Pepin’s Pharmaceutical Prattle for 03-07-2005

 Good morning !

Responsibility and Authority

My mother always told me I was a responsible person….if anything was broken, I was usually responsible.  There is a lot in the popular, business-guru press about delegation as a way to manage people and projects.  The key to success for all participants is exactly WHAT is being delegated.  As an executive, can you ever delegate responsibility? If you try to delegate responsibility and the project fails who is really responsible? You are of course. We have seen some recent examples in corporate America where the CEO is in hot water due to the mistaken belief that the responsibility for financial matters was delegated. 

 As an executive or manager you can delegate something much more valuable and effective in getting projects completed: authority! If you ask someone to take on a task but do not provide the authority to act and the resources necessary to be successful the responsibility for failure remains yours. There are circumstances where both accountability and authority can be delegated but the most important aspect is authority.

When asked to take on a new task by a superior you might want to learn to request the AUTHORITY to act concomitant to your request for resources. You may not be “delegating up” but be sure that you reflect the responsibility back up to the level it belongs. Like it or not, you will remain accountable.

 When things go wrong, as they will occasionally, everyone involved should be “trying to fix the problem and not fix the blame”.  We should assume that everyone truly desires to succeed. Using purely Demming thinking, everyone should try to uncover the flaw in the process.

 Think of “responsibility” and “authority” the next time you are involved with delegation as either pitcher or catcher. You are responsible for the tasks you give or receive. You have the authority to make sure you have the authority and resources to do the job. You are accountable to yourself and your career to make sure all goes well. Let me know if it makes a difference (you don’t have to because I don’t have the authority and you are not responsible to tell me).

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ps. Best answer this week to the question "How are you?" was "Practically Perfect"  (I guess this was a Mary Poppins wannabe)

 1) Minnesota pharmacists to evaluate drugs for welfare patients.

Right now only a proposal  that would pay pharmacists to evaluate Medicaid patient’s drug therapy. Sounds like a great idea but is something that they should ALREADY be doing when they dispense the medicines. This is almost impossible at retail when patients go to many different pharmacies. Only the PBM that adjudicates the claims would have the full picture of the medication profile (still don’t have most OTC products captured). Proposal spells out what the pharmacist is monitoring but depends upon the pharmacist to convince the physician to change therapy.  Pilot study showed a 2:1 ROI for this imperfect “system”. Imaging what would happen if they did it right!!!

http://www.startribune.com/stories/1556/5268087.html

 2) Vermont Vexes Vendors

New Vermont law in effect 3/1/2005 requires pharma reps to disclose their AWP and the AWP of the other drugs in the class….including generics. This should be interesting for classes like ACE Inhibitors where there are a few brand name products left but a huge number of generics. I don’t see this as having a positive impact on the citizens of Vermont. One reason that this is useless is that the AWP does not reflect what the pharmacist ACTUALLY has to pay to acquire the drug.  (What is in the water at the Vermont State house?) 

http://www.kslaw.com/library/clientalert/ca011305.pdf

 3) Marshal Dillon!… Marshal Dillon!…

“What is it now Chester?!” US Marshals seize the manufacture’s supply of Paxil CR and Avandamet due to alleged quality problems. This is only a Class II recall and does not rise to the level of a safety emergency. Allows the FDA to looks tough on safety issues…A few years ago the FDA did something similar to Schering to get their attention. Let’s hope this is just an attention getting mechanism. While this will be sensationalized there are few public health concerns from this “artificial” shortage. Paxil CR patients could take regular Paxil or the generic. Avandamet patients can get each component of the combination product and keep there diabetes under control (for 2 copays).

http://www.fda.gov/bbs/topics/news/2005/NEW01162.html

 http://today.reuters.com/news/newsArticle.aspx?type=healthNews&storyID=2005-03-04T210901Z_01_N04450501_RTRIDST_0_HEALTH-HEALTH-GLAXOSMITHKLINE-FDA-DC.XML

 4) I’ll just take my ball and go home.

That is what Pharmaceutical innovators are saying with their feet. What is happening is that foreign (read NOT USA) are not honoring the US patents on AIDS drugs under the guise of “humanitarian” issues.  It makes no sense to invest a billion dollars into discovery and testing of a new compound if the manufacture does not have enough “protection” to make back the investment, a little profit, and some additional cash to invest in the next new drug (which may or may not make it to the market). The foreign companies will have a harder “humanitarian” case to prove if pharma moves the AIDS research funds into something less politically charged. China recently “vacated” the US patent on Viagra so that they could manufacture all that they wanted without paying any license fees to the originator. This goes well beyond the “humanitarian” arguments and should have drawn the wrath of the civilized world. (“It jest ain’t right, McGee!)

http://www.forbes.com/investmentnewsletters/2005/03/01/cz_sg_0301soapbox_inl.html?partner=yahoo&referrer=internet_drug_news_inc

 5) Will FDA desire to write make your taxes rise?

Right now the FDA reads the information submitted by the pharmaceutical companies and negotiates the final verbiage. Pharma puts extensive resources into the PACKAGE INSERT.  FDA will have to add a lot of staff if they want to write all of the drug labels. They want the authority to change the labeling information unilaterally. Will they accept all the accompanying responsibility? I can’t see Pharmaceutical companies wanting to have everything that can be said about their drugs (and the way it is said) entirely in the hands of a government agency.

http://www.reuters.com/newsArticle.jhtml?type=healthNews&storyID=7775152  

6) Not enough Beers?

The Beers criteria speak to which drugs should be avoided in seniors. When applied to actual patient data they found that about one third of seniors are taking a drug that could lead to falls, dementia, and other problems. If I were in charge (aren’t you glad I am not?) I would pull the list of drugs from the new Medicare Part-D drug benefit for seniors. It would certainly cause a heightened level of awareness! The seniors would then be asking their physicians for safer drugs for the same indication that are covered.

http://news.yahoo.com/news?tmpl=story&cid=97&u=/hsn/20050226/hl_hsn/almostoneinthreeseniorsgiveninappropriatemeds&printer=1

7) I said second and fourth fingers!

Aggression appears be related to the ratio of the lengths of the second (index) finger and the fourth (ring) finger. Possibly related to the effects of testosterone in utero. I am sure that the idiots on the highway are just confused as to the number and selection of digits to display when asserting their aggression. (This article just shows what can be done when you have a lot of time and a powerful statistics program).

http://today.reuters.com/news/newsArticle.aspx?type=healthNews&storyID=2005-03-04T210402Z_01_B578498_RTRIDST_0_HEALTH-AGGRESSION-FINGER-DC.XML

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