ppp 03-19-07

Quote of the day: For the sense of smell, almost more than any other,

has the power to recall memories and it is a pity that

you use it so little. Rachel Carson (1907 - 1964)

Nothing can evoke memories as vividly and profoundly as the sense of smell. Fresh linen off the clothesline in the backyard, the smell of roses, freshly baked bread, the musky smell of the woods after a thunderstorm, a cattle farm, incense, lilacs, ground coffee, pipe tobacco, frying bacon. Each can conjure a special time in our lives or a special person… or both.

Last week's "Prattle" contained an article on the essence of the rose and its purported memory enhancing powers. A friend (VP at a large PBM) wrote back about how roses are loosing their fragrance as they are bred for size and color. It reminded me of the old sales adage; "You can have it good; you can have it fast; you can have cheap…. you just have to pick 2." If things are done too inexpensively under time constraints then quality suffers. If you want something done well and under time constraints then you hire experienced (read "expensive") consultants. (I have some "extra" time until fishing season opens if you have any projects in mind). How do you work? Quantity over quality or quality as job #1? (I'm assuming that you work for the same rate of pay.)

When the government pushes for lower healthcare costs; what are they seeking? Much of the healthcare costs involve the money paid to healthcare professionals all along the production chain. Will doctors, nurses, or pharmacist take less money to see more patients? In pharmaceutical circles we can not compromise quality for any reason but the market demands low costs. This could be one reason that "things" take a long time to accomplish. When the system is pushed to further cut costs it will only be able to do so by reducing the workforce that provides the services either in absolute numbers or on a per patient/visit basis. When it comes to your health which 2 would you pick?

ps. Best answer this week to the question "How are you?" was "Today?...I'm Irish!"

pps. Occasionally, some of the links require FREE registration.... I'm sure you can handle THAT slight inconvenience.

Not a new car but a newly approved orphan drug for the treatment of a rare blood disorder. It keeps the body's immune system from attacking its own red blood cells. While this may end up being expensive for the treatment of an individual, it will not add significantly to the cost of an employer drug plan due to the rarity of the disease.

Zyvox mortality greater than that with other antibiotics. This FDA warning discuss the organisms involved and alternative drugs. Zyvox is NOT indicated for catheter related infections! All this is based upon preliminary data so FDA will issue its final report in awhile. http://www.fda.gov/cder/drug/InfoSheets/HCP/linezolidHCP.htm

Marie Antoinette said "Let them eat cake" when told that the peasants were out of bread. Abbott Labs is frustrated with the government of Thailand because they will not enforce patent laws on the manufacture of its drugs. Abbott will not sell any new drugs in Thailand. Simply put, the Thai government either enforces international patent laws or goes without any new drugs.

More and more people are landing in emergency rooms across the nation due to abuse of prescription and OTC drugs. This is approaching the number of visits for cocaine, heroine, methadone and other street drugs. Abusers report stealling the drugs from friends or relatives, Moral… keep your Vicodin, etc under control and in a places safe from friends and relatives.

CVS and Express Scripts have been duking it out over the fair damsel called Caremark. Despite a lower offer (by only about $4 Billion) CVS has won the proxy fight. Seems that shareholders fell for the one-time cash dividend strategy. Time will tell whether the Caremark executives who pushed for the CVS deal (and their jobs) will last very long in the combined company. Of course with the huge amount on money involved they will cry all the way to the bank.

It looks like the Commonwealth is headed for additional mandated employers expenses. Proposed new rules would require that all health plans include a prescription drug benefit. Plan would limit the amount of money spent by individuals and shift those costs to employers. Sounds like another disincentive to cost-effective care. This would also remove lifetime caps on health spending. Maybe the money trees are already in full bloom in Massachusetts.

FDA will now require a new warning on all sleeping pills…essentially "may cause sleep-driving!"… after many reports of patients being rudely awaked by an automobile crash while driving. Experience is something akin to sleep-walking but with a heightened chance of injury. Original reports were made on Ambien but the FDA considers this potential side effect a class effect. Warning also covers sleep-eating and sleep-phoning (does this explain all those cell phone minutes?)

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 1998-2007 PHARMWORKS, LLC all rights reserved.

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