flaco Recants on Pharmaceuticals...

[flaco]

So.

 

I had breakfast with an old friend this morning, a stock analyst. He picks issues--companies--for a few funds, and private clients. Also, obviously, himself.

 

I asked him if he was invested in pharmaceuticals.

 

"Heavily," he replied.

 

Why?

 

Their stocks are so beaten down by the threat of suit that they're paying phenomenal dividends.

 

Merck, I believe he mentioned, in particular.

 

He mentioned a 6% dividend, which is amazing.

 

Since I spend all my discretionary cash on stock blanks, actions, sights and the like, I haven't gone to the trouble of confirming the numbers he mentioned.

 

And I'm not certain whether this is other peoples' money or his own. Most likely both, I imagine.

 

And if the stock prices go down further, he's gonna by more.

 

Just thought I'd mention it.

 

flaco

 

N.B Also, I find it impressive that there's now a vaccine for cervical cancer, and the human papilloma virus, which is commonly associated with cervical cancer.

[Guest MorgnasBoss]

I have a family member who works in R&D for a major drug company. When the evening news reports obscene profits on a particular medicine, when they cry that some unforeseen problem has resulted in an unfortunate death, illness or other unanticipated side-effect, when they insinuate that lives have been lost due to delayed marketing... Well what they don't tell the general public is that years - maybe as many as twenty or thirty years - have gone into development. They don't tell you how many millions of dollars have gone into developing one successful treatment, as well as several (for each success) that never made it. We do know how (seemingly) contrary FDA approval can be and that lives are undoubtedly lost waiting for it, but people still somehow blame that on the drug companies.

 

Remember to that these companies whose testing (to make sure stuff works to save OUR lives) are largely dependant on animal testing. This makes them as much a target of animal rights fanatics as we hunters - only the stakes are much higher.

 

The people who make villains of Pharmaceutical companies for making huge profits and demanding their patent rights must realize that these companies are in business because there is money to be made. If they were forced to hand over developments without recouping their investment and building capital for the next important break-through, we wouldn't have the treatments we do today. Contrary to many's beliefs, they DO care about people, but money is what enables them to do something about it!

 

Invest with a clear conscious Flaco!

[Doble Troble]

With antibiotic resistant bacteria becoming more of a problem, let's all buy pharma stocks and give new drug R&D a shot in the arm.

 

We could save the world and make money at the same time. What a great country!

[Jimro]

Everything said so far is true, but it is also true that the average Pharmacuetical company spends three times the amount on advertising than it does on research.

 

I believe that DTC, direct to consumer, advertising is unethical for prescription (aka, ask your doctor about....to see if it's right for you) drugs. Advertising to doctors through JAMA, NEJM, so that they know when new medications are available is another story all together.

 

Jimro

[fritz]

Everything said so far is true, but it is also true that the average Pharmacuetical company spends three times the amount on advertising than it does on research.

 

 

What's wrong with that?

 

This is America, and if you don't advertise your product, who will buy it?

 

OK, I know! If the NEW product is so great, EVERYONE will buy it (even without advertising).

 

Get real!

 

fritz

[Doble Troble]

Jimro, I understand your reasoning re: the questionable practice of DTC marketing.

 

On the other hand it is a free country and we shouldn't assume that people can't make intellegent decisions about prescription drugs. Even MDs can use a leg up every now and then.

 

I haven't seen statistics regarding marketing expenditures, but again we need to keep in mind that new drugs aren't a right. If we try to turn them into a right we should expect to see fewer of them available.

[Guest MorgansBoss]

Jimro, I respect your opinion but I do not agree. I've known of several doctors (old and set in their ways) who didn't take much interest in new drugs no matter what was printed or how many salespeople called on them. Yeah, they were not "good doctors" but their patients were long established (again, mostly older people) and trusted them. I'm not up much on drugs or doctors but my wife is! She is forever asking about this or that med she saw on TV or in a magazine, and sometimes it ends up working better than her usual prescription. If she hadn't asked, she'd still be using something less effective. Some of these ads as well as the internet medical info sites may be a pain with people self diagnosing and expecting their doc to take THEIR advise, but I still prefer an informed public.

How many men would still be unhappy without Viagra's ad campaign because they just didn't mention their "problem"?

[Emul8]

Good points, all.

 

However, there is, in my mind, a significant difference between DTC advertising a medication to aid a man with "erectile dysfunction", and all the advertising that catapulted Celebrex and Vioxx to the front of the American consciousness, then started contributing to heart attacks and/or strokes. Resulting in those drugs being removed from the market.

 

Yes, at the onset and under heavy marketing from advertising, pharmaceutical representatives and copious sample drops to physicians, some medications appear to be virtually miraculous, and with the clamor by consumers for better, more effective medications that do more things, the FDA has rushed medications through the process to get them to the market faster.

 

But in the end, when projections for the class-action suits in the Celebrex and Vioxx fiasco could top $18 billion dollars, not to mention the lives lost, or that have been impacted by the "magic" wrought by the pharmaceutical companies in these cases alone, just who is being served the most?

 

An informed public is great, tempered with sense, and yeah, it's preferable...it isn't so much that which bothers me...it's the way the the pharmaceutical companies and the FDA rush from A to Z, bypassing some critical areas along the way in their zeal. That's where lives are lost, reputations are shattered and credibility is sacrificed.

 

Thankfully, Celebrex and Vioxx are the exception rather than the rule, but then again, exceptions usually best serve to prove the rule.

[Doble Troble]

Celebrex and Vioxx are very effective drugs that meet a real need for NSAIDS that don't ruin the digestive tract. It's very hard to effectively control the type of pain and inflammatory problems that these drugs treat.

 

They are essentially victims of their own success. So many people have been taking them that very rare cardiac toxicity has become apparent. This side effect wasn't found until hundreds of thousands of people took the drug. Not many have had serious problems, but in our country killing a few trumps helping hundreds of thousands.

 

There is no perfect drug. Every one has potential side effects. Everyone taking drugs has to consider this. This is the the tough situation facing both patients and the pharmas. The lawyers are just enjoying the ride (unless they have arthritis).

 

Both the potential liability risk and potential payoffs are great. We as a people need to decide how much risk is acceptable.

 

A few years ago FDA was in very hot water for taking too much time in approving new drugs, especially for treating AIDS and cancer. Do we really want the pendulum swinging back?

[Emul8]

Doble Troble --

 

I understand your point, but your analogy is bad...the pendulum, by necessity will swing back, but no, we don't want it to!

 

In all honesty, I don't know what the answer is as it relates to the questions raised in this thread, beyond the question of investing in pharmaceuticals.

 

As far as that goes, I would invest...despite the occasional risk -- and what doesn't have risks -- the benefits should far outweigh them.

[flaco]

Actually, I'm with Jimro on this one.

 

One of my best friends is a physician, and he hates patients walking in suggesting various drugs.

 

And why, really, DT, must Americans pay more for drugs than most any other developed nation?

 

flaco

 

N.B. I expect you'll see any number of MDs leading the charge against the pharmaceuticals.

 

Still, a good stock tip is a good stock tip.

 

And... my analyst friend made a lot of money on Phillip Morris. LOL.

 

Guess he made his clients a lot of money, too.

[Doble Troble]

And why, really, DT, must Americans pay more for drugs than most any other developed nation?

 

You got me there, flaco. I guess the answer is because we we get them more quickly and the new ones first. I suppose we could adopt a Hillary Clinton/Canadian/UK type of government run health care. That would solve the problem of new, expensive drugs.

 

Hopefully the better-off Canucks, Brits and US could find and afford the timely and effective care (albeit with only established drugs) that would ineviably crop-up in some unregulated part of the world. Maybe Mexico, or China?

 

And the rest of us could be reassured in our ill health that at least now noone is paying less for prescription drugs.

[Dr.Hess]

You wanna know why we pay more for drugs? Well, it is complicated, but it comes down to lawyers and corporate greed.

 

In 1997, the wholesale price of a 800mg Ibuprofen was three cents per tab. Retail price at the cheapest pharmacist (Wal*Mart) for a patient with no insurance was $18/100, 18 cents ea. That's 600% markup. Insurance companies have it set up so that they get the “special” rate while everyone else gets screwed. And they have the laws set so that it is illegal for the pharmacist to give you the same deal that they get. So, this is what happens: Wal*Mart pays 3 cents for the pill. Your prescription is for 50 ea, or $1.50 wholesale. Not manufacturer’s cost, mind you, but wholesale. You pay a $5 or $10 “co-pay” for that $1.50 worth of medicine. The insurance company might kick Wal*Mart a couple bucks for paperwork and everyone makes money except you, who get screwed. If you don’t have insurance, you pay $13 for the 50. Keep in mind that the above example is 1997 prices. I don’t have a current wholesale med list handy. The insurance company takes $400/month from your paycheck to provide you with this “service.” Then there is the added costs from legal action against everyone in the entire food chain from the pharmacist to the doctor to the drug company.

 

Everyone wants something for nothing, and those ads on late night TV from the lawyers looking for people to sue cost you as well.

 

The drug companies make plenty. Sure, research is expensive, but it is pretty easy to shuffle paperwork around, buy some new lab equipment, back some extra studies and make it look like your research costs twice as much as it really does. Don’t think that doesn’t happen, too.

 

Drugs are cheaper in Canada because they cut a deal eliminating some of the middle people, like the lawyers and some of the insurance companies. And no, we don’t get new drugs faster. Slower, actually.

 

Oh,and wholesale drug prices have gone through the roof since 1997, too. Probably up 100%, maybe 2-300%. That three cent ibuprofen is probably six cents now. You still pay ten bucks for fifty, but Wal*Mart is paying six cents, and try to buy a non-generic. I believe that the drug companies deliberately raised the wholesale prices way up so that the elderly would complain to the congress critters that they can’t afford their medicines (which they really need, or they could die) and that the congress critters “have to do something” and that was why the Medicare prescription drug benefit was passed. With that in place, the drug companies and the insurance companies will certainly sell more drugs to the public, which is more profit for both of them.

 

Well, you asked.

 

Dr.Hess

 

 

[Jimro]

I would like to clarify my previous statement, mainly that I am all for open source information, just not direct to consumer advertising. Eli Lilly was for quite a long period an "ethical" company, only advertising to doctors and pharmacists, but now who hasn't heard of strattera?

 

I support having public library subscriptions to medical and science journals, as well as having the Public Library of Science, and Public Library of Medicine. This allows everyone access to the same raw data showing how the study was conducted, and the researchers and methods used.

 

This means that those who are actively seeking something better will get the information that they need by looking for it. There is no way a thirty second commercial can convey all the pertinent information about a drug therapy. And while there may be doctors resistant to change, there are patients who are resistant to a doctors advice because they've seen a commercial about a pill that can cure the symptoms they are having.

 

As far as NSAID's specifically COX-2 inhibitors, I will quote Paracelus, "The dose makes the poison". Or as my friend Dan says, "There are no toxic substances, only toxic levels." I just had blood drawn yesterday to get my g6pd tested to find out if I could recieve the antimalarial drug primaquine.

 

Jimro

 

 

[AzRednek]

Right now I woud give my right nut for the ability to use NSAID's again. The alternatives have not been pleasant. The previous poster that stated NSAID's wont ruin your digestive system, I say respectfully you're wrong. At least from the standpoint of Celebrex, I didn't take Viox long enough to make a judgement.

 

In the previous poster's and Celebrex's defence, had I followed directions, by not exceeding the recomended dose and taking with food I might not be writing this. One thing you haven't seen in the news in regards to NSAID's is the problems with gastric reguritation while sleeping. It damm near killed me but I would be willing to take the risk all over again.

[Doble Troble]

Az,

 

Sorry you're still having GI trouble. It would be much worse without a COX-2 selective drug.

 

For the nighttime dyspepsia try an H2 antagonist: Tagamet, Zantac, Pepcid and Axid should really help. These are now available over the counter. Most drug stores carry generic versions that will be just as effective and much cheaper.

 

And no beer/vino/booze after dinner .

 

And good-old Peptobismol can help relieve NSAID GI probs. Take it after you brush your teeth - yum!

[AzRednek]

Thx for the advice, I've been on the stomach meds and the liquid pink manure as I call it sits on my nightstand. My problem is I can't get a Dr to write an Rx for any of the anti-inflamotory meds because of the fear of possible liability. I'm trying via a medical school to get into a clinical trial of a new and hopefully wonder drug.

[Doble Troble]

Good luck with the clinical trial. I don't think the cost of liability fears justifies the benefit of all the trial lawyers (like Kerry's pal, John Roberts). Actually there's no benefit anywhere when it comes to liability and lawyers - they get most of the money.

 

Hopefully there'll be another good NSAID coming out. But with the Vioxx situation it's unlikely. I guess it depends on how bad the lawyer feeding frenzy gets. Time will tell.

 

 

[fritz]

Regarding the lawsuits against the drug Vioxx--my local MD takes the drug, and will continue to do so, regardless of all the lawyers suing the drug companies.

 

Maybe the lawyers know something my local MD does not?

 

Don't be facetious.

 

fritz