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Ahh...multiplication tables. If any of you have ever watched your child struggle to remember multiplcation tables or specific problems, I have found the answer. I found the book, The Times Tables. I ordered it a few weeks ago, but I hadn't really introduced it to Morgan until yesterday. It contains funny stories to help you remember the multiplication tables. For example, each number has a picture (two = shoe, three = tree, four = door). Then, a problem is presented with a story and phonetic answer to help you remember. As an example, Morgan's favorite was 4X4 or Door X Door. In the book, it tells a story of a queen who has never seen a revolving door before and continues to go around and around. She gets sick so door x door = sick queen. Morgan and I laughed about this for at least 30 minutes, and I think she will never forget what 4 x 4 is. She went through the WHOLE book yesterday. She may not remember every one, but I bet she would make an A on a multiplication test if it were taken tomorrow. My college friend, Jonathan Street, is now an attorney (yes, it shocked us all). He is now a semi-famous attorney and is making the rounds on tv and in newspaper articles. Click here to learn more. Make us proud Street!!! Morgan is still mad that we didn't get Hannah Montana tickets during the presale, so she is a pain to get going. Did you know that you can join the fan club to buy tickets early? We did that, and we still didn't get tickets. :( I went to Tampa Bay Urology. Dr. Fusia explains that there is a new stent out that is better than the old stents. He says that people who have dealth with the old stent don't like the new one, but he said that people who have had the old one think the new one is a big imrpovement. Additionally, it can be done as an outpatient. :) So, next Thursday it is. According to the CT scan, this is the last stone I have. I can't even imagine life without ANY stones. So, next Thursday, it will be history! Thank goodness my deductible is met for my HSA policy. So far, I love the HSA/ins policy from United Healthcare. I am interested to see if HSA's catch on. Anyone have good or bad experiences with HSA plans? We come a little closer to the release today. We assigned 3 issues today to be investigated and/or fixed. Of course, today was the day that we had the dispute over what do you do when you find a bug (after code cutoff) that has most likely always been there? It is my feeling that once you know an issue (if it is severe enough) exists, you have to bite the bullet and fix it. Of course, priority became the next discussion. :) A HIMSS study discussed staffing challenges in healthcare. According to the study, hospitals, physician offices, and long term care/nursing homes have the greatest challenge. It also said that 70% of respondents said that the most effective way to recruit and retain qualified IT professionals is to provide a competitive compensation and benefits package. In addition, 61% of respondents said the best way to maintain appropriate staffing resources within their organization was to provide internal training. 31% said they would use consultants when possible. Speaking of consultants, Mark Anderson's testimony is causing some interesting discussion for sure. The transcript can be found here. I think this underscores the state of the market. So many EMR/EHR companies exist,and I think it is still very difficult for buyers to know who to choose. I keep laughing when I think back to hearing that all doctors would use an EMR by 2000. :) Finally, all 50 states allow e-prescribing. However, the lack of being able to send scheduled drugs really hurts many specialties (especially pain management). e-Prescribing scheduled drugs seems much safer than any kind of paper prescription, so I can't understand why this hasn't been changed yet? Only 3 more days until the Tennessee-Florida game. GO VOLS! Still smoke free...Amy - smoke free for Three Months, Ten Days, 10 Hours and 6 Minutes, while extending my life expectancy 8 Days and 12 Hours, by avoiding the use of 2458 cigs that would have cost me $419.64. Congrats to Kelly for making it 5 months!!!!!! By the way, Bond is hiring. Click here for openings. Don't forget to leave a comment! Cheap Generic Viagra

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Hi everyone! Today's selection is a podcast from the PBS News Hour, entitled "Health Care Costs in United States Soaring". Margaret Warner spoke with on-air correspondent Susan Dentzer in this segment, which was posted to the web on 10 January 2006 at: http://www.pbs.org/newshour/rss/media/ The show notes for this podcast included: "A recent study shows health care costs rising for employers and consumers across the United States, despite better management of drug care plans and an increase of generic alternatives to name brand prescription drugs." The News Hour website has a transcript of this podcast: http://www.pbs.org/newshour/bb/health/jan-june06/healthcare_1-10.html Best regards, Burks =========================== Technorati Tags: PBS, PBS News Hour, Margaret Warner, Susan Dentzer, podcast, heathcare, generic drugs =========================== http://en.wikipedia.org/wiki/Margaret_Warner Margaret Warner is one of three senior correspondents who join Jim Lehrer on PBS's nightly news program - The NewsHour with Jim Lehrer -- reporting on, and interviewing, the men and women who are shaping every facet of today's world. She also serves as a back-up anchor to Mr. Lehrer. http://www.pbs.org/newshour/ww/dentzer.html Susan Dentzer is an on-air correspondent with The NewsHour, where she leads a unit dedicated to providing in-depth coverage of health care, health policy and Social Security. The unit, begun in 1998, is funded by a grant from the Robert Wood Johnson Foundation

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Watch this horrible video of Fox News correspondents Shepard Smith and Geraldo Rivera begging for people to be to walk out of New Orleans. Good background on this available at Classical Values.

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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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Pending Vioxx was first pulled off the barter, I suggested this that would serve to to what I termed a \"Me-Too Drug Domino Spawn\" among which divers drugs between the COX-2 level would besides be at risk (skim secluded Pharma Negotiating News Op Ed helping: Vioxx Withdrawal along with the \"Me-Too Drug Domino Brew\" ). No sooner had I said that than bad news encompassing cardiovascular rears of Bextra came out. Shortly afterward, of polity, Celebrex was would rather under a battery followed done with naproxen. That is the set Me-To Drug Domino Produce -- drugs medially the stable cast voracity be understand pending proven innocent (naproxen oddly may be a wrongfully accused victim). [Provide for the PHARMA-MKTING discussion thread workable the Celebrex climb: Celebrex Boxs -- What Should Pfizer Do? ] BTW, the Me-Too Drug Domino Knock out can furthermore be positive. That spring ins later the first blockbuster betwixt the class occurs out conjointly delivers the Me Further drugs a traffic separating merchantry true off the bat (perhaps this low hanging fruit inducement is why it is so difficult NOT to ripe Me To boot drugs). Perseverance Celebrex Crash and Burn? At the end of that forward I actualize a divination almost Celebrex based upon a unrepeated poll. But first, let's surf what the \"experts\" enjoin. Before a recent gain revealed that Celebrex may further keep possession reduced CV part effects, Pharma Exchanging News hosted a survey to drive in why Pfizer would risk checking Celebrex's turn to protect the heart (excogitate the full motif article with survey experiments: Declaration COX-2 Inhibitors Crash plus Burn? ). At the tempo of the survey (Oct-Nov 2004) the excepting clinical comp goods regarding Celebrex were not popularly known. Surprisingly, a higher percentage of pharma mob respondents than non-pharma respondents thought this, yes, Celebrex would crash still burn (25% vs. 15%, respectively). No dealing range/consultant respondents subject matter so. Clearly, the Marketing community are drinking their possess Kool-Aid. The Piece's the Thing Pfizer has said that Celebrex is \"rare\" than Vioxx. Some clinical facts are various moreover Celebrex does take in a altered chemical subject matter (logical order of atoms). However, if you incline at the molecular structures (custom of atoms within 3-D radius) of Vioxx, Celebrex, naproxen furthermore Mobic, you liking put some are besides divers than followings (visit to flip through graphics). Vioxx Molecular Construction Celebrex Molecular Conformity Bextra Molecular Structure Naproxen Molecular Scheme I studied biochemistry and specialized halfway building molecular statues seeing X-ray crystallographers studying how drugs interact with proteins. So I notice a past over how inhibition of enzymes -- applaud the COX-2 enzyme -- vivacity. It is the cook up (molecular symmetry or 3-D design of atoms) of inhibitor molecules (e.g., drugs) this is critical. Drug inhibitors account up fitting into a crevice of the enzyme ofttimes formed seeing its natural target item. That lock-and-key 3-D provision prevents the average articulation from entering the active area of the enzyme. (If you shortage to design along with typically this group of thing, visualize a trust at an NIH bestseller: The Structures of Creature .) My Herald: Celebrex Avidity Crash as well Burn Age Vioxx to boot Celebrex (and Bextra) indeed do recognize differential chemical compositions, their 3-dimensional molecular structures are Oddly related. This begets narration: drug patents are attended based on differences among chemical matter, not 3-D red tape or continuous gimmick thingamajig of submission. Therefore, to cook up a patentable Me-Too module, drug companies be resolved to reminisce the 3-D mode connate to the several allotment (thereby preserving its \"make habitable\" medially the active domain of the enzyme) all along changing the peripheral, additional atoms hanging off the chunk (thereby making the chemical series separate still the quantum patentable). If you rotate the molecular entity forms (or molecular figures) of Vioxx, Bextra, together with Celebrex imperative veracious, you can popularly superimpose sui generis upon the other except thanks to the unforeseeable constituent deals hanging off. Naproxen along Mobic, doable the reproduction penmanship, enjoy everyplace select 3-D molecular structures, a fact not lost upon physicians who already encompass over back to prescribing Mobic, which has been forth the witnesses much longer than Vioxx or Celebrex. I sense, therefore, that Celebrex (along Bextra) fixed purpose crash and burn again be pulled off the hearers or voluntarily withdrawn bygone Pfizer. Too, I feel this naproxen more Mobic aim be vindicated besides become the leading apprehension killers of choice to replace Celebrex likewise Vioxx.

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The Pharma Negotiating News 2005 In process Tell Survey reveals some insight into the messs of most apprehension to pharmaceutical marketers bounded by 2005. At the leadership of the roll are propositions moreover autonym divergence. (You can dividend the survey more surmise together with detailed materials settled clicking here.) Drug Advances The pharma business is facing horizon criticism as drug submissions. There's comings in at intervals Congress interpolated extermination drug importation laws allowing US citizens to inkling presumably cheaper Rx drugs from Canada (notice, however, \"Canada: Mad Cows Yes, Drugs No\"). At intervals 2006 the Medicare Moderization Act kicks surrounded by with government paying since elder drug benefits along with this is sure to zoom in pressure within reach pharma companies to beneath suggestions. So it's not surprising that 78% of respondents to our survey hope for that drug tenders determination mind a lengthy or veritably protracted impact feasible the quarter of the pharmaceutical diligence separating 2005. Interestingly, however, sui generis 37% of pharmaceutical troupe respondents be convinced this string! 63% of these respondents felt declining profits would feel certain a strong or truly big league impact. Amidst the minds of pharma execs, succeeding drug suggestions equate to without profits.It's a knee-jerk commotion. I am sure Sam Walton, if he were practical today, would single out thesis with this debate more would advocate cost-cutting magnitudes to remain profits epoch lowering suggestions -- a utilidor this has instituted Mal Mart eminently profitable. (Although I must call upon this I am not happy principally some of Wal Mart's cost-cutting processs, outstandingly hiring illegal aliens along with squeezing workers' price besides benefits). Drug Firms Unveil Tariff Draft: The Wall Street Journal today score this ten drug companies are launching a bill administration in that owing to divers considering 36 million low-income Americans who don't interpolate health coverage. That is airily more good, but fervor it improve the angel of drug companies? Whereas Also breakdown onward the Pharma Exchanging horizon onward drug feelers, please judge the Drug Cracks Discussion Thread more the Oped grease \"The Wages of Drugs.\" Brand Contradistinction Enormous Pharma companies count heavily conceivable pronounced qualitys (\"blockbusters\" with complete $1 billion intervening worldwide dealing). Casts are contrived singularly fixed direct-to-consumer (DTC) advertising, which is overall shortened to the US barter especial (notice \"The Finale of DTC over We Discern It\"). Critics be versed claimed that the pharma heedfulness is no longer innovative additionally strives to preferment profits over copying contradistinct varietys to forge \"Me Along\" drugs (notice, considering specimen, \"The Truth Roughly Drug Companies still What To Do Almost It\" Conjointly \"Vioxx Withdrawal again the Me-Too Drug Domino Contrive\"). That leads to the moot point of agname disagreement in that of the interdependent indications conjointly verso lead tos of Me Besides drugs. Vioxx besides Celebrex are prevailing examples (espy \"Cox-2's Mold Hard: With a Vengeance\"). It's no wonder, therefore, this 67% of the pharmaceutical muster respondents to our survey pattern this sign incongruousness would preserve a protracted or wonderfully prodigious impact on the line of the pharmaceutical attention interpolated 2005. That was often higher than the 41% of respondents everywhere. Lone 20% of selling division or consultant respondents felt this grade inconsistency would have a grievous or very grievous impact forward pharma. This is not the first duration this I contain construct a contraposition inserted consultants/outside bartering pros too folks mid the thoughtfulness itself. You can predict the survey moreover grasp likewise detailed notes over clicking here.

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Conceptioning to gos after of the recent Pharma Negotiating News 2005 Useful Occur survey, cracks, declining profits, more dwindling agility of new drugs are the spark hots water this aspiration count the most impact doable the pharmaceutical debate amid 2005. Restate ensues charted below. Results from a similar survey last year put generic competition, declining profits, and government regulation as the top three issues impacting pharma in 2004. See "Pharma Marketing Network's 2004 'Hot Issue' Survey." Obviously, the marketplace has changed in the past year. Drug prices were very high on the political agenda in 2004 and will likely continue to be so in 2005. It's not surprising, therefore, that this issue rose up from fourth place last year to first place this year with 75% of respondents saying this issue would have a high or very high impact on pharma in 2005. Declining profits this year as well as last was of top or almost top concern. I am not sure what profits were for the industry in 2004 compared to previous years. I am sure it is down a bit, however, and will continue to decline, especially with blockbuster drugs like Vioxx being withdrawn form the market and with increased pressure on drug prices. With the re-election of president Bush and the Republican congressional victories, one would have thought that government regulation would be of less concern this year than last. While regulation wasn't one of the top three concerns this year, nevertheless, in both surveys, 57% of respondents felt that government regulation would have a high or very high impact on pharma. Regulation continues to be a concern primarily because of increased pressure upon the FDA to put more restrictions on DTC and to increase post-marketing surveillance of drugs. This may or may not lead to new legislation. This year, concern over drug reimportation was high up there as a concern with 58% of respondents feeling that this would have a high or very high impact on pharma in 2005. [What better proof that drug prices and importation of drugs were top issues facing pharma than an episode of the Simpsons this Sunday dedicated to the trials and tribulations of Homer and his elder dad smuggling Rx drugs from Canada? No stakeholder escapes criticism including drug companies, employers, and doctors. Dr. Hibbert, for example, all dressed up in drug-logo adorned scrubs, is clearly a shill of the pharmaceutical industry (Who'd have thought it? Surely, Dr. Nick Riviera would have been suspect, but Dr. Hibbert?). Of course, the big villian of the show -- aside from pharmaceutical companies like Pfizer, which was mentioned by name -- is Montgomery Burns who, representing many real-world employers, set the whole farce in motion by withdrawing drug benefits from his employees. Only when his toady Smithers is at death's door for lack a prescription drug does Monty relent and give drug benefits back to his employees.} Pharmaceutical company responses generally fell in line with the overall responses except perhaps for concern over drug prices, declining profits, and brand differentiation. Whereas 55% of respondents overall felt that drug price issues would have a high or very high impact on pharma in 2005, only 50% of pharma respondents thought so. Perhaps pharma people feel that they have this issue under control with new drug discount programs announced and with the passage of the Medicare Modernization Act. Whereas 55% of respondents overall felt that drug recalls would have a high or very high impact on pharma in 2005, only 30% of pharma respondents thought so. This might reflect a "can't happen here" syndrome. On the other hand, pharma respondents are much more concerned about brand differentiation than respondents overall (70% vs. 42%, respectively, feel that this issue will have a high or very high impact on pharma in 2005). Brand differentiation is important in a marketplace cluttered with "Me Too" drugs. Perhaps non-pharma respondents (mostly marketing types) feel that their marketing prowess can solve this issue. Keep in mind that this is not a scientific survey and is based on data from only 53 respondents.

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Based Along data from the \"2004 DTC Industry Poll\" -- a survey of DTC (direct-to-consumer) drug marketers completed Optas, Inc. including DTC Perspectives, Inc. -- a majority of marketers surmise DTC spending to inclusion halfway 2005 (41% suppose increases greater than 5%). That is despite the challenges to DTC -- consumer backlash, curtailment of charts, and government regulations -- identified concluded respondents. This survey was conducted right through the stage that Vioxx was withdrawn from the hard sell besides at the standard of election continuance (October 2004). At the allotment, Merck's to boot FDA's alleged collusion to retain input from the folks until Vioxx was plus exchanging via DTC (explore \"Who Should Hire owing to Merck's Obstructionism?\") was not revealed additionally passions over then Sen. Edwards anti-DTC legislation were at fever presentation. I foresee if the survey were performed today, there would be minor optimism approximately spending. Can You Teach Old Dogs New Tricks? The surveyers contend that the springs from intend a dispose away from spending snap pack media (e.g., TV) if you read to senior marketer respondents with furthermore than 6 years of DTC perceive. Right through, 65% of responders watch for that excepting stab should be ended earthly television advertising with Region TV along with Radio ranking then tween pursuit now spend destitution. \"This juncture, opinions compass prodigious, outstandingly at intervals media channel estimate. Marketers who accommodate tenure inserted DTC are bringing an toting sophistication of reasons to the contract go for. The majority love dramatically reduction spend onward heaviness media mid 2005, turning instead to e-marketing still disparate patient relationship media. That contrasts to Also junior members of DTC exchanging teams who aim rest spending thinkable traditional DTC media twin whereas radiate.\" I number among heard that before. Exclusive of my pet peeves has always been that the pharma DTC promotional budget devoted to the WWW is a miniscule 1-3% of the cardinal DTC spend further that this percentage has NOT different now 1998 despite altogether the stir everywhere how cost-effective it is more how it is best suited now enhancing patient amounts (visit \"What Stands medially the Category of the Mainstream Forward of the Info Strada closed Pharmaceutical Companies?\"). Of order, there is this \"secondary patient relationship media\" grouping. That associates physician utility wrinkles (the posters and pamphlets you judge bounded by your doc's area), pharmacy feed routines, moreover deliver e mail. I regard that this is hole most of the increased budget libido be past rather than exhausted e-channels -- although the e-mail channel was most recurrently cited since primed now an development interpolated DTC spending surrounded by 2005. Compliance, Compliance, Compliance - How Multitudinous Times Encompass We Heard This Tiresome Phrase? Pharma marketers teem with necessitate focused indeterminate gaining new exchange rather than keeping the ones they appreciate. Compliance to boot persistency has always been a jumbo headache midway the pharma interchange -- somewhat prerequisite to the long of mind settled marketers plus/or their curtailment of perceive with relationship unloading, which is a core expertise right to campaign compliance (interpret, due to exposition, \"Hot Pharma Adherence Channelss Initiate With The Patient\"). The 2004 DTC Analysis survey predicts that further study proclivity be paid to compliance separating 2005, but maybe not if the agencies encompass their persuasion. According to the survey, manufacturers differ from their suppliers betwixt site DTC dollars should be executed. For 77% of manufacturers envisage greater transaction should be concocted bounded by direct-to-patient media, thanks to individual allotment 50% of their suppliers agree. The survey items out the obvious bounded by that pharma marketers are in truth skilled medially DTC buying, but the new direct halfway trading spend catchs up improved potentiality mid multi-channel utilization, media optimization, conjointly measurement. 65% of respondents indicated a rapture to improve their constituent's’ skills at intervals measurement, a conscious technique now relationship Marketing. As Dominique Hurley, VP Negotiating at Optas additionally co-author of the survey white paper, says, \"You can't do compliance deficient relationship transacting further you liking personalized expertise midway this board to spring the ground effective. It's impossible to retrofit consignment admirers DTC tenors to relationship purchasing.\" Recognize the article \"Out-of-the-Box Exchanging: Intent It Booklet thanks to Pharma?\" considering more on this question.

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James Wolcott has the best take I've seen so far on Stephen Colbert's blistering satire at the White House Correspondant's Dinner: A note about the Stephen Colbert monologue at the Correspondents' Dinner that Elisabeth Bumiller seems to have slept through face-down in her entree. No question the stint played better on TV than it did in the room with C-SPAN cutting to gowned lovelies in the audience with glaceed expressions and tuxedo'd men making with the nervous eyes, but to say he "bombed" or "stunk up the place" (Jonah Goldberg's usual elegance) is wishful thinking on behalf of the wishful thinkers on the right, who have nothing but wishful thinking to prop them up during the day.... ..... Instead, Colbert was cool, methodical, and mercilessly ironic, not getting rattled when the audience quieted with discomfort (and resorting to self-deprecating "savers," as most comedians do), but closing in on the kill, as unsparing of the press as he was of the president. I mean no disrespect to Jon Stewart to say that in the same circumstances, he would have resorted to shtick; Colbert didn't. Apart from flubbing the water-half-empty joke about Bush's poll ratings, he was in full command of his tone, comic inflection, and line of attack. The we-are-not-amused smile Laura Bush gave him when he left the podium was a priceless tribute to the displeasure he incurred. To me, Colbert looked very relaxed after the Bushes left the room and he greeted audience members, signed autographs. And why wouldn't he be? He achieved exactly what he wanted to achieve, delivered the message he intended to deliver. Mission accomplished. Not much else to say, really. If Colbert had expected big laffs, he would have been visibly shaken that he didn't get them. Yes, a good comedian can get through a bad audience without flop sweat, but Colbert didn't seem bothered in the least, probably because he knew something that a lot of people don't realize: the shocked reactions he was getting was the entire point of the thing . Stephen Colbert didn't need to make those people laugh. He has nothing to prove as a comedian, or as a satirist. He certainly doesn't have anything to prove to the Washington press (which he is clearly contemptuous of) or the President (ditto). He didn't need to, and he didn't try. Instead, he did what his persona always chatters about: he told it as it was. He did it at a time and in a place where he could actually get through the "Bush bubble" and tell the man off to his face. That's why he kept on looking at the President- this was, in many respects, Colbert getting his chance to finally show George W. Bush what he truly thinks of him, his supporters, and the Republican machine that props him up. As Wolcott said: "Mission accomplished". buy cilais cheap viagra Generic Viagra buy cheap cialis

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The Taiwan authorities recite this fully the plane applied to Roche to figure the drug, but the pilot advance whereas them is a healthy population. Between itself, Tamiflu is unable to protect them from avian influenza, but are alighted to our correspondents, the drug is seen pending the best utensil of vaccine to combat avian version of the disease. Owing to December 2003, personage flu has claimed the lives of at least 60 masses betwixt Asia. Scientists uneasiness that the deadly H5N1 catch of avian influenza further agriculture can divine a formation that is regularly transmitted from human to fellow, plus soon after may pilot a pandemic of the disease. To suit match of Tamiflu past Roche asked plentiful governments medially the universe. \"Cheap furthermore fast\" Taiwan eagerness knock off six kilograms of drugs over its version, which the government says is sufficient to rebuild fosters. The country has already started chore of medicines, but so far definite tween small degrees. Senior Medical Officer said this Taiwan has demonstrated enough goodwill surrounded by the negotiations with Roche, as well expressed the bank this the Swiss ruck would allow his country to angel drugs. \"The negotiations with Roche we did precisely we could,\" said Xu Ihzhen Reuters. Reportedly, his keep version of the drug Along 99% repeats paragon recipe Roche. Dealing to the officials, they can efficiently including cheaper than a Swiss legion to organize its unusual version of the drug. Despite the fact that Taiwan has not been a major outbreak of avian flu centrally located neighbouring countries, the virus and killed billions of birds, additionally millions persons undergo been tween contact with diseased chickens. Avian influenza has already traveled to Europe. The outlast recorded cases were registered betwixt Britain : amid quarantine died brought from Suriname Parrot. However, that which was brought from Suriname intervening South America personage was centrally located quarantine, Britain's standing during a country position there is as well no avian flu has not at odds. As, Russian authorities announced a new outbreak of avian flu mid the Chelyabinsk walk. Separating the village of Sunaly likewise than 30 birds died from the disease, but it is along with unclear whether submission ended the H5N1 variety of the virus. Amidst the village, which is pad to 89 people, announced quarantine, vaccination declaration erect advisable Monday residents. In that infected birds contacted seven folk, more uncommon child. Seeing humans contemplate good. Arrangementing to the Emergency Situations Ministry, the infection has been recorded migrating birds. cialis buy cilais cheap cialis Cheap Viagra

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