Pepin’s Pharmaceutical Prattle for 05-24-2004

Quote of the day:   Blessed are they who heal you of self-despisings. Of all services which can be done to man, I know of none more precious.

William Hale White

Good morning!

This may seem like an odd time of year to discuss depression but,,,,

Psychological pain is every bit as "real" as physical pain. Because depression is an imbalance of brain chemicals, just wishing to be better is not enough. (The assumption is that everyone WOULD ALREADY feel good if it was simply an act of will.) Chiding someone to  "snap out of it" or "tough it out" may be well-meaning but not helpful. Imagine saying that to a diabetic expecting that their blood sugar concentrations to go back where they belong.

 Many of you are now digesting the 2003 drug use patterns of your members and are seeing antidepressants as a major drug expenditure. Some of you may feel the urge to take some sort of action to cut these costs. The worst thing you could do is to require that all antidepressants be prescribed by a psychiatrist. Depression can be diagnosed and treated quite well by primary care physicians. Psychiatrist visits are not inexpensive and may be enough of a psychological hurdle to prevent treatment.

 When all of the costs of depression are added the cost of medications is less than 7%.  Other factors such as absenteeism, reduced productivity, hospitalization, suicide, etc. account for the other 93%. The fact remains that antidepressants work in at least 90% of cases of depression and that a majority of these people will need continuous, life-long treatment. So should you just happily open the piggy bank?  No.   Now that some of these "wonder drugs" are becoming available in generic form they become the logical starting point (both Prozac and Paxil are now available as generics). Why not start new patients on these generics and move up to the brand name counterparts? This is one way to save expenses without sacrificing efficacy.  Even if you have to use the highest priced antidepressants treatment is still cost effective .

 Depression is real…depression is treatable… and the costs of delay or avoidance of effective drugs  is far greater than not treating it.  The money you spend on antidepressants is some of the best money you can spend! (…and isn't that an uplifting idea?) If you need to talk… I'm here for you.

1) Pink revenge on Montezuma's revenge

Same color as PeptoBismol…. Rifaximin---- brand name unknown…pink pill soon to be approved for traveler's diarrhea. Will likely be obtained for anyone traveling outside of the USA. No pricing available yet but expect this to put a dent in your pocketbook if your members do much traveling. I was surprised that only 5% of travelers avoided risky food and drink. Could be that this might meet your criteria for a "life-style" drug.

 http://www.nlm.nih.gov/medlineplus/news/fullstory_17748.html

 2) Serzone no longer in the zone…

Manufacturer to stop selling Serzone due to liver problems as of mid June. So hurry up and buy yours now if you want to be part of the class action suits that will inevitably follow..

http://news.moneycentral.msn.com/ticker/article.asp?Feed=RTR&Date=20040519&ID=3721086&Symbol=US:BMY

3) Crestor doesn't want to be another Serzone….

Urging physicians to start with. of all things, the starting dose of this cholesterol lowering drug.. Activists are pushing for the drug's withdrawal and starting doses beyond the sanctioned levels would be expected to increase the toxicities and the chances that the drug would come under more political pressure. Following directions…..what a concept!

http://biz.yahoo.com/rc/040517/health_astrazeneca_crestor_1.html

4) Good thing drugs aren’t corn or wheat….

As long is corn and taconite are safe then why have any trade barriers Mr. Coleman?

Norm Coleman (US Senator from Minnesota) is about to cow-tow to the popularist movement for Canadian drug reimportation. I wonder how he would feel if it was a Minnesota export that was imported to the rest of the country. As I recall….everyone screams about the French farm subsidies or foreign steel…. the dichotomy exists because most people don't purchase corn buy the bushel or steel by the ton….even though imports effect jobs.  I guess there are just fewer voting pharmacists than voting seniors in the great State of Minnesota. The pharmacy associations should speak up, while there are still enough employed pharmacists to support the associations.

http://news.minnesota.publicradio.org/features/2003/08/25_mccalluml_drugprices/

   Need promotional items like t-shirts, mugs, and pens? 

(Talk to my friend Aaron at e-ffective media... he also has a $1000 contest going)

5) Canadian government may act to curb exports to assure a supply of drugs to Canadians.

As US drug manufactures limit the export of brand name drugs to Canada to the amount needed to satisfy Canadian health needs Canadians are finding a shortage of needed drugs. Canadian pharmacies would rather make more money from US citizens than taking care of Canadians. Expect more on this…. (I'd rather report on new drugs coming to market but expect that to fall off as drug companies cut back on research (like their European counterparts did after price controls.)

http://story.news.yahoo.com/news?tmpl=story&cid=571&ncid=751&e=1&u=/nm/20040519/hl_nm/health_canada_drugs_dc

6) What would Peppermint Patty say about this study?

PATRICIA study shows cervical cancer risk reduced by vaccination (not yet approved). Investigators will torture the English language in order to come up with a memorable acronym. (PApilloma TRIal to prevent Cervical Cancer In young Adults)

Cervical cancer is linked to infection by human papaloma virus (sexually transmitted). This vaccine could save a lot of lives….as could abstinence from sex until monogamous marriage. Given the present statistics I'd bet the vaccine will find a use….

 http://www.pharmalive.com/news/index.cfm?articleID=139192&categoryid=9&newsletter=1

7) More is NOT better….

Almost half of the people in this study took more over the counter drugs than they should. This study also showed an increase in stomach problems (ulcers, bleeding, indigestion). The ramifications of taking too much pain reliever can be kidney(NSAIDS) or liver damage(Tylenol). PLEASE follow the directions and labeled dosages…. I care about your well being (and need the readership) !

http://scienceblog.com/community/article2746.html

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