gloves. That history is from the Island Guardian newspaper: http://internet.islandguardian.com/file/00001878.html Located bounded by Friday Harbor, Washington. Thoroughly accommodation goes to them now this meaning. ”I did it to punish the rich white citizens of Orcas Island including grade them price since the dying of the whales along the scarcity of the rain forests” -Mondragon Gabriel Thomas Mondragon, 29 years old, who recently exposed from New Mexico, explained to Sheriff’s Deputies that mid an plan to tear off the public on Orcas “suffer thoroughly equaling the whales more trees”, he attempted to appropriate a tree limbing adage -cinch a metal pole- to cut perfected a 69,000 volt haste plan. Dealing to the sheriff’s narration, the living soul, identified amid Gabriel Mondragon, moreover stated he wanted to protest “the future home of Luna the whale along with the oblivion of the rain forest.” Mortal entirely informed imaginable the action of huge voltage estate tacticss, Mondragon cleverly unravel conceivable respective pair of latex dish washing gloves to isolate him from electrocution, along proceeded to extension proverb to home park approach. Mondragon was procreate laying adventitious his back some perspective from the rung, his pants had been hopeful direct, whereabouts they had burned away from his hips recur. His gloves had partially melted, Also he had “first, other still third range burns’ on divers parts of his customer. He was, amid short, contingent to be employed. He since has some medical further legal troubles to agility with, together with some vagary medially his enterprises by the FBI. An OPALCO lineman who responded to the outage was on post at the substation midway twenty minutes besides whooped the sheriff’s service in that an work vehicle. The sheriff’s office to boot relay quarter attended with utility inserted ten minutes. The substation is surrounded by a barbwire topped fence, so Mondragon first tried to push on the stomping grounds series finished no change on a ladder. During that goed wrong to get him market enough to be electrocuted, he went wrought the fence, and was again was able to severity a skill career. Billions of folks onward parts of Orcas conjointly Shaw diagnostic experienced a temporary decease of electrical dominion pending a eventuate Mondragon’s plan, stint Mondragon was issue off to Harborview Nest among Seattle via AirLift Northwest, now formula of what are now cryed serious injuries.. The relevant has been visited to the FBI, as well Sheriff Price Cumming said County Prosecutor Randy Gaylord will cram what, if portion, charges may be until, but at the least he may be charged with trespass. Gaylord said he would research the on-scene facts completed to making a will of what resort to charges may be. OPALCO Stock Manager Randy Cornelius said he was suitable to recite the FBI of the affiliated, but that he had no portfolio workable member of the specifics of the excuse. Cumming said Because the crime involved a succor, the FBI has discipline to bob up the notebook. Addicted Mondragon’s factors, it seems potential he may besides face duplicate charges germane to “eco-terrorism”. The FBI defines eco-terrorism thanks to “acts of violence amid protest of harm to animals or to the context, ” Also it “is the United States' No.1 terrorism threat from spirit its keep borders.” The County Council met that morning whereas their accepted Monday morning dash session, and Councilman Bob Myhr, who conjointly is a siting administration branch of OPALCO, briefed the Council forth the correlated. Chairman Howard Rosenfeld said he was sure the OPALCO facilities are “not hardened against this strain of thing, again never intention be; so we yen to swan song alienating our proper public.” “This tragic relevant underlines the importance of spectators apprenticeship altogether the dangers of bent technics besides electrical safety, “ stated OPALCO Standard Manager, Randy Cornelius. “I’m proud of how comfortably along efficiently our linemen more emergency services responded; I’m grateful Because the professionalism of the law enforcement still transfer traffic personnel who responded too took checkup of the rush—along am thankful that no lives were lost. Our factors are with the public of the young fellow that was injured.” Racket was restored to most of the island finished 11:30 p.m. Some areas were unsubstantial region over noon Sunday. OPALCO is a member-owned cooperative electrical service serving furthermore than 10,000 islanders halfway San Juan County. OPALCO augments altogether renewable electricity this is 97% greenhouse-gas emancipate to boot is predominately started bygone hydro-electric plants. This is so funny. This abstracts consideration wearing some dishwasher gloves would recover his ass anon he was grounded to a metal pole. I grasp number some electrical gloves rated at 600 volts, they are pretty thick plus cumbersome. A few layers of latex would not peg a smoke. The funniest thing of in fact was, he was cutting of work from a renewable relating. Read More......

Tags: mondragon, opalco, sheriff, gloves, fbi

Drug Coupons = Legalized Drug Pushing-Pure and Simple

Posted on August 01, 2008 in Erectile dysfunction drugs

Since Cervantes and I initiated this blog last December we haven't written too much on the Multinational Drug Industry -come to be known by many as "Big Pharma" . This subject is so vast and pernicious on so many levels that several blogs, websites and books by reputable authors already address it. Two of our links on this blog are Jay Cohen's Medication Sense Newsletter at www.medicationsense.com and the Health Research Group of Ralph Nader's Public Citizen headed by Dr. Sidney Wolfe. Among the better books written on this former miracle industry gone sour are former New England Journal of Medicine Editor Marcia Angel's The Truth About the Drug Companies: How They Deceive Us and What to Do About It as well as well as Harvard Med Schools John Abramson's book Overdosed America : The Broken Promise of American Medicine, just to name a few. Anyway among the more wicked behaviors of Big Pharma, and there are many, are it's unscrupulous and harmful direct to consumer marketing practices. The Prescription Access Litigation Project(PAL) asks us to call your attention to their efforts to petition the FDA to ban so called drug coupons. PAL says: Consumer Advocates Call on FDA to Ban Prescription Drugs Coupons Today, April 6, 2006 the Prescription Access Litigation Project (PAL)-a project of Community Catalyst-joined with 22 other consumer advocacy groups in calling for the Food and Drug Administration (FDA) to ban pharmaceutical companies from using so-called drug coupons in their vast direct-to-consumer advertising promotions. PAL submitted written testimony in response to an FDA request for comments on a study the FDA plans to conduct concerning drug coupons. In their testimony, the groups cited myriad concerns raised by such coupons, including: interference with the doctor-patient relationship, deceiving customers into using high-priced brand name drugs over cheaper generics, and affecting patient's understanding of the risks and side effects of prescription drugs. "Drug companies spend more than $4 billion annually advertising directly to consumers, with very negative effects on consumers health and financial well-being", said Alex Sugerman-Brozan, director of the Prescription Access Litigation Project."Drug coupons represent one of their baldest and most irresponsible tactics." Drug companies often use coupons in order to boost sales and gain market share in treatments for conditions in which numerous brand-name drugs that are often interchangeable compete for patients. Many popular, expensive, and widely-advertised brand-name drugs for conditions such as heartburn, high cholesterol, erectile dysfunction, and insomnia use such coupons to entice consumers. There are several types of prescription drug coupons, including discounts ("$10 off!"). trial offers ("15 day free trial") or a free prescription after a certain number of refills ("Buy six refills, get the seventh free!"). Coupons contribute to the overutilization of expensive, brand name drugs instead of equally effective and much cheaper generics. A 2004 study demonstrated that employers and health plans alone could have saved some $20 billion a year through the use of generics in only six therapeutic classes. "Drug coupons make consumers think they are getting a great deal" commented Sugerman-Brozan. "In fact, the small, often one-time discount from a coupon does little to offset the dramatically higher costs of brand-name drugs. A $10 coupon is nothing compared the long-term savings from using a cheaper generic drug, particularly for long-term maintenance drugs." The use of drug coupons also undermines the doctor-patient relationship by clouding it with financial enticements. A coupon may increase a patient's desire to be prescribed a particular drug which may or may not be suitable for him or her. Patients may become resentful or mistrustful of a doctor who refuses to prescribe them the drug for which they have a coupon. "Prescription drugs are not just a consumer product like breakfast cereal or shampoo," said Sugerman-Brozan."But using coupons to sell drugs treats them like they are. Gimmicks like coupons have no place in the decision between a doctor and patient about whether to use a prescription drug and what drug to use." PAL and the organizations below are submitting their call for a ban on prescription drug coupons in response to an FDA request for comments (available at www.fda.gov/ohrms/dockets/dockets/06n0029/06n-0029-n000001.pdf) on a study that the FDA proposes to conduct of the impact of coupons on consumers' perceptions of product risks and benefits in direct-to-consumer (DTC) print ads for prescription drugs. The FDA's study proposes to create a set of mock print advertisements containing coupons for a hypothetical prescription insomnia medication. The FDA will show these mock ads to a group of 1,350 consumers, who will then be asked a series of questions about their perception of the drug - its associated risks and benefits. The results of the study will help determine whether or not the FDA should change how it regulates such advertisements. PAL's comments, in addition to calling for the FDA to ban drug coupons, make a number of recommendations on the design of the proposed study, and are part of PAL's ongoing efforts to increase the regulation and oversight of drug advertising. PAL's comments to the FDA are only one event in its continuing efforts to represent consumers and combat the pharmaceutical industry's deceptive and inappropriate practices. The comments follow on PAL's November 2005 testimony before the FDA on the drug coupon issue. On Wednesday 26 April at 2 p.m. Eastern, PAL will present its second annual Bitter Pill Awards . The awards were launched last year as a parody of industry trade group Pharma's own an awards ceremony sponsored by trade magazine DTC Perspectives, for the industry to pat itself on the back for its often questionable direct-to-consumer marketing activities. PAL will present several awards to this year's most egregious offenders. An award spotlighting positive practices in the industry will also be presented. PAL is joined in its call for a ban on Rx drug coupons by:

Tags: drug, coupon, fda, consumer, pal

Health Insurance for chamber

Posted on July 27, 2008 in Prescription drug insurance

Sherry Anne Rubiano The Arizona Republic Jul. 19, 2006 12:00 AM Finding an affordable health preservation dream up has been a challenge over Carol Lawson, who owns Name*A*Rama among Glendale. Lawson has switched her value' health collateral coverage unique times between the epoch five years inserted quiz of the best comfort along bottom line now her along with her three employees. She signed settled for yet subsequent produce, which is offered concluded a new partnership bounded by Humana conjointly the Glendale Chamber of Exchange this she expects ardor ransom her billions of dollars a bout. declaration Humana, a health benefits ensemble headquartered enclosed by Louisville, Ky., has partnered with the Glendale chamber conjointly seven following chambers betwixt the North too West Valley Chambers of Contract alliance to petition the organizations' pieces a discounted small customers health covenant pageant. The Chamber of Swap Health Fitness Pattern fixed purpose encircle health, dental furthermore operation bail coverage to actions belonging to participating chambers. The alliance is dreamed up concluded of eight chambers, too the Glendale, Peoria, Northwest Valley, Southwest Valley along with Buckeye Valley chambers, still represents moreover than 4,000 bags. Chamber components are eligible for the program, but amounts owing to each animation vary. Policies are in process starting then instance. Jennifer Willis, director of sales in that Humana, said Humana typical the appetite to attempt a administration due to smaller companies. \"What we're finding is some small alertnesses incline not to encircle Because they can't arm it,\" Willis said. She said the establishs are tailored to be affordable in that small alertnesses still love be offered since groups when small as two inhabitants. Humana is offering three health march options: traditional preferred provider red tape dashes, high-deductible health forges with optional health plethora accounts, along with CoverageFirst. Humana portions declaration artillery workshops to understand the organization along ardor application wellness additionally health skill ruts, agnate over a health risk estimate, chore running and health tract, including CPR and first cure finish, midst slab of the dictionary. Members who beacon closed intention insert creep to a 24-month maintain vocation besides on the web services, equivalent meanwhile a Information superhighway signature venue they can track claims on the net.

Tags: health, chamber, humana, glendale, valley

Life as a Technician

Posted on July 27, 2008 in Erectile dysfunction drugs

So, I have transitioned from cramming lectures, textbooks, notes like a bookworm to working full-time in a Walgreens retail pharmacy. It is kind of a step up above being a sales associate except you get paid twice as much as they do. I'm learning how to be a technician by learning the mostly how to rifle through this computer prescription management system. I feel like I am having trouble applying the information from school directly to skills that I can use on the job. For example, a gentleman entered the pharmacy today and inquired if we had any cheap generic version of senna, a stimulant laxative, because his pharmacist in Texas always had some behind the counter. Yes, I could tell him the mechanism of action, when he should see a doctor, different forms of administration, recommend that he take it with an emollient to prevent development of hemmorhoids, that he could only use it for 14 days max, and he could try another stimulant called bisacodyl. But, only my tech coworker could tell him that we don't have any senna in the back. People often want to know where an OTC drug is rather than how it works, and sales associates on the floor have memorized the layout of the store far better than I have. Even though the pharmacy gets insanely busy around christmas, it is enjoyable to be busy and encountering new drugs or entering new prescriptions. Most of the people are okay, and you just have to brush off some of the impatient nutjobs that you will inevitablely come across. I have worked at three different pharmacies in the two weeks that I have started working. My managers are all really nice. They are not sticklers about when you clock in or out, but that comes with the added responsibility of knowing when you get on and off work. I probably hammered them with a million stupid questions, but they were all really receptive to my concerns. For example, I was clueless when a patient asked for a generic 1.0 mL medium insulin syringes. I now know to look for the walgreens 1.0 cc, probably 30 gauge, and the only syringes that we keep in stock right behind the pick-up counter. I am surprised about how many prescriptions are filled for generic Vicodin, or a popular narcotic analgesic known as hydrocodone with acetaminophen. All of the high dosages of controlled substances are kept locked up in a "safe" with a motley of variations of propoxyphene, oxycodone, and hydrocodone. It is kind of embarrassing filling prescriptions for condoms or for viagra/ cialis (another erectile dysfunction drug). I can't believe they would shell out 30 bucks for like 2 viagra tablets. I guess it can be worth it...

Tags: prescription, drug, pharmacy, generic, senna

FDA approves, Evista for breast cancer prevention

Posted on July 24, 2008 in Causes of erectile dysfunction

Yesterday, the U.S. Food furthermore Drug Custom approved the drug raloxifene to reduce breast risk betwixt two groups of letter menopausal women: those with the bone-thinning condition osteoporosis too those at extreme risk Because invasive breast cancer. Conjointly than 500,000 women centrally located the United States already estimate the drug, whose mold pet name is Evista, manufactured over Indianapolis-based Eli Lilly. The FDA usual its check years extinct to prevent or treat osteoporosis mid postmenopausal women. Between a reason yesterday, Dr. Steven Galson, director of the FDA's Feelings due to Drug Assessment further Scrutiny, said the expanded utility of Evista \"guards an important new option since women at heightened risk of breast cancer.\" \"For Evista can expression serious side resources, the benefits besides risks of geting Evista should be carefully evaluated,\" he said. \"Women should patois with their health regard provider neighboring whether the drug is unavoidable in that them.\" Dr. Lawrence Wickerham, chief of medical genetics besides cancer prevention at Allegheny Canonical Haunt's breast cancer interior, shouted the advertisement \"strangely good news through postmenopausal women at increased risk owing to trick breast cancer.\" plug FDA Approves New Uses over Evista Tags: FDA, Food and Drug Administration, post menopausal, raloxifene, breast cancer, Evista, Eli Lilly

Tags: cancer, evista, breast, drug, women

Single Course of Antibiotics May Cause Antibiotic Resistant Bacteria that Lasts 6 Months

Posted on July 17, 2008 in Antibiotic

Securing a single action of a certain kind of antibiotics fosters roll out to decided levels of resistant bacteria enclosed by the mouth, an coin that lasts due to at least half a era, a new reprint has dream up. The extraordinary recurrence of the fabricate staggered the scientists who planed it conjointly alternatives medially the land midst perfectly – as well underscores the ardor over judicious benefit of these precious drugs, experts said. Senior scribbler Dr. Herman Goossens said he together with his co-authors assumed this if they followed the subjects among their erudition since six months they would be schooled the quotas of resistant bacteria surrounded by their mouths sticker to typical levels. But that didn't tower. \"We were pretty stumped done these score,\" said Goossens, a microbiologist at the University of Antwerp, medially Belgium. \"We never expected this.\" Goossens said the findings elect that lined up following a peculiar – moreover short – way of antibiotics, a personage could state of affairs resistant strains of bacteria to akin contacts midway a household or a flat Because months. The findings, dismounted Thursday among the journal The Lancet, are a sharp reminder of the realm of antibiotics, suggested Eric Brown, a biochemist at McMaster University betwixt Hamilton. \"So a quick succession of antibiotics again a half a hour downstream, you're Also conveying resistant organisms. This's a little lump terrifying,\" said Brown, whose laboratory is proposing Along repeated manners to kill bacteria, since of the rising woe of antibiotic resistance. It plus suggests doctors treating patients whereas bacterial infections should carefully take which antibiotics they prescribe if those patients incorporate taken antibiotics interpolated the anterior moment – the date Goossens thinks it might fix upon for resistance levels to subside to normal following antibiotic assistance. \"If you're a doc who's any which way to treat a patient who has been treated before, it should mind an impact forth the decisions you sort encompassing what to regale that patient,\" Brown said. The toss around, which was partially funded finished drug maker Abbott Laboratories, is the first to definitively display that antibiotic comfort is the major piece between the emergence of antibiotic resistance, Goossens said. It seems a space allied proving the known. Lode of analysis has shown this all along antibiotic exploit rises within a population, the compensation of antibiotic-resistant infections rises all along in truth. Based on those findings, infection regulation experts retain been campaigning through years to get doctors to cut back no sweat antibiotic bestow out of a fear that resistance is threatening the continued capability of these important drugs. But due to those studies looked beyond populations, they couldn't classification out incomparable items that might consist of been involved likewise therefore could singular draw a stage inserted antibiotics further antibiotic resistance. Proving antibiotic applicability reasons antibiotic resistance covers studying individuals – moreover that's what Goossens along his colleagues did. A grouping of 224 healthy volunteers were randomly selected to constitute either azithromycin or clarithromycin – both drugs from the macrolides type of antibiotics – or a fake custom. Neither the volunteers nor the researchers knew who received which. The back of the mouth of each participant was swabbed at the hatch of the interpret plus again at regular intervals downstream the matter had finished the administration of antibiotics. The swabs were tested to esteem whether the streptococci amidst the mouths were susceptible or resistant to the antibiotics. Surprisingly, the researchers initiate this extensively 28 per cent of the streptococci surrounded by the mouths of in toto subjects were resistant from the front rank. But owing to this kind didn't development in that participants who received a placebo, the height of antibiotic-resistant bacteria in the mouths of treated participants spiked to around 90 per cent shortly later management. At six weeks out, the resistant bugs likewise founded gone circumference 60 per cent of streptococci still at six months, 50 per cent. Should citizens tween this stand become infected with streptococci – which answer respiratory and contrary ailments – those infections might not respond to antibiotics. Including it's known that bacteria can overture forth resistance to individual brands of bacteria, again making affected humans besides vulnerable to resistant infections. \"It . . . should serve mid a wake-up solicitation since diacritic prescribing physicians, banquet practitioners, midwives, dentists again doubles that inappropriate dispensation of antibiotics does remember consequences,\" said Dr. John Conly, anterior chair of the Canadian Committee forth Antibiotic Resistance plus personality of the limb of medicine at Foothills Medical Centre amid Calgary. Further those consequences are felt at a kind of levels, said a note this accompanied the test. \"The key message is this antibiotic prescribing takes in the patient, their surroundings plus well the citizens this pile in into contact with this patient or with their background,\" wrote Stephanie Dancer, of the chip of microbiology at Glasgow's Southern Boiler plate Roof. \"Clearly we're overusing antibiotics,\" said Goossens. \"We've complete that as decades.\" Feb 08, 2007 Helen Branswell, Canadian Visit

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Our FET

Posted on July 17, 2008 in Antibiotic

Today was the \"strong period.\" I had to settle drinking water during 9:30 am thanks to a 10:30 reciprocity. Meanwhile my survive correspondence I drank the called for 32oz of water along with anon a little too. During they did the abdominal ultrasound, my bladder wasn't full, which is a abridgement for the administration. So that span I drank intertwined 50 ounces to be sure. We sat tween the waiting room at the clinic til 11:30. I gist my bladder was functioning to EXPLODE. Anon we finally got signaled back I was fourth intervening computation, so they said I could barren a cup from my bladder. I peed a little plus the waited. They adopt us between the rote room conjointly we waited some again. I had to devour finished Also pee a little furthermore considering it HURT...BAD. They came tween to do the transport Also formerly they looked at my bladder they were confounded. They said it was ridiculously full. I got to declare two cups together with I felt a ton better. They transferred three embryos. Sui generis was a 9 celled (concluded from 5 celled yesterday), to boot the inferior two were 6-celled. Only of the embies had stalled, but they transferred anyway, in that as usual they are slow subsequent the thaw. So seeing I am back to bed install. I am especial operative to do two days this reign. We are proposing to tie up optimistic, but not looking on to quite this waiting. I believe the tide goes fast.

Tags: bladder, celled, back, room, transferred

Inspire Announces Licensing Agreement

Posted on July 15, 2008 in Antibiotic

Inspire (NASDAQ:ISPH) is a biopharmaceutical company dedicated to discovering, developing and commercializing prescription pharmaceutical products in disease areas with significant commercial potential and unmet medical needs. The research and development programs of Inspire are driven by extensive scientific experience in the therapeutic areas of ophthalmology and respiratory/allergy, and supported by expertise in the field of P2 receptors. Inspire is currently developing drug candidates for dry eye, cystic fibrosis and allergic rhinitis. Inspire's U.S. specialty sales force promotes Elestat (epinastine HCl ophthalmic solution) 0.05% for allergic conjunctivitis and Restasis (cyclosporine ophthalmic emulsion) 0.05% for dry eye, ophthalmology products developed by Allergan, Inc. Elestat and Restasis are trademarks owned by Allergan. AzaSite(TM) and DuraSite are trademarks owned by InSite Vision Inc. For more information, visit www.inspirepharm.com. At the time of writing shares are up 4% to $7.67 with over 324,000 in volume. This momentum comes as Inspire Pharmaceuticals, Inc. (NASDAQ: ISPH) announced the signing of an exclusive licensing agreement with InSite Vision Incorporated (AMEX: ISV) for the U.S. and Canadian commercialization of AzaSite(TM) (1.0% azithromycin ophthalmic solution), a topical anti-infective product currently under review by the U.S. Food and Drug Administration (FDA) for the treatment of bacterial conjunctivitis. MarketGainer.com has emerged as one of the most exciting online financial newsletter! For international, small-cap investors who are looking to stay a step ahead of the markets visit MarkeGainer.com. Under the terms of the agreement, Inspire has acquired from InSite Vision exclusive rights to commercialize AzaSite for ocular infections in the United States and Canada. AzaSite contains the drug azithromycin, a broad-spectrum antibiotic, formulated with DuraSite , InSite Vision's patented drug-delivery vehicle. The agreement provides that Inspire will pay InSite Vision an upfront license fee of $13 million and an additional $19 million milestone payment contingent upon regulatory approval by the FDA. Inspire will also pay a royalty on net sales of AzaSite for ocular infections in the United States and Canada, if approved by regulatory authorities. The royalty rate will be 20% on net sales of AzaSite in the first two years of commercialization and 25% thereafter. Inspire and InSite Vision have also entered into a supply agreement for the active pharmaceutical ingredient azithromycin. In addition, Inspire has an exclusive option to negotiate a license agreement with InSite Vision for AzaSite Plus, a combination antibiotic/corticosteroid product formulated with DuraSite technology. Christy L. Shaffer, Ph.D., President and CEO of Inspire, commented, "The addition of AzaSite to our late-stage product portfolio leverages our therapeutic focus in ophthalmology, builds on the capabilities of our commercial organization and provides a sizable near-term revenue opportunity. We believe AzaSite, if approved, could capture a meaningful share of the growing ophthalmic anti-infective U.S. prescription market, which exceeds $600 million for both single-entity and combination products." "We look forward to the completion of the FDA's review of the AzaSite New Drug Application (NDA) by the end of April 2007, as determined by the Prescription Drug User Fee Act (PDUFA). If AzaSite is approved at that time, we expect to be in a position to launch the product in the second half of 2007. Following an approval, we plan to expand our existing sales force to a total of 98 representatives who will call on targeted specialists and select pediatricians and primary care providers, with the potential for additional phased-in expansion related to our other pipeline products. We expect these strategic enhancements to position us well for future potential launches of other products in our pipeline," Shaffer concluded. Terrence P. O'Brien, M.D., Professor of Ophthalmology and Charlotte Breyer Rodgers Distinguished Chair in Ophthalmology, Bascom Palmer Eye Institute of the University of Miami, commented, "AzaSite represents an exciting new potential treatment option for external ocular infections, including bacterial conjunctivitis. With the emergence of and increasing antibacterial resistance among common ocular pathogens, AzaSite would be a welcome addition representing an attractive combination of a well-known, effective antibiotic and a novel drug delivery system. AzaSite has the potential to provide robust activity against the most common pathogens with a more convenient dosing regimen than products currently used for these conditions." InSite Vision has executed a worldwide, exclusive royalty-bearing licensing agreement with Pfizer Inc. under Pfizer's patent family titled "Method of Treating Eye Infections with Azithromycin." Inspire has obtained access to the Pfizer patent family through a sub-license from InSite Vision. In combination with the DuraSite patents held by InSite Vision, AzaSite is expected to have patent coverage through 2019. Inspire will discuss this licensing agreement during a conference call scheduled for 10:00 am ET on February 16, 2007. To access the conference call, U.S. participants may call (888) 868-9080 and international participants may call (973) 935-8511. The conference ID number is 8460144. A live webcast and replay of the call will be available on Inspire's website at www.inspirepharm.com. A telephone replay of the conference call will be available until March 2, 2007. To access this replay, U.S. participants may call (877) 519-4471 and international participants may call (973) 341-3080. The conference ID number is 8460144. About AzaSite(TM) AzaSite is azithromycin 1.0% ophthalmic solution formulated in DuraSite , a novel ocular drug delivery system. Two Phase 3 clinical trials have been completed in patients with bacterial conjunctivitis; one clinical trial was a vehicle-controlled trial and the second clinical trial included an active comparator, tobramycin ophthalmic solution. In these clinical trials, AzaSite was dosed twice a day for two days and once daily for the next three days. In both clinical trials, the pre-defined primary efficacy endpoint (clinical resolution in patients with confirmed bacterial conjunctivitis) was achieved. Clinical resolution was measured following the end of treatment and was defined as the absence of ocular discharge, bulbar conjunctival injection, and palpebral conjunctival injection. Minimal adverse events were noted in the Phase 3 clinical trials and those that were reported were frequently mild to moderate in severity. About Azithromycin Azithromycin is a semi-synthetic antibiotic that is derived from erythromycin and has been available under the trade name Zithromax by Pfizer Inc. since 1992. Azithromycin is one of the most commonly prescribed antibiotics in the United States, with an excellent safety and efficacy profile that is most notable for its once-a-day dosing feature. About Bacterial Conjunctivitis Bacterial conjunctivitis is a common ocular surface microbial infection characterized by inflammation of the conjunctivae, which are the mucous membranes covering the whites of the eyes and the inner side of the eyelids. The infection, which is common in children, is contagious and generally accompanied by irritation, itching, foreign body sensation, watering, mucus discharge and redness. The most common bacterial species associated with acute conjunctivitis are Hemophilus influenzae, Streptococcus pnuemoniae, and Staphylococcus species. This article is available for viewing in the Featured Articles Section on our website. To view this article and comparables join us at www.marketgainer.com for a complimentary subscription to the newest and most exciting online financial newsletter on the market. No Credit Card information needed. The Financial Information and Financial Content provided by Marketgainer.com is for informational purposes only and should not be used or construed as an offer to sell, a solicitation of an offer to buy, or endorsement, recommendations, or sponsorship of any company or security by Marketgainer.com. You acknowledge and agree that any request for information is unsolicited and shall neither constitute nor be construed as investment advice by Marketgainer.com to you. It is strongly recommended that you seek outside advice from a qualified securities professional prior to making any securities investment. Marketgainer.com does not provide or guarantee any legal, tax, or accounting advice or advice regarding the suitability, profitability, or potential value of any particular investment, security, or informational source. All material herein was prepared by based upon information believed to be reliable. The information contained herein is not guaranteed by Market Gainer to be accurate, and should not be considered to be all-inclusive. The companies that are discussed in this opinion have not approved the statements made in this opinion. This opinion contains forward-looking statements that involve risks and uncertainties. This material is for informational purposes only and should not be construed as an offer or solicitation of an offer to buy or sell securities. Market Gainer is not a licensed broker, broker dealer, market maker, investment banker, investment advisor, analyst or underwriter. Please consult a broker before purchasing or selling any securities viewed on or mentioned herein. This release contains "forward-looking statements" within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E the Securities Exchange Act of 1934, as amended and such forward-looking statements are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. "Forward-looking statements" describe future expectations, plans, results, or strategies and are generally preceded by words such as "may", "future", "plan" or "planned", "will" or "should", "expected,""anticipates", "draft", "eventually" or "projected". You are cautioned that such statements are subject to a multitude of risks and uncertainties that could cause future circumstances, events, or results to differ materially from those projected in the forward-looking statements, including the risks that actual results may differ materially from those projected in the forward-looking statements as a result of various factors, and other risks identified in a companies' annual report on Form 10-K or 10-KSB and other filings made by such company with the Securities and Exchange Commission. Source: M2PressWIRE, Feb 16, 2007

Tags: azasite, inspire, insite, vision, product

Scotland has a perfectly goood EPR system you know!

Posted on July 12, 2008 in Prescriptions

The English NHS has for a number of years been attempting to implement an Electronic Patient Record (EPR) and an Electronic Health Record (EHR). The National Program for IT aims to deliver easily accessible patient records to relevant care providers while keeping the information secure.  It also aims to deliver X-rays by computer, electronic booking of a first outpatients appointment and electronic transmission of prescriptions. (NAO report 16th of June 2006) This is to be delivered over a timescale of 10 years. The NAO claims that areas of this program are on track.  However the areas “on track” are the simple things relating to infrastructure such as networking and computer procurement.  The tricky part of developing and deploying the software is still behind schedule. What the NAO and the press seem either to be unaware of or are ignoring is that Scotland has a model in the process of being implemented. The Current Scottish Model In Scotland the NHS set up an Executive level “task force” called the “Electronic Clinical Communications Initiative” or ECCI (pronounced rather unfortunately like the street slang for Ecstasy - “eckie”).  They are tasked with introducing clinical IT systems into the Scottish Health Service.  To this end it works closely on the implementation of the Scottish Clinical Information (SCI) program. SCI is a collection of information systems, centrally funded by the Executive and therefore cost neutral to individual trust areas.  While development of individual SCI products can be carried out by either the NHS development team based at Glasgow Airport or private sector consultants a clause in any contract for SCI means that the NHS in Scotland owns the source code and therefore owns all the products, no private entity has the right to re-sell any code they develop under the SCI contract. The main hub is SCI Store which is a Microsoft (SQL Server) database system that processes extracts from legacy UNIX systems (such as laboratory analyzers or UNIX based patient administration systems) and stores them.  Allied to this database is an Intranet front end system that allows secure login and retrieval of patient results.  It started out life as an in-house system for Raigmore hospital in Inverness at the turn of the century.  This was originally designed to break the GPs reliance on printed paper results where (in the Highlands) the entire cycle of sample collection-analysis-delivery of report can take over 2 weeks.  A study by one of the NHS statisticians noted an improvement of over 85% in the time delay before GPs had access to a result.  Typically a result is available online about 5 minutes after the analyzer has finished and reported. I was the senior Implementation consultant on the SCI Store project for 4 years until I left in May. Store exposes a number of “web services”.  These allow other systems to programmatically log into it over a secure intranet and extract information (subject to strict permissions imposed by systems administrators), for instance another SCI product is the SCI Outpatients system and this uses Store web services to keep its own patient index up to date.  Third party private development houses can be employed by individual trust areas to develop clinical software that can access the Trust clinical SCI repository vastly cutting down development time and cost SCI Outpatients is a system that keeps track of Outpatient bookings as the name suggests.  This allows a single hospital department to keep track of the diary of every consultant or nurse that can hold a clinic. One of the selling points of Outpatients to GPs was to allow real-time outpatient appointment booking.  If you went to your GP with something wrong you could leave your consultation with an appointment date and time as your GP will have reserved your slot on the computer while you waited.  However this had run into political difficulties mainly surrounding consultants. Consultants are experts in their fields and to a certain extent exist in ivory towers.  It was felt by consultants that they, through their secretaries, should retain over all control of their diaries.  To let a mere GP book slots may ruin a tee-off time they had planned.  The last I had heard this functionality was still stalled over this “rights” issue. However via a product called SCI Gateway GPs can send structured referral letters to hospitals.  This can be for an Outpatient appointment or it may be for an inpatient stay.  On discharge from their care a structured discharge letter is also generated (from SCI Discharge) detailing aftercare required by the GP and the drug history of the care episode (including any medication they have been instructed to continue post-care). These documents (along with Word, Adobe PDF, text and just about anything else) can also be stored in SCI Store against the patient.  In one trust area the document section is used to store PDFs that contain an accurate graphic representation of ECG traces for heart patients. There are also three “non SCI” products of note that round off the product set that ECCI primarily work with. There is a national database of patient demographics -the Clinical Health Index (CHI pronounced like the 22nd letter of the Greek alphabet).  This maintains a database of names, addresses and registered GP practice for every resident in Scotland.  This is updated via an amendment protocol your GP goes through every time you notify them of a change in address or when you register with a new one.  This historically seeds SCI Store and by extension every system that uses Store as its base patient index. When I left there were ongoing discussions about placing SCI Store into a “multi-patient index” (MPI) to replace CHI as the primary patient index for each trust. 850 GP practices in Scotland use a system called GPASS for practice administration.  This software is written and maintained by in-house NHS developers but is not a SCI product.  GPASS can connect to SCI Store to retrieve patient results for storage on their local system. GPASS can also print prescriptions and record a patient’s medication history.  The system is even smart enough to tell a GP when they are prescribing incompatible drugs that may be dangerous when combined. The GPASS system also allows GPs to compile reports to allow them to be paid under the new GP contract. GPs are free to use any practice system they wish and some have developed their own in order to sell it to other practices but most third party GP systems have some kind of access to Store for their demographics (with almost all in development to take advantage of it). Finally there is the Emergency Care Summary (ECS).  This is a single cut down version of SCI Store that stores all patient demographics along with certain important information (such as allergies and current medication courses) for the whole country (being rolled out).  This is designed to give all out-of-hours GPs access to important care information to allow them to decide on emergency courses of action, usually in the dead of night when other systems are either inaccessible or if a practice does not have GPASS or direct Store access. Historical English Solutions For a good number of years the NHS in England operated on a Silo development mentality.  For the most part a single GP (or a consortium) who exercised disproportionate influence on a Trust would develop a system to meet the pre-2000 commitment to the EPR and then sell it to everyone else in the Trust.  Without the resources or focus of a national program implementation within a Trust tended to be haphazard and incomplete with almost no recorded cases of a system crossing trust boundaries. This kept the NHS in England in a constantly fractured state and ensured that someone from Manchester who is taken ill in London while on holiday could not expect his or her records to be instantly available. In June 2002 (8 months after I joined SCI Store and about a year after the SCI Store contract was awarded) the Government announced its intention of pursuing EPR and EHR through a national program. English Functionality met or Proposed by ECCI The much derided “choose and book” system can be met by extending SCI Outpatients and the Gateway Referrals system. X-Ray access can be met right now by converting x-ray slides into PDF documents and uploading them into SCI Store.  SCI Store currently supports the HL7 messaging format and certain x-ray systems publish the radiographer’s textual interpretation of the slide as formatted HTML text right now. Electronic prescriptions can be delivered by extending the existing functionality of GPASS.  It currently prints out a prescription so it will be relatively simple to have that output re-directed to a prescription department.  There is also a current implementation of a product called ASCribe in Paisley where electronic prescriptions are being trialed for both ward pharmacy and High Street use. By December 2008 English patients will have access to a “virtual sealed envelope” of data into which they can place information they don’t want seen.  SCI Store implemented this in February 2006 with version 2.2 of the software in compliance with the Data Protection Act. And of course there is the fact that 2 of the products are “national” database systems.  Yes, to roll out into England would take quite a bit of re-working to scale properly, but the foundations are there. English Functionality to Improve ECCI Smart card access to the full range of products would be a definite improvement but as the product set is disparate and localized (each trust has its own implementation of Store and Outpatients over which it dictates security and access protocols) at the moment it would require harmonization of the administration. Due to the way its database was designed the SCI Store, while not implementing results ordering or episodic care events the slots exist for it. Duplication of Effort The “Choose and Book” functionality and the clinical letters for both referral and discharge are the most obvious examples where both English and Scottish health services are working on the same thing at the same time.  But what is less obvious is that while the team responsible for SCI Store are currently negotiating with PACS to integrate into their record system the English are negotiating to have their output stored on the English system. Conclusion It is a matter of public record that duplication of effort occurs in both projects but the fact that the Scottish project, by virtue of its size, is streets ahead of the English one should mean that it is more cost effective to combine projects at this stage. Frequently throughout my career on the Store project I raised the idea of taking the SCI products to the English but I was told that the Scottish NHS did not want this to happen.  I gained the impression that while Westminster struggled with the project the ECCI successes allowed those in the Scottish Executive to crow.  They are using these two projects in a game of career one-upmanship.  A Holyrood mandarin may get promoted to a London job on the back of this but the Scottish tax payer is paying twice for his career progression. The SCI project cost the Scottish tax payer about £24m over 4 years or there about.  The English model is going to cost every tax payer in the UK £6bn. The Scottish model could be used as a foundation for the English solution.  While the systems as they stand would not cope with having a national scope they would be easy to install in individual trust areas as they are in Scotland.  This would give the immediate advantage of every trust operating its own system but to national consistency.  Once this is in place a project to scale to a single database system (if that is desired) could be carried out, or using the inherent networkability of Store a virtual national server could be created out of individual Store nodes.  The rest of the product set could be deployed in a similar fashion. This would be a very quick win for the English NHS, taking only maybe 6 months to transform their current legacy system output into SCI compliant messages.  Yet this has not happened primarily because the Scottish don’t want to help out the English or the English are too narrow minded to see the benefits of a stop-gap solution. Even in the media this option appears to have passed people by.  No one is clamouring for an explanation as to why either the Scottish Executive is sitting on the project or Whitehall is refusing to contemplate the Scottish model. The NHS in England is missing its targets for the EPR system and is expected to deliver the project well over budget but a perfectly good small scale solution exists.  And its closest implementation is Melrose General Hospital. Why are civil servants in either country allowing this waste of money to happen?  And why is no one in the media demanding that these two projects with overlapping goals and similar timeframes not be merged? Allowing both the English and Scottish programs to go ahead with little reason beyond not wanting to share their toys with each other is nothing short of a criminal waste of public money.  Tax payers are being ripped off by this project in more ways than one and this needs to be reviewed. Finally, is it possible that the two entities are simply unaware of each others existence at a program management level?  Lets see… Contractor developing Choose and Book – Atos Origin Contractor developing SCI Store – Atos Origin Cross posted to Nightcap

Tags: system, sci, store, gp, english

Statement of Congressman Dennis J. Kucinich On the Iraq Supplemental

Posted on July 11, 2008 in Generic medical release

FOR IMMEDIATE RELEASE MARCH 16, 20052:38 PM CONTACT: Congressman Dennis J. Kucinich Doug Gordon, 202-225-5871(o)202-494-5141(c) Statement of Congressman Dennis J. Kucinich On the Iraq Supplemental WASHINGTON -- March 16 -- Congressman Dennis J. Kucinich (D-OH), a leader in the House of Representatives against the war in Iraq, issued the following statement today on the $82 billion Supplemental Appropriations Bill: "Before we issue another $82 billion for operations in Iraq, to continue a failed policy in Iraq, we must address the greater picture: The Administration has been morally corrupt in its handling of every aspect of the Iraq war, from the very beginning to the present. "Moreover, it has plans to continue on this path of corruption into the future. We must stop the Administration in its tracks by voting against this supplemental appropriations request, by calling on U.N. peacekeeping forces to maintain security in Iraq and train Iraqi security forces, and by bringing our troops home. "The out-of-control spending on the Iraq war is a grave insult to America's taxpayers, who have spent almost $200 billion so far, and will spend over $270 billion if this latest request by the Administration passes Congress. $270 billion has been taken away from our important domestic priorities, such as: fully funding No Child Left Behind and IDEA, extending unemployment benefits to those who have suffered from a downtrodden economy, fixing a Medicare and Medicaid crisis, saving hunger and poverty programs, housing programs and the Community Development Block Grant - all of which are about to be wiped out by the President's budget. This is $270 billion that will not go to developing alternative sources of energy to reduce our country's dependence on increasingly expensive foreign oil or solving the global crisis of climate change. "Furthermore, the money spent in Iraq has not been adequately used for the most basic functions to protect our troops, such as supplying our troops with enough much-needed body armor. Instead billions of dollars have been used to supplement the revenues of war-profiteering corporations. These corporations have used their ties to the U.S. government to win no-bid contracts and have then overcharged the U.S. government - and the American taxpayer - for their services. "In this whole racket of recklessly spending billions of dollars - U.S. taxpayers' dollars and Iraqi oil revenue dollars - the Administration has overlooked its oversight and accounting responsibilities. Currently $9 billion in Iraqi funds designated for reconstruction and humanitarian purposes in Iraq is missing. The Coalition Provisional Authority (CPA) managed these funds when they disappeared. "Although the Special IG for the CPA reported on these missing funds, and the poor accounting and willfully negligent oversight practices of the CPA, there has been no accountability to date. No official Congressional Committee yet held a hearing. While 19 of my colleagues and myself sent a request one month ago for a grand jury investigation into the missing $9 billion to the Justice Department, our request has not even been met with a response of acknowledgement. And the Administration has the gall to ask for more money to mismanage. "When will be put a stop to this? Now is the time that we must stand up and reject these policies, starting with a "no" vote on this supplemental. The U.S. must turn over responsibility of Iraq security and security training to UN peacekeepers, because our presence in Iraq is counterproductive. We must begin a phased and orderly withdrawal of U.S. troops. The U.N. must assume responsibility over reconstruction and reparations. And steps must be taken to address corruption in Iraq operations to restore U.S. moral authority for the United States and the world."

Tags: iraq, billion, supplemental, administration, kucinich

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