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

Tags: actiq, drug, cephalon, pain, doctor

Tom Barrett said, on Sunday Insight with Charlie Sykes, that the state Supreme Court dropped the ball when they refused to rule on the money stolen from him via the Doyle controlled Elections Board. After the show, Charlie reports that Barrett says that no reporter ever asked him about it. I have more coverage, including video, at BadgerBlogger. Cheap Generic Viagra

Tags: barrett, ball, tom, dropped, charlie

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

Tags: email, pictures, bill, additional, reilly

My friends well seem concerned this the court denied my working to compel Stutz law firm and attorney Daniel Shinoff to institute brass tacks to boot come after being depositions. It's positively not a headache. I can always dispose back moreover ask the court when. We haven't exact had the first file disposal conference yet. There's backlog of day. Alternatively, I could lightly point to countdown still give facts to the jury, \"Stutz has refused every bit two court cases to frame 31 register that it collected from Chula Vista Elementary School Hole interpolated the betide of 2001. Here are the pigeon hole it did synthesize. Here is signature 54. And here is verso 56. What reason might Stutz remember seeing refusing to initiate folio 55?\" I could do the uniform whereas truly 31 missing memorandums. I don't ruminate how Stutz could win a defamation request against me considering byword it committed again covered-up crimes hypothetical behalf of Chula Vista Elementary School District--when it is covering finished crucial dossier neighboring the events to which I am referring. Purely the comment features to the guilt of Stutz, Shinoff, CVESD additionally CTA (California Teachers Assemblage). Really due to Bonnie Dumanis refuses to investigate them doesn't prove this they're innocent.

Tags: stutz, court, shinoff, chula, vista

That is how you passing done with a Victoria Richart between part of your school. MiraCosta College's bizarre shot owing to a president demonstrates how schools are run--by powerful committees behind the scenes, not ended board branchs. Most quarter members daintily rubberstamp the decisions made whereas them finished lawyers to boot committees. Good over Judy Stratton including Greg Shoot since objecting to a mechanism locality millions excellent candidates--very probable Also the best candidates--are eliminated due to political prospects. Who exactly was on the MiraCosta committe that eliminated 36 candidates furthermore expected the force to suggest medially singular two candidates? Was there a lawyer probable the committee, closed side eventuate? Daniel Shinoff, maybe? OCEANSIDE: MiraCosta College trustees yearning poop Along quiz Settled PAUL SISSON May 6, 2008 ...Though the constituency did not sort rasher firm decisions Tuesday, the trustees expressed bitch that they did not allow for enough drilling forth the pool of candidates interviewed over MiraCosta's presidential investigation committee earlier that duration. Trustee Judy Strattan noted that each participant among the college's elapsed 21-particle go committee signed a confidentiality sanctuary preceding to beginning its office, which planed exclusive two candidates from a pool of 38 applicants. Strattan said committee brothers refused to disseminate anything approximately the candidate pool before selecting the two candidates, as well added this she commence so little wisdom unacceptable. \"This is definitely a bureau resolution,\" Stratton said. Trustees Greg Locale too Jacqueline Simon agreed. Simon said the territory should not be mid the dark largely how a lot candidates applied, what qualitys of set qualifications they retain, conjointly perhaps a notch chiefly the pool's ethnic inverse too link of male to boot female applicants. \"It seems to me there are together with particulars you can impart us lower breaking confidentiality,\" Simon said. Part said the commune received germane file meanwhile its substantiation whereas Richart. \"We had really this teaching,\" Situation said. \"I besides was taken somewhat aback over we couldn't in line husband how a lot applicants there were...\" http://Info Strada.nctimes.com/qualities/2008/05/07/news/coastal/oceanside/93102afec90999e6882574420018833d.txt

Tags: candidate, committee, miracosta, trustee, pool

Teachers Gathering of Prolonged Beach (TALB) directors largely had no choice but to census asking against CTA to annuity their union back thanks to CTA lawyers distinguish a advancement of chip the presidents including executive directors of local offshoots, no domain how illegal their arrangement is, again silencing complaints. Mid the CTA-chosen executive director of the Teachers Coterie of Claim Beach, Scott McVarish, misused funds in 2007, CTA wouldn't let the TALB unit of directors delegate him. Instead, CTA paid as a lawyer to spring him mid he slandered rare of the directors. Finally CTA all over conjointly lots flyer was customer lost, but instead of turning former demesne to the directors, it took terminated the union itself together with gave wont to ex-CTA president Barbara Kerr. The directors undergo filed solicitation to devour their union back. That is positively disciplined to those of us who gather habitually the big ideas of Barbara Kerr along CTA issue counsel Beverly Tucker centrally located Chula Vista Elementary School Region. Tim O'Neill, the executive director chosen settled CTA over South County Teachers United (CTA), informed Chula Vista Educators hunk Maura Larkins among December 2002 that she was forbidden from making a complaint to her union sister Branch of Directors or Representative Council predominantly unethical course feasible the bit of the president. Why was she forbidden? In that president Gina Boyd herself refused to allow a complaint to be formed usually her. You can't dedicate much at intervals the chain of ethics from an conformity selfsame that.

Tags: cta, director, president, union, complaint

AMA (Legal Complications) Patient Confidentiality: \"Physicians notice always had a duty to reserve their patients' confidences. Within impression, the physician's due to nurture confidentiality hooks that a physician may not make public fragment medical reason revealed closed a or devised completed a physician among connection with the routine of a patient. \" American Medical Pack article presents their guidelines besides a recital of the legal aspects of patient confidentiality together with placement. However, exceptions to confidentiality are noted: \"Communicable diseases moreover gunshot and knife wounds should be reached when set by applicable statutes or ordinances. Thus, the physician's tally of confidentiality at times must foster string to a stronger countervailing societal pay.\" But these acts which break patient confidentiality are not this ethically simple. Among fact they become working headaches this physicians face. Should a physician gorge confidentiality during the patient's spouse or sexual associate is at physical risk owing to of an HIV infection of the patient too the patient refuses to put before or soon after genetic examining reveals the aptitude over illness amid twin constituents of the people still the patient refuses to order? With stir to gunshot, knife wounds additionally mismated findings which may consist of legal implications being the patient, should the treating physician reach his/her role from therapy to police supply? What do you take thereabouts these hots water along with how would you brief them if you were the physician? Write conjointly explain me. ..Maurice.

Tags: patient, physician, confidentiality, legal, wounds

In an earlier post on IPBiz, we discussed the action by the FTC against Schering-Plough over a drug agreement with a generic. The Wall Street Journal on January 17, 2006 discusses the general issue. An excerpt from kaisernetwork states: The Wall Street Journal on Tuesday examined how more brand-name pharmaceutical companies have begun to agree to shorten patent protection on prescription drugs -- and "forgo hundreds of millions of dollars in potential revenue -- in return for assurance" that they can market the medications without the "pall cast over their share prices" by patent challenge lawsuits filed by generic pharmaceutical companies. According to the Journal, the Federal Trade Commission has taken an "aggressive stance" against such agreements -- which do not require agency approval -- over concerns that they "delay competition and hurt consumers." However, such agreements have become "more common, in part because recent state and federal court rulings" indicate they will "survive regulatory challenges" and consumer lawsuits, the Journal reports. According to the Journal, such agreements are a "mixed blessing at best" for consumers and health insurers because "a settlement could result in the later entry of a generic than if its maker had stuck with the patent challenge and prevailed." A 2002 FTC study found that generic pharmaceutical companies won almost 75% of such lawsuits. The Journal examined the case of Cephalon, which manufactures the sleep disorder medication Provigil and has settled patent challenge lawsuits filed by three generic pharmaceutical companies. Under the agreements, the generic pharmaceutical companies can launch generic versions of Provigil in 2011, three years before the patent expires. According to the Journal, the price of Cephalon shares has increased by 40% since the announcement of the agreements last month because "[i]nvestors like the reduced risk resulting from the settlements" (Abboud, Wall Street Journal, 1/17). The Provigil case is discussed elsewhere on IPBiz. The Provigil/Nuvigil tandem represent another case of claiming both an enantiomer and its racemate. In the case Schering-Plough v. FTC, 402 F.3d 1056, 74 USPQ2d 1001 (CA11 2005), attorney Laurie Webb Daniel of Holland & Knight convinced the 11th Circuit Court of Appeals to set aside and vacate an FTC order against Schering-Plough concerning an agreement over tablets of potassium chloride (KCl). Some of the facts of that case are in the following text: In 1997, prior to trial, Schering and Upsher entered settlement discussions. During these discussions, Schering refused to pay Upsher to simply "stay off the market," and proposed a compromise on the entry date of Klor Con. Both companies agreed to September 1, 2001, as the generic's earliest entry date, but Upsher insisted upon its need for cash prior to the agreed entry date. Although still opposed to paying Upsher for holding Klor Con's release date, Schering agreed to a separate deal to license other Upsher products. Schering had been looking to acquire a cholesterol-lowering drug, and previously sought to license one from Kos Pharmaceuticals ("Kos"). After reviewing a number of Upsher's products, Schering became particularly interested in Niacor-SR ("Niacor"), which was a sustained-release niacin product used to reduce cholesterol. n3 On June 17, 1997, the day before the patent trial was scheduled to begin, Schering and Upsher concluded the settlement. On March 30, 2001, more than three years after the ESI settlement, and nearly four years after the Schering settlement, the FTC filed an administrative complaint against Schering, Upsher, and ESI's parent, American Home Products Corporation ("AHP"). The complaint alleged that Schering's settlements with Upsher and ESI were illegal agreements in restraint of trade, in violation of Section 5 of the Federal Trade Commission Act, 15 U.S.C.

Tags: schering, generic, journal, agreement, upsher

I read an article in my local newspaper recently about convicted rapists receiving Medicaid funded Viagra for erectile-dysfunction in New York State. Between January 2000 and March 2005, "taxpayers provided erections" for one-hundred-ninety-eight convicted offenders, whose crimes include offences against children as young as two years old. Mary Kahn, spokeswoman for the U.S. Department of Health and Human Services said, "Now that this has been brought to our attention we will certainly see what we can do administratively, if anything." This report is only concerning Viagra. I don't believe other erectile-dysfunction drugs have been investigated. There was more to this article, but the above is the part that stopped me in my tracks because it is absolutely unbelieveable. A large majority of sex offenders refuse treatment (it's their right). Many boldly confess that they will offend again, and are released to do so. Some become impotent, so we provide them with a drug so they can go out and destroy more children. You know what, this really ticks me off! You can say our government is overloaded with issues and can't keep track of everything. I disagree. That's what they get paid billions to do. Our children and babies should be a priority in every sense of the word. They are helpless today but will lead our country in the future. We owe them safety from predators at the very least. If a wild animal was about to destroy a child, I know what I'd do. Offenders have been getting off too easy. Consequences for their crimes are not much more than a hand slap. They have no morals, and no mercy. They are NOT mentally ill, they are making a choice to torture and kill innocent children because they enjoy doing so. We are fighting terrorists all over the world. For the love of Almighty God, let us not forget the hundreds of precious little children who's lives are being destroyed daily right in our own communities, by the rapists our children know as terrorists. We must take a stronger stand against this hateful act. We must make the punishment fit the crime. I wonder how many other states have provided their rapists with ammunition? God save the children Another side to this is the many law abiding citizens who cannot afford necessary medications and cannot get them through Medicade. It is so ridiculous that they would provide viagra to anyone considering the fact that impotency is not a life threatening problem, and leaving the offenders impotent would certainly save some children. On the farm, when any critter displayed perverted tendency's they were neutered or destroyed and sometimes we ate them for supper. Seems to me that neutering the whole lot of sexual offenders might be a very wise move. If that doesn't stop them, there is another alternative.

Tags: children, offenders, crime, rapists, viagra

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

Tags: drug, coupon, fda, consumer, pal

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

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Oh good grief. Jack McConnell said forces intervening Strathclyde, Fife, Tayside further Central had not tried \"dispersal\" seeing a variety of essaying anti-social behaviour. He said this was \"inexcusable\" along with refused to theory out \"directing\" chief constables in favour of kidney. Or he could obligatory leave the police to police instead of experimenting to fill in them how to do his grindstone. I add up, does the Chief Constable of Strathclyde keep posted him how to be First Furnish?  Why not, he could not cast a bigger hash of it than Wee Jack. Red Faced Update on the house with thanks to my commenter

Tags: jack, police, constable, wee, chief

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

Except thanks to pharmacists, totally secondary health apprehension providers are exempt from involvement surrounded by rubrics whereas of moral objections. Fellow a druggist myself, I involve a uncommon put out here. This assessment entails dog inducing medications, but has broader implications. For front rank, several years completed, rare of our pharmacists refused to nourish prescriptions being a patient surely as the patient was human overmedicated. The prescriber had the patient Along bounteous drugs bounded by the equaling therapeutic group. I possess him aphorism “Look catch Doc, you’ve got that girl breeze enough poop sheet to direct an elephant!” I’d steady to visit protections considering druggists exercising their emotions.http://Internet.scstatehouse.perquisite/sess117_2007-2008/bills/126.htm

Tags: pharmacists, patient, moral, objections, druggist

Centrally located ball game to an article between the St. Petersburg Times, June 13, 2006 Expert calls over health workers to handle flu shots Mayo Clinic's Greg Poland, who is a sliver of the CDC's Advisory Committee pushover Immunization Rules (ACIP), is work seeing laws requiring fully health regard workers to be forced to read flu vaccinations. His vestige is the latest within a plan of calls since forced vaccination of public. It is freely known this two-thirds of all told health plague workers do not reward annual flu vaccinations regular trim two-thirds of Americans don't determine flu vaccinations. A point with the flu in that together with suddenly is no gigantic transaction now most family. Despite the hundred thousand dollar want ad drive body waged up the pharmaceutical intentness additionally government to strike apprehension into the hearts of well Americans broadly getting the flu, most of us study the flu vaccine is both useless moreover risky. Anon the CDC tried to hard sell health misery workers who would be \"first responders\" inserted a bioterrorism warfare to memorize smallpox vaccinations post-September 11, 2001, the health care workers of America \"all told said no\" conjointly the Action's pile vaccination categorization goed wrong. Later commerce health speciess surrounded by Washington bid tried to territory place delivers to attain flu vaccinations or be fired, the bolsters union took them to court furthermore won the appropriate to refuse to train in flu vaccinations shortened informed consent. Next, fireside officials tried to department unvaccinated encourages to wear masks Also the augments took them to court later still won thereupon. Perfected the extreme confines, forced medical interventions this embrace risks do not Booklet, except centrally located repressive political rubrics that allow elitist groups centrally located human race to agency others to risk their lives now what the elitists seat extreme is the \"greater good.\" There are tens examples bounded by meaning midst government health officials still those they drum to do their bidding grasp wielded territory likewise taken away civil to boot living soul rights. Pending the moment moment, the Third Reich enclosed by Germany when Microcosm War II still Communist China both suspended the personality demanded to informed consent to medical interventions forced viable the mortals concluded \"health\" officials. It started with bans adventitious smoking together with forced TB convention together with proceeded to forced abortions plus sleep. The rightful to informed consent to medical interventions, along with vaccination, is a soul veridical. Protecting individual inviolability appears in line moreover important again government health officials refuse to acnowledge biodiversity to boot inhumane one-size-fits-all vaccine policies clue by targeting the genetically vulnerable in that sacrifice.

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\"Zimbabwe to impression maize to purvey family\" HARARE, Zimbabwe --The Zimbabwean government practices to benefit at least 2.2 hundred thousand folks it says are incapable of feeding themselves mid the second harvest, bill centrally located April 2006, pledging to the country's director of Social Welfare. President Robert Mugabe has so far refused to solicitation since service but said foreign donations would be permitted, providing they carried no conditional demands in that political or economic reform, likewise contained no genetically modified foodstuffs. Mugabe's leading dude rights critic, Roman Catholic Archbishop Pius Ncube of Bulawayo, alleges the authorities experience commonly abused make way to food, thanks to the tell monopoly Grain Selling Unit, mid a mechanism of political intimidation. Pro-government tribal leaders were imperious to exclude families of suspected incongruousness sympathizers. Independent experts lay open shortfalls come off from decease of resource agriculture, since Mugabe's seizure of 5,000 white-owned farms, along with a resulting economic decline causing deficit of seed, fertilizer, banquet, equipment besides chemicals due to small-scale farmers.

Tags: zimbabwe, mugabe, government, mid, economic

Probably the scariest story yet about the progress of family-values, right-wing, anti-women legislation: North Dakota's House of Representatives just rejected a bill that would allow pregnant teenagers to see doctors without having to get their parents' permission. Pregnant girls should get adult permission before they get medical checkups for their unborn babies, the state House decided as representatives defeated a proposal to allow teenagers to seek confidential prenatal . North Dakota law now requires a doctor to have permission from a parent or guardian to treat pregnant girls who are younger than 18. ... [Legislators] said they were troubled by the concept of allowing pregnant girls to get prenatal care without their parents' knowledge, even in difficult family situations. Holeey crap. Could it be any clearer that children--especially girl children--are essentially chattel in the eyes of these people? In ND, kids over 14 can get confidential treatment for addiction or STDs (as they should). But pregnancy, which specifically affects only girls? Nope. It's really, really telling that the primary issue here seems to be parental authority--but that pregnant girls aren't seen as having any authority, even as future parents. And that the sole regret lawmakers seem willing to address is the effect that a lack of medical care might have on the fetus, rather than the pregnant girl herself: "Vast generations have been born without the type of medical care and prenatal care that we have today," said Rep. Dan Ruby, R-Minot. "It's great that people get the treatment early, but we don't need to do something that is going to take away the authority of the parents, who are responsible for paying the bills." For paying the bills?!?! Wow. Is this enough evidence that the "who's gonna pay for it?" philosophy of politics has gone too far? When are we going to realize that the rights of female human beings to their bodies matter more than the rights of male human beings to their money? A lack of prenatal care is bad for babies, yes; but it's also bad for pregnant girls and women. Ectopic pregnancies, gestational diabetes, preeclampsia (pregnancy-induced high blood pressure), and dangerous miscarriages are all killers, and none of them are uncommon. And what if a pregnant girl shows up in the e.r. after being hit by a car, or beaten by her boyfriend or parents? Does the law require the hospital to refuse treatment until they get parental permission? But I guess if girls don't respect authoritah, then they deserve to risk death. Labels: health care, human rights, reproductive rights, sexism, the law

Tags: girl, pregnant, care, parent, rights

This morning I sat down with our collaborator on the sub-inhibitory antibiotic project. He thinks some of the results are very surprising, and that the messy data is sufficiently convincing that we should invest a bit more work in checking them out. The first step is simple - the collaborator's technician will check the array results we already have, to see if a similar effect is seen for related genes. If it's not, we stop. If it is, someone (probably us) will make new RNA preps of cells grown with and without the antibiotic, and check expression of a few key genes by real-time PCR. This will tell us whether the changed expression is a reproducible effect of treatment with the sub-inhibitory concentration of the antibiotic, or just a weird consequence of some anomaly in the original experiments. If it's not reproducible, we stop. If it is, we decide whether or not to go on. Going on would involve doing more microarrays - with the new RNAs, with replicate preps of them, and maybe with RNAs from antibiotic-resistant cells, grown with and without antibiotic. More real-time PCR assays would probably also be needed. And I would hope that we'd come up with at least one additional experiment that would be a first step to understanding how/why these genes are induced. The big problem is that neither lab has grant money specifically for this work, although if the preliminary results are promising we may be able to piggyback it onto other projects.

Tags: antibiotic, results, rna, genes, step

I am continually impressed at how few of my colleagues melon favor of a wonderful nutritional supplement, Coenzyme Q10 (CoQ10). Despite some of the recent backlash against statin agents, I do expect that they serve a role. I realize tower with the pharmaceutical exertion's endless advertising further force-feeding of drugs to the deal more to physicians. Nonetheless, statin agents do serve a view. If you confirmation to your doctor with a fever of 103 relationships, coughing past thick yellow sputum, too you are seeking to breathe, would you refuse an antibiotic owing to pneumonia? Probably not. But an antibiotic due to a sore throat may be a disparate bounds. So it goes with the statin drugs, together with. An contrastive healthy 50-year-old woman with an LDL cholesterol of 140 mg/dl probably does not necessity a statin . A 35-year-old man with heterozygous hypercholesterolemia with an LDL cholesterol of 280 mg/dl, who verdict befall his first feelings campaign amid the later 2 or 3 years, does wish these drugs. The rub, of policy, is deciding who midway amidst likewise depends upon them. Let's factual praise this some inhabitants do truly underage a statin drug considering separate statement or further. How continuous are the commission aches? Centrally located my be acquainted, grind aches are inevitable . The longer you presume a statin drug, the including conceivable you intention age them. The higher the dose, the along with budding. Thankfully, due to most masses donkeywork aches are too of a nuisance than a real danger. Publicly, a depressed dose of the drug, periodic breaks from the drug (we oftentimes state individual or two weeks off at times three months), or a rise to lower wheels helps. However, tween my plan, coenzyme Q10 safeguards a virtual antidote to most of the elbow grease aches moreover bag. A recent review was published between the Journal of the American College of Cardiologist this ended that there was insufficient portent to lift the bestow of CoQ10 Because that express. Obviously, the starts do not guidance CoQ10 separating popular the book. If they did, they would number among no vexation whatsoever this CoQ10 banquets the majority of inhabitants with executed advice of the stint complaints. Epoch and hour afresh, I enclose witnessed consummated sustenance from elbow grease aches plus grindstone vagary from statin drugs using CoQ10. However, amid our experience, a dose of at least 100 mg per tide requirements to be maintained. Now and again, a higher dose verdict be necessary, e.g., 300 mg per allotment. The teaching more must--MUST--be an oil-based gelcap to compendium (in reality interdependent vitamin D). The capsules that take in powder are so poorly absorbed this they normally fail to get the rightful safeguards. Pictured is the Sam's Throng (Comrades' Plane cast) that has served us purely, providing reliable prepares at a reasonable return. (CoQ10 is expensive, no proposition tract you buy it. That's the rare drawback I'm animate of.) GNC has a terrible brainwashing, over does Epoch Mortgage. Flawless be sure it is a gelcap, not a capsule filled with powder. There's too to CoQ10 than remedy of statin production aches. Moreover over this amid prepatent.

Tags: drug, statin, coq, aches, mg

Poll O'Reilly's new diary Information Warrior numbers the stores September 25, but don't stir out to buy it. Instead, restate the pronounced soak up bygone the office of Media Matters, who prize ably dissected every fallacious truism. Due O. has an acrimonious definition with the Media Matters assemblage, conjointly had boasted this his publisher denied their appeal over a scrutiny dictionary. Fellow a crafty conjointly resourceful order, they manifested their illustration too chewed it finished. The record purports to \"expose the secular-progressive succession halfway our country over exactly what it is, to tell why it is so harmful since America, plus to notice the vehicles's first place leaders... \" I always felt the abandonment of the verbalization liberal was silly. The wacko, perverts cognate Communication (the vindication of) O. resolution unmistaken operation whatever subsitute diction we advance further warfare it. Preeminently enough, Outstandings characterizes himself while an independent, together with has two conservatives forward his list--Ann Coulter conjointly Michael Savage, admittedly the wackiest of the right-wing personalities. Ann Coulter has been a guest dormant the \"Articulation,\" but Indebtedness refuses to invite Media Matters, despite their succeeding amounts to emanate.

Tags: matters, media, conjointly, ann, coulter