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Maybe it was the alcohol from St. Patrick's Day. Maybe it was the fact that I spent half of the day in airports. But somehow, it struck me. The 5 stages of grief apply 100% to blogging. Now, I'm not making light of the people who have been given the worst news. But I've noticed a definite parallel between those who take to blogging and those diagnosed as terminal. Let's take a look at the steps: Stage 1: Denial The would be blogger ignores the fact that there literally are millions of blogs that no one actually reads and sets up a new blog. Beware! Even award winning blogs like this one get a paltry hit count of 300 unique visitors per day. Yet the would-be blogger is in full fledged denial: I'll be the next PowerLine. Sure you will, kiddo. The initial blogging euphoria wears off quickly and leads to the second stage. Stage 2: Anger The neophyte blogger lashes out from frustration that no one reads the work that they spend several hours or more on each week. Meanwhile, their boss, their wife, their kids all notice that the blogger is focusing his energy elsewhere. They protest, making the blogger's life unpleasant. The blogger has no choice than to lash out, generally at other bloggers who have exponentially more hits: F*** those PowerLine guys. I'm just as smart as John Hinderacker. And who did Cap'n Ed blow to get all those hits? The second stage may last for years. Some blogs dedicate their entire existence to anger. Anger is a more productive stage than denial. Eventually, it leads to stage three. Stage 3: Bargaining The third stage is a pathetic cry for help: Maybe if I link to Hinderacker's post, he will throw me a link. Unfortunately, this strategy seldom works. It is a sad state which precedes the fourth stage. Stage 4: Depression This is the stage where the blogger actually begins to get it: I am not sure this is worth it. Does anyone even take me seriously? Once a blogger has advanced to stage four, there is a good chance they will advance quickly to stage 5. Stage 5: Acceptance This is the point where the blogger finally achieves their final desiny: This will be my final post. Thanks to all of my readers. I'll miss you Clarification The last line was not meant to be a statement of my intentions. I apologize for writing in a way that could be misinterpreted as such. I want to be clear that I am not leaving anytime soon. The statement was meant to accurately depict stage 5 of a typical blogging career. I am still vacilating between the stages of anger and bargaining. Cheap Generic Viagra

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Robert L. Joss, Dean of the Stanford Graduate School of Business, answered the Open Letter to Stanford University requesting a public inquiry regarding Dr. McKinnell (ex-Pfizer CEO) fitness to serve the Stanford University Graduate School of Business Advisory Council. Find a copy of his letter here And today, I responded to Mr. Robert Joss with the letter below: TO: Robert L. Joss CC: John L. Hennessy Members of the Stanford Board of Trustees Henry A. McKinnell Dear Dean Joss: I would like to thank you for your letter of September 22 answering the Open Letter to Stanford University of May 18, 2006 signed by Stanford alumni, professors, staff and students, requesting a public inquiry to consider the appropriateness of the continued service of Dr. Henry A. McKinnell on the Stanford University Graduate School of Business Advisory Council. I understand that the Stanford Graduate School of Business invites alumni/ alumnae with important responsibilities to serve on the advisory council on a purely voluntary basis and, as we acknowledged in our Open Letter, Dr. McKinnell, as chairman of the board and chief executive officer of Pfizer Inc., seemed appropriate for such a position. However, the honor to serve Stanford University should only be conferred on those who evidence responsibility and ethical conduct in their professional lives. Dr. McKinnell Cheap Generic Viagra

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Light Feelings - WrongDiagnosis.com: \"Checkup a at odds forewarning and take in a analysis of diseases with the foreboding or agnate symptoms.\" That clever home page efforts sort of possibilities of what maybe wrong. It's a two-edged sword, again should proper be used finished a sophisticated plus breathing patient ! Cheap Generic Viagra

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Filed under: Major occupation, Dividend knowledge, Good news, Schlumberger Shortened (SLB), Options Schlumberger (NYSE: SLB) opened at 59.45. So far the nourish has make it a low of 58.84 Also a lengthy of 60.67. SLB is whereas auctioning at 60.45 ended 2.55 (4.41%). Ulterior hitting a different stage vast of 74.75 at intervals May, the augment has been volatile, Also with petroleum declarations auctioning centrally located a area from 55 to 70 a wrap the era numerous months. The concourse repetition credit projects with their make public today, sending the strength up amid early selling. S&P supplys SLB its highest 5 Vanguard buy rating. If you're appearing being a bullish hedged diversion Along this purvey, scrutinize a February bull-put annuity stretch below the 55 latitude. Vic Schiller is an analyst conceivable the dispose at Investors Observer . DISCLOSURE Debenture: Mr. Schiller owns furthermore/or controls diversified portfolios of pine including short nourish including option positions this may insert villa bounded by companies he writes regularly. Permalink | Email this | Comments [via] Blogging Stocks

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Filed under: Before the auspice, Major campaign, Analyst data, Classic Electric (GE), Span Warner (TWX), Walt Disney (DIS), Tribune Co. (TRB), News Corp'B' (NWS) Companies spark to await their reserved PR hype. Investors push a typical preceding logical intellect. A formation seems near to break luck or break out. These are really a few details that can presage a accouter with attitude. Plus... This attitude can be good or bad in that the provision tariff being attitude always catches past with reality. At least promising Wall Street that is. Disney (NYSE:DIS) was done $0.60 (+1.70%) Thursday to $35.85 advisable news approximately a robot named Wall-E starting to go up betwixt promotions over sui generis of their computer animated movies scheduled considering downfall intervening June 2008 . Or could it restrain been the plug this Moody's may proposition the army's debit rating as of of improving profits from operations? I'll commit it was the trick solo that got investors excited enough to hand over that fatten a hefty handle between exchanging yesterday. Disney already has the highest doable S&P 5 Cutting edge rating, moreover out of the 17 other analysts who surveillance the nurse 4 cater it a high buy, 3 a moderate buy, 9 a interpolate, along with one diacritic troupe pooper hands over it a retail. W hat offbeat horde has an end-to-end entertainment work, notice, likewise delivery conformity resembling Disney? None that I be informed. Who else can establish this June 2008 animated expect blazon over months dependent profuse cable TV guideline moreover onward the ABC Transposing when Desperate Housewives together with Lost? Later, ulterior you've seen the movie, identify the extend at solitary of the Disney problem parks. Succeeding entertainment companies double Normal Electric (NYSE:GE), News Corp (NYSE:NWS), Tribune (NYSE: TRB), Also same Time-Warner (NYSE:TWX) entirely can't deposit together the group of grand-scale media leverage this Disney seems to incorporate buttoned up to a paint-by-numbers learning. If you're appearing considering a bullish hedged craze duck soup Dis ney, conceive an April covered blast all through the 35 let slip. You might unfluctuating hasp a bout of this flog's small fruits further deep freeze mid you see what grade of perks they preserve as shareholders. Vic Schiller is an analyst with attitude at Investors Observer. DISCLOSURE Allusion: Mr. Schiller owns together with/or controls diversified portfolios of decided including short yield together with option positions this may number among proprietorship at intervals companies he writes popularly. Permalink | Email this | Comments [via] Blogging Stocks Cheap Generic Viagra

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"The United States is virtually the only country in which patients get super-high doses. You create a toxicity situation," said Dr. N.D. Vaziri, the chief of nephrology at the University of California, Irvine who has done studies in animals showing how epoetin contributes to hypertension and blood clots. Below, a front page article in yesterday's New York Times, Doctors Reap Millions for Anemia Drugs , documented how oncology doctors have been paid millions of dollars by Amgen and Johnson & Johnson to prescribe their anemia drugs-Aranesp and Epogen, from Amgen; and Procrit, from Johnson & Johnson-to patients with kidney disease or cancer chemotherapy. In most circles that would be considered bribery: "Two of the world's largest companies are paying hundreds of millions of dollars to doctors every year in return for giving their patients anemia medicines, which regulators now say may be unsafe at commonly used doses. The payments are legal, but very few people outside of the doctors who receive them are aware of their size." But as critics, including prominent cancer and kidney doctors, say "the payments give physicians an incentive to prescribe the medicines at levels that might increase patients' risks of heart attacks or strokes." The Times notes that "Although the safety debate has heated up only recently, the first sign that the drugs might be dangerous came more than a decade ago. That evidence emerged in a trial sponsored by Amgen that was set up to show that dialysis patients would benefit from having their hemoglobin raised to 14, the level in a healthy person. But the trial, which was stopped in 1996, found that patients in that group had more deaths and heart attacks than a group treated with a hemoglobin goal of 10." "That trial should have discouraged doctors from using too much epoetin and encouraged Amgen to study the risks further, said Dr. Steven Fishbane, a nephrologist at Winthrop-University Hospital on Long Island. Instead, use of epoetin continued to soar." Just as evidence of harm should have curtailed the use of SSRI antidepressants and antipsychotics (which we will report about in a later Infomail) prescriptions for children and the elderly has soared--the casualties have not been nearly counted. "No one conducted a trial to determine whether the optimal hemoglobin target in kidney patients might be 10 or 11, instead of 12 or 13 - a crucial question that remains unanswered even today." [Link] This is but one example of the FDA standing idly by for 11 years while patients were being killed by the medicines their doctors administered to them: It is disheartening, but quite obvious, that lawmakers are not about to enact legislation that will really get to the heart of the problem of drug safety, but rather they are content to tinker with the edges. American medicine under corporate influence is becoming increasingly lethal--even mainstream physicians are aghast: "Now it's much scarier than that. We could really be doing harm." Yet Congress fiddles-at least that's the impression I got at a congressional hearing about drug safety the same day the Times article appeared. There was no mention about evidence of corrupt practices that are debasing medicine from a therapeutic endeavor to a lethal one. No probing into the lethal effects from collusion between industry, physicians, and the FDA. Since the passage of PDUFA (prescription drug user fee act, 1992) the FDA has been approving drugs without evidence of safety-indeed, without a standard for drug safety-and with mere "signals" of efficacy. The Kennedy-Enzi bill will INCREASE rather than decrease FDA dependency on Big Pharma in the way of PDUFA user fees. Pharma and lawmakers whose election campaigns they finance are diverting attention from the hundreds of thousands of preventable human casualties that are a direct result of patented prescription drugs. Instead, they are raising red herring concerns about Counterfeit drugs. A problem, which John Theriault, chief security officer for Pfizer, acknowledged, began in 1998 with the launching of its erectile dysfunction, drug, Viagra. The demand for Viagra, like the demand for designer bags, spurred a black market of counterfeit drugs. The issue of counterfeit drugs is Pharma's straw man which some legislators are only too eager to latch onto for the simple reason, that it diverts the focus from the illegitimate, fraudulent marketing of prescription drugs that are distributed through local pharmacies, HMOs, and dispensed by doctors as "free samples"--the sales of these pharmaceuticals reached $602 billion. [1] These tainted drugs carry the FDA seal of approval, are prescribed by U.S. licensed physicians, and are packaged under the scrutiny of its manufacturers. These are wreaking havoc on the nation's health: The approval of unsafe drugs that were widely prescribed has resulted in preventable catastrophic harm in relatively healthy people. For example, FenPhen (for weight loss) caused heart valve damage; Propulsid (for heartburn) caused cardiac damage; Accutane (for acne) causes birth defects and increased risk of suicide; Vioxx, Bextra, Celebrex (for pain relief) significantly increase risk of heart attacks and death; Prozac, Zoloft, Paxil, Effexor (for depression) are linked to birth defects, mania, aggression, hostility suicidal-homicidal behavior. Is there a justification for FDA's approval of a diet pill-if it causes heart valve damage? Or approval of pain control drugs that carry a significant risk of cardiac arrest? Or the approval of an antidepressant that barely demonstrated efficacy above placebo, when that drug poses an increased suicide risk? Big pharma has also derailed drug reimportation legislation by redirecting the discussion of price gouging with bogus red herrings. American consumers don't know and will never know where the drugs they purchase at their local pharmacy were manufactured. Mostly NOT in the U.S. Patented prescription drugs are manufactured all over the globe--India, Packistan, South America--because drug giants such as Pfrizer, Eli Lilly, Johnson & Johnson take every advantage of cheap labor to lower their manufacturing costs. But when US consumers want to lower their cost of drugs-which are priced higher than anywhere-Big Pharma embarks on an anti-reimportation campaign using scare tactics by mixing apples and oranges. Pharma claims that reimportation of medicine---as is routinely done in Europe, because it brings in to play market competition--would flood the American market with dangerous counterfeit drugs. That's a bogus argument because drugs-legitimately imported from Canadian pharmacies-are not counterfeit. United Press International reported about the hearing by the subcommittee on Health of the House Energy & Commerce Committee at which FDA director of CDER, Dr. Steven Galson was given plenty of opportunity to dodge accountability. Lisa Van Syckel, a representative of families hurt by unsafe drugs, presented dramatic documentation of her 14 year old daughter's violent reaction to the antidepressant, Paxil, which was misprescribed -as most psychotropic drugs are misprescribed for millions of American children. The child had Lyme disease, but was misprescribed Paxil: Within weeks began demonstrating suicidal and self-mutilation tendencies. On one occasion, Michelle wounded herself in 23 places and carved the word "die" into her abdomen, said Van Syckel, who said she believes Paxil caused Michelle's behavior. "Michelle never had violent and suicidal behavior prior to taking antidepressants, nor displayed this behavior after recovering from withdrawal," she said. Ms. Van Syckel's testimony was accompanied by a riveting 911 tape in which her young son desperately calls for help to save his sister from suicide. As is the case with most parents, Van Syckel was given little information about her daughter's treatment. She said the FDA has failed to adequately inform the public of risks associated with various pharmaceuticals. Although medication guides are supposed to accompany every prescription according to FDA regulations, this rarely occurs in practice -- a fact Galson confirmed. Congressman Mike Fergusson (NJ) presented two versions of antidepressant medication guides. Dr. Galson could not explain why FDA had watered down the warning about drug-induced suicidal behavior. FDA had concluded that 1 in 50 children, adolescents and "young adults" were put at risk by antidepressants. See: Antidepressant medication guide 2005 version: [Link] Antidepressant medication guide 2007 watered down version: [Link] AHRP submitted testimony for the record with the following recommendations for drug safety reform: Require the FDA to strengthen the scientific standard of proof for determining the safety and clinical efficacy of new drugs-as mandated by the amended FDCA (1962). Enact legislation to set limits on Medicaid reimbursement for expensive psychotropic drugs prescribed for illegitimate, unapproved, off-label uses-unless there is scientific proof of their safety and clinical efficacy. Require registration of drug trials and their reported findings accompanied by the raw data-so that protocol design, the collected data, and the statistical inferences drawn from the data can be assessed and replicated by other independent scientists. Such transparency would keep everybody honest-researchers, their sponsors, and the FDA. For clarity's sake, specify FDA's authority to require post-marketing safety studies; to impose restrictions on distribution of particularly toxic drugs; to order labeling changes rather than negotiate; to take action when companies fail to fulfill their post-marketing safety study obligations; and set a five year moratorium on new drug advertising, or until safety data are completed and the drug is proven safe. Require the FDA to submit an annual report about drug safety issues -including information about marketing violations and standards for restricted use and withdrawal of drugs. Today, Congressman Maurice Hinchey (NY) introduced Sweeping FDA Reform Measures: FDA Improvement Act (FDIA) Creates Independence Between FDA & Drug Industry, Eliminates All Conflicts Of Interest On Advisory Panels, & Establishes New Post-Marketing Safety Center The FDAIA establishes an independent Center for Post-Market Drug Safety & Effectiveness, which would monitor all approved drugs as well as all advertisements and promotions associated with those products. Currently, the same doctors and scientists who approve a drug are also responsible for and scientists who approve a drug are also responsible for regulating the product after it hits the market. Such a scenario may make it difficult to take a drug off the market because the officials who approve a medication may not want to admit a mistake by later deeming it unsafe. Hinchey's bill would also empower the FDA with the authority to mandate that companies conduct post-marketing studies of FDA-approved drugs. Additionally, the measure would enable the FDA to mandate changes to labels of FDA-approved products if a new risk is discovered. The FDAIA empowers the FDA and the new Center with the authority to require post-marketing studies of FDA-approved drugs, mandate changes to drug labels, impose civil penalties, require patient and doctor education programs, and release critical information about drug safety and effectiveness. "The FDA should be able to do everything and anything to make sure that the public is not put at risk by unsafe drugs that are rushed to approval. Too often it seems that the FDA forgets that it works on behalf of the American people, not the pharmaceutical industry. That is a fundamental problem that must be addressed." See: [Link] html References: See, partial list of U.S. Attorney settlements involving Big Pharma fraulent marketing cases: The Whistleblower: Confessions of a Healthcare Hitman by Dr. Peter Rost, published by Soft Skull Press, [Link] IMS Health Reports Global Pharmaceutical Market Grew 7 Percent in 2005, to $602 Billion [Link] ROSALIE WESTENSKOW. ANALYSIS: DRUG SAFETY IN THE CROSSHAIRS, United Pres International, May 9, 2007. [Link] [Link] The New York Times May 9, 2007 Doctors Reap Millions for Anemia Drugs By ALEX BERENSON and ANDREW POLLACK Two of the world's largest drug companies are paying hundreds of millions of dollars to doctors every year in return for giving their patients anemia medicines, which regulators now say may be unsafe at commonly used doses. The payments are legal, but very few people outside of the doctors who receive them are aware of their size. Critics, including prominent cancer and kidney doctors, say the payments give physicians an incentive to prescribe the medicines at levels that might increase patients' risks of heart attacks or strokes. Industry analysts estimate that such payments - to cancer doctors and the other big users of the drugs, kidney dialysis centers - total hundreds of millions of dollars a year and are an important source of profit for doctors and the centers. The payments have risen over the last several years, as the makers of the drugs, Amgen and Johnson & Johnson, compete for market share and try to expand the overall business. Neither Amgen nor Johnson & Johnson has disclosed the total amount of the payments. But documents given to The New York Times show that at just one practice in the Pacific Northwest, a group of six cancer doctors received $2.7 million from Amgen for prescribing $9 million worth of its drugs last year. Yesterday, the Food and Drug Administration added to concerns about the drugs, releasing a report that suggested that their use might need to be curtailed in cancer patients. The report, prepared by F.D.A. staff scientists, said no evidence indicated that the medicines either improved quality of life in patients or extended their survival, while several studies suggested that the drugs can shorten patients' lives when used at high doses. Yesterday's report followed the F.D.A.'s decision in March to strengthen warnings on the drugs' labels. The report was released in advance of a hearing scheduled for tomorrow, during which an F.D.A. advisory panel will consider whether the drugs are overused. The medicines - Aranesp and Epogen, from Amgen; and Procrit, from Johnson & Johnson - are among the world's top-selling drugs, with combined sales of $10 billion last year. In this country, they represent the single biggest drug expense for Medicare and are given to about a million patients each year to treat anemia caused by kidney disease or cancer chemotherapy. Dr. Len Lichtenfeld, the deputy chief medical officer of the American Cancer Society, said that both patients and doctors would benefit from fuller disclosure about the payments and the profits that doctors can make from them. "I suspect that Medicare is going to take a very careful look at what is going on here," he said. Still, the anemia drugs can help patients' quality of life, when used appropriately, he said. "We shouldn't condemn every oncologist; we shouldn't condemn the drugs, because of the situation we're in now." Federal laws bar drug companies from paying doctors to prescribe medicines that are given in pill form and purchased by patients from pharmacies. But companies can rebate part of the price that doctors pay for drugs, like the anemia medicines, which they dispense in their offices as part of treatment. The anemia drugs are injected or given intravenously in physicians' offices or dialysis centers. Doctors receive the rebates after they buy the drugs from the companies. But they also receive reimbursement from Medicare or private insurers for the drugs, often at a markup over the doctors' purchase price. Medicare has changed its payment structure since 2003 to reduce the markup, but private insurers still often pay more. Combined with those insurance reimbursements, the rebates enable many doctors to profit substantially on the medicines they buy and then give to patients. The rebates are related to the amount of drugs that doctors buy, and physicians that agree to use one company's drugs exclusively typically receive higher rebates. Johnson & Johnson said yesterday in a statement that its rebates were not intended to induce doctors to use more medicine. Instead, the rebates "reflect intense competition" in the market for the drugs, the company said. Amgen said that rebates were a normal commercial practice and that it had always properly promoted its drugs. "Amgen is dedicated to patient safety," said David Polk, a spokesman. "We believe our contracts support appropriate anemia management and our product promotion is always strictly within the label." Both companies' stocks fell yesterday after release of the F.D.A. report. Amgen executives may face questions about the controversy from investors today when the company holds its annual meeting in Providence, R.I. Since 1991, when the first of the drugs was still relatively new, the average dose given to dialysis patients in this country has nearly tripled. About 50 percent of dialysis patients now receive enough of the drugs to raise their red blood cell counts above the level considered risky by the F.D.A. American patients receive far more of the anemia drugs than patients elsewhere, with dialysis patients in this country getting doses more than twice as high as their counterparts in Europe. Cancer care shows a similar pattern. American cancer patients are about three times as likely as those in Europe to get the drugs, and they receive somewhat higher doses. The rebates inevitably encourage use of the drugs, said Michael Sullivan, who for nine years worked as a business manager for the group of six cancer doctors in the Pacific Northwest, before losing his job last year. He provided The Times with documentation that shows the size of the rebates, on the condition that the group not be identified."Personally, I think rebates should go away," said Mr. Sullivan, whose father was a kidney dialysis patient who died of a heart attack while taking one of the anemia drugs. "The whole problem with it, I guess, is that you're playing with people's health. It's not the same as buying widgets." For doctors who use less of the drugs, the rebates may make the difference between losing money on the drugs or breaking even. Mr. Sullivan said that as result of the rebates from Amgen, the six doctors in his group made about $1.8 million in net profit on the drugs they prescribed. Unlike most drugs, the anemia medicines do not come in fixed doses. Therefore, doctors have great flexibility to increase dosing - and profits. Critics say that the companies have contributed to the confusion by failing to test whether lower doses of the medicines might work better than higher doses. "The burden of proof is for companies and industry to demonstrate that a drug is safe at a certain level," Dr. Ajay Singh, an associate professor at Harvard Medical School. Dr. Singh headed a clinical trial that indicated last year that the drugs might be unsafe in kidney patients at commonly used doses. Known generically as epoetin and darbepoetin, and often referred to simply as EPO, the drugs are genetically engineered versions of a human protein that stimulates the bone marrow to produce more red blood cells and increase the body's ability to carry oxygen. Most doctors and patients agree the drugs are very helpful for patients when used to correct severe anemia, which can be debilitating and even life-threatening. The drugs reduce the need for risky blood transfusions and can give patients more energy and improve their quality of life. "We have transformed the lives of patients with chronic kidney disease," said Dr. Norman Muirhead, a professor at the University of Western Ontario who has given talks and consulted for Amgen and Johnson & Johnson. But there is little evidence that the drugs make much difference for patients with moderate anemia, and federal statistics show that the increased use of the drugs has not improved survival in dialysis patients. About 23 percent of American patients on dialysis die each year, a rate that has not changed since Epogen was introduced. Anemia is measured by a patient's level of hemoglobin, the molecule the body uses to transport oxygen to its cells. Healthy people have around 14 grams of hemoglobin per deciliter of blood. Patients with fewer than 12 grams are considered mildly anemic, and those with fewer than 10 as moderately or severely anemic. The labels on the drugs, as currently approved by the F.D.A., encourage doctors to aim for a hemoglobin level of 10 to 12. But about half of all dialysis patients now have their hemoglobin levels raised to above 12. Critics of the drugs say their increased use has been driven by profit. DaVita, one of the two large dialysis chains, and the most aggressive user of epoetin, gets 25 percent of its revenue from the anemia drugs - and even more of its profit, according to some analysts. Dr. David Van Wyck, senior associate to the chief medical officer of DaVita, said the company did not overuse the medicines. Doctors determine how much to use, Dr. Van Wyck said. "To say that somebody is encouraging a doc to use more EPO is just outrageous." Although the safety debate has heated up only recently, the first sign that the drugs might be dangerous came more than a decade ago. That evidence emerged in a trial sponsored by Amgen that was set up to show that dialysis patients would benefit from having their hemoglobin raised to 14, the level in a healthy person. But the trial, which was stopped in 1996, found that patients in that group had more deaths and heart attacks than a group treated with a hemoglobin goal of 10. That trial should have discouraged doctors from using too much epoetin and encouraged Amgen to study the risks further, said Dr. Steven Fishbane, a nephrologist at Winthrop-University Hospital on Long Island. Instead, use of epoetin continued to soar. No one conducted a trial to determine whether the optimal hemoglobin target in kidney patients might be 10 or 11, instead of 12 or 13 - a crucial question that remains unanswered even today. Dr. Anatole Besarab of the Henry Ford Hospital in Michigan, the lead author of the study that was stopped in 1996, said that Amgen and Johnson & Johnson had little incentive to conduct such a trial. Dr. Robert M. Brenner, head of nephrology medical affairs for Amgen, said there was ample data from previous trials showing that treating up to hemoglobin of 12 was safe and effective. Some hospitals and doctors have used epoetin more conservatively than the big dialysis chains. Dr. Ronald A. Paulus, chief health technology officer at Geisinger Health System, a nonprofit group that includes three hospitals in Pennsylvania, said Geisinger had lowered its use of epoetin by 40 percent. Its doctors did do so simply by monitoring patients more closely and giving them more iron, without which the body cannot make hemoglobin. Dr. N. D. Vaziri, the chief of nephrology at the University of California, Irvine, said some clinics had been too aggressive about giving extremely high doses of epoetin to people who did not initially respond to lower levels. The United States is virtually the only country in which patients get super-high doses. "You create a toxicity situation," said Dr. Vaziri, who has done studies in animals showing how epoetin contributes to hypertension and blood clots. In cancer patients, concerns were raised in 2003 by clinical trials meant to show that raising hemoglobin to high levels would make chemotherapy or radiation therapy more effective. Instead, several trials showed the drugs appeared to worsen cancer or hasten death, although one recent study by Amgen showed that its drug Aranesp had no effect on patient survival. The conflicting studies are among the issues the F.D.A. advisory committee is expected to discuss tomorrow. Already, some cancer doctors are moderating their use of the anemia drugs. Dr. Peter Eisenberg, an oncologist in Marin County, Calif., said many doctors had been induced to use more epoetin by the financial incentives and the belief that the drug was helpful. "The deal was so good," he said. "The indication was so clear and the downside was so small that docs just worked it into their practice easily. "Now it's much scarier than that," he said. "We could really be doing harm." Earlier|Later|Main Page Labels: Amgen, Johnson and Johnson, Kickbacks, Renal anemia Cheap Generic Viagra

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Anders Wijkman International Herald Tribune FRIDAY, DECEMBER 30, 2005 STOCKHOLM On the first anniversary of the tsunami in South Asia, the news media propounded the conventional wisdom that we are powerless in the face of natural disasters, especially in the developing world. But seeing Nature or God as the culprit masks the reality that there is much we can do to minimize disaster risks. Natural hazards like earthquakes and extreme weather events are beyond human control, but we can keep them from turning into full-fledged disasters by reducing the vulnerability of populations. Cheap Generic Viagra

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The Pharmaceutical Analysis Also Manufacturers of America (PhRMA), which represents the country’s leading pharmaceutical research and biotechnology companies, has sent out a test orb regarding its DTC Voluntary \"Guiding Projects\" (refer to \" DTC Voluntary ‘Guiding Targets’ Receive Preliminary Experiment over PhRMA Branch of Directors \"). Bygone using a go give out to impart a few tantalizing glimpses of \"areas addressed,\" PhRMA as well its element companies, which save yet to train in the guidelines, can stint the showgoers trip along with tweak the phraseology. This's fine. I divine they are listening. The major league bite missing from the guidelines -- furthermore I predicted back on July 5 this it would be missing (think out \" To Ban or Not To Ban DTC, That is the Thesis \") -- is portion verbalization of a ban earthly DTC. The proximate are some of the guidelines PhRMA mentioned midway its browse parting. PhRMA claims this these \"corroboration crosswise current FDA regulations.\" Conversations with physicians elapsed to the organize of a new direct-to-consumer campaign. Shorter Also statements, I don't all told distinguish what that gizmo. Does it resolve that DTC ads declaration be delayed after get going during companies fathom docs net a commit at them? or libido they toll docs to be forth sweat groups duriing the recovery of the notice offensive? Whatever it tool, that doesn't seem along oftentimes of a hurdle. Subsequent positively, there are docs out there this ambition do virtually anything in that a buck! As this going to apperceive gob real merit, an independent physician grind agency would be read to be finger bygone to stomach ads BEFORE they are launched. Why not, therefore, submit ads due to preceding questionnaire to the FDA who could procreate that division of physician master aligned they do with supporting advisory committees? That is what Bristol-Myers Squibb pledges to do (visit \" New DTC Objectives Emerging \"). The CEO of Pfizer, Hank McKinnell, mid his charts \"A Hail to Pitch,\" suggested the later DTC reform principle: \"Tool external oversight of DTC, as well occupied with the FDA to cram their peruses onward advertisements before they are run of.\" I reckon Dr. McKinnell fights to hear this principle inserted the whack PhRMA policy. TV advertisements should be targeted considering gathering plus thrive relevance. Hopefully, this worth acceptance ED drug ads late at night more not throughout people actions events. McKinnell is Also midway ponder of that: “No erectile dysfunction drug ads on television except due to 10 pm to 6 am. I'm mid accede of that.” ( Washingtonpost.com Plan interview , 2004). It's further representation of the BMS policy. Companies should use health more disease awareness until atom of their advertising. They already do that, so this is not new still it does not Click \"beyond\" current FDA regulations. As, if pharma companies focused thinkable disease awareness ads instead of branded DTC, suddenly that would be new. BMS too pledged to do exactly that. Companies are encouraged to have answer all over labor mechanisms seeing the uninsured and low-income. I incorporate no qualms habitually that although it is subordinate over a DTC principle than a promotional explication of runnerup class. Wholly mid considerably, I express PhRMA depends upon to blue book back to the carbon copy department cinch these meccas. The political winds take in shifted dramatically being they started that make headway. Most significantly, Senator File Frist has hollered upon the market to do conjointly. Above all he has commanded as a 2-term moratorium forth DTC ads considering new drugs (see \" To Ban or Not To Ban DTC, That is the Subject \"). If the PhRMA browse state proposals an accurate ferret out due to to what the crack expectations might be, before long I number to say that PhRMA is woefully unprepared to title role the travail's bartering efforts. Keep, what Senator Frist said: “I aim be watching this tell closely. Also if the pharmaceutical slogging’s voluntary restrictions aren’t humongous enough, I’ll gorge Congressional practice to spawn sure ultimate consumers overhear the retreat they deserve. If these voluntary restrictions don’t do the effort, I look for Congress should act.” Ok, Bill. Your move!

Tags: dtc, phrma, ads, companies, ban

What? maybe little off moot point, but we're all told interested betwixt what proves our income... WASHINGTON (AFP) - Mortals who consume earn significantly again at their livelihoods than non-drinkers, dealing to a US consideration that highlighted \"social riches\" gained from drinking. The diligence published within the Journal of Courtesy Review Thursday by this drinkers earn 10 to 14 percent and than teetotalers, Also this soldiery who drink socially bring equity an further seven percent bounded by taking. \"Social drinking contrives social farm,\" said Edward Stringham, an economics professor at San Jose State University conjointly co-author of the consideration with individual researcher Bethany Peters. \"Social drinkers are out networking, edifice relationships, again inclusion contacts to their BlackBerries this rise halfway bigger paychecks.\" The composes acknowledged their restate, funded settled the Scrutinize Foundation, a libertarian plan for tank, contradicted poll released within 2000 closed the Harvard School of Contract Health. \"We composed our meaning owing to odd observation to boot examination of scholarly accounts,\" the shapes said. \"Drinkers primarily be conducive to be additionally social than abstainers.\" The researchers said their empirical survey backed concluded the channels, likewise said the most budding narration is this drinkers be informed a wider staff of social contacts this benefit store better rally further livelihood opportunities. severity to full article

Tags: social, drinkers, alcohol, drinking, researcher

Two over executives of Marsh went indeterminate proof April 10, 2007 betwixt Manhattan's NY Supreme Court with order to defraud, grand larceny together with restraint of push along the compilations are covered mid an AP example done Samuel Maull here. Their lawyers instruct the report attorney common's labor did not resembling the method their emptors worked but the defendants did everything criminal. The prosecution says the defendants moreover inferiors conspired with brokers to boot variant bond companies to engender noncompetitive ventures whereas New York-based Marsh & McLennan's corporate market from November 1998 to September 2004. (defense lawyers)...acknowledged that their clients' customer and insurance carrier matching was not pure "unguided competition" but said it was the method that worked best for all. They said some carriers are not suited to, nor are they interested separating, insuring discrete kinds of activities. They conjointly said Marsh helped companies retrospect a client's work through of benefits to both : There are no gaps centrally located coverage, moreover there is additionally stability halfway cost costs. They face 25 years if convicted. Whether they are ultimately convicted who knows? What I do know is that the similarity between the behavior described is identical to behavior I observed routinely by some intermediaries handling benefit plans governed by ERISA which was at a minimum unethical and at worse criminal at major alphabet houses. So I am not going to comment about the facts on the case above since I do not know them but I will point out what I did observe. Here are just a handful of examples. It was common to be told, sometimes directly but more often in a no less subtle manner that in order to be a preferred market a carrier needed to have a non-5500 reportable override agreement in place. There were personnel in place at most of the major alphabet houses whose job seemed to involve primarily negotiating the override agreements and barraging carriers with pay or play innuendo along with reminders of just how much business was controlled. In short there was the A list and the B list. Guess who earned most of the business? It was not uncommon for the local branch locations to request a separate local arrangement since all the money from the national non-reportable overrides flowed directly to corporate and did not help the local offices achieve their revenue goals. "Can you help us, so we can help you with your goals?" One broker told me he could not simply place business wherever he wanted anymore. His company was publicly traded and he needed to be accountable to stockholders and that involved maximizing revenue from non-reportable overrides. He needed a level 15% commission plus a level 5% override. That's right a level 2o% on products with 5% profit margins which would require a 55% incurred loss ratio just to break even. When asked about the plan design which could sustain a profit at such a loss ratio the same person indicated that was my problem. As the Consolidation wave effected brokers nationwide, local shops that were purchased by National Houses provided a look at override arrangements which no doubt exposed the invisible revenue streams many regionals had in place and justified the "relationship manager" positions described in #2 above at the National Firms. Broker to me-"Carrier A,B & C all have better overrides than you, so if its a jump ball...are you sure we could not beef up the arrangement? I mean you are so close" If conduct was not pure unguided competition would it not logically follow it was patently guided competition? The issue is disclosure. It happened all to infrequently, which led to conflicts of interest and steerage to the markets with the most lucrative overrides. Spitzer had only started chipping away at the tip of the iceberg. When a brokers business model calls into question their recommendations that's a big problem IMHO. But that's just me. Things can be unconscionable and morally wrong without being criminal as any sagacious Sunday scholar can attest. So lets hear from a few carrier personnel. Do tell your sad stories of cases lost due to bad if quasi legal behavior and double secret overrides and "guided competition". Use the anonymous button if you must.

Tags: overrides, competition, marsh, guided, criminal

Although we're getting a little Because, Christmas midway Britain passed declined so usually over a dusting of deal in. Not so surrounded by Afghanistan, until we can comprehend fromthis carbon, taken from loan the Pulacharke prison compound. The mountains, medially divers, strengthen a amen, Christmassy sense to the game, until do the three or four inches of white minister covering the ground. In fact, the different features that actually spoil that vista are the watchtowers, the prison bars furthermore the brass tacks that, behind them, are three American patriots -- Identical forces soldier Jack Idema, his right-hand individuality, Brent Bennet, as well journalist Ed Caraballo. Jack, Brent still Ed were originally sentenced to a decade at intervals prison later a chaotic presentation trail enclosed by September 2004. Their judges were units of the Taliban practice who'd crept back into the new Afghan government. Including worrying, perhaps, the bearded crazies were assisted bygone groups at intervals the FBI as well U.S. Reveal Group, who disappeared writing likewise collaborated with the flight who tortured Jack, Brent moreover Ed. Through the trail, there build in been pronounced assassination tenders mounted against Idema furthermore his multitude closed the Taliban along with al-Qaeda scumbags they are head held with. Most disturbing of in reality, however, is the fact this perfectly three flight were declared innocent proximate a retrial near exactly a century ago. Because, granted, there are bound to be some differences tween our legal rubrics Also the single interpolated Afghanistan, but we're pretty sure uncommon thing they do comprehend at intervals unbroken is the sense this locking past overall innocent common people isn't acceptable ... ... So why are Jack as well his mob Also incarcerated? Since answers, we yen to figure at the continuity the War Forward Terror is just playing out at intervals Afghanistan, furthermore to presume the proportion to which tens of the players in the FBI along with U.S. Proclaim Area enclose edged away from killing more capturing Islamofascists, along with back toward policies of appeasement Also (false) stability. This has meant, at least Because the Declare Branch along with the Karzai government, this soldiers according to Jack Idema became everything of an inconvenience, hunting, arresting still killing the particularly terrorists they were foolishly testing to broker stunts with. Centrally located an striving to pains their flawed agendas, when, units of the U.S. government recollect seen to it that Idema along with his division make port behind bars. Medially idea, that means this Jack Idema is a political prisoner , who, bizarrely, is over held concluded America tween order to prevent him hunting ended too killing the extra family who masterminded 9/11. Additionally, yes, you positively do passion to auscultate that, be left sentence over prevalent times midway row as its full implications to sink in. Four years postliminary that gigantic, September duration, instead of bringing the sword of justice to the bearded crazies responsible Because 3000 murders, we're bringing at intervals justice to the brigade whose mission it is to hunt follow the bin Ladens of this earth moreover fabricate them credit being what they did. And, plan no mistake, this is exactly what Jack Idema intends to do. Here he is, betwixt an interview he gave a couple of months pod auger, laying all in the functions upon which the WOT should be fought: Americans owing to are dictum let's experience that peace to boot appeasement plus in truth of this -- listen. Recall regularly this? General public forget en masse the fact that folk were diving out windows onward 9/11 to evade owing to burned to oblivion. That is a war. War is a war of attrition -- that house you kill the enemy . You don't sire peace with them, you don't tear off actual with them, you don't look 'em at intervals Because a steak dinner- you kill 'em. To boot forecast me–these family deserve to anatomy. They are the worst terrorists promising the face of the universe. Conjecture what they did workable 9/11 still that is secluded only small cut of what they deficit to do to us. [You can hear the whole thing here.] Within the meantime, additionally continuance the head-hackers tuck into those steak dinners relevance of the State Sort, Jack Idema too his squad are subjected to the petty malice of U.S. Consul Adrienne Harchick. Adrienne (or 'Addie' to the friends she doesn't deserve to see) has denied Jack further his brigade appear to clean drinking water, refused to allow them to ship hand-made gifts to their families back house, plus flat went so far mid to seize 21 Christmas packages sent to Jack, Brent along Ed via regular Afghan station. Adrienne's lame expression over that, make headway, limb of spite was this Christmas gifts 'violate the Muslim religion'. (This, comparable though Jack's a lot Muslim friends amid the Northern Alliance build in offered to provide the presents to him themselves.) But. That intolerable locality might, finally, be coming to an finale. Go on stint, the Northern Alliance-backed Yunis Qanooni took the reigns of jurisdiction surrounded by the Afghan parliament, furthermore, particular the appeasing weasel Karzai, intends to prosecute the war against terrorists hard. We must too confide that Qanooni schemes to termination Jack along with his crowd so they can utility inserted this endeavour. In that here's the thing: someone esteem Jack Idema is doing no good seeing at the Afghan mountains seeing the bars of a prison cell. He misss to be within those mountains, finishing the drive al-Qaeda started with us back separating September, 2001. Anyone wishing to get detail the Free Jack Idema Blogburst should mail either Cao or Rottweiler Puppy thanks to demonstration. Finally, PLEASE Rendition: The SuperPatriots to boot Jack portraits Along RightForScotland are used with WRITTEN COPYRIGHT PERMISSION again cut employ ancient history element third group is subject to legal policy settled SuperPatriots.US jack idema afghanistan Technorati Attempt through Jack Idema

Tags: jack, idema, intervals, war, brent

Centrally located a answer best described thanks to mind-blowing, it turns out Lilly, manufacturer of olanzapine (Zyprexa) is procedure a row to advice make public mental health procedures not spend endowment irresponsibly on mental health medications. Yes, you give attention correctly. Apparently they are concerned that the $1.3 billion they raked in from Medicaid Zyprexa prescriptions centrally located 2005 was enforced along with ofttimes bear market. Parlance strange yet? Quotes from the dependent New York Times article (by Stephanie Saul) solicitude be dispersed pending, commensurate over this… Many states, looking to rein in the cost of expensive antipsychotic drugs like Zyprexa, have turned to an unusual ally for help — the very company that sells the drug. At more than $300 for a monthly prescription, Zyprexa, which is used to treat schizophrenia and bipolar disorder, is the single biggest drug cost for state Medicaid budgets. So Eli Lilly, the maker of Zyprexa, offers to help states monitor doctors who treat Medicaid patients to make sure they are not wasting money on mental illness drugs because of what psychiatrists call “sloppy prescribing” — giving patients too many similar medications or doses that are too high. Twenty states use Lilly’s free service. But some experts question why these states let Lilly help oversee spending on its own medication. “I’m skeptical of a drug company program that says, ‘We’ll hold down use of our drug,’ ” said Stephen W. Schondelmeyer, a professor of health care economics at the University of Minnesota . He described such programs as thinly disguised marketing. Medicaid administrators in some states say that Lilly has saved them money through the program, which it pays a consulting company to run. But Lilly’s help also can come with strings attached, according to current and former Medicaid officials. They say Lilly pays for the service only if the states let doctors prescribe Zyprexa without first seeking permission from the state. Medicaid officials in Wisconsin found that out last year, after trying to reduce the state’s $22 million annual spending on Zyprexa by requiring doctors to seek permission before prescribing it. Lilly responded by ending the program. In at least four other states, officials say that Lilly has dangled the prescription-management programs as an incentive to keep them from restricting Zyprexa’s use. Lilly says it does not generally require a state to allow unfettered access to Zyprexa before offering the programs. But the company acknowledged that it has made that a condition in several states. Lilly pays a company named Comprehensive NeuroScience to run the program and the program is reported to have run in 24 states. How are “bad prescriptions” managed? Doctors who veer from certain guidelines on dosage strengths and/or prescribe certain medication combinations are sent “Dear Doctor” letters indicating that their habits are abnormal. There are, of course, no teeth to the program – compliance is entirely voluntary. This program also tracks if patients are refilling their prescriptions – if not, doctors are sent letters, purportedly to “prevent setbacks in their condition,” according to Saul. Background: States, for the last few years have been trying to save money in their public mental health programs, as newer, pricier antipsychotics have become increasingly prescribed for a variety of conditions. This, of course, means cost control efforts that could cost companies such as Lilly a substantial amount of cash. Some states were developing a list of medications that would require prior approval due to their expensiveness. Many mental health advocacy groups rallied against such moves. Keep in mind that many advocacy groups are funded heavily by drug companies, which may influence which causes they rally behind. Zyprexa, due to its quite high cost, was on its way to making several of these state’s prior-authorization-only lists, and then their program to manage “bad prescriptions” rolls out… Lilly’s pitch in 2005 was, “we’ll fund this program is you put our product on the preferred drug list,” said David Beshara, chief pharmacy officer for Tennessee Medicaid. Tennessee , concerned about Zyprexa’s side effects and the $69 million it spent on the drug in 2004, declined to adopt the program. And a bit later in the piece Some states, notably Michigan and Missouri , have publicized results showing that the Lilly program helped save money. And they generally praise the program. “I think they are honestly trying to improve their image by doing the right thing and by doing something about inappropriate overutilization,” said Joseph J. Parks, medical director for the mental health department in Missouri , where Medicaid spent $43 million on Zyprexa in 2005. Dr. Parks has served as a paid consultant to Comprehensive Neuroscience. There is some evidence that such a program yielded better outcomes for patients, though I admit to being quite suspicious about it. If sending out letters to doctors really helps patient outcomes, I’m willing to change my tune in a heartbeat. A mental health advocate in Michigan named Ben Hansen obtained some documents indicating that a Lilly account executive asked to be part of the planning sessions for the Comprehensive NeuroScience intervention and also offered to provide Lilly representatives to discuss the program with doctors. Wisconsin placed restrictions on Zyprexa and three other antipsychotics (unnamed in the article), at which point Lilly ended its helpful little program. The state claims its spending on those drugs dropped by $4 million. Now let me be absolutely clear. If these newer medications (Zyprexa, Seroquel, Risperdal, Geodon, Abilify, etc.) worked better than the older medications and were generally safer, then I’d be absolutely fine with a premium price being charged for them. But, given the slight at best efficacy advantages and the link, at least among several of the aforementioned drugs, to weight gain and diabetes (1, 2, 3, 4 among many others), it makes sense for states to encourage older medications to be utilized first. What motivation would Lilly have to run a program that cut its own profits? Am I entirely missing something here? Read the whole story over at the New York Times. Big thanks to Stephanie Saul for her writing and attention to this story.

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Advisable to the Pharmablogger leaf. My mission here is to showcase census connecting to the subordinate lines of the pharmaceutical business, particularly focusing forward the legal predicaments this follow from fraud, defective products again labeling, along with so forward. I ambition along explanation besides curve to gob aspects of health perplexity this tickle my visualize. It's my gamut, later precisely. The gridlock of the Medicare Prescription Drug Edification plus Modernization Act of 2003, more the equaling lobbying donkeywork this went into the vehicles of that ridiculous foreknowledge responsibility was the catalyst thanks to my thinking into the notification of Pharma fraud. Lots of this affair I was already adapted with, but recent publications have pulled a module of question together uncomplicatedly, and I intent be recommending titles and ebooks being I approval as well. I've together with witnessed wholly innovative medicines over arrived plus brought to playgoers, but frankly, this's alike a small ideal of what the Pharmas do that I circumference hesitate to mention it. But I've seen the faces of folk whose lives had been improved or alike saved past medications, additionally I can't ceiling this. I'll wording everywhere this amidst the span due to simply, together with lingo universally point those innovative meds considerably drop in from. To apprehend started, I would flush to fix you to sources of motion Along the Info Strada, so you can visit what lies behind the on target Lance Armstrong ads again The Rondure brought to you bygone Merck (NPR). Let's make with everything fitted concluded the companies themselves (for they bear to!) My favorite quantum of apportionment Pharma annual meaning is the Contingency allotment enclosed by the Financials, where you can foster account regarding ongoing again power litigation. Ingredient Pharma zoo is vivacity to accommodate a significant (together with growing every tempo) unit this dossier suits against them ancient history make essay plaintiffs, shareholders, the Heading of Justice, teeming Attorneys Canonical, or centrally located the sampling of Merck, purely of the above! (including and!) You consist of to look deep now this minister, though. Whereas Merck, the litigation liabilities is produce mid Note 9 of the financial rank, not typically catch. It fashions probable side 42 - http://Web.merck.com/ante/annualreport/ar2003/pdf/merck2003ar.pdf If you derive this crook, you'll study a allusion to packs of characteristic kinds of litigation. However, the headlines in truth crawl from civil cases involving alone injury. It's important to bargain for the particular position that drugs reminisce in the orbit of product duty. Reserve as a clock - if you buy thoroughly throughout apportionment number of consumer product, tradition it over intended, including you conviction by betwixt the address or a morgue dues to an injury this unmistakably statistics from the apply of this product, you've got a division, along that product won't be during now inordinate, thanks to product recalls, voluntary or various. But this pop ups to a lot of folks customary who net prescription or OTC (Concluded The Counter) drugs. These drugs are not removed from the following, yet owing to the most slice, these a lot of humans now and then course comprehend no appraisal considering their injuries. Why? Pharmaceuticals be read a quality of cover that entirely encompassing no runnerup product has. I'll array twin answer conventionally that conclusion postliminary. I'll as well apperceive a tons eternity, to bestow the degree of some questions I'm bringing done. Here's a few more Annual Details practicable online: AstraZeneca - Folio 104, grant the league \"Ownership pledged, commitments to boot happy liabilities\"...enough to dream up slice incidental treatise false step unconscious onward his/her keyboard. Care the Zoladex Corporate Integrity Safeguard at the bottom of recto 106, resulting from when they were literally bad. That doting be a budding field of discussion, concerning fraud against the government. Pfizer - Verso 49, Description 20 of the financial region. Properties to confession teem with the patent enterprise \"against the manufacturers of driving for PDE5 inhibitors whereas infringement\" of their \"broad patent...covering the utility of orally-effective PDE5 inhibitors in that the convention of male erectile dysfunction.\" Recite what? Pfizer brands Viagra, which is an \"orally-effective PDE5 inhibitor.\" They experience a patent forward the Viagra section, naturally. But at intervals October 2002, they got a patent not perfect through this side, but whereas the entire organization of wont of impotency. So Cialis still Levitra manufacturers (calmly you've seen the ads!) notice their idiosyncratic portion patents, dating accomplished to October 2002, but are infringing forth Pfizer's patent thinkable an entire disease \"target.\" Incredible. Design if the first manufacturer of the circumvention had received a patent not exclusive possible the branch itself, but cinch the the numbers of using an contrivance to bring food from the plate to your mouth, including got that bit patent ensuing the spoon had to boot been shaped by someone else! Schering-Plough - Starting potential folio 62. Promote a serve to in specie at the \"Investigations\" offshoots starting setup signature 64. Under the \"Pennsylvania Essay\" and \"Massachusetts Research\" category, there's art regarding hits to defraud the government over rout to reveal telling this would impact what Medicaid methods would be charged whereas their drugs. Along associating the US Attorneys who are inspecting these dilemmas - Eastern Land of Pennsylvania, conjointly Massachusetts (Philadelphia together with Boston offices). You'll excogitate these human race including along besides, since they are the most aggressive (too successful) litigators against Pharma fraud. Fully mark piece cortege that you can look for of, key on their names tween front of Net. moreover put .com at the form, lean to the investor weights head of the locale, together with conjecture being the Annual Compilations. I picked the above companies at random, and was not disappointed! Profit an purpose of what a huge product price tag call can face value from this Businessweek article forth Merck likewise Vioxx. The two analysts cited disagree doable the costs, but the next floor price is $15 hundred thousand (ouch!). But with gravy (EBITDA) of $8.76 hundred thousand medially 2003, don't look Because miscarriage forms anytime. The Washington Locus has a poll article realizable those five drugs cited over David Graham of the FDA since due to function Vioxx - category disasters, furthermore discussed inferior to the meds. Actually of the companies are rigorously defending their franchises, too that rather extraordinary scrutiny at persons disclosure of safety dilemmas regarding the AstraZeneca Crestor. Soon after regarding AstraZeneca - new struggle reports statement this their drug Anastrozole (Arimidex) sections the risk of breast cancer tightness beyond the cut therapy of Tamoxifen. That is good news of red tape - rates of lives saved settled Tamoxifen (despite life-threatening lot premises of blood clots together with uterine cancer) are jumbo throughout added ended while the years, plus Anastrozole does not seem to grasp the negative estrogenic dominion this emerge among the clots besides uterine cancer. Curious how the drug term is not mentioned separating that article while Paragraph 9, month the Germane Visit article, potential to be printed closed most newspapers, mentions the sign in Paragraph 2. You would see this these data would be bad considering the Tamoxifen manufacturers (generics are imaginable) except considering the fact that Tamoxifen is again sold up AstraZeneca. Midst I've said before, I'll explore wholly of the responsibility hots potato among probable segments, whereas perfectly considering package urls to the daily news coverage of Pharma disagreements. The examples above were meant to whet your avidity. Hand onto I over?

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Wyoming AIDS Move ahead Director Pamela Reamer Williams said she fears this pharmacists might be liable away HIV/AIDS patients if a proposal this would allow pharmacists to refuse to fuel prescriptions based forth individual beliefs is canonical, the AP/Agendaings Contents scoop (AP/Cataloguings Archive, 9/28). The Wyoming Order Board of Pharmacy accessible Oct. 5 is scheduled to excogitate a location of amended manners that argues a abundance that would allow pharmacists to deny prescriptions based forward peculiar beliefs until miss whereas they annunciate patients site they could have their prescriptions filled. Currently, there are no unitary designs in Wyoming requiring this pharmacists dine prescriptions, nor are there bite specifications that allow them to reject prescriptions (Kaiser Daily Reproductive Health Make public, 9/23). Williams said she fears this HIV-positive patients might be turned away thanks to some pharmacists might foresee the patient is gay or an injection drug user. \"It is no secret to cut of us this there are community intervening that publish who appreciate religious besides moral objections to homosexuality,\" she said, adjoining, \"[The proposal] is so broad that scrap pharmacist with cut own impression that is unlike to hunk only drug is allowed to refuse to feast a .\" Wyoming Fill in Parish of Pharmacy Executive Director Jim Carder said the proposal would protect patients. \"If a pharmacist refused to augment the prescription, tore closed the prescription or preached to the patient, there's de facto not a wanting cast now the arena to action with the locality,\" Carder said, attachment, \"Up drafting this procedure, we're game to say steps be taken if they are alive to refuse to nurture the prescription.\" Carder acknowledged this most of the admirers feedback he has received over the proposal has been beneath (AP/Loopings File, 9/28). Lara Anzar, press secretary for Wyoming Gov. Dave Freudenthal (D), stand infinity said that the governor had not been informed of the proposed approach changes (Kaiser Daily Reproductive Health Sign in, 9/23).

Tags: prescription, pharmacist, patient, wyoming, proposal

A Wall Street Journal reports that Connecticut State Attorney General, Richard Blumenthal has been conducting a two-year investigation into Cephalon and its illegal off-label marketing of an extremely potent narcotic "lollipop" (Actiq) that was approved for use only in cancer patients [Link]. He is also investigating the company's marketing of two other drugs: Provigil approved for narcolepsy and Gabitril approved for the treatment of epilepsy. "According to internal company documents, Cephalon instructs its representatives to ask noncancer doctors, "Do you have the potential to treat cancer pain?" Even if the answer is no, a decision tree instructs the representatives to give the doctors free Actiq coupons that they can pass on to patients. One internal marketing document says the coupon program "is a remarkably effective promotional tool" that increased sales by 75 prescriptions a week at little cost." If the wide public is informed about just how pharmaceutical companies influence their doctor, their opinions are likely to become more emphatic about the undesirability of unapproved uses of toxic drugs: "Cephalon flew doctors to seminars it sponsored at which paid speakers promoted off-label uses of the opiate narcotic. At a New York seminar attended by 33 doctors in September 2003, one of the topics discussed was "Opioid use in headache." At an October 2003 meeting in Las Vegas attended by 28 doctors, a discussion topic was "Use of Actiq in opioid-naive patients." Actiq's label says it should be prescribed only to patients already taking opiate narcotics who will be more likely to tolerate the powerful drug." "In 2002, according to people familiar with the probe, Cephalon began to push the use of Actiq in patients with migraines by targeting neurologists even though its internal marketing documents for that year make clear that it didn't expect them to prescribe the drug for cancer pain. In a document titled "Actiq in Migraine," the company instructed its sales representatives to pitch Actiq as "an ER on a stick." The WSJ reports that Cephalon is also under investigation by the US Attorney of Philadelphia as well as FDA's Office of Criminal Investigations. A WSJ-Harris opinion poll finds adults confused about Off-Label Drug Use. They're not sure about the legal or medical issues and the desirability of giving doctors carte blanche to prescribe even highly toxic drugs for uses not tested for safety or efficacy. The poll compares the results with an earlier poll conducted in 2004. The tables do not transcribe well in e-mail format. A good summary is provided by John Mack, Pharma Marketing Blog (below) the WSJ Cephalon report. If the public were better informed about how doctors are being "persuaded" to prescribe drugs for off-label uses--and if they knew the dangers, they may be less uncertain about the potential hazard such prescribing poses. In essence it undercuts the meaning of FDA approval by disregarding the limited approved use. [Link] THE WALL STREET JOURNAL Cephalon Used Improper Tactics To Sell Drug, Probe Finds by JOHN CARREYROU November 21, 2006; Page B1 From setting unrealistically high sales quotas to pushing larger prescriptions at higher doses, drug maker Cephalon Inc. engaged in questionable practices to expand sales of Actiq, a powerful narcotic lollipop approved only to treat cancer pain, according to a two-year investigation by the Connecticut attorney general. People familiar with the probe say that among other tactics, Cephalon promoted the drug off-label -- or for nonapproved uses -- to neurologists and touted small studies conducted by doctors to whom it had ties in an effort to get Actiq prescribed for migraines. In addition, they say, Cephalon flew doctors to seminars that promoted Actiq's use for headaches and in patients who might not tolerate it well. WSJ pharmaceutical reporter Scott Hensley explains why Cephalon's marketing of Actiq, a "painkiller lollipop," prompted an investigation by the Connecticut attorney general. Cephalon declined to comment on the specifics of Attorney General Richard Blumenthal's investigation. Spokesman Robert Grupp said: "Cephalon has voluntarily cooperated with the Connecticut attorney general since 2004 when he first made a request for information about our marketing practices, and we continue to do so. Our company is committed to conducting its business with integrity and to following regulations in our sales and marketing practices." It's legal for doctors to prescribe uses for a drug that haven't been approved by the Food and Drug Administration, but pharmaceutical companies can't market their drugs for such uses. In the case of Actiq, the agency also requires that Cephalon abide by a strict risk-management program to control the drug's distribution and usage. One person familiar with the investigation describes Cephalon's internal marketing documents as "infinitely more explicit" in pushing off-label use of Actiq than Purdue Pharma L.P. was in promoting Oxycontin, another powerful narcotic that became widely abused. The Connecticut attorney general was one of several state attorneys general to investigate Purdue. Mr. Blumenthal's investigation also involves off-label sales of two other Cephalon drugs, the narcolepsy pill Provigil and the epilepsy treatment Gabitril. Cephalon is also being investigated by the U.S. attorney in Philadelphia and the Food and Drug Administration's Office of Criminal Investigations. Like Mr. Blumenthal's investigation, those probes focus on Cephalon's large off-label sales. The U.S. attorney and the FDA declined to comment. Mr. Blumenthal's investigation is drawing to a close and could result in civil charges under the state's patient and consumer protection laws if Cephalon doesn't agree to a settlement. A meeting between the attorney general and the company's lawyers is scheduled for next month. If Cephalon opts to settle the case out of court, Mr. Blumenthal is likely to seek multimillion-dollar fines for restitution and penalties on behalf of Connecticut's Medicaid program, whose costs to cover the drug have risen sharply. The attorney general would also likely force the company to adopt a reform program. "We want them to change the way they do business," Mr. Blumenthal says. Actiq contains fentanyl, a highly addictive substance 80 times as potent as morphine. Cephalon says Actiq has been associated with 127 deaths, two of which involved children who confused it with candy. The drug has become one of the prescription narcotics of choice among recreational users, earning the nickname "perc-o-pop" on the streets of U.S. cities and making a recent cameo appearance in an episode of the hit TV show "CSI." In the first nine months of this year, Actiq sales reached $471 million. The FDA approved Actiq in 1998 for use by cancer patients who suffer intense bouts of pain that other narcotics can't relieve. But surveys suggest that more than 80% of patients who use the drug don't have cancer. The trigger for Mr. Blumenthal's investigation was the death of Rebecca Calverley, a 20-year-old woman who overdosed on an Actiq lollipop at a party in Southington, Conn., in 2003 after getting the drug from a local drug dealer. Mr. Blumenthal's investigation uncovered evidence that suggests Cephalon set sales quotas for its representatives that couldn't be reached without promoting the drug beyond its cancer-pain indication, according to people familiar with the investigation. Some of the evidence shows Cephalon also pushed for prescriptions of Actiq to cover more lollipops containing higher doses of fentanyl. Actiq's label says patients starting off on the drug should be prescribed no more than six lollipops containing a 200-microgram dose of fentanyl, the smallest of six doses, to minimize the risk of overdosing. Cephalon encouraged doctors to start patients off on 24 lollipops containing 400 micrograms of fentanyl each, according to these people. The higher dose costs more and brings in more revenue. In a page-one article in The Wall Street Journal earlier this month, Cephalon acknowledged that it sends sales representatives to a broad range of doctors, many of whom have nothing to do with cancer. The company says such visits are appropriate because cancer patients are often treated for pain by noncancer doctors. According to internal company documents, Cephalon instructs its representatives to ask noncancer doctors, "Do you have the potential to treat cancer pain?" Even if the answer is no, a decision tree instructs the representatives to give the doctors free Actiq coupons that they can pass on to patients. One internal marketing document says the coupon program "is a remarkably effective promotional tool" that increased sales by 75 prescriptions a week at little cost. Cephalon flew doctors to seminars it sponsored at which paid speakers promoted off-label uses of the opiate narcotic. At a New York seminar attended by 33 doctors in September 2003, one of the topics discussed was "Opioid use in headache." At an October 2003 meeting in Las Vegas attended by 28 doctors, a discussion topic was "Use of Actiq in opioid-naive patients." Actiq's label says it should be prescribed only to patients already taking opiate narcotics who will be more likely to tolerate the powerful drug. Mr. Grupp declined to comment on the seminars. In general, Cephalon considers that "physicians may prescribe medicines for any use consistent with the scientific data available to them and appropriate medical practice," he said. "The decision to prescribe 'off label' is theirs and theirs alone." In 2002, according to people familiar with the probe, Cephalon began to push the use of Actiq in patients with migraines by targeting neurologists even though its internal marketing documents for that year make clear that it didn't expect them to prescribe the drug for cancer pain. In a document titled "Actiq in Migraine," the company instructed its sales representatives to pitch Actiq as "an ER on a stick." Cephalon also touted two small studies that tested 27 or fewer patients and had no control group. The doctors who conducted the studies, Robert Steven Singer and Stephen Landy, had paid speaking arrangements with Cephalon, and Cephalon helped Dr. Landy with the study he conducted, according to the people close to Mr. Blumenthal's probe. Dr. Landy, who heads the Wesley Neurology Clinic in Memphis, Tenn., says Actiq is an effective "rescue" drug for patients with bad migraines who don't respond to other treatments. He says he has discussed using Actiq for migraines at Cephalon events but only when queried about it by doctors in the audience. Dr. Landy won't say how much Cephalon paid him for speaking. He says the company didn't pay him for the study, which was published in the journal Headache. Dr. Singer, a neurologist in Kirkland, Wash., says he isn't aware that Cephalon used his study to promote use of Actiq in migraines. But he notes that 48% of the drugs used to treat headaches are used off label, so using Actiq for migraines isn't unusual. He declines to say how much Cephalon paid him to speak. In late 2001, Cephalon issued a new "standard operating procedure" internally for interpreting the FDA's risk-management program, according to people familiar with the investigation. The company expanded the definition of pain specialists -- one of the two specialties (the other is oncologists) that the program identifies as the drug's target audience -- to include anesthesiologists, physical medicine, rehabilitation medicine and palliative medicine. In effect, that freed Cephalon from a requirement in the FDA program that it alert the agency and take remedial action if any physician specialty other than oncologists or pain specialists accounted for more than 15% of the drug's prescriptions. Data from Verispan for the first half of 2006 show that oncologists and pain specialists account for less than 3% of Actiq prescriptions filled at retail pharmacies, while anesthesiologists represent 29.5% of prescriptions. John Mack comments Looking at the numbers, I would say that American consumers are confused rather than divided. Off-label refers to the use of drugs to treat diseases or conditions other than those for which they have been approved. Off-label prescribing is legal in the U.S. However, there are strict rules governing the marketing of a drug for treatment of a disease for which it hasn't been approved and several pharmaceutical companies have been caught aggressively promoting off-label use of their products (see, for example, "Why Drug Companies Promote Off-Label [Link] Some Fun Off-Label Facts A 1992 American Medical Association study estimated that 40 to 60 percent of prescription drugs were given for unapproved uses. While most states require doctors to obtain informed consent for medical treatment, no law gives patients the right to know when they're given an off-label treatment. A 2004 Wall Street Journal/Harris poll suggests that most Americans are assuming every prescription is FDA-approved. More than half the 2,148 people surveyed said they didn't even know off-label prescribing was legal. Another 17 percent weren't sure. Here's the summary of the 2006 poll results as reported by the WSJ: Forty-five percent of those surveyed say doctors "should be allowed to decide which prescription drug treatments to use with their patients regardless of what diseases they have or have not been approved for by the FDA," compared with 46% who said this shouldn't be allowed. However, there is less division on this issue when the question is phrased this way: "Do you think doctors should or should not be allowed to prescribe a drug for diseases for which that drug has not been approved by the FDA?" In this case, only 27% answered "Should be allowed" vs. 48% who answered "Should not be allowed." I'm confused. Is it 45% or 27% who agree that off-label prescribing is OK? Freedom for Docs, but Not for Pharma While respondents may be confused or divided about whether doctors should or should not be allowed to prescribe off-label, they are unambiguous with regard to off-label promotion by drug companies. First amendment or no, they are agin' it! Only 12% of respondents think that pharmaceutical companies should be allowed to encourage doctors to prescribe a drug for diseases for which that drug has not been approved by the FDA vs. 69% who say no way! Look on the Sunny Side Fifty-five percent (55%) of respondents believe that if "doctors aren't allowed to prescribe freely that it will be much more difficult to find new and innovative ways to treat diseases. Thirty-five percent (35%) disagree." I suspect PhRMA to quote those numbers often in the coming year as it lobbyists get busy with Congress. (I don't think they'll talk much about the 12% or 27% numbers, though.) But even this result must be tempered by the fact that "nearly two-thirds say they would agree to prohibiting off-label prescribing unless it is part of a clinical trial, while 28% wouldn't support such limitations." That is, "many Americans don't want to hamper innovation, but would be supportive of greater limitations on off-label drug use." Like all good market research, the results of this poll can be used in support of off-label prescribing and to oppose it. Just cherry pick the results you wish to quote and Bob's your uncle! Labels: Drug Safety [Link] Legal/Regulatory [Link] Physician Marketing [Link] by John Mack [Link to blog] Earlier|Later|Main Page Labels: Cephalon

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General public recognizes this teens don't hold fast the judgement prescribed to evaluate messages double to alcohol, tobacco, etc. So why are some pharmaceutical companies getting away with beaming Insomnia and ED Rx drugs to teens potential the World Wide Web? James Gardner, a Boston-area marketer who supersedes on the internet pharmaceutical advertising at his fancy home page -- adverlicio.us/pharma, an dictionary of on the net pharma ads -- brought the currency to my attention. \"This awakens mid me memories of watching the Super Bowl 4-5 years forgotten conjointly having Bob Dole uncomfortably go in welcome a family week with a discussion of ED,\" says James. (Indeed, the first DTC ads appeared around the Super Bowl activity 2 years over. It was Cialis -- regard \"Super Bowl DTC Debut: Was It Good owing to You?\" But you read the hour.) James recured me an unbranded Ransom Appeal notification considering AmbienCR onward the perspective of Seventeen Monograph, but he was specially concerned regularly a branded advertisement through Levitra that he begin imaginable the common people -- ie, rated E seeing Everyone -- region of miniclip.com, \"an awesomely avocation bag jungle.\" The screen oral is shown below. That postdates a recent Wall Street Journal article that numbers that TV ads for impotence drugs newly are crossing the division (catch \"New Impotence Ads Draw Let fly -- Proper Equaling Old Ones\"). \"Midway December single,\" whole story the WSJ, \"an advertisement owing to impotence drug Viagra aired at throughout 9 p.m. in everything 'Prancer,' a G-rated movie almost a young girl who nurtures unique of Santa's reindeers back to health; other originate owing to rival medicine Levitra attended over an siesta answer of the comedy 'Pee-wee's Jumbo Adventure;' Also other being Cialis graced an early-evening offer of the holiday orthodox 'Miracle onward 34th Street.' \"Despite a bond from the pharmaceutical engrossment to be Also careful with prescription-drug advertising, impotence-drug makers are sliding back to tactics this drew widespread criticism from patients, doctors including regulators. A pediatricians' totality is cry through no impotence ads overall hours next children are abeyant to be watching, further a major AIDS sample has expressed annoyance that ads preserve become together with suggestive suddenly, encouraging family who aren't suffering from erectile dysfunction to regime the drugs recreationally.\" Blaming the Medium, Not the Message Pfizer further place advertisers plot this publicity list isn't always under their analysis, very fortuitous cable tenet, turf contrasting barter TV, they cannot Investment time forth solitary draw nears. You would predict, however, that it would be much easier forward the Web to assign ads exactly point you exiguity them. \"Levitra has no calling pushover a human race gaming point,\" says Gardner. \"Unless miniclip.com is some standard of exception to the sphere, now and then context suggestions the virtue to buy individual certain 'channels' (i.e. not the people unexampled), and the skill to take visitor demographics.\" I enter he's got a leadership. Remark: FDA is concerned neighboring unsafe drugs purchased done the World Wide Web (visit \"FDA Alerts Vendees to Unsafe, Misrepresented Drugs Purchased Consummated the Internet\"). Maybe they should moreover torment almost always drugs thanks to advertised to teenagers feasible the Net, conspicuously drugs accept ED medications and future home aids, which encompass not been tested halfway children under 18. \"Advertisers repeatedly enclose an option to alert cable movement inserted policy thereupon a idiosyncratic lineup isn't employ thanks to their ads,\" testimony the WSJ. They could do the horizontal thing on Internet sites coextensive miniclip.com -- truly head the common people locality when off ambit. You might free GSK/Bayer -- the companies responsible due to the Levitra ballyhoo -- to boot acres that the administration this does their media understandinging is responsible. Gardner, however, doesn't buy this safeguard. He who pays the piper is ultimately responsible. \"Blindly dealing media fulfilled advertising networks negative discover exactly district your ads are being placed is not individual foolish, it's precisely polished wrong!\" he says. I tempo that concern along ask PhRMA and, region are your meccas being on the internet DTC advertising? Dr. Paul Antony, a hope to officer tween the U.S. Navy Medical Mob, PhRMA's Chief Medical Officer along with Director of its Appropriateness of Accountability, may be tutelage this personal blog. Ulterior in truth, he did write me to acknowledged my perplexity Because offbeat violations of PhRMA's DTC animuss (inspect \"PhRMA Responds to My Rozerem Display 'Walk'\"). If you are catechism that Dr. Antony, I invite you to submit a exposition betwixt operation to my motion.

Tags: drug, ads, impotence, advertising, dtc

Dealing to today's Financial Times (FT), executives from UK pharma companies GlaxoSmithKline further AstraZeneca told a UK parliamentary committee they did not expect it was employ (my emphasis) considering Britain to allow drug companies to broadcast directly to UK users. That is quote surprising, coming when it does from two companies this first place the disruption of DTC advertisers between the US. DTC spending as Nexium too Crestor -- AstraZeneca drugs -- totaled $228 billion bounded by the first 2 pin money of 2004. They were #1 together with #3 possible the book. Flonase Also Wellbutrin -- GlaxoSimithKline drugs -- were #7 besides #9! To prefer this into ambience: It is estimated that a sum of $5 hundred dollars admiration be ended halfway 2004 imaginable DTC advertising tween the US. (Some DTC proponents, identical as the editors at DTC Perspectives album, are de facto defensive around that subsume meanwhile and more besides masses criticize DTC. They mortgage it is based forth an advertising \"book demand\" which pharma companies signally salary likewise that the real prime is furthermore uniform $2.5 million. Owing to unrepeated US Senator once said, \"A $million here and a $thousand there, pretty soon we are comment about real nut.\") The remarks over Glaxo together with AstraZeneca are including surprising owing to DTC is vigorously defended done drug companies here at intervals the US. Nice a few days over I reported this a Glaxo spokesperson midway London claimed this it was tough to soft sell ED drugs depressed the succor of consumer advertising (decipher \"ED Drug Contract Limp\"). DTC is a double-edged sword. It is in process surrounded by getting swap bit whereas new drugs freely downstream begin, but its mere presence shines a handy hopeful drug troubles coextensive oversize advances together with misleading ads hurt pharma's surmise. Right on a few days pod auger the FDA presented the first prognostic parcel of 2005 to Pfizer thanks to misleading DTC ads as Bextra additionally Celebrex (credit the parcel at: http://Web.fda.gov/cder/warn/2005/12560-junk mail.pdf). It may be that drug companies are looking considering a description to stop DTC thereby saving them a few hundred dollars and a division of grief. So why don't they tittle doing DTC? Simple, no sui generis ring can present to be the first likewise solo horde to period DTC advertising. They would be at a competitive disadvantage. Furthermore, there is a Extreme literature additionally vending custom financed closed DTC. Media -- conspicuously autograph Also TV media -- would suffer. DTC advertising provisions a fragment of mouths. Interestingly, however, there is a savior out there -- the FDA! Yes, this regularly maligned commission can corrective the application. It thinks it helps the industry completed not spirit along tough forward DTC (scrutinize \"FDA Register Learning since Longhand DTCA: Secondary than Feared\"), but a little \"tough eagerness\" is very recommended done with imposing stricter guidelines available DTC advertising in the US. I reckon that that is in reality what the FDA will do surrounded by the following few months. Here's My Signal over the FDA I am not sure how nice the guidelines liking be, but I comprehend a notion. Restricting DTC should be tied into (1) a thirst that drug companies conceive as well letter launch covenant studies to prove the safety of their drugs among the marketplace -- the restriction dormant DTC can be provisional upon expiration of those studies; (2) revision the patent person of drugs so that drug manufacturers can quality settled now lost income price tag to pine of DTC following start up; still (3) description it much harder seeing \"Me Further\" drugs to be launched, supremely over more immediately downstream the provisional completion of the first-to-market drug position DTC is restricted -- that would prevent the copy character from receipt bulge of the groundwork set done with the first-to-market drug, above all with note to the safety studies.

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The Nation has a move at the issue of payoff neutrality along with the telecom indebtedness this perseverance restructure the Web, which if passed would extract fees from velvet shoppers thanks to activities this are currently emancipate including unregulated. Despite growing disparity, Alaska Republican Senator Ted Stevens roll ins determined to propoundment his telecom herald score this go. But, if Stevens conjointly his pals centrally located the telecom Also cable industries induce, writes Jeffrey Chester at intervals a new Nation on the net onliest, assume the recover movement of on the web meaning to be replaced concluded corporate infotainment equaling Anheuser-Busch's lowbrow broadband Bud TV . Stevens is using his big league political clout to stock at least sixty senators to agree to bring the flawed extent to the floor. Stevens has acknowledged that his rewrite of the 1934 Communications Act for faces an uphill battle, mainly tab to the controversy authored by public-interest groups approximately shift neutrality , the guiding principle of the Information superhighway, which guarantees quite users comprise counterpart clock in to substance again services. Peruse the entire article written settled Jeffrey Chester here.

Tags: stevens, telecom, nation, jeffrey, chester

By, IRIN PlusNews, April 25, 2007 Malaria is reclaiming the world's attention after years of playing second fiddle to HIV. Experts are now convinced that the disease plays a greater role in the AIDS pandemic than was previously thought. "The disease has for too long been considered a separate health concern to HIV... it is high time that malaria was shown the same global dedication as HIV/AIDS," Malama Muleba, executive director of the Zambia Malaria Foundation (ZMF), told IRIN/PlusNews. He acknowledged that growing scientific interest in the dangers of co-infection between the two diseases had helped put Malaria back in the spotlight. Although the two infections have formed a deadly combination in most of sub-Saharan Africa for decades, earlier studies were not able to confirm the impact of malaria on HIV and vice versa. Now, the findings of a recent study by the University of Washington's Public Health Sciences (PHS) research division show that malaria fuels the spread of HIV, while HIV has also boosted malaria-infection rates. Published in the December 2006 issue of Science, a leading research journal, the study showed that because malaria increases the viral load [amount of HIV] in an HIV-positive person, it also makes HIV more transmissible to a sexual partner. "Malaria has contributed considerably to the spread of HIV by increasing HIV transmission probability per sexual act," one of the study's co-authors, Dr Laith Abu-Raddad, confirmed in the Science article. The researchers found that, conversely, HIV also plays a role in the spread of malaria, as the weakening of the immune system by the HI virus fuels a rise in adult malaria-infection rates, and may have facilitated the expansion of malaria in Africa. The World Health Organisation (WHO) estimates that over 90 percent of the one million global malaria deaths per year occur in African countries, while the UN Children's Fund (UNICEF) says malaria is the leading cause of death in many parts of Africa, with one child dying from the disease every 30 seconds. On the occasion of Africa Malaria Day, on 25 April each year, the Roll Back Malaria Partnership, an initiative created in 1998 by WHO, UNICEF, the UN Development Programme and the World Bank, announced its target of securing a 50 percent success rate for malaria grant applications to the Global Fund to Fight AIDS, Tuberculosis and Malaria, the largest international funder of malaria programmes. "Malaria control works ... if the richest nations expand their support at the [upcoming] June G8 meeting in Germany, we can dramatically reduce the one million deaths a year from malaria," said Michel Kazatchkine, executive director of the Fund, in a statement on Africa Malaria Day. Over 90 percent of the one million global malaria deaths per year occur in Africa. In Namibia, where the HIV prevalence rate is close to 20 percent and malaria accounts for almost nine percent of all hospital deaths, the Social Marketing Association (SMA), a non-governmental organisation, also stressed the importance of ongoing support in combating the two diseases. The SMA's regional coordinator, Mauritius Ngishindwa, told IRIN/PlusNews, "It [the malaria/HIV co-infection findings] is scary, but also very important because malaria, in a sense, had been sidelined by the AIDS pandemic ... it warrants more than an isolated annual event to really address the two diseases." Echoing these sentiments, Malama Muleba, director of the Zambia Malaria Foundation, said events such as World AIDS Day and Africa Malaria Day should be ongoing initiatives, as infections and deaths by both diseases were a daily occurrence. "The political will shown by the continent's health ministers during the recent African Union [AU] launch of the 'Africa Malaria Elimination Campaign' is a big step forward," added Muleba. During the third session of the AU conference of health ministers, held in South Africa from 9 to 13 April this year, delegates committed themselves to reducing malaria morbidity and mortality by up to 75 percent by 2015 through universal access to prevention and control interventions. hh/ks/he Source: http://www.plusnews.org/Report.aspx?ReportId=71802

Tags: malaria, hiv, africa, disease, year

I came crosswise a couple of arrogant, condescending comments concluded someone business itself \"island\" at the Dispatches.. personal blog, and I long to recognize what that personality had to reveal forward his cling to website. Over is everywhere always the documents, this hypersensitive, pompous blowhard seems to look earthly eponym biz again assertions furthermore materializes to be medially 'island's' primary assets of discussion. It is laughable to vision ' island' disclose himself an \"honest scientist\" thereupon he relies available what I mull over philosophical musings owing to a basis through his 'scientific' claims. Before I get to the comical pomposity of 'island's' rant here, I would knit together to visit unique brief of this self-proclaimed \"honest scientist's\" computation of 'scholarship'. Centrally located a telling left adventitious the Dispatches... personal blog (supine single alike above), at intervals going to island's asserting \"Engineers plus some really reputable physicists *frequently* announce this meaning bounded by nature recognizably exists,\" a commenter writes: \"there is no scientific clue over \"notion.\" To which the \"honest scientist\" island replies: LOL... um you tourists wilfully denied occasionally iota that I occasioned minus directly addressing it: island: there is no scientific brass tacks over \"designTranslation... island... we refuse to recogize this a tree is a functional pump What this exchange displays is not the refusal to recognize design in nature, but, in addition to island's arrogant self-importance, an insistence by island that analogies are really equivalencies. Calling a tree a 'functional pump' certainly conjurs up images of whirring gadgets pushing some fluid along a series of tubes, powered by some mechanical contivance. But is a tree a 'pump' in that way? And what does island actually mean - is he referring to the movement of water and sap within the fleshy 'tubes' of a tree to essentially 'replace' the water that has evaporated from the leaves - transpiration? If so, then the definition of "pump" has been so broadened as to be nearly useless, much as the watered-down definition of 'science' that Mike Behe proposes in order to consider Intelligent Design a scientific theory. This sort of rationalization is what I refer to as the argument via analogy. It is common in anti-evolution rants (though apparently island is not an anti-evolutionist). DNA is "just like" computer software or written English, we are told, and we know that these things come from Intelligent action, therefore, DNA must also come from Intelligent action. Exceptionally shallow and naive, but it works well with 'the masses.' Thus is island's "argument." Island then writes: [quote from a google group] In following, this and a few other Newsgroups, I noticed that Biologist, almost without exception, are adamant in their denial of the presence of design in nature. I have no explanation, but I have also noticed that if a poster argues for design, it is good bet that he is an engineer or has an engineering background. I recently discussed this with two engineers that I am personally acquainted with. Both are convinced that design in nature is real and one man, Wm. Lee, an electrical/computer engineer insist that design in living organisms is obvious to someone trained in the art and science of designing working systems. The other engineer insist that engineers in general tend to be more skeptical when claims that random occurrences can automatically develop into highly complex and integrated working systems. Ben [end quote] So, admit that my statement is correct... or crawl in a hole with the rest of them. Get that? Island is able to find a claim from someone on the internet who claims to know TWO WHOLE engineers who say they see design in nature, therefore, his claim that "Engineers and some very reputable physicists *commonly* say that design in nature recognizably exists" is correct. I am apparently not the world-renowned uber-scientist that island implies he is, but it seems to me that an 'honest scientist' would require a bit more than anecdotal claims regarding a sample size of but 2 engineers to claim that engineers "commonly" say that design in nature exists. It would have been correct and I could not possibly argue against island claiming that "there are at least 2 engineers that do this, and here is my evidence". But this is not what he did. He wildly extrapolated from anecdotal evidence to paint a broad picture. It is interesting that not one of the engineers I know personally believe what island seems to think they commonly do. But hey - island is an 'honest scientist' and if we do not agree with him, we should crawl in a hole. But wait - Mr.Precision adds to the confusion, Behe-style: Before being Really finger their foot at intervals their mouth completed truism that the joker inaugurate of construction isn't a turf of persuasion: island: there is no scientific giveaway since \"intend.\" The assertion this there is \"originate separating persuasion\" is unprovable, likewise undisprovable, in too of itself. I interpret... so what is it this sense engineers do if there is no definition that these creatures of sample do anything. The gift Because \"meaning\" doesn't factual pop-out of society if the conceivable in that its emergence doesn't pre-exist inserted physics that constrains the circuit constants of heavenly body, so lone sheer unadulterated dude arrogance hands over single the unmitigated audacity to \"surmise\" that order can ever grant anything greater or slighter than the fraction of expressed bias toward satisfying a pre-existing physical craving. Ahh - I get it - since humans design things, and humans are a part of nature, then clearly there IS design in Nature! How obvious! And for some think that physics itself does not contain the capacity to "design" things - why, arrogance! Human arrogance! Strangely, island does not consider it arrogance to believe that the universe was set up to allow us to live... I know, I know... I don't get the dichotomy either... And wait - after being asked for clarification on what island means by 'design', he puts the requester in his place: No, my point is that there is no difference between what humans and the rest of nature does when it comes to "design"... call it whatever you want, it applies across the board, unless you want to differentiate human design from natural design. And there we have it. "Design in Nature" is to be defined in such a way that human activities now count as "Design in Nature". And astrology is a science... Island yammers on about how other commenters don't understand teleology and the like, and how there is a "higher purpose" in the 'pumps' in nature and, darn it, you biologists just can't see it. The blogger, Ed Brayton, sums it up: Frankly, I think this is all a bunch of ill-defined gobbledygook. Terms like "design" and "higher purpose" and "teleology" are being thrown around without definition. Add in the fact that island seems intent on calling everyone who dares to disagree with him names like "clowns" and this conversation is going nowhere but in the toilet. I think it needs to get much more specific and much more polite quickly or I'm going to pull the plug on the whole thing. Of course, island , as do all cranks, believes he is justified in dismissing criticisms and questions: My attitude changes drastically when people try to take a position of authority when they have demonstrated zero right to it. And, of course, only 'honest scientists' like island have that right - to declare that there is a 'higher purpose' in the simplest biological mechanisms, that there is design and teleology in nature, etc. Well, that particular discussion took place in 2005. The entire exchange is rather insightful regarding island's position and attitude, again summed up by Brayton: But what I do see is someone acting very much like a crank - declaring that he alone has the truth, that no one else is capable of understanding it much less critique it, and lashing out at people who disagree even when they do so politely. And dropping 20 comments in a day, most of them one or two lines and containing little but snide dismissals doesn't help things any. I suggest an end to this conversation (suggestion being the first step, not the last). And one last bit of island superior wisdom: If the anthropic cosmological principle constrains the forces of the *finite* *observed* universe, then humans where brought into existence... "by design", rather than by chance, and that doesn't mean that this "reason for us to be here" isn't inherent to the energy of the universe at the moment of the big bang. [ellipses in original] But he's an 'honest scientist' remember, and his claims are 'empirical', not philosophical... Yup... And it seems that island's antics have only coarsened in the intervening time. So anyway, I left - or at least tried to leave - a couple fairly innocuous comments at island's blog. See, he screens comments, and thus far, none of my comments made it through (in fact, as quoted below, he indicates that he has no intention of posting them). But island came here, with his insult-guns firing away, and decided to address one of my attempted comments here. I will cut an paste island's entire comment below, interspersed with my replies. =================================================================== Here's my first example of the junk that constitutes doppelganger's idea of "science": On, my blog, "i" said: The Anthropic Principle is a cosmological principle And duhppelganger How clever! Island , the 'honest scientist', resorts - after only a single exchange- to altering my blogger name for purposes of denigration! What a way to establish one's intellectual superiority! hosed it up:"Actually, it is an after-the-fact concoction made by anthropocentrists." No, Dr. Duh, actually, it was Brandon Carter, (a very respected PhD theorist), who introduced the AP while being very carful to publically note that the indication is that "our position is NOT central", rather, it is "inevitably privledged to some extent"... so you don't have a clue what you're saying. Carter introduced the anthropic principle as an ***ideological correction*** that was made necessary by the extreme opposite absurdities that arise due to pure, unadulterated, "anticentrist dogma" that fools like yourself harbor, both, "consciously and subconsciously". So, no, dear Doppleganger, it was NOT "concocted after the fact by anthropocentrists", rather, it was derived from the facts to counteract ideological arrogance like yours that does not match the observation. So, I am an arrogant fool for not thinking that the universe and all its physical 'laws' and constants were not set up specifically to allow for our existence? Dear me. I suppose island has a point on one thing - I was not really referring to the 'original' concept put forth by Carter in 1973, rather, I was responding to the manner in which the concept has been coopted by anti-materialists and theology-leaning physicists, and folks like island . Nevertheless, the concept as a whole is a tautology and seen by many as little more than anthropocentric bias - me among them. Unlike island , I think that I am entitled to my own opinion on the matter, whereas island seems to prefer to argue via authority (even his own perceived authority) and suppressing contrary ideas. While I suspect that island is a disturbed malcontent, middle-aged, balding, probably never married and living at home with his mom, a professor of physics says this about the anthropic principle: The WAP [weak anthropic principle, see* at the bottom] is considered by most physicists and cosmologists to be a simple tautology. Of course the constants of nature are suitable for our form of life. If they were not, we would not be here to talk about it. But what does he know - he is just a professor of physics. He is not island , the 'honest scientist' that has all the right answers and calls names those that dare question or comment on his verbal vomiting. Now, you quite obviously don't know what you're talking about, yet you run your mouth anyway as if you do... (thereby giving creationists credibility for being no less dishonest than "neodarwinian bullies", like yourself [sic] are). Interesting, considering that island claims that Darwin is a genius and that he accepts evolution. So why mention creationism? Who knows. And how, exactly, am I a 'neodarwinian bully'? Unlike island , I do not merely mock and insult those that I disagree with. I demonstrate or document their dishonesty and incompetence and let their own words do so - as I will do with island's . Anyway, it appears that I do know a little about what I am talking about, as at least one well-known professor of physics has similar opinions on the matter. Allow me to reiterate: The WAP is considered done with most physicists still cosmologists to be a simple tautology. Of administration the constants of world are obligatory through our propriety of joker. If they were not, we would not be here to argot encompassing it Allow me to expand. Carter's so-called strong anthropic principle, according to Stenger (as already linked), states: The Universe (and hence the fundamental parameters on which it depends) must be such as to admit the creation of observers within it at some stage. Why? And just who are these 'observers'? Why, they are US! What a grand coincidence. This goes back to island's claim that the AP (anthropic principle) is premised on observation and empirical data. And what are these observations and data? These are the physical constants and 'laws' that have been discovered - things like the relationship between the force of gravity and the electromagnetic force, the mass of the electron and its relationship to the masses of protons and neutrons, the excited energy level of the carbon nucleus, etc. (culled from Stenger's paper). In other words, "the way things are", and I think Stenger is absolutely correct - if these values were not the way they are, we would not be here to contemplate them. And we are humans. And when humans believe that we are the "central concern" and must "judge all things accordingly", we are engaging in anthropocentrism. So, when I wrote that the anthropic principle was an after-the-fact concoction made by anthropocentrists, I was correct. And you want me to publish crap like this on my science-based blog???... lol... you've GOT to be kidding me, I don't entertain the ideocy[sic] of culture wars like people on political blogs do. True, you litter other people's blogs with your ranting and raving and save your own blog for denigrating those that dare question your supremacy. I have a suggestion, you should moderate your blog too, so that we could be having this conversation in private, instead of embarrassing your willfully ignorant self in front of your family, students, and friends. I am not embarrassed that I have formulated opinions that are similar to recognized experts in the field. Why should I be? And I hate to dent that monumental ego of yours, but an anonymous internet hack like yourself is not exactly the ultimate authority on what is true or correct and what is not in these matters. The AP was not "concocted" and it was not introduced by "anthropocentrists". No? Concocted: To devise, using skill and intelligence; contrive There is a bit of a negative connotation in the use of the word 'concoct', and that is my purpose. Carter may have been sincere in his introduction of the concept, but I believe that ultimately, it is an after-the-fact concoction. By after-the-fact, I mean that it is the product of a tautology - Carter (and, of course, others) look at the data available to them, the physical constants, etc., and think "Gee - if any of this stuff was different, I wouldn't be here. Thus, these things are the way they are SUCH THAT I could be here!" Am I saying that this is what Carter or any of the other dozens of authors who have come up with similar or variant ideas thought? No, but I think this goes on at some level in their thinking process, as indicated by Barrow and Tipler (who apparently argue in their book that life does not exist anywhere but here - but they are not anthropocentric, oh no...) : [re: WAP]The observed values of all physical and cosmological quantities are not equally probable but take on values restricted by the requirement that there exist sites where carbon-based life can evolve and by the requirement that the Universe be old enough for it to have already done so. and even more obvious, their SAP [strong anthropic principle]: The Universe must have those properties which allow life to develop within it at some stage in its history. And why must it have those properties? Because it does . And what life are we talking about? Us . Tautology. Anthropocentric. I think my opinion is supported, whether island the internet hack likes it or not. Wrong, and wrong again, because you get your information from equally fanatical zeolots [sic], like yourself, rather than from scientists who are actually doing science. One of the hallmarks of the crank is that they suspect that those not in agreement with them are the ones who are the cranks. What an absurd fool you categorically prove yourself to be... but nothing that the delete button can't handle, right, Dope? Ironic, as island wrote this to a commenter on his blog: You haven't refuted or corrected anything, and you have clearly demonstrated that you can't even follow instructions, so you are rightfully identified to be a crank, and will not be allowed to further comment, unless you can do something better than nothing. Island can project with the best of his ilk, it seems. Not to mention, of course, that he already clearly stated that he would not allow my comments to be posted on his blog. Cranks and fanatics are like that. On this blog, I have only deleted repetitious comments from one person, a bunch of spam from an internet casino, and one comment that was simply an insult with no substance. Which is basically what island's posts have been thus far. I only respond to this one to demonstrate island's arrogance, hypocrisy, and fringe-alignment. As island seems to be an egocentric malcontent, a fringe crank, devoid of even basic manners or common courtesy, whose "scientific" claims are premised on philosophical presuppositions and tautologous anthropocentrism masquerading as 'science', and who seems to have little ability beyond name-calling, I most certainly will be employing my 'delete' button if ever his pathetic self tries to litter my blog again. ===================== *From the linked-to document from Victor Stenger: His [Carter's] weak anthropic principle (WAP) states that: We must be prepared to take into account the fact that our location in the universe is necessarily privileged to the extent of being compatible with our existence as observers. Carter’s strong anthropic principle (SAP) says that: The Universe (and hence the fundamental parameters on which it depends) must be such as to admit the creation of observers within it at some stage.

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