Month: April 2007

AARP – Selling to you AND advocating for you at the same time

Am I just slow on the uptake? How can you simultaneously be an advocate for someone, and also sell them something very expensive and important? If at some point in time, these two tasks conflict, will AARP drop out of the healthcare industry to ensure that its role as advocate does not get compromised? I think not, the conflict of interest simply boggles the mind. How can you write a whole article about this issue and not have CONFLICT OF INTEREST flashing in big bold letters!!

For example, if it is proven that single payer, universal healthcare was the most effective way to ensure that people 50-64 (before they hit medicare, which used to work very much like single payer healthcare without drug coverage until a really complex and crazy drug insurance was written on top of it) were insured and healthy, how would this affect the AARP? They are now in the business of selling you the health insurance that would be rendered less necessary by said policy, what would the AARP do? Somehow, I don’t see them saying “Yeah, we’ll close our multimillion dollar profit making business because it is the right thing to do”.

This is ridiculous!

AARP Says It Will Become Major Medicare Insurer While Remaining a Consumer Lobby – New York Times

AARP, the lobby for older Americans, announced Monday that it would become a major participant in the nation’s health insurance market, offering a health maintenance organization to Medicare recipients and several other products to people 50 to 64 years old.

The products for people under 65 include a managed care plan, known as a preferred provider organization, and a high-deductible insurance policy that could be used with a health savings account.

When the new coverage becomes available next year, AARP will be the largest provider of private insurance to Medicare recipients. In addition to the new H.M.O., AARP will continue providing prescription drug coverage and policies to supplement Medicare, known as Medigap coverage.

William D. Novelli, the chief executive of AARP, said, “In launching these initiatives, we are driven by our mission to create a healthier America.”

The group also said it would use its leverage to reshape the health insurance market. The organization has 38 million members, and Mr. Novelli said it hoped to have 50 million by 2011.

The new Medicare product will be marketed with UnitedHealth Group. Policies for people under 65 will carry the AARP name and will be marketed with Aetna.

Bill could block some ads for new drugs – Not so Fast!

Bill could block some ads for new drugs – Yahoo News

Pharmaceutical companies could be prohibited from advertising new drugs directly to consumers for the first two years they are on the market under a bill moving through Congress this week.

The goal, supporters say, is to ensure medicines are safe before allowing industry to promote them to consumers in the hopes they will request prescriptions from doctors.

But a reduction in TV and print advertising, which helped transform medications for heartburn and arthritis into blockbusters, would be a serious financial blow to drug makers. According to one study, every $1 spent on pharmaceuticals advertising often adds more than $2 in sales.

While the Food and Drug Administration already screens a small portion of ads voluntarily submitted by drug companies, consumer advocates favor much tougher regulation, arguing that the studies companies use to test the safety of new drugs are not always large enough to spot dangerous side effects.

“We don’t know, and we won’t know, how truly safe a drug is until it’s been used in millions of people,” said Consumer Reports analyst Bill Vaughan. “The real testing of these drugs takes place after a pill hits the market and that’s why the advertising needs to be regulated.”

This is pretty significant. Big pharma is increasingly reliant on the blockbuster drug that addresses chronic and/or lifestyle diseases affecting the a large proportion of the affluent adult population. To reach this population, you need to target it with massive advertising blitzes that

  1. Alert you to the fact that you might have a problem – Restless leg syndrome, anyone!. This might be something that may be important, but nothing you might have noticed.
  2. Prod you to get treated for it.
  3. Convince both you and your doctor that the flashy new drug, which is 100 bucks per month is so much better than the other drug that is 10 bucks a month (Not much science is necessary here, just a major advertising blitz and continuous access to doctors through visits, “seminars”. “gifts”, etc.)
  4. Work with insurance companies to make this drug the treatment of choice
  5. Lather, rinse and repeat!

Note that advertising is a huge part of this circle, and any restrictions to this said advertising will have pharma crying foul, and free speech. Call me old fashioned, but free speech protects an individual from surveillance, imprisonment, torture, execution, etc. by his oppressive government of choice due to views he/she might have and/or express. All corporate speech is regulated by definition because it involves a flow of information from a party that has a knowledge edge to one, that does not. To the extent that corporate speech helps the end user, it is beneficial. To the extent it hurts, it is not. So regulation of this speech should be a line drawn by government/regulating authority based on maximizing the benefit to the consumer, not to the industry.

Davidson has urged Senate staffers to eliminate the provision on advertising, arguing that the Supreme Court has already struck down similar attempts to regulate commercial speech.

I do not think that in the current regulatory and judiciary environment, this provision has any chance of passing. As long as “commercial” speech is as free as “individual” speech, we will forever be exploited by organizations that have a knowledge gap on us and use this knowledge gap to make us buy/do things that may not necessarily be in our interest.

EPA chief: Bush climate policy working

If by working, you mean increasing CO2 is good for the world, a warm place is a better place, right!

EPA chief: Bush climate policy working – Yahoo News

The EPA said its annual greenhouse gas assessment showed that 7.26 billion metric tons of carbon dioxide and other heat-trapping gases were released by U.S. sources in 2005, an increase of 0.8 percent from the previous year.

“The Bush administration’s unparalleled financial, international and domestic commitment to reducing greenhouse gas emissions is delivering real results,” Johnson proclaimed in a statement.

This statement makes perfect sense and is the complete truth if you assume that increasing GHG emissions demonstrates “unparalleled” commitment to “reducing” greenhouse gas emissions? Unparalleled all right! Nobody’s better at emitting CO2 than the U.S of A! Wohoo!!

Snake Oil Comes a Full Circle

Ah, back to the good old days of snake oil..

ScienceDaily: Snake Venom As Therapeutic Treatment Of Cancer?

This certainly sounds unusual, but Dr. Son and colleagues report on the effectiveness of the snake venom toxin (SVT) Vipera lebetina turanica in the inhibition of androgen-independent prostate cancer (AICAP) in the journal Molecular Cancer Therapeutics.

These novel findings suggest that SVT can inhibit the growth of AICAP through the induction of cell death.

I am glad they put the question mark at the end, lest people extrapolate from a few cells in a petri dish (or a small animal study) to a cancer cure, as happened recently with dichloroacetate! Health reporting is very tricky because the average reader cannot understand much more than the headline. It almost seems like every health article should have the following things clearly labeled:

  1. Human, animal or cell?
  2. Clinically tested, or anecdotal?
  3. Double blinded, controlled, etc, or not?
  4. Any chance that this result applies to people?
  5. How far away are we from a real cure?
  6. DO NOT TRY THIS AT HOME!

At least viper venom is hard to find! The Madras crocodile bank helped start a venom extraction cooperative run by the Irula Tribe, so I’ve seen viper venom being extracted, pretty cool. India is home to two vipers, the Russell’s and the Saw Scaled vipers.

Russell's
Russell’s viper

saw scaled
Saw scaled viper.

The Russell’s is 3-5 feet long, and slow, but a big hisser! The saw scaled viper is tiny, a feet or two, but aggressive and very venomous. One of my favorite wild snake sightings was a saw scaled viper, looked very innocuous curled up in a parking lot in Pondicherry.

Cool, snake oil and venom for all…

Bonus Turtle Coverage – The Great Turtle Race

Great Turtle Race

Follow eleven turtles as they sprint from Costa Rica to near the Galapagos. Each of them has a corporate sponsor, and at 20 miles an hour, they will get there in a couple of weeks! I think Billie’s going to win, but the leatherback turtle is in bad shape, endangered due to poaching, adult mortality and habitat loss. They may be gone very soon.

Here’s the flickr page for the race, some beautiful pictures already.

Chart of the Day – The Arms Trade

asales1.png
This is a chart for arms sales by country in 2005. USA is currently tops by far, but if you read the accompanying Boston Globe article from last year, Russia’s trying very hard to catch up.

This is the oxygen that keeps conflicts going a lot longer than they should, and also make them so much more destructive. Remember this when your favorite government (they’re all to blame here, no singling one country out) starts talking about “peace”.

Happy Friday!!

The Carrboro Citizen on the Smoking Ban

The Carrboro Citizen is a new local paper (less than a month old at this point in time!). It has a well written summary of the current state of North Carolina’s anti smoking bill.

The Carrboro Citizen

The fierce behind-the-scenes battle continues over legislation to protect people from deadly second-hand smoke at workplaces, restaurants and bars. Despite his best efforts, House Majority Leader Hugh Holliman has been unable to convince a majority of House members to support his comprehensive plan to protect the public health.

The opposition has coalesced around a soundbite in this case masquerading as a philosophy, that somehow protecting workers on their jobs is an infringement of private-property rights. Holliman points out that he owns a small business that complies with all sorts of government regulations, including fire safety inspections every year.

The regulations are designed to protect the health and safety of workers, just like Holliman’s ban on smoking in the workplace. No one is arguing that businesses should be able to refuse the fire inspections and let people who object find other jobs, but that’s what the smoking ban opponents are saying.

Yes, seems obvious to me, but as I may have mentioned before, property rights is just the catchall excuse here, following the money trail leads to the tobacco industry and to various other entrenched interests represented (as the article points out) by the National Association of Tobacco Outlets! Chris Fitzsimon who wrote this article makes the same point.

Here’s a nugget tucked away in the middle of the article:

The latest version of Holliman’s proposal would ban smoking at all restaurants and most bars that serve food, exempting only establishments that function almost entirely as bars and only admit customers above age 21. The bill would not affect smoking at workplaces, but would overturn the 1993 law that prohibits local governments from passing their own anti-smoking regulations.

This means that private “clubs” like the dead mule (a smoke filled horror that I frequent!) would be exempt. On the other hand, the Chapel Hill and Carrboro local governments could act anyway to ban smoking in these clubs, which to me is a compromise I could live with!

The Citizen is off to a good start. I have only seen their website (and blogs), looking forward to picking up a copy of the paper version.

Abbott Drops AIDS Drug Price in response to Thailand's hardball.

Moral of the story, you have to play hardball with the drug companies. Use your power as a sovereign country. You are a market to them, their threats to stop selling their drugs in your country cannot be taken seriously because if the drug is made unavailable in your country, that gives you even more right to make it yourself (or better, buy it from India!). I mean what are they going to do, invade you? The worst you will get is a scolding and lecture from the U.S ambassdor on patents and free trade, just ignore it, or better still, protest outside the embassy!

Chemical & Engineering News: Latest News – Abbott Drops AIDS Drug Price

Abbott Drops AIDS Drug Price, move follows compulsory licensing decision by Thailand

Jean-François Tremblay

Abbott Laboratories will drop its price for Kaletra, a protease inhibitor used to treat AIDS, to the equivalent of $1,000 per patient per year in 40 developing countries.

The move, facilitated by the World Health Organization, is apparently Abbott’s response to a decision by Thailand earlier this year to resort to compulsory licensing of Kaletra, a practice that reduces health care costs in a way that pharmaceutical companies view as patent infringement (C&EN, Feb. 5, page 11).

Following Thailand’s decision, Abbott announced that it would stop selling Kaletra and other patented drugs in Thailand, a move that the nongovernmental organization Doctors Without Borders called “a major betrayal of patients.”Abbott had already been under fire for not supplying Kaletra to several other low-income countries.

The price of $1,000 per year per patient, Abbott says, is 55% less than the average price at which the drug is now sold in the 40 countries. The company says it wants to increase drug affordability while “preserving the system that enables the discovery of new medicines.

Compulsory licensing is a perfectly legal option underlined by TRIPs (Agreement on Trade-Related Aspects of Intellectual Property Rights) in response to national emergencies (AIDs is a national emergency, isn’t it?). More importantly, governments in poorer countries really should invoke this provision as much as they can. Because every time they invoke it, they make big pharma come to the bargaining table.

$1000 per patient per year is still a lot of money, though, I would encourage Thailand to play even more hardball!

Tuesdays with Turtles – Gahirmatha Arrribada Hatchings

In case I forgot to mention, the Olive Ridley arribada started during the 2nd week of February, so about 50 days later, here they are, the “millions” of hatchlings.

The Hindu News Update Service

Olive Ridley hatchlings emerge in Gahirmatha

Kendrapara (Orissa), April 10. (PTI): Millions of tiny olive ridley sea turtle hatchlings are now emerging out of nests at the Gahirmatha beach in Orissa’s Kendrapara district, wildlife officials said on Monday.

The eggs laid by thousands of adult females in the Nasi-2 and Babubali islands in the Gahirmatha marine sanctuary have began to hatch over the last two days, they said.

Wildlife officials stationed at the nesting grounds were witness to the phenomenon, but tourists and researchers were not allowed into the unmanned territory close to the Wheeler’s island where a defence test range is located.

India’s intermediate range nuclear-capable missile Agni III is likely to be test fired from there some time this week, defence sources said.

You know what, the fact that this area is under close military supervision because of India’s grandiose missile dreams may not be sucha bad thing (sacrilege!!!). The area is under so much development pressure that even military operations are better than the alternative.

For more about the Gahirmatha area, visit the official website. At this point in time, the Arribada is very tourist unfriendly, and there are few, if any volunteering opportunities. I will keep any eye open for changes

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