Pepin’s Pharmaceutical Prattle for 12-22-2003
	Quote of the day: Do give books - religious or otherwise - for Christmas. They're never fattening, seldom sinful, and permanently personal. Lenore Hershey

Good morning! Give a book this time of year? Yes! A gift certificate is so impersonal. If you like you can enclose a gift receipt for the book should the recipient already own the book or if you really missed the mark. Picking out a book takes time and thought. I have heard of families where one parent or the other does all the shopping for everyone. Little Johnny's present to his sister may even be wrapped and he may be told what he has given but he is totally "out of the loop". This "system" does provide each recipient with the goods they need but neglects the sender's needs. Remember the anticipation about whether your father or mother would like the present that you made (or invested the effort into selecting) and the pure JOY you felt when they opened it? For me it's Christmas all year long because each week I pick out the best stories I can find and wrap them in one way or another to delight, entertain and enlighten you. I truly enjoy the giving and the times when you write back to let me know that you appreciated a particular issue. ( I know some are like fruitcake or neck ties but it's the thought that counts!). I could be politically correct and just leave you with a Happy Holidays… but that never stood in my way before! For those of you who celebrate Christmas with me I wish you the Peace and Joy of the Lord. For those who do not celebrate this holiday…I wish you PEACE and JOY. Steve

1)Brace yourself for the "Tamiflu Blues"

With the amount of media attention that the "flu" is getting and the vaccine shortage many members (patients, employees) might eventually discover Tamilfu and Relena. The manufacturer of Tamiflu is going to give them a little nudge by DTC advertising. Many plans do not have this as a covered benefit because it saves about 24 hours of symptoms but only if taken within 48 hours of the FIRST symptoms of influenza. Even the manufacturer of Relenza knows better than to push their drug in this circumstance.I would not recommend opening this up as a benefit. We have to remember that a pharmacy plan only determines who pays for physician prescribed therapy…. the patient with a valid prescription has the power to get it filled and take it if they wish to pay for it. …Click here for full text .

2) Treating wrinkles with calk?

New drug is an alternative to Botox to treat wrinkles. Rather than paralyzing the facial muscles, Restylane fills in the facial fissures from underneath. This is a little like collagen injections but does not carry the allergy warnings of collagen. It will be absorbed over time. This is a cosmetic under any definition and should not be part of ANY pharmacy benefit package. It's approved but this will not be a blockbuster.(it only my opinion…I could be worng) …Click here for full text .

3) It's just so crazy that it might work…

Of Mice and Men….German scientists try erythropoietin (Epogen and Procrit) in 5 schizophrenic patients (and some mice). Don't get excited about this one…blocking the effects (side effects or other) of an effective antipsychotic drug is not compelling. Families may ask for it after seeing this sensational story but I surely would not authorize its use….(It your money though) …Click here for full text.

WARNING!
	Many changes will occur around the first of the year and I can not promise that any of the 2003 pages will survive. If there are articles or issue you think you will need then you would be well advised to print what you need before 1/1/04. I'll salvage what I can as I change the software used to post the site.

4) Walk slowly for the exits…Fire…Fire…

Expect price controls within 5 years. The FED has a predictable way of dealing with certain health issue…. they make getting into the business lucrative for about 3 years and then (when they have encouraged many people to get into it) scale back funding and let the competitive nature of American take over as too many vendors cut prices further to keep their businesses afloat. (this worked for Home Health Care and for Total Parenteral Nutrition). The FED will be buying a lot of drugs and will push price controls when the BOOMERS REALLY hit the new Medicare Pharmacy benefit hard. Expect PHARMA profits to rise for about 2 years after the benefit starts then…. BUST for about 3 years. Curtailed R&D and fewer new drugs will then scare them into relaxing the price controls. Only those PHARM with a decent pipeline now will survive. (Hey, I write 'em as I see 'em...why else do you pay me the big buck?) …Click here for full text.

5) This bug won't eat your face off…

but could kill you. A drug resistant stain of staphylococcus is off and running. Normally this type of "bug" is found in hospitals where high doses of powerful antibiotics are used. This one is in the general population. Patients with the "flu" are getting this in the form of pneumonia. So what caused this Godzilla to arise? Probably the indiscriminate use of antibiotics in the general population for viral infections that would not be susceptible to the antibiotics in the first place. …Click here for full text.

6) What wonder drug will come from Reindeer?
	Over the years I have brought you these 'Pharmazooticals' one at a time but here is a wrap up and a look to the future of using animals other than as a main course. …Click here for full text.

7) Unfair to pork producers?
	Bush signs anti-spam legislation…. …Click here for full text of story. Did you know that Minnesota is the home of SPAM (the food)but that no one has ever seen a spamnimal? Hope you pick Turkey or Ham for your feast! If any of you ever do NOT want to get the ppp e-mail reminders then PLEASE let me know. (If you spontaneously go to the site then you get what you deserve! BAH HUMBUG!)

Have a GREAT week and a Merry Christmas (or acceptable substitute)! Steve

Disclaimer: "Pepin's Pharmaceutical Prattle" (AKA "The Prattle") is the property of PHARMWORKS, LLC and Steven M. Pepin, Pharm. D, BCPS. The opinions expressed are those of the bald-headed author. To start or stop any drug without the advice and supervision of your physician would be stupid. So don't do anything based upon what you read here without professional advice. To be added to or removed from the distribution list please e-mail your request to spepin@pharmworks.com . All insightful comments from readers are thoughtfully considered (the rest are callously discarded). Copyright 1998-2003 PHARMWORKS,LLC all rights reserved.