Pepin’s Pharmaceutical Prattle for 12-08-2003
	Quote of the day: Remember that there is nothing stable in human affairs; therefore avoid undue elation in prosperity, or undue depression in adversity. Socrates (469 BC - 399 BC)

Good morning! I heard a true story this week…She had her dream job! A big office with a window on the world and an executive secretary. Her work was stimulating and rewarding. She lost her job in May of 2001 and her life appeared to be crashing in on her. She looked for work but jobs like THAT did not come along very often. She was still looking for work on September 11th, 2001. Her dream job had been on the 101st floor of the New York World Trade Center! This time of year many companies are "dressing their books", "down-sizing", "right-sizing", and "reallocating resources.". If you are (or have been) one who has lost a job then you know the agony…the pain….the hurt. You can turn your emotions in on yourself, direct your anger back at the company and or people….or you can use the situation to take a hard look at where you are and where you want to be. As …Keith Harrell. always says "Attitude is altitude!". You may not realize the gift you have been given until years from now…. or sooner as you can imagine the heroine of the above true story immediately understood the "gift" she was afforded. If you have never had to face the "tap on the shoulder" then you are fortunate. Give thanks for your job, don't grumble about the company or your boss…. take on the attitude of Bob Cratchett in the Christmas Carol and toast the health of those that provide the salary that clothes, feeds, and shelters you and yours…… "And God Bless us …Every one!"

1) I know you are…but what am I?

Walgreen's says that it will not accept contracts with PBMs that have MANDATORY MAIL. Surprise…surprise….Walgreens has their own mail order facility in Florida as part of their own PBM. What they do not seem to understand is that EMPLOYERS select plan designs which may include MANDATORY MAIL. The PBM may have less than 5% of their lives under such a plan. ….and that 90 days at retail?….again an employer benefit design choice…but guess who makes the most money on this!….right! …Click here for full COMPANY PROPAGANDA text .

2) 3 tier boogie man or saving angel?

Author implies that members stop taking their drugs and are harmed when they are asked to pay more for their drugs. The reality is that the third tier offers members and their physicians the opportunity to use the more expensive, non-formulary drugs if they wish to pay a greater percentage of the cost of their choice. In a 2 tier closed benefit they would have to pay 100% of the cost. The 3 tier saves money by shifting members to a product with a lower net cost. The member wins with a lower copayment and the plan wins with lower ingredient costs. Other studies have shown that no detrimental effects occur to member as a result of changing to a 3-tier benefit. On another note: if employers did not make this responsible choice then the FORMER employees health would probably suffer more from malnutrition and exposure after loosing house and home. (a little dramatic but companies have to be responsible for their own health too!) …Click here for full text .

3) Sex and Rock n' Roll but no drugs?

Internet service providers are cracking down on illegal internet "pharmacies" which offer weight loss or Viagra essentially without a prescription. Hopefully this will eliminate some of the pop-ups too. (With all of the research I do on drug sites you can only imagine the volume of offers I receive) Unfortunately the SEX advertising has been increased….as if we don't get enough offers for this type of junk already (having never visited even one such demeaning site). Let's hope that Yahoo can change Alta Vista to match their previous policy. Then they can go after the audio pirates. …Click here for full text.

4) Alzheimer's: the NEW kissing disease?

Herpes infections (the common "cold sore" not the venereal type) has been linked to proteins present in Alzheimer's disease. The research was not done based on a theory about this…they just stumbled on it while studying something else on Giant Squid Axons. ( a single cell can be 3 feet long which allows scientists the opportunity to study a single nerve transmission at a time) Before you get too riled up…. this was NOT a clinical study…when 80% of the population has the virus you can expect a high correlation. While we all want to avoid any kind of infection I would want to wait for more data before worrying about this. …Click here for full text.

5) ...Sounds like…..

Not charades but an FDA group looking into sound alike drug names. The confusion at the time of dispensing (or taking) results in drug misadventures. This group should be meeting BEFORE the drugs are given FDA approval. (Just an observation… I could be wrong!) You can understand how Losec and Lasix might be confused- The FDA made them change Losec to Prilosec in the USA to avoid confusion. …Click here for full text.

6) Name your poison! ....Fugu!
	Chefs in Japan must carry special license to prepare the potentially deadly blow fish for gourmands. A canadian firm thinks that the poison would make a good pain killer. I think this has some promise! (but I could be wrong)……remember how they laughed at botulism toxin use? (that was before the Botox parties when they could actually use their facial muscles). …Click here for full text.

7) One drug company offers GREAT OPPORTUNITY to 10% of their workforce.

Just in time for Christmas…Schering-Plough to reduce payroll by 10%. Other Pharma companies are now hiring. Expect more shake-ups as the full force of the new Medicare legislation is felt. The reality is that corporations are like living organisms....they must survive and do what they must .... if they do not adjust then they will die and take the rest of their workforce with them financially. If you know someone who had to let another employee go....show them some tenderness....they feel bad enough (most do) without the added bad vibes of survivors. (Group Hug!) …Click here for full text.

Have a SUPER-FANTASTIC week. 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.