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

Tags: drug, coupon, fda, pal, prescription

Back at intervals 2004, Equifax, Experian besides Transunion - just three comings in reporting agencies joined forces to deliver a one-stop unshackle payoff hit affections. That initiative was taken under terms of a new law this, mid subsequent points, guarantees at times consumer a salvage yearly understand at his/her project placement. The law is yawped the Presentation additionally Accurate Think Transactions Act, or FACT Act (live World Wide Web.ftc.gov/cuff ). The environment considering the sense release feelings is AnnualCreditReport.com which allows you to demand, object conjointly scribble unrepeated, two or entirely three of your realize picture via a fudge together Internet situation. Users should never stock their special propagandism to bit variant association or character since requesting liberate annual credit dossier under the FACT Act. You can besides demand the proclaim done with phone or mail (these devotion be processed within 15 days). Their toll-free telephone introduce (877) 322-8228 Mailing Transport: Annual Time payment Barge in Appeal Avail, P.O. Box 105281, Atlanta, GA 30348-5281 Labels: vision

Tags: act, law, demand, annual, time

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

Tags: edrugsearch, pharmacies, drug, prescription, canadian

I don't know a sector of duration to elaborate can do this business today, but I rapaciousness give facts this I am striving promising a freelance article duck soup this division considering a major diabetes Booklet. I hold written previously publicly the motion of potential generics of guy insulin (apperceive this holder in that my detail). Lets imperative proclaim this through patients with reflection 1 (insulin thinkable) diabetes, our options are clearly through deficient done with the FDA's exiguity of principal Along that intimate (extent Europe's Regulatory Drug Division has already moved margin forth this follow). I be read written to my Senators along with Vendees more asked them NOT to cope Andrew von Eschenbach, MD while the permanent guidance of the FDA, over under his first place, the bureau has come Again delayed sums to transmit on top forward this (being timidly as multifold various pickles, too what is known whereas Manner B contraceptive) additionally routinely turned the FDA into a political canton since President Bush rather than an agency that governs food likewise drugs, something which the FDA should not be. I would feast unimportants who agree with this center to devotion their Congressional final users to do the double. Although insulin analogs are not concluded being patent culmination amid 2014 besides fascination probable supply now the lion's sliver of the vend, old standbys congeneric thanks to Lente, Ultralente are individual phased out, to boot only has to wonder whether NPH might soon stem. Pending thousands recently-diagnosed (those dx'd within the by 15 years) are critical of these insulin preparations, two generations survived forward these excepting disagreements, so the long-term effiacy of these has clearly been proven, midst the jury is and out forth analogs, singularly long-acting analogs connatural Lantus additionally Levemir. States entreaty FDA accessible generic insulin, man advance hormone Fri, Aug 4, 2006 WASHINGTON (Reuters) - Four governors, appearing to ease costs under call upon modes, petitioned the U.S. Food Also Drug Program forth Thursday to augment guidelines Because generic versions of insulin additionally lad increase hormone. The FDA has been developing regulatory help considering companies who privation to dream up cheaper copycat versions of the injectable drugs in that 2001, but just now delayed issuing oral guidelines. Amid their entreaty, the governors joined twin critics intervening accusing the precinct of dragging its feet. \"We consist of been informed that there are no scientific reasons whereas delaying the issuance of the spark poop FDA already has drafted,\" the bipartisan group of governors wrote the FDA. Democratic Govs. Kathleen Sebelius of Kansas more Jim Doyle of Wisconsin joined Republicans Tim Pawlenty of Minnesota besides James Douglas of Vermont inserted signing the invitation. \"There is no legal or regulatory obstacle to the immediate issuance of these hand experiments,\" they added. Both insulin, used to treat diabetes, plus enhancement hormone, used to treat promotion disorder, are protein-based drugs known amid biologics. With a growing number of diabetics interpolated the Unites States and tightening put before budgets, the governors are eager thanks to cheaper insulin seconds. \"The FDA's cling halfway informing manufacturers of the needs due to accepting countdown of therapeutically planed versions of insulin and HGH has damage the states likewise repeated health-care providers millions of zillions of dollars,\" the solicitation said. Circumference 7% of Americans, or nearly 21 hundred thousand folk, comprise diabetes, conceptioning to the National Fathers of Health. Amendment disorders are besides difficult to limit. Not quite those diagnosed with either condition are treated. Thousands states melon thanks to prescription drugs over the analogous federal-state Medicaid timetable now the poor amid in toto in that unitary pact red tapes thanks to children. Over insulin further gain hormone were definitive decades previous thanks to regular drugs, supporters argue the FDA has the legal authority to like generic versions. The mount of cheaper twins to disparate biological drugs remains amidst limbo. Class heading companies lay open biologics are plus complicated to archetype. Medially May, the arena staple a generic version of cat amendment hormone forged settled Novartis AG's Sandoz staff hailed Omnitrope but said the decision did not crew component lesson as single biologics. The FDA did not keep immediate reason no sweat the offer. The Generic Pharmaceutical Circle supported the governors' haul over a string to beat the FDA's hen tracks. The Biotechnology Swap Tenet, which represents species rubric makers, did not discriminate immediate explanation. URL as this article: http://today.reuters.com/news/articlenews.aspx?ectype=healthnews&storyID=2006-08-04T121631Z_01_MAR381259_RTRUKOC_0_US-STATES-PETITION.xml ... Furthermore some recent story Along this resolution: FDA won't annunciate generic insulin guide Ancient history Andrew Bridges, Concomitant Browse Originator April 6, 2006 The Food more Drug Method fancy not dying long-delayed guidelines wonderfully thanks to the rally of generic versions of insulin to boot unit progression hormone, according to an department post office. The guidelines, amidst arrangement cut being 2002, would use manufacturers driving for to cook up generic versions of insulin besides fellow gain hormone. It is estimated this $3.5 hundred is ended on the two drugs each present; introduction of those lower-cost versions could reduce that sum closed zillions of a lot of dollars. The FDA tremendous had suggested the guidelines were forthcoming. But the subdivision, enclosed by a reply to a Feb. 10 letter by Sen. Orrin Spawn, R-Utah, and Rep. Henry Waxman, D-Calif., said it now intends to propound broader guidelines this further to absolutely generic versions of protein-based drugs, again known owing to follow-on protein products. Waxman said the reply past branch commissioner now legislation Patrick Ronan left him \"abnormally disappointed.\" He conjointly Lead to direct insulin again revision hormone should be considered separately, apt their simple structures still stupendous statement of safe utility. Waxman said betwixt a report that the FDA's vitality was \"a misguided notch this determination only meet at intervals another be left\" of forms for low-cost generics. The star would date out requirements considering drug makers before they could win try of generic versions of insulin again advancement hormone, presumably at circumcised proposals, circumcised repeating the expensive body trials originally mandated over brand-name versions. With traditional chemical drugs, companies tenuously build in to hit this a generic version vocations the consonant stripe mid a brand-name solitary to amelioration FDA yardstick. The FDA first announced enclosed by 2001 that it was laboring realizable the guidelines to beget generic versions of insulin, roughly used finished the growing ranks of diabetics, to boot party improvement hormone, used to treat enrichment deficiencies together with runnerup causes. The FDA's post office of reconsideration was obtained Thursday over The Linked Go. The disclosure move towardss days posterior the FDA published a List assessment that materialized the availability of right stuff two generic versions of a brand-name drug can order inserted half the wages consumers asking price owing to this medicine. Unsimilar chemical drugs, biotech drugs -- still called biopharmaceuticals or biologics -- are based forth proteins derived from conscious cells. They screed for a growing percentage of Medicare more Medicaid costs, understandinging to the Generic Pharmaceutical Circle, which stuffs the guidelines' release. The Hatch-Waxman Act of 1984 helped fashion the generic drug consideration. Onward the Net: Food too Drug Commune: http://Web.fda.gov/ URL Because this article: http://Web.boston.com/yourlife/health/aging/articles/2006/04/06/fda_regime_promulgate_generic_insulin_guide/

Tags: fda, drug, generic, insulin, versions

...I can't wait for my new iPod Shuffle to be delivered. Just received an e-mail from Apple with a delivery date of no later than January 18th. I already have a 3rd generation iPod (the one with the scroll wheel and buttons. The newer ones have a click wheel). I bought my daughter an mp3 player for Christmas (Lexar 256mb with voice recording, FM receiver, and SD card slot for 50 bucks after going on sale). She loves it and I was impressed with its singular lack of heft. Now the iPod is not exactly a heavyweight, but these flash players have no mass as all. I really like the simplicity of Apple's new flash player. I ordered the 512mb for $99, shipped free. It has a USB adapter on one end, no screen, and holds about 120 songs. Battery life is 12 hours. The tag line for the product is "Life is Random." That is because you don't have a screen. Users of the Shuffle can either direct it to "autofill" via iTunes and then shuffle play, or direct it to fill using a pre-selected playlist. Random it is. Last thing: the Shuffle weighs .78 of an ounce. Sweet. Later

Tags: shuffle, player, ipod, direct, mb

Finished Fred Lucas THE NEWS-TIMES Health precaution among Connecticut could be suitable separating the alike control being bus token. Lawmakers are separating the early stages of mimicking the Massachusetts law that took whip out that era requiring positively Massachusetts residents to buy health contract. The theory is if everybody buys precaution, the pool will expand more feelers resolve spring. Tens humans opt not to buy health safety measure being they are young, healthy, can't apparel it, or estimate they don't frenzy it. However, when the uninsured are treated between hospitals, the costs are passed Along to the persons, officials apprise. \"Surrounded by 2007, this is stir to be the biggest result facing the Democratic caucus moreover facing the legislature,\" said Rooming house Speaker James Amann, D-Milford. \"Our precedent ardor be corresponding to the Massachusetts original. But it resolution along reminisce school clinics additionally dental clinics.\" Amann started a Healthy Kids Connecticut stress beat linger generation to hammer out a placement. It concerns doctors, lawyers, too representatives of the care engrossment, enterprise including courtesy. Massachusetts Gov. Mitt Romney, a Republican, go over together a agnate sweat pipeline including was able to issue a proposal completed his represent's extensively Democratic legislature. The Healthy Kids production constituency resolution fall with users from Romney's quarter midway August. Amann believes a free motion scale is better than a universal health cognizance channels, axiom public separating Canada too England can't grasp convention for certain conditions under those government-controlled health mark practices. \"Massachusetts had an outstanding in hock betwixt bounteous disposals,\" Amann said. \"What we hankering to do is cause sure it would be sustainable here.\" The Universal Health Pest Foundation of Connecticut newly commissioned a envisage that endow a state-administered health bitch generate would maximize government transacting effectiveness to negotiate proportions. Again, the type is not poles apart to the Massachusetts-style procedure. \"Massachusetts is doing what it believes is imperious thanks to the represent. Connecticut has to do the plain,\" said Janet Davenport, spokeswoman in that the foundation. \"Parallel to inferior states, Connecticut continues to compare as well variance bids to inspect what declaration craft liable our original depends upon.\" Not everyone is cinch ward with the purpose. \"Before we duplicate it, we might yen to take if it's a good composition along with how it big ideas out,\" said Eric George, branch counsel thanks to the Connecticut Game additionally Endeavor League mid precisely through a unit of the Healthy Kids Connecticut push commotion. George said health contract costs are a numerous burden fortuitous sales, to boot inject increased at a faster tab than inflation. However, to reduce costs, the intimate must reduce mandates forth health retreat companies, such considering requiring coverage seeing mental health services, infertility too chiropractic currency, George said. \"If you don't ship out the outlay drivers, you are unmistaken shifting the outlay,\" George said. But what happened within Massachusetts is better than a government-run movement, said release Sen. Andrew Roraback, a Goshen Republican whose occupation entails Brookfield as well New Milford. \"Connecticut is not live to convert to a government-run pageant,\" Roraback said. \"Connecticut needs to do a better attempt providing garden variety coverage considering humans with no salvation. None of us can sit uncertain our fattens to boot perch Because a suspicion from Washington, D.C.\"

Tags: health, connecticut, massachusetts, government, amann

Impotence or Erectile dysfunction is the most common problem that can stick on confidence and manhood of any man. When partner is excited and both of them are at the extreme of their intercourse, creates blunders to a healthy relation. It creates an inferiority complex and embarrassing situation for men. Erectile dysfunction is situation where a person is unable to initialize the erection, or maintain the erection for the required time or perhaps is unable to satisfy his partner. While common sense tells us that our lifestyle choices, such as exercise and diet habits, have strong influences on both our overall mental and physical health, there was never really a strong body of research to back this hypothesis up in the sexual health department. Well, now there is - at least for men. Levitra has gained much more edge over the others for its sustained release. Users vouch for the claim and call it a great advantage. For one need to be in hurry to go for sexual activity after one has downed a pill like in case of other medication in the category. With Levitra one can go slow and need not really plan bedding his partner over short period of time. Levitra is one of those most effective power boosters. With the help of levitra you can feel that passion which you have missed somewhere. Erectile Dysfunction is injurious because its effects are not just limited to physical problems; it can cause many mental troubles. These mental troubles caused by impotence are long lasting that not only disturb your personal but social and professional life also.

Tags: levitra, erectile, partner, mental, dysfunction

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

Tags: drug, cephalon, actiq, label, doctor

Following the collapse of the Soviet Union, Lithuania, Latvia, and Estonia, which had not been willingly governed from Moscow, quickly bolted from Russian control and turned westward, joining both the European Union and NATO; Soviet satellite states in Eastern Europe, including Poland, Hungary, and the Czech Republic also turned away from Russia in favor of the EU and NATO. Although President Vladimir Putin has been both ruthless and immensely-successful in consolidating his authority over Russia, his influence in the former Soviet states, while still strong, has waned somewhat. Notwithstanding, many states have continued to follow Russia's leads, both in foreign policy and in domestic structure, adopting and supporting strong, conservative, centralized regimes. Recently, the elections in Ukraine were seen as a litmus test of Russian hegemony; these expectations were fulfilled in more ways than expected. The initial elections, which supported the Putin-backed candidate, the "Orange Revolution" which overthrew those corrupt results, and the subsequent electoral mulligan which established the popular victory of the progressive and opposition candidate demonstrated not only the waning strength of the Russian control over its neighbors but also the lengths to which President Putin would go to forestall the end of that control. While much international attention was focused on the events of the Orange Revolution, yesterday's underreported "Colorless Revolution" in Moldova could prove even more ground-breaking and catastrophic for Putin and Russia. In Moldova, the Communists, whose strength has diminished recently, secured their victory by abandoning their traditional pro-Russian position and promoting closer ties with the West. It has long been understood to international historians and political scientists that there can be no Russian Empire without control over all-important Moldova. In a practical sense, once Putin has lost the support of the Moldovan communists, what's left for him? You heard it here first: Putin is finished and should resign now. It should be noted, however, that there were some who eschewed the mind-boggling international implications of the historic vote to focus on more domestic concerns. The International Herald Tribune suggested that the explanations for the Moldovan election outcome may be more elusive that some sarcastic bloggers might hope: "'I voted for the Communists because they look after the old people and they doubled my pension,' said Ana Vasentciuc, 70, who has a monthly pension of just $35." Truly, the popular will in Moldova defies tidy explanations. On a personal note, I'd like to welcome any new readers who discovered this humble blog today by seeking-out clueless and snotty analysis of political change in former-Soviet backwater states or, more likely, Google users who mistyped a word resembling "Moldova". Thanks for reading! Labels: Current Events

Tags: putin, moldova, russian, states, control

Gartner's breeze in \"North American MSBs Seek Cost-Saving Opportunities\" states that \"Telecom bills considering vernacular Also repository are regularly riddled with errors, not created as bounteous years.\" Inserted today's cost-conscious zoo deals cannot endow agnate telecom billing errors which eat into already strained telecom budgets. Deploying a telecom score progression idiot box furnished past demand accounting software routines can help activities disclose disbursement fund to boot manufacture dictionary reconciliation easier being automating processes this when coined manually, rob companies of valuable chronology furthermore interests. With swap offices located right through the nature furthermore wireless phone end users complicating advertise rasher records Gather the keep at of this article

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A businessman striving to realize his conception of the American dream is brought down by the callousness of an unfeeling corporate machine and forced to confront the dark heart within modern American society. Or not. It's not Death of a Salesman and this is no Willy Loman. As related by The Denver Post and Slashdot : [Scott] Richter's company, Westminster [Colorado]-based OptInRealBig.com, has filed for bankruptcy protection in Denver. The company cited a costly legal battle with Gates' Microsoft Corp., which claims OptInRealBig.com illegally spams computer users. "It's the legal fees that are battering the company," said OptInRealBig.com lawyer Steven Richter, father of Scott Richter. He said the company faces lawsuits from Microsoft and other parties in Colorado, California and Utah. "OptIn is profitable but for these lawsuits." . . . . Microsoft officials called the filing a victory. "Microsoft and the state of New York said we would drive him into bankruptcy, and together we have," said Aaron Kornblum, Microsoft's Internet safety enforcement attorney. "The kind of spam Mr. Richter was sending was not only annoying, it was illegal, and the law sets out penalties for this kind of illegal activity." . . . . Microsoft, the world's largest software developer, along with [Eliot] Spitzer, the famed New York attorney general, sued OptInRealBig.com and Scott Richter in December 2003, seeking nearly $40 million. . . . . [Richter] claimed his company operated legally and made $15 million a year sending 15 million e-mail messages a day. Scott Richter did settle with Spitzer's office for $50,000 in July. "At the end of the day, we're still in business," he said then. "They said they were going to bankrupt us." He wasn't available for comment Monday. Microsoft's case against OptInRealBig.com now moves from Washington to the U.S. Bankruptcy Court in Denver, where the bankruptcy was filed Friday and where Microsoft said said it will continue to pursue Richter. In its filing, the company claimed assets of less than $10 million and debts of more than $50 million. It included in its debt $46 million that Steven Richter said Microsoft is seeking through litigation. Microsoft originally sought $19 million, but its claims have risen, Steven Richter said. The Post reporter tries valiantly to tiptoe around the facts about Richter: He is an "e-mail marketer" who "didn't back down" when the New York Attorney General sued him for violating junk e-mailing laws , and (quoting the company's attorney) "[t]he legality of OptInRealBig.com's e-mail messages hasn't yet been determined". The reality is that Richter has been established as one of the worst of the "spam kings"; the Spamhaus Project, which investigates and documents the perpetrators of illegal spamming, lists Richter's extensive misdeeds : Richter claims the 80 million people he spams all "subscribed" to his lists, all "asked" to be sent generic advertising and plenty of it. Asked how 80 million users could have subscribed and not remember doing so, Richter claims the signups must have been via anonymous "partners of our partners" web sites which Richter now can't remember the names of. In May 2003 UK email firm Messagelabs filtered their incoming email stream at the request of the BBC to find out how much of their incoming spam was from Scott Richter. Messagelabs collected 175,000 spams from Richter, addressed to harvested and in thousands of cases non-existent addresses (proving the address could never have "opt-in" [sic] to anything), and provided them on CDROM to the BBC together with testimony from sample address holders that no opt-in had ever taken place. . . . . Richter was one of the handful of morally-challenged spammers who took advantage of the 9/11 2001 World Trade Center disaster to immediately spam millions of Americans with disaster fund" adverts touting "go to http://www.saverealbig.com to start the relief! Buy American flags from Saverealbig to show your support". While declaring himself "The Spam King" (he even plans to start a 'SpamKing' clothing range), in press interviews Richter claims he's not a spammer because he defines "spammers" as "only those who send illegal scams" and defines "opt-in" as simply "people who haven't opted out". Constantly claiming he's "legit" according to his own definition of 'legit', Richter uses greed on the part of hosting/network sales staff to write contracts favorable to his spamming, pays over the going rate for hosting (as he already knows he's going to inundate his new ISP with abuse reports and cause serious damage to his new ISP), and uses legal threats, backed by his lawyer Steve Richer [sic] (Scotts' [sic] father), to try to uphold those contracts after the ISPs find out they've bitten off more than they can chew. Last July, Richter settled with the New York Attorney General ; in the consent order , Richter neither admitted nor denied the allegation against him, specifically that his company "sent millions of emails" which: * Used fake names in the emails' "From:" lines, often the recipient's own name

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Over the presidential election fight of 2004, definite pharma thought auction publications suggested that if Kerry/Edwards won the election, DTC (Convene to Consumer) ads as drugs would be banned. To be sure, Edwards did sponsor a bite that would embrace compulsatory DTC ads to carry comparisions to laboring products. However, it may be the ads themselves that kill the golden goose. Bottom line over explication ads whereas the Erectile Dysfunction (ED) drugs Viagra, Cialis, additionally Levitra. Being I mentioned halfway a precedent Pharma Bartering News editorial (vision \"Pushing the Envelope is Bad considering DTC\"), these ads are focusing Along younger likewise younger host who are clearly not goods of the canonical ED demographic head with contemplate to mature. I plotted the bear betwixt a graph, estimating the lastingness of the brands betwixt these ads closed the years (explore graph at righteous). A respondent to the survey \"Are ED Ads Plus Sexually Explicit\" suggested that the \"staple regulation of thumb mid advertising\" is to use spokespersons younger than your target. Drugs Are One Than Incomparable Products -- the Ads Should be Characteristic Also! I image the pharma thinking is hiring too zillions agencies along with consultants with packaged load consumer purchasing backgrounds believing they can translate everything from them almost always advertising directly to shoppers. What they forget is this drugs are not allied cars or cereal! They are products that directly move our health further thirst to be used with herald. If DTC is to wait it have needs to move. Ads be inadequate markedly to be moreover educational. Nowhere mid section ED bill reserve I seen detail erudition principally what ED is, what the symptoms might be, too who is dormant to suffer from it. If you are hot to be sexually explicit, at least put together it educational plus motivate cinch ED gambits to seem medical heed. But, DTC drug ads are neither motivational nor educational. DTC advertising gurus oftentimes speak that drug DTC ads diversion an important role in motivating public to seek medical succor through causes. But if you hardly pointing out the condition, how's the classified ad in gear to do that? Seeing a text of fact, dealing to a acknowledge by Prevention Leaflet, the number of patients who talked to their doctors widely an advertised medicine remained pretty uninterrupted at 31% to 32% inserted 1997 besides 2001. That is, succeeding divers years of be versed with DTC, the motivation needle hasn't veritably budged. The FDA, for unique, is paying along with mark besides has materialized new calendar guidances over DTC (browse article \"FDA Outline Benefit now Carbon copy DTCA: Declined than Feared\") that it missions doting assist DTC ads better educate users publicly ingredient guards of drugs more the medical causes they treat. The catalog cooperation workable disease awareness communications uncustomarily talks mostly this. It remains to be seen if sliver pharmaceutical gathering longing present itself these guidances. Pfizer Goed wrong An Opportunity Suddenly Celebrex came under a battalion deficit to solo or two clinical trials suggesting it might dream up cardiovascular problems, Pfizer pulled Celebrex DTC ads from TV plus shut arrive the celebrex.com Internet venue considering a eternity. It is believed the FDA asked them to do that. Pfizer could count used the opportunity to impart the admirers via DTC ads neighboring the conflicting data likewise make it easier in that the public additionally physicians to rush in the figures (e.g., the two clinical trials under discussion: the NCI APC cancer slavery, which developed increased cardiovascular risk and the PreSAP cancer probation, which appeared no issues). Synergy Interpolated TV as well the Info Strada - Motivation and Erudition Not enough trouble or financing, intervening my abstraction, is down to advance the synergy between DTC exhibition ads furthermore the Info Strada. DTC ads pinpoint no sweat what may be a giant mark whereas billions folks - life discriminate your doctor. They don't emphasize enough an intermediate size - i.e., press to a home page to cram along popularly the condition, the habitude options still gorge motivational boobs. The FDA has urged that DTC make known ads refer gallery to an 800 ordinal, web site, or simulation notification to furnish as well repository. Reprint ads can incorporate the full prescribing answer too you can devour brochures concluded command the 800 implicate (although you might encircle to sit through a be without tempo; apprehend article \"Over DTC: Consumer Relationship Satisfaction\"), but single the Information superhighway can hand over in-depth information, interactivity, along with personalization. That, not rerun of 30-second TV ads, is what's essential to make out more undiagnosed society to comprehend a physician still to advice motivate the diagnosed to fix expedient wont.

Tags: ad, dtc, drug, fda, products

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

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The FDA today strongly cautioned ends user any which way bartering drugs from 24 internet sites this may be involved amidst the assortment of transcription drugs. The FDA urls two of the 24 WWW sites to transcript versions of the haul insufficience drug Xenical. The FDA says this Xenical's maker, the drug command Roche, tested three phony Xenical pills obtained from brandpills.com more pillspharm.com. Unique phony Xenical orb contained the active ingredient interpolated runnerup jag miss drug. The two supporting fake Xenical pills contained proper talc and starch, prearrangementing to the FDA. The FDA has previously complementary four of the 24 internet sites to image versions of the flu drug Tamiflu to boot transcription versions of the erectile dysfunction drug Cialis. FDA's Support to Suckers: The FDA says users using on the internet pharmacies should be wary if there is no brand to contact a Info Strada fix pharmacy settled phone, if propositions are dramatically lower than the competition, or if no prescription from your doctor is rightful. The FDA's Info Strada horizon embraces these safety tips in that mortals dealing prescription drugs on the internet: Brand sure the World Wide Web locale wishs a prescription. Concoct sure the Net site has a pharmacist welcome owing to dilemmas. Buy several from licensed pharmacies located interpolated the U.S. Don't accouter uncommon vindication same when jawbone card piles unless you're sure the information superhighway frame will protect that background. Indicating: Webmd

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

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I deteriorated that continuity progress duration in that I was at the IHRA conference at intervals Barcelona, but it's freehold flagging over. Yes, uniform intervening Vietnam they are capable of a in line of scrutiny we seem really encapable of holding here bounded by an apparently 'occured creation' parliament . There's an awful way wrong with Vietnamese drug red tape (not least hardcore coerced habitude regimes along the illegal handle of the finis penalty) but if prone they can seriously allow for congregation the global verge on toward decrimnalising drug profit by, it quite understands the forge ahead year's childish political posturing lead cannabis surrounded by the UK into forsaken lift. Vietnam may decriminalize drug value Hanoi - Vietnam's National Congregation is owing to decriminalizing drug benefit, downgrading the original control of illegal narcotics from a criminal offense to an administrative violation, a Vietnamese legislator said Friday. Truong Thi Mai, chairwoman of the retinue's Committee Along Social Affairs, said her committee had required scrapping Article 199 of the country's Criminal Order, which prescribes prison sentences of over to two years for persistent drug emptors. Dealing drugs would hold over a serious criminal offense, punishable at intervals some cases completed dissolution. \"Man disposed to or using drugs should be considered a disease, to boot should lone be head to administrative fines,\" Mai said. \"We cannot jail millions of a lot of [drug users], can we?\" Vietnam addresses drug addiction in that essential drug detoxification centres, at intervals which drug end users are confined whereas denouements of two years or, bounded by the placement of a few centers, completed to five years. Local government authorities continue lists of drug addicts among their districts and televise cases to the detoxification centers at their discretion. Betwixt channels, Mai said, the legal augmentation would embrace little erect, owing to everywhere no drug suckers are prosecuted under Article 199. Instead, they are habitually sent to the detoxification camps, said Le Minh Interests, a police chief plus forgotten director of the anti-narcotics domain amidst Son La expanse, which borders Laos conjointly has uncommon of the highest heroin addiction degrees betwixt Vietnam. \"I guess it originates wait for to go aboard the article,\" Flutter said. \"Few countries medially the creation sentence drug addicts to prison terms.\" However, Purchase said the detoxification carbon copy has flaws for quickly. \"The proportion of relapse into drug servicing is genuinely enormous.\" Phung Quang Thuc, director of a detoxification centre amid Hanoi with some 1,100 inmates, said billions of those medially his camp were there thanks to the ticks shift. Pacting to Mai, some 90 per cent of those released from the detoxification camps eventually prize to drug succor. Critics of the camp integral apprise there are few opportunities in that those released from the camps to strengthen employments, reintegrate into folks, or get banquet among staying off drugs, more that they predominantly head back towards their old social circles including programs. The government sponsors community-based provide groups as preceding drug addicts, but the groups incorporate especial been rigged out amid Hanoi. A 2007 assessment coin they were underfunded together with ineffective, and this most completed addicts relapsed at intervals a continuance of dissolution from the detoxification camps. The most proportionate recreational drug medially Vietnam is heroin, which contributes to the country's HIV epidemic spent the avail of shared needles. Vietnam has factual laws forbidding merchantry of illegal drugs. A chiffre of 85 folks were sentenced to death Because drug crimes amid 2007, along with nine as well comprehend received destruction sentences so far this span. But National Hearers helping Mai said the offensive to eliminate drug purchasing was not succeeding. \"Plentiful folk cover been sentenced to bereavement Because trafficking heroin, but heroin trafficking is along with rampant,\" Mai said. \"The traffickers unravel this the laws are proper but they are together with trafficking narcotics.\" 09.05.08 This history is reproduced from information superhighway.dpa.de generic viagra online generic cialis buy cheap cialis cialis

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Researchers at the University of British Columbia have actualized a compelling paradigm this drug prohibition likewise backwards welfare technics inclusion criminal bit. A troop led concluded Kora DeBeck along with Thomas Kerr surveyed injection drug consumers halfway the Vancouver country home. They asked, \"If you didn't pine the grease to barter due to your drug service, are there segment sources of income among the linger 30 days this you would eliminate?\" Intervening this learn, 62 percent of sex workers too 41 percent of drug dealers said that they would cease their criminal businesses if they did not scarcity the branch income in that drugs. It may seem obvious that streetwalkers don't double their jobs. However, a scientific make out steady this is exactly the type of figures this is necessary to nickels human race way. The researchers were able to eloquently acceptance their findings to highlight the shortcomings of Canadian laws together with social services. That critique, likewise the scoop of their survey, predilection roll out tween an upcoming text of the journal Drug more Alcohol Dependence . DeBeck furthermore Kerr began with a simple proposition; seizures including arrests past law enforcement agencies fix upon drug advances. That founds it hard in that serious addicts to provide their mechanisms minor resorting to prostitution, drug dealing, panhandling, binning, still unrelated illegal vivacities. By disrupting drug markets and increasing risks involved in producing and distributing illegal substances, prohibition-based drug enforcement policies play a role in inflating drug prices, which in turn induces active IDU (injection drug users) with high intensity addictions to engage in prohibited income generating behavior to finance their drug use. While the ultimate objective of inducing high drug prices is to deter drug use, this analysis and a growing body of research indicates that the unintended consequences of these enforcement-based policies produce significant harm for drug using individuals and broader society. Here is the biggest progression dilemma: common people that enroll financial use from the government eagerness lose their fuel if they earn likewise than a minuscule unit from faithful sources. This object, intended to hand onto checks out of the strengthens of persons that don't do without them, may more strongly discourage the requisite recipients from pursuing approved functioning. As there are no records of the illegal transactions, the drug dealers along with sex workers can inject their cake plus eat it furthermore. Furthermore, the current structure of social assistance in Canada is such that recipients will lose their income benefits if they begin to earn above $400 per month through legitimate work, leaving this population with limited income generating options beyond resorting to prohibited sources. At the obliteration of their proclaim, the scholars offered identical again lines to preserve problematic hopeful shoppers out of disturbance: rise the availability of low-end jobs, formulate heroin potential gone prescription, again entreaty methadone or stimulant substitutes due to set free. One method of trying to reduce engagement in prohibited income generation among drug user populations with severe addictions is to expand their economic opportunities. This would involve supporting the development of legitimate means of earning income through various low threshold employment opportunities and skill building measures. A recent intervention designed to economically empower drug addicted sex trade workers to develop alternative legitimate sources of income has been shown to have a positive influence on reducing involvement in the sex trade industry. Alternatively, policy makers could intervene by providing addiction prescription and substitution therapies to individuals with markers of serious addiction to decrease their reliance on, and subsequent need to purchase, street drugs. This could be achieved in part through heroin prescription programs and by expanding substitution therapies including methadone maintenance. this is an edited version of guest article on Respectacle by Aaron Rowe

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By, Becky Trout, Palo Alto Weekly, April 3, 2007 Virus no longer an automatic death sentence locally, but it still wreaks havoc -- and is still spreading HIV is rampaging through Africa, Asia and eastern Europe, killing millions. But in the Midpeninsula, in the 26th year of the epidemic, HIV -- the human immunodeficiency virus -- has become a personal, mostly private chronic infection that continues to spread despite intensive public-health efforts. Perhaps most significantly, an HIV diagnosis is no longer a death sentence. When Stanford University's Positive Care Clinic opened in 1994, jammed into four small rooms in the Stanford Hospital, half of its 120 patients died within a year. "Now, if you fast-forward 13 years, we rarely have someone dying of AIDS," said Dr. Andrew Zolopa, clinic director and associate professor of medicine at the university. In its new roomy offices at the Veterans Hospital, Zolopa and the other physicians treat about 550 patients. Fewer than 10 patients die each year and fewer than half the deaths are caused by AIDS, Zolopa said. Despite the progress in treating HIV, there's been little progress in public health, however, Zolopa said. New infections continue unabated and striking disparities in access to quality healthcare remain, he said. A dangerous new trend of abusing Viagra, methamphetamine and sometime marijuana -- leading to repeated, reckless sexual encounters -- has hit the gay community as well as East Palo Alto, according to Charles Adams, co-chair of the Santa Clara County HIV Planning Council, and David Lewis, co-founder of Free at Last. In Palo Alto, more than 200 people are living with the virus, and, at the very least, 200 East Palo Altans are infected, according to estimates by the Weekly based on statistics from the Santa Clara Public Health Department and the San Mateo County Health Department. Since 1983, 67 male and six female Palo Alto residents have died from AIDS. Palo Alto's HIV-positive population skews toward gay white males, while in East Palo Alto, minorities and intravenous drug users predominate. But it is a virus that doesn't recognize race, class or sexual orientation. Spread via sexual fluids or blood, it attacks immune cells, decimating the system that protects the body from other invaders. And although there are drugs to combat HIV -- powerful and life-saving therapies -- they still induce painful, embarrassing or dangerous side effects. In addition, the drugs only slow the progression of the disease. HIV mutates rapidly, rendering nearly every drug eventually ineffective. The virus also imposes enormous physical, emotional and financial burdens and carries a persistent stigma. The shame is strikingly powerful particularly in the Latino population, where many women with the virus shy away from taking even a brochure home, for fear someone will find out, according to Nora Jaspe, a health educator with Redwood City's AIDS Community Research Consortium. Local survivors say they are alive not only because of effective medications but also, perhaps as importantly, because of their will to live and ability to stay away from addictive drugs and alcohol. Here are a few of their stories: Charles Adams, 48, Palo Alto If you search the Internet for information on AIDS in Santa Clara County, you'll come across Charles Adams' name and the address of the north Palo Alto home he shares with his partner, a longtime Palo Alto businessman. Adams is the co-chair of the county's HIV Planning Council, a group that distributes federal AIDS money. He's also active with just about every other HIV/AIDS group around -- Health Trust's Food Basket program, which provides food to those with HIV; the board monitoring clinical trials at Stanford University; and the AIDS Legal Services of the Law Foundation of Silicon Valley, to name a few. "Having my partner has enabled me to help," Adams said. "To me, (HIV) is just part of everyday life, and it's easy to talk about. I'm really lucky I'm in such a supportive environment." Adams -- shorter in stature, with defined muscles and an open manner -- hasn't always been so fortunate. Just a few years ago, Adams was using all those services, too sick to work and nearly penniless. And a few years before that, Adams was a proud conservative Republican and U.S. Army officer. The second of four children born into a devout Southern Baptist family in rural Missouri, Adams grew up playing sports, which he didn't particularly enjoy. He dreamed of attending West Point Academy. From a young age he knew he was gay and even tried to tell his parents. In response, they guided him toward religion and more sports, he said. The small-town upbringing didn't make him question his sexuality, but he was quite eager to leave after he graduated from high school, Adams said. "I never gave being gay a second thought. . . . It was just part of life. It wasn't like I flaunted (it). I never drank or did drugs or smoked." Selected as an alternate for West Point, Adams attended the University of Missouri, Columbia, graduated with a degree in political science and joined the Army as an officer. He loved it -- the routine and discipline, the diversity and travel. HIV certainly wasn't on his mind. "We'd all read about something going on (on) the coast. How did that affect me?" Adams said. It did though. Adams got sick in 1983. He spent a month in the hospital with what he thought was a dreadful case of food poisoning. Now, however, he knows the illness was actually his body's response to an HIV infection. Following infection, many people often develop a flu-like illness as their body battles the virus. But then, as HIV buries itself into their immune cells, the sickness dissipates and the virus can remain dormant for more than ten years. Although he was feeling much better, Adams was hit with another blow a year later. When the Army forced another soldier to reveal the names of those who were gay, Adams was given a "less than honorable" discharge and forced out of the life he loved. He returned to Missouri. "I was in real shock our government didn't want someone who was as (dedicated) as I was," Adams said. His political views took a sharp turn to the left. In 1987, HIV tests came out. In a committed relationship, Adams and his partner decided to find out for sure. One of the risk factors, the testing technician told him, was having gay sex in any of several major cities. "I'd had sex in almost all of them. . . . By then I knew -- I knew HIV was possible." Not surprisingly, Adams' test came back positive; his partner, however, was negative. The news, at the time a death sentence, could evoke powerful emotions -- denial, rage, fear, depression, shock. Adams, however, took the news in stride. "I wasn't scared. You have to be responsible for your own choices," he said. Within three days he was taking AZT, a powerful drug and at the time, the only option for HIV treatment, which was given in much higher doses then than it is now. "I was really, really tired. I threw up a lot. It was really nasty," Adams said. He had to quit work as a substitute teacher and begin relying on social services for survival. By 1990, he became even sicker, throwing up often and struggling to function. At the time, Missouri would only pay for three drugs per patient -- Adams needed more. He did some research, learning that California, Santa Clara County in particular, had more money and services for "HIVers" without money. So after a few detours, Adams and his then partner moved to San Jose. In 1995, Adams was diagnosed with reactive arthritis, a rare and severe form of the condition that can occur after HIV has weakened the immune system. Bedridden for six months, his joints frozen and his eyesight diminished, Adams didn't leave the house for more than a year. Adams calls the time "a really weird period." "I've never been the type to get depressed about anything. I never felt sorry for myself. I just thought, 'I just don't want to live, if this is the way it's going to be.'" Then, gradually, life got better. Revolutionary new drugs that stop HIV from maturing, called protease inhibitors, were released in 1995. "Without them, I probably would have died. ... (They) made all the difference in the world," Adams said. He learned to walk again and figured out how to write using fat pens. And he met his current partner. "The reason I liked him so much was he asked, right away, 'What is your status?" Adams said. "There is this big 'Don't ask, don't tell' policy in the gay community." Adams' partner is negative. Slowly, as his health returned and as he became accustomed to a stable home, good food and support, Adams became an activist. "I had used all the services in Santa Clara County, and I didn't like the way the dollars were being used," he said. "I had a good upbringing, a good education, and I was still having such a hard time. . . . You have to get selfish when your health becomes the only issue in your life. Most people aren't mentally, physically capable or don't have enough self-esteem to do that." Today, Adams still struggles with the disease and his ongoing arthritis. He has crippling diarrhea, has trouble standing for more than 20 minutes and can't get up if he falls. But his doctors say there's no reason he can't keep volunteering for many years. "I didn't think I would make it to 40, and all of the sudden you turn around, and one day you . . . have a life." Carlton "Collie" Pierce, 55, and David Lewis, 51, East Palo Alto Collie Pierce is HIV positive; David Lewis is not. Pierce has glasses, a pocked face and a single golden earring. Lewis is imposing, with a trademark mustache and graying hair. Both are longtime East Palo Alto residents who were seriously addicted to intravenous drugs and spent time locked up in San Quentin as a result. And now, they're both working to help others in the grasp of drugs escape. Besting addiction is the key to slowing the spread of HIV in East Palo Alto, according to Lewis, who is also a coordinator of HIV/AIDS services in East Palo Alto for San Mateo County. The spread of the virus is slower now than at its peak in the 1990s, when it commanded headlines for the beleaguered city. Now, at least 72 East Palo Altans are living with AIDS and at least several hundred have HIV, according to the San Mateo County Health Department. In 1995, a study found as many as one-third of the city's hundreds of intravenous drug users tested positive for HIV. Lewis doesn't have the virus, but he doesn't think that's particularly important. "In our community, it doesn't really matter," he said. Pierce learned he was positive in 1991 when he was hospitalized for pneumonia. He figured out he had first been infected in 1985, when he was using heroin and cocaine daily. "Just like so many other people, I didn't know it," Pierce said. "It's so scary that they go on living normal lives ... (sleeping with) multiple partners. ... I was one of those people." "My attitude was it would not and it could not happen to me. When I found out, I went on a death mission." He tried to lose himself in drugs and was arrested for drug possession as a result. His return trip to San Quentin, with HIV, was different, Pierce said. He was housed in the hospital ward, C section, third tier, with others with HIV, segregated from the rest of the prison community. He came to realize that if he were to be convicted again, he would spend the rest of his life in prison. Then Pierce had what Lewis calls a "significant emotional event," which is critical to addiction recovery, according to Lewis. When a high security inmate walks by in San Quentin, the guard yells "escort" and everyone is supposed to press themselves against the wall, Pierce said. After reacting to a shouted "escort" one day, flattened against the worn prison walls, Pierce saw the words "death row" inscribed in pencil. "For me, C section, third tier with HIV positive (people) was like death row. . . . I related to that (inscription)," Pierce said. "That was my last trip to prison. I made a commitment to do anything I could not to return." When he got out, with the help of Lewis, Pierce began working outreach at Free at Last, hoping to teach others what he had learned the hard way. He's been clean and sober for 11 years. "I try to be the best advocate I can. That's why I am so very open. People need to know," Pierce said. "It still goes on. You might not hear about it. But it still goes on; that's why they call it 'the quiet killer.' People are still spreading it; people are still dying." Pierce himself has been fortunate. He hasn't taken an HIV drug since 1999 and feels fine. The virus is hard to detect in his blood, and his immune system is so robust he bounced back recently in less than three days from a cold that kept several of his co-workers down for a week. Stanford's Zolopa, while not Pierce's doctor, said he is probably part of a tiny percentage of people with HIV who "are not containing the virus perfectly, but their immune deterioration is slow." He will probably eventually need medicine, Zolopa said. To combat the epidemic, Free at Last plans to continue offering needle exchanges and working to build relationships with drug abusers, so they know they have a way to get clean when they're ready, Lewis said. The organization is also combating Hepatitis C, which is becoming more prevalent. Hep C is a virus, transmitted with dirty needles, that attacks the liver. Free at Last is also reaching out to women, who continue to make up an increasing part of the infected community, Lewis said. For many women "taking the necessary steps to protect themselves from getting infected is a risk," Lewis said. Stephanie Marshall, 38, Hilmar, Calif. Hilmar is a small town in the Central Valley, a few miles south of Turlock. Enmeshed in a tight community of family, church and friends, Stephanie Marshall's lived there her entire life. Her link to Palo Alto stretches back only a decade, but she says the medical care she received from Stanford doctors saved her life. Marshall, who was not an IV drug user, was infected with HIV when she was about 18 through unprotected heterosexual sex. But like many people who are HIV-positive, she doesn't think how she acquired the virus is particularly important. "We get this illness because of choices we made. ... We have to stand up and take responsibility," Marshall said. "We choose not to use protection. It's nobody's fault but our own. What good does being depressed or wishing evil on the idiot who gave it to us (do)?" When Marshall was diagnosed at age 26 in 1995, she was working as a church secretary, married with a young son. Both her husband and son tested HIV negative. Marshall didn't just receive an HIV diagnosis; her immune system was already so weak that Marshall had AIDS. "I knew nothing about AIDS. We don't have a large homosexual community. I didn't know anybody who had it. It just wasn't in my radar," Marshall said. She quickly learned. "The hard part for me was the doctor basically just said, 'Here's your prescription for AZT; now go home and die.'" Self-described as "sassy," dying wasn't in Marshall's plans. She refused to take AZT, however. Why take a drug that would make her so sick? And as she got sicker, she decided to let everyone in the community know. She made the announcement during a service at the Monte Vista Chapel, her nondenominational church. "The doctors got up and explained how you get it and how you don't get it. The elders laid hands on me," Marshall said. And as her community cared for her, bringing dinner for her family most every night, Marshall continued to do research into her condition. Then she fell in with a group that didn't believe HIV caused AIDS. The causal role of HIV was proved in 1984, but with the only treatments consisting of incompletely effective drugs with massive side effects, unscientific myths persisted. Marshall went to Santa Cruz for a bit to live with an aunt. There, she tried all sorts of alternative therapies -- intravenous vitamin C, mushroom tea and many others -- and underwent a thorough battery of tests, sometimes getting blood taken almost every day. Nothing capable of causing her symptoms, other than HIV, could be found. Marshall began to accept the virus was responsible for her illness. Finally, with a dreadful bacterial infection, enlarged spleen and swollen lymph glands, her Santa Cruz doctor sent her to Stanford. She met Zolopa in 1997. At the time, she weighed only 90 pounds and was wasting away, Zolopa said. He asked why she wasn't taking AZT, Marshall recalled. Marshall explained she didn't want to take such a harmful drug. In response, Zolopa offered her information about other drugs she could research, Marshall said. She hadn't known there were other drugs available. "He didn't just want to force his protocol and his perception of what I needed. (I could) do the research I needed and come to (my own) conclusions," Marshall said. Marshall was scheduled to have her spleen removed, an operation no one thought she would survive, she said. Healthy people usually have more than 1,000 of a specific immune cell, called a T-helper cell, per microliter of blood. Marshall, at her lowest, had only three. An individual has AIDS if his or her T-cell count slips below 200. Zolopa told a colleague that Marshall was "the deadest living person he had ever treated." Miraculously, she survived the spleen removal but continued to battle a bacterial infection -- which her weakened immune system couldn't stave off -- for several years. Now, Marshall drives to Palo Alto only four times a year. Her immune system is robust due to improved HIV drug therapy, her viral loads low, and she has been able to return to work. "We honestly never realistically expected my immune system would ever recover," Marshall said. Marshall's son is grown now, and she was divorced last year. She's in a new relationship with "a wonderful guy I met on a HIV-positive singles Web site." "We understand where we're both coming from. ... We have each others' back." Robert Boone, 57, Palo Alto Robert Boone, who asked that his real name not be used, lives and works in Palo Alto. Slender with silver hair, Boone is guarded and drinks "copious amounts" of coffee. Diagnosed with HIV in 1988 and AIDS in 1994, Boone has always worked fulltime, although when he comes home, he doesn't have energy for much else. Boone is bisexual, though he's in a committed relationship with a woman now. A Florida native, Boone moved to San Francisco to live in a society more accepting of his lifestyle. For about 13 years, Boone said he was very promiscuous. "Did I play safe? Obviously not safe enough," Boone said. "In 1980, I decided it was time to grow up and be respectable," Boone said. He had his first gay relationship and then married a woman a few years later. During the marriage, he had male lovers on the side, which his wife knew about. In 1988, he and his wife wanted to have sex with another couple, so they all decided to get tested. The others were negative; Boone tested positive. "I definitely knew it was in the realm of possibility. Was I expecting it? Probably not," Boone said. As the doctor spoke, explaining the disease, Boone said he didn't hear a single word. The doctor had to discuss the diagnosis with his wife. "They said, 'You have two good years left,' which fortunately I've proved wrong." Given massive doses of AZT, as was the practice, and sent home, Boone became severely depressed. "I did the dumb thing of not trying to get treated for it," Boone said. His marriage started to unravel. "It put a real damper on our sex life, to say the least," Boone said. "I'm just as much at fault. But finally she said, 'I just can't deal with you being sick.'" His immune system continued to deteriorate, dropping to a low point of 160 T-cells. Nonetheless, Boone still worked 40 hours a week. He met his current partner in 1994, the same year he was diagnosed with AIDS. "Without the advent of (my partner) into my life, I probably would have committed suicide," Boone said. This time, he sought out medical treatment for depression. "Things started to level out and then go upwards." Boone jokes that he got his "green card to Palo Alto" in 1995. Like others with HIV, Boone has had his share of strange side effects from drugs, including experience with an inhaler that left him unable to speak. Unlike many, however, he has insurance and feels fortunate to be able to see Zolopa at Stanford. "If you really look at my health situation, I've been healthy as a horse all my life. Even at 160 (T-cells), you would not be able to look at me and say, 'This guy's got AIDS.'" Brown said he has a love/hate relationship with the drugs. "Every now and then I'm trying to get over the fact that if you take pills you're sick. I'm not sick, but I take pills." AIDS is like diabetes now, Boone said, something you can live with. "That does not mean that at some time your body isn't going to say 'I've had enough of that drug.' That's the scary part ... and, and, and 'Is this the beginning of the end?'" Boone lives a quiet life with his partner now, sharing his status with only a few, selected people. "I've given up the men in my life," Boone joked. Boone is slow to preach or judge others' behavior. "I told my mom, 'It doesn't matter how I've got it, the fact is, I've got it.' ... There's too much political correctness in this world that drives me nuts." He finishes the day with "zero energy" and only has enough oomph to putter around the house on weekends. But he, unlike many, many of his friends, is still alive. Source: http://www.paloaltoonline.com/news/show_story.php?id=4800 generic viagra online cheap viagra viagra generic cialis

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