doublesecretprobation: SPEND LESS

This is a tangent, but one I felt I could at least speak to. Several posters here have wondered why anyone opposed the casino idea. I actually wrote Patrick a letter about it, something I've never done before (I got a nice form letter back).

It's not that I have anything against casinos. Well, I do--they prey on the gullible and the stupid, but they're adults, they can do what they want with their money. I do have a problem with my government keeping itself afloat on the backs of those gullible, stupid people. That, I think, is a devil we are better off not dealing with if we want to have any pretensions about our form of government being a good one.

I oppose cigarette taxes and lotteries to fund government programs, for the same reason. If the government can't fund something without creating a dependency in itself on people behaving stupidly, we're better off without it.

Nestea Plunge: C,mon. Who hasn't had their dick sucked by a busty "drug rep".

I haven't :(

BravadoGT: I hope his principles will be enough to keep all those newly unemployed people warm this winter...

Best let corporations continue to rule us with money than to stand up with them and deal with the consequences.

sassyfrancis: As a medical researcher, this ruling applies to my field as well. Say I'm running a project to find out why certain drugs are prescribed more in certain parts of the country while they aren't in others. Is it due to advertising? Is it due to environmental conditions in a specific area? Inaccurate information being passed to the doctors, or maybe not enough?

In order to find this out, I'm asking physicians to dedicate up to 2 hours of their time to talk to me about cases, types, symptoms, etc. in order to sleuth some of these questions out. The doctor isn't going to do this for free - my company (an independant company with no bias toward any drug) has to pay these people for their time. With this bill, the couple of hundred dollars I'm offering them for insight for time spent is now considered a 'gift'.

There are other states where we can't do research of this type due to similar laws in place. MN and VT for instance have similar rulings. Enact this bill in a state where you've been attracting cutting edge researchers and physicians, and you lose valuable insight that helps to solve and properly treat people.

This isn't about pens.

Tough titty. Take out some advertisements in magazines or newspapers and talk to end-users/patients about their treatment experience. You'll probably get less biased answers, but it might cost a bit more.

Every scientist, every researcher in the world has a bias. If they are paid by a drug company, you know what that bias is and can read accordingly. If they are not, then they don't typically disclose what their bias is. Free salad aside, drug company lunches come with good up-to-date lectures. Doctors who don't get some of their information from drug reps are shooting themselves in the foot.

/but this bill and this article have only a tangential relationship.

PsychoTherapist: To everyone saying "I / my group / this doc I know has never had their prescribing practices influenced by pharmaceutical marketing":

1. Good for you / them / your mom, but please explain why the fark the pharmaceutical companies bother to market to doctors, if it doesn't work.


Of course it works. The company buys lunch, which buys them facetime. They use that time to give the doctors useful information about their drugs. The doctor is then more likely to prescribe said drug appropriately, because doctors are fans of prescribing those drugs that they are more familiar with. And because the new drugs they are marketing are typically better in certain ways than the older drugs that the doctor would otherwise be more familiar with.

Nestea Plunge: C,mon. Who hasn't had their dick sucked by a busty "drug rep".

Lt. Cheese Weasel: *raises hand*...me sir...over here.....*skulks away in shame*.....

*raises hand*...This is total BS! How dare they ban this when I haven't gotten mine yet. Who the hell do they think they are? Why do politicians think we would tolerate them trying to corner the market on BJ's from busty drug reps for themselves?

Dr Dreidel: but the fact that the drug was rushed to market before ALL the facts were known does not speak too well

Very true but its because the administration wanted an AIDS drug or cure

The Drug Companies said, Yes we can work on this and along
the way we will find 'Toenail fungus drugs' and a bunch others.
Since we spending all this money how about rushing our drugs like
Celebrex, Vioxx to market and circumventing the normal 20 year testing procedure?

Administration...you got it.

I read it as drug dealers instead of companies...

Don't need yer "science".
Baby Jesus gave us all the pharmaceuticals we need.

How were we supposed to know ALL the facts about Celebrex or Vioxx before they came to market?
Do a 10-year safety study on 5 million people who had no disease, before prescribing it to people who did?

There was conflicting evidence on whether Cox-2 inhibitors simply failed to provide the cardioprotective benefits of NSAIDS, or whether they posed a tiny cardiac risk. Doctors knew about that controversy. When the prevailing data began to favor "posed a tiny risk" over "failed to provide NSAIDS' benefits", most drugs were pulled.

/wish they hadn't pulled Vioxx. It was a great drug for certain patients.

bhcompy: case in point: it is widely accepted that diuretics(waterpills) are the most cost effective ways to fight high blood pressure with solid results(generic prescription costs like 5 bux a mont). so doctors never prescribe diuretics. they prescribe drugs at are not in generic form like cardizem and diovan(which has a diuretic component but is coupled with something else so it costs you 40$+ after insurance)

First of all, saying that "doctors never prescribe diuretics" is bullshiat. The majority of my patients with hypertention are on a diuretic, but for many patients a diuretic alone is not enough to control their hypertention.
Other types of antihypertensives like beta-blockers and ACE inhibitors are also very cheap and these along with diuretics are almost always the firstline drugs for people with high blood pressure. Yes the newer drugs like ARBs and renin inhibitors are quite expensive, but most patients don't need these.

Also, from the doctor's perspective it doesn't matter if a drug cost $4 or $400. He doesn't see a dime from the prescriptions he writes. So to say that doctors aren't prescribing a certain class of drugs because they want you to pay for more expensive drugs is just plain wrong.

tlchwi02: Blues_X: Restless Leg Syndrome

the only people who laugh at RLS are the people who haven't had it.

/i'd rather have normal insomnia

THIS

And it gets worse with pregnancy and you can't take the drugs when you're pregnant :(

Of course I won't be taking the drugs anyway until they come up with one that doesn't list "gambling problems" and "sex addiction" as side effects because WTF I don't even WANT to know what that would be doing to my brain.

Dr Dreidel
Cox-2 inhibitors passed all appropriate basic science trials, animal trials, etc.
The issue isn't deliberation. It's sufficient human experience. We can only discover rare adverse effects (or minor changes in common disease processes) when we use it on enough humans.
Those humans can be volunteer subjects or patients, but either way it's human beings.
And that's why we continue to monitor drugs after they've been released.

BravadoGT: I hope his principles will be enough to keep all those newly unemployed people warm this winter...

People who would be willing to work for a company that blackmails them don't deserve to be warm in the winter.

/Is that the right librul spin on conservative logic?

fark the drug companies.

/in the ass with a piece of glass

Holden C
3) Don't necessarily limit reasonable gifts (hey people, sales are a part of capitalism), but make it ALL reportable. Shame works.

Which is exactly what the bill in question does. It doesn't limit anything. It just makes the gift reportable if its over $50. The people opposing it have no good reason to give for their opposition other than they want to keep bribes from being reported.

I wholeheartedly agree about the commercials too. We need to get rid of them. "Ask your doctor about...". No. How about I tell my doctor my symptoms and let him do his job? If he's completely stumped, then we'll go from there with a referral, investigation, whatever... but that's not usually going to be the case.

The posts from people saying things like, "come on, it's just lunch. It won't effect what's prescribed when" are, I think, being disingenous. If it's anything at all like another poster said when he described drug reps delivering lunch to an office every single day, it's hard to believe that wouldn't have an effect on how favorably their products are viewed and simply how often the doctors think of their product.

Some doctors seem to think they are above a basic human psychological response. When people do favors for us, we are more inclined to think well of them and whatever they are representing.

most generics suck, they aren't the same as the name brand drug they are copying and can do a lot of damage. It's like your "Rolex" from TJ, it tells time but why is your wrist turning green? Some of the generic small molecules are bad enough, just wait for generic biologics. Scary stuff. Ask the UK

Not every big pharma should be nominated for sainthood but they aren't evil either. I know a biotech that continues to manufacture a failed drug (costing millions) for just two people and gives it to them free.

how about the one that gives more product away to people that can't afford it than they sell.

you anti-pharmas can suck it, and after that you should take 5 minutes to learn what is really going on.

/Naw, just suck it
//have a pen
///and a notepad

iaazathot:

I have studied statistics

make way for the medical expert

Approves.

sassyfrancis: logruszed:

Tough titty. Take out some advertisements in magazines or newspapers and talk to end-users/patients about their treatment experience. You'll probably get less biased answers, but it might cost a bit more.

Wow - you sure have one gaping hole of knowledge when it comes to sample purity. I'm sure in your world only talking to people who respond to an ad in a newspaper or magazine will give a much less biased response.

Here's a news flash discovering new medicine doesn't come cheap. It's little nuances that help focus research and save millions on months and years of research dead ends. Finding this information out includes talking to general physicians, specialists, and patients.

1) MD's who are only value their time spent talking to you at a couple hundred bux are probably GP's, GP's don't make dick (a lot of time for good reason) and need your patronage and your bribes to stay afloat. They are just as or more likely to tell you what they think you want to hear than some schmoe off the street who knows this is a one-time hundred bux and has no reason to fluff you or your product. The GP, who is getting payola from four other local reps but needs yours too can't share patient specific information with you, either (go ahead and tell me they do. Then tell me what state you're in when you conduct these interviews.) while a patient can provide you with explicit and verifiable detail if you even do a half decent job setting up your study.

2) As to "saving millions": Even if this were true, 90% of the time what that amounts to money that goes to shareholders. The public rarely sees any material benefit from your research savings. The closest regular advantage seen by the public is that sometimes a savings in proposed research acts as an incentive to come up with a drug to treat something that isn't much of a big deal, but now it's affordable enough to make it worthwhile (profitable), or to research a drug to treat something where a drug already exists which may drive the price down or may not but a) that price was already inflated by your bullshiat economic practices and b) it probably won't bring the price down, instead it will give jobs to more of your shills which will work to edge out the competing drug.

So again I say to you: tough titty.

Sure there should be caps on what drug companies can give. The main pharma industry trade association has a code of conduct and it seems to be working. The phrama companies don't want each state to pass its own gift law. Pharma seems to be doing a good job at policing itself, so just leave them be. So they bring in lunch to get face time with the medical staff. Who cares? I bet for most of these docs, its the only time they have to set aside to even keep up to date on new drugs on the market. The FDA controls the content of the marketing. If a generic is available for the product being marketed, they insurance industry has worked equally as hard as the pharma companies to make sure the generic version is the only option (unless you want to pay a massive co-pay).

Pharma has to sell their product just like any other industry. I'd rather they market to docs who are smart enough to understand. It's the direct-to-consumer advertising they should do away with.... plus I'm getting tired of seeing old men signing about their boners to an Elvis tune... yuck!

naugahyde monkey: most generics suck, they aren't the same as the name brand drug they are copying and can do a lot of damage. It's like your "Rolex" from TJ, it tells time but why is your wrist turning green? Some of the generic small molecules are bad enough, just wait for generic biologics. Scary stuff. Ask the UK

Not every big pharma should be nominated for sainthood but they aren't evil either. I know a biotech that continues to manufacture a failed drug (costing millions) for just two people and gives it to them free.

how about the one that gives more product away to people that can't afford it than they sell.

you anti-pharmas can suck it, and after that you should take 5 minutes to learn what is really going on.

/Naw, just suck it
//have a pen
///and a notepad

1) If you're going to troll so late in a thread don't be so wordy, or reply to a specific user. Most people won't read what you have to say unless they're anal (like me)

2) If you're going to make a claim try to make one less obviously bullshiat, anyone who knows shiat knows generic formularies are identical to name-brands and are so because they are regulated by the FDA.

1.3/10

Accepting gifts of any value from a vendor is unethical. I work for a cement company, and we have a policy forbidding this practice. Should a cement company have higher ethical standards that a doctor?

Billions spent every year on R&D yet they still can't cure my stigmata.

Everything in this State is so deeply entrenched that it would take an extra-democratic (violent) revolution to dissolve the Conglomerate.

logruszed: naugahyde monkey: most generics suck, they aren't the same as the name brand drug they are copying and can do a lot of damage. It's like your "Rolex" from TJ, it tells time but why is your wrist turning green? Some of the generic small molecules are bad enough, just wait for generic biologics. Scary stuff. Ask the UK

Not every big pharma should be nominated for sainthood but they aren't evil either. I know a biotech that continues to manufacture a failed drug (costing millions) for just two people and gives it to them free.

how about the one that gives more product away to people that can't afford it than they sell.

you anti-pharmas can suck it, and after that you should take 5 minutes to learn what is really going on.

/Naw, just suck it
//have a pen
///and a notepad

1) If you're going to troll so late in a thread don't be so wordy, or reply to a specific user. Most people won't read what you have to say unless they're anal (like me)

2) If you're going to make a claim try to make one less obviously bullshiat, anyone who knows shiat knows generic formularies are identical to name-brands and are so because they are regulated by the FDA.

1.3/10

Generics are not the same.

FDA does not regulate inactive ingredients (binders, fillers, dyes, etc) or manufacturing process in generics. You'd obviously be surprised what kind difference either of those can have. Hell, even the amount of active ingredient can vary pretty widely since generic manufacturers tend to keep doing something (usually wrong) until someone catches it and tells them (thanks FDA). Google can show you lots of articles on the subject, real articles from medical journals even.

/not trolling
//was late to the thread

oops, requoting that whole post sucks.

my bad

Little.Alex: I won't say you're stupid, because I'm sure you get that all the time. But if you don't think chemothereapy is worth the cost, then don't buy it.

You've just expressed the fundamental problem with for-profit health care.

Q: What is it worth when your life hangs in the balance?
A: Everything you have.

/and more

naugahyde monkey: you anti-pharmas can suck it, and after that you should take 5 minutes to learn what is really going on.


I ask again: What's it like being able to see a doctor?

Rasraf Mekerk:

First of all, saying that "doctors never prescribe diuretics" is bullshiat. The majority of my patients with hypertention are on a diuretic, but for many patients a diuretic alone is not enough to control their hypertention.
Other types of antihypertensives like beta-blockers and ACE inhibitors are also very cheap and these along with diuretics are almost always the firstline drugs for people with high blood pressure. Yes the newer drugs like ARBs and renin inhibitors are quite expensive, but most patients don't need these.

Also, from the doctor's perspective it doesn't matter if a drug cost $4 or $400. He doesn't see a dime from the prescriptions he writes. So to say that doctors aren't prescribing a certain class of drugs because they want you to pay for more expensive drugs is just plain wrong.

yet every doctor my wife has been to and all the research ive done on hypertension shows me that drugs like the continually refreshed(to stay non-generic) cardizem(which is a calcium channel blocker if i recall) and such seem to be prescribed more often as a first case solution rather than one of the cheapest drugs available(diuretic). my wife had to ask the doctor for a diuretic prescription rather than being offered one for treatment for hypertension

i understand some doctors dont operate that way, but i understand how kickbacks work. i worked in an industry(liquor) that was rife with competition through kickbacks. big drug companies dont make the same type of money off of cheap generics as they do non-generics and they have to get the doctors "educated" to prescribe them. persuasion is big business. theres a reason why so many pharmaceutical sales reps are pretty women. same goes for any industry sales is involved, both in pretty women and kickbacks.

i work in veterinary medicine as a technician, and it's true that at the luncheons they present the product and it gets discussed; the doctors may or may not decide to pick it up. But it's the random things the reps bring, especially bayer, that get me. a couple of weeks ago our rep dropped off a digital photo frame that came pre-loaded with a slideshow about fleas, and the bayer products that kill them. i couldnt help but wonder how much cheaper drugs would be if they weren't wasting so much money on stupid things like that... the pamphlets still do just fine. and sometimes it does feel like bribery - last week our staff got to go have free dinner, free drinks and a styx/boston concert, all courtesy of bayer...

/if i had stronger morals, i wouldn't have gone, but it was STYX!
//it was awesome. but it still makes me feel weird.

New method of pharma funding:

The government creates a target for a cure or treatment for X condition. Specifications for the treatment are determined ahead of time. It must do x, y, and z with as few side effects as possible, etc.

Companies, universities, etc all begin research. Minimal public money is invested in interested companies to help cover SMALL amounts of investments.

The company or group that comes up with a drug that hits all the criteria then sells the rights of the drug to the US government, receiving their payout instantly in the form of cash.

The US government can then contract out the manufacturing of the publicly-owned drug and sell the drug at a rate that they will make back the investment in a pre-determined number of years.

The US government then can license the PRODUCED drug to other countries at steep discounts -- all manufacturing is maintained in US to promote jobs and trade.

iaazathot: 1proudneocon: It's marketing and advertisement, not bribery.

Uh, no, it is bribery. I worked for a company that planned "medical educational meetings" for Glaxo-whateverthefarktheyarenow and Novartis. These doctors got free five star accomodations, tours, fishing trips, golf trips, at one point free airfare for families (that was discontinued) all to sit in on a meeting that presented very doctored data (I have studied statistics and there were holes a mile wide in the presentations).

My sister was a drug rep and was told by more than one doctor in Florida that sexual favors were granted by the previous rep. My sister quit inside of a month.

Drug companies are no better than the drug cartels. Actually they are worse, because the drug cartels don't hide behind a veneer of respectability. They cause a lot of harm.

So, just because your sister wasn't as big of a whore at the rep before her, you automatically assume that drug companies are evil and profiteering capitalist pimps? Your logic reeks of sophistry, and it is rooted in the assumption that everybody is out to screw the little guy. Have another glass of kool aid, smoke another joint and go back to bed will ya? Loser.

bhcompy:
yet every doctor my wife has been to and all the research ive done on hypertension shows me that drugs like the continually refreshed(to stay non-generic) cardizem(which is a calcium channel blocker if i recall) and such seem to be prescribed more often as a first case solution rather than one of the cheapest drugs available(diuretic). my wife had to ask the doctor for a diuretic prescription rather than being offered one for treatment for hypertension

i understand some doctors dont operate that way, but i understand how kickbacks work. i worked in an industry(liquor) that was rife with competition through kickbacks. big drug companies dont make the same type of money off of cheap generics as they do non-generics and they have to get the doctors "educated" to prescribe them. persuasion is big business. theres a reason why so many pharmaceutical sales reps are pretty women. same goes for any industry sales is involved, both in pretty women and kickbacks.

I'm not saying it doesn't happen, I just know that myself and many of the doctors I know make a conscious effort to not be too influenced by drug company propaganda.
By the way diltiazem (Cardizem) is available as a generic. It's only $4 at wal-mart.

Let's see if I've got this right:

The Feds regulate some drugs and bust up a medical marijuana dispensary that's legal under California law.

However, regulation of other drugs is not federalized, so pharmaceutical companies can engage in extortion of the various states.

Please invade us, Canada.

I promise I won't shoot back.

tekmo: Let's see if I've got this right:


No, you don't.
The Feds regulate all drugs other than "dietary supplements". The States may add on their own additional regulations, which can be even more strict than the Federal regulations. It is difficult for States to create leniencies in Federal law, as California is finding.